Functional Genomics with Kashif Khan: Rational Wellness Podcast 309

Kashif Khan discusses Functional Genomics with Dr. Ben Weitz.

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Podcast Highlights


Kashif Khan is the Chief Executive Officer and Founder of The DNA Company, where personalized medicine is being pioneered through unique insights into the human genome. The website is TheDNAcompany.com. With a background in business, Kashif dove into healthcare and functional genomics and he has a successful podcast, The Unpilled podcast, and an upcoming book being released on May 16, The DNA Way.

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 website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.

                                Hello, Rational Wellness podcasters. Today, we will be speaking about personalized medicine based on your genetics. We’ll be speaking with Kashif Khan, who’s the chief executive officer and founder of The DNA Company, where personalized medicine is being pioneered through unique insights into the human genome. With a background in business, Kashif dove into healthcare and functional genomics. He also has a successful podcast, the Unpilled Podcast, and an upcoming book to be released on May 16th, The DNA Way.  Kashif, I recently heard you on Ari Whitten’s The Energy Blueprint, and I was blown away with the way you were able to couple explanations of various SNPs, DNA variants, and how they affected various metabolic pathways and how certain diet, lifestyle and supplement approaches might help to steer a patient towards greater health. Prior to this, I’ve spoken to other experts on genetics. And often, we get simplistic explanations like you have the C677T or the A1298C variant of the MTHFR gene, and therefore you need to take methylated folate and B12. And that’s pretty much the end of the story.

Kashif:                  Yeah. Something as complex and powerful as a human genome has been brought down to “Here’s a supplement you need because of one gene, and that’s all we’re going to talk about.” And I’m not saying that that’s not useful information, but the clinicians that are using these tools haven’t… So the tools are too difficult to use. Let’s start there. So when it’s too difficult to use, there’s one or two tricks up your sleeve that you stick to and that’s it because how much time do we have to reeducate ourselves? And so there is so much more, and that was part of our mission, is making it easy to use so it’s easy for people like yourself to implement. And there’s so much more we can do than just “Here’s your folate.” Right?

Dr. Weitz:            Right. And I just want to let you know that we have a fair number of healthcare practitioners and also educated consumers. So in our discussion, feel free to dive deep into the science if it’s appropriate.

Kashif:                 MTHFR.  Well, let’s use that as an example. You’re talking about a methylation gene. And just this morning, I was speaking to this influencer from the UK that calls herself the MTHFR guru or something. I said, “That in itself tells me you’re not a guru because you don’t understand methylation, that that’s one gene in a cascade that builds up a system.”  You have to first understand human biology, and this is where genetics is broken. A gene is not independent of the process happening in the body. It’s like looking at one link in a chain and then making a judgment on the whole chain, and they’re all different sizes and different qualities.  And so methylation is a cascade of a multitude of genes, six or seven of them. So if I tell you, “Your MTHFR is off. You’re not doing so well there,” you still don’t know where to intervene because it starts at B12 metabolic pathway B9. Is it folate or is it folinic acid? And what do you actually need? And if you know what part of the chain isn’t working, MTHFR means the cascade in itself is inefficient, but how and where do you intervene? So we can be a lot more precise and we can give someone exactly what they want. And then it’s no longer “This has a 80% chance of working.” It’s now “100% of the time, we’re going to get it right.”

Dr. Weitz:            And that’s an example of the difference between functional genomics and genetics.

Kashif:                 Exactly. Genetics is “Here’s what this gene does, and we’re going to speak about it independently.” Functional genomics is “Here’s how the body actually works, and let’s look at that first. And not only let’s look at the system, but let’s look at how several systems interlink.”  And I’ll use methylation as another example. Methylation is phase two of detox. If I only focus on that and don’t understand phase one first, methylation is like, “Here’s the door open to take the garbage out.” If I don’t understand who’s picking up the garbage and bringing it to the door, I’ve only solved half the problem, right?

Dr. Weitz:            Right.

Kashif:                 There’s glutathionization. There’s glucuronidation. There’s antioxidation.  There’s all these detox functions happening in the body.  And if I don’t pair them, I haven’t understood the full cascade.  What does my body do from the point that a toxin enters to the point that it gets out?  So first understand that, and there’s not one gene that does every single step along the way.  There’s multiple processes.  When you connect them and you have your full functional answer, you can then solve the problem fully also.

Dr. Weitz:            Yeah. Well, we don’t really need to do that because as soon as the person brings the garbage to the door, you just shoot them in the head. No, I’m just kidding.

Kashif:                 That works.

Dr. Weitz:            So when you were talking to Ari Whitten, Ari Whitten asked you a question about the BRCA gene. And I loved your answer, so I want to ask you the same question again. And he basically said, “If I’m a woman and I have the BRCA gene, should I have my breast cut off?”

Kashif:                  Yeah, so that’s exactly the… That paints a picture of genetics. So genetics is pharma and disease backwards. Here’s the disease, and how do we treat this disease? They’re asking the wrong question to begin with. If you have somebody’s DNA in hand, their human instruction manual that tells every cell in the body what to do, why are we waiting to treat a disease? Why don’t we ask, “Why does the disease happen in the first place?” and not have it? So when you ask the wrong question, you get the wrong answer.  And so the answer we now have is a certain version of BRCA means cancer risk. That in itself, by the way, is a false statement. BRCA doesn’t cause cancer. BRCA is a tumor suppressor. So when you have breast cancer, god forbid, BRCA’s supposed to come along and fix it. And if you have the wrong version, you just have a bad repair tool. So you’re more likely to die from breast cancer because you can’t come back from it. So we’re solving the wrong problem once again. Why did the cancer happen to begin with?   So I can give you one example, the same example I gave Ari, because I would say it’s the most prolific and easiest to deal with. Some women in their hormone pathway make a lot more estrogen. They’re estrogen dominant, and this is very easy to predict genetically the hormone cascade and how you go from progesterone to testosterone to estrogen. The genes that do each one of those steps, to what degree are they working efficiently or not efficiently? So some women just make a lot more estrogen. There’s a big pool of it every month. Step one of three.  Step two is when you have your monthly cycle, you’re not clearing estrogen. You’re clearing a metabolite. And there’s three options: 2, 4 or 16-hydroxy estrogen.

Dr. Weitz:            Right.

Kashif:                 Some clinicians listening here have done DUTCH testing and looked at these things, right?

Dr. Weitz:            Right.

Kashif:                 So 2 is the good, clean stuff you want. 4 and 16 are toxic. 4 has a lot of publications and education around its connection to breast cancer, but we still haven’t answered the full question as to why.  Then we look at functionally okay, I’m estrogen dominant. I make too much. The version that I make is a toxic version. I go down the four pathway. Well, let’s look at how well I detoxify it because again, how does the human body work? So you do look at glutathionization, antioxidation, COMT, which is the tail end of methylation, and you start to look at the jobs that your body does well or not so well. And you may understand that not only am I estrogen dominant, estrogen toxic, but I also don’t have the right detox genes kicking in to help me get rid of it.

                                So now you have the avatar, the profile of the woman who truly is at risk, but she still may not get sick. So what’s the difference between the woman at risk and the woman that gets sick is the epigenetics. You have to pair these two, and that’s another layer to functional genomics. It’s not just “Here’s your genes.” It’s also what are your habits? Because bad genes doesn’t equal disease. Bad genes equals elevated risk, right?

Dr. Weitz:            Right.

Kashif:                  You have to do something to create chronic disease. You’re not born with breast cancer or Alzheimer’s, diabetes. These things develop because of your choices that you make. One other [inaudible 00:09:04]-

Dr. Weitz:            Because of your diet, your lifestyle, et cetera.

Kashif:                  Exactly. And some of these things are obvious. Some of them are completely counterintuitive, that you would never think are related to the problem. So for this profile, now we say this woman’s bad choices may be that she goes on the birth control pill for 10 years and elevates that estrogen level. She goes on BHRT. Not that you shouldn’t take BHRT, but where do you intervene? What hormone are you taking? Is it estradiol? Is it estriol? Where do you actually plug in that hormone, and are you fueling that 4-hydroxy pathway or not? She may not understand the hormone disruption in her environment and what her Teflon-coated frying pan and her cleaning chemicals and her pesticides that make her lawn so beautiful are doing to her body.  So now, you have… The woman has a profile. She also has the wrong choices that are misaligned to that profile and what it’s capable of. And now, you get to the level where the genes can’t handle it anymore. There’s too much of that net 4-hydroxy causing too much inflammation.

                                So then last step, going back to biology, why is it that you typically see breast cancer around the menopause age? It’s not because that’s when BRCA magically creates a problem. It’s because at that age, you no longer have a menstrual cycle and you no longer have the ability to get rid of this toxic load that you’re making every month. And your body, to protect you because it doesn’t want your organs and your vasculature, your veins, getting damaged, will store it in fat. It says, “Hey, I’m smart. I’m going to get rid of this stuff and not cause inflammation. Let’s put it in fat.” And women have fat in their breasts, and in the breasts you have all these glands and ducts for which the cellular structure was not designed to deal with that level of inflammatory insult. Then you get cellular degradation, mutation, eventually cancer. And then if you have the wrong version of BRCA, you’re not going to fight the cancer so well.

Dr. Weitz:            Right.

Kashif:                  Right? After all of that. So now you name a chronic condition. It can be laid out in this manner so that we can understand how to prevent it. Why would it happen to me? And my why might be different than somebody else’s why. That’s functional versus genetics.

Dr. Weitz:            What is some of the important genetics related to cardiovascular disease? We know about familial hypercholesterolemia.

Kashif:                  Yeah, so that’s a perfect example. Cholesterolemia, to me, is a myth. It’s not a disease. It is the response to the true disease, which is endothelial inflammation.   So when we look at the genetics of heart disease, which is the number one killer, still number one drug prescribed is statins. Why is that so? Because most of us are not genetically designed for today’s reality. What does that mean? Our hardware, our endothelium, the actual inner lining of the blood vessel, most of us don’t have the best quality endothelium. We can actually predict that genetically. Is it stainless steel resilient or is it more paper thin, this papyrus that’s prone to inflammation, right?

Dr. Weitz:            Right.

Kashif:                  Most of us are walking around with that, the not so good stuff. So if that’s the case, and just like this breast cancer woman you happen to be breathing in the wrong stuff, eating the wrong stuff, having the wrong stress load, the wrong sleep load, et cetera, et cetera, et cetera, and you may also pair that with the wrong detox pathway or inefficient detox pathways that can’t support the inflammation being caused here, you’re going to get endothelial inflammation, which is the actual disease. Your body then responds with cholesterol as a hormone to reduce the inflammation. It acts like a Vaseline dealing with all these microabrasions and tears and inflammation and resolves them. The same oxidation and toxicity that caused the inflammation also oxidizes the cholesterol and causes it to harden and deposit because our body didn’t understand that our 200,000 years of caveman habits were going to be deposited in this industrial reality at some point. And so it hasn’t changed yet, and we still are not prepared for this.  So that’s the true why behind cholesterolemia. And if you understand this, not only can you predict it and prevent it, but if you have it, you can deal with the root cause and then prevent it. Or sorry, reverse it.

Dr. Weitz:            Right. Okay. How can our DNA blueprint help us to determine what type of diet might be best for each person?

Kashif:                  Yeah, there’s a lot that can be said there. Starting with the brain, and this is… What I’ll speak to is the unique things. There’s obvious things like there’s genes that tell you how you metabolize fats and starches. There’s genes that tell you how you break down chickpeas, lentils and “Should I actually be a vegan?” My primary protein sources, do I actually make the enzymes efficiently to digest them, or do I get bloated and not eat enough? Right?

Dr. Weitz:            Right.

Kashif:                  So those are the basics. Then there’s things that are a little more functional in nature. So how do we look at the human mind and determine why some people just perceive things differently? So do they not produce or bind enough dopamine, so it’s hard for them to experience pleasure? In which case, they may lean on food as a source of pleasure and overeat without even knowing it. Is their serotonin pathway dysregulated and they’re slightly more irritable?  It’s easy to dysregulate their mood because their serotonin receptors are a little too short and they can’t bind it efficiently. These people end up leaning on food as coping mechanisms because they’re constantly stressed.

                                There’s a gene called MC4R that determines the satiety of the palate. So as an ancestral trait, typically there wasn’t enough food. So we developed this desire to seek variety in our palate, a lot of us. And so it’s like, “Give me the crunchy. Give me the soupy. Give me the salty. Give me the sweet to make sure that I got enough nutrition.” And we’re still walking around with this trait and then going to the grocery store and filling our carts where it’s so convenient to overeat. And then when you get home and you have your meal, it’s not enough. You still need to graze to the pantry, the Doritos and the cookies, because you’re not satisfying the palate.  Same thing for the gut. There’s genes that determine how efficiently you feel full, that signal from the gut to the brain, and maybe your plate being appropriate just isn’t enough. You need to wait. Maybe you need a glass of water. So there’s a lot we can speak of these hidden areas when it comes to diet planning that go far beyond calories in and calories out.

Dr. Weitz:            Let’s talk about one particular gene, the APOE gene. And if a patient has one or two copies of the APOE4 variant, we know that they have an increased risk of Alzheimer’s. What does that tell us about what we can do about that?

Kashif:                  So another great example of how functional genomics can support that genetic question, so genetic… We do test for APOE and we do report on it, but there’s a lot more you need to know than just APOE. So APOE is how well do I, to keep it simple, transport lipids and more likely to develop amyloid plaque in the brain?

Dr. Weitz:            Okay.

Kashif:                  Which is highly connected to Alzheimer’s and dementia. So even then, people walk around with APOE34 and 44 don’t get sick. What’s the difference? Something has to trigger the inflammation.  Everything that we talk about that’s chronic in nature is typically rooted in inflammation. So if you do everything right, you could have the APOE 44 and have a better brain than somebody that has the APOE 33 that did everything wrong. All we’re saying is that this is a priority for you. This is a red flag. If you’re APOE34 or 44, you need to focus on this. What’s your health plan to make sure it doesn’t happen? What are the potential things you look at? Same thing as the breast cancer.   If you produce toxic estrogens, which is why, by the way, 80% of Alzheimer’s and dementia cases are in women. The vast majority are in women, and it’s much harder for women to reverse and deal with because they’re also dealing with the estrogen toxicity which leads to more inflammation.   A vast majority of today’s dementia is rooted in inhalation. What are we breathing? I spoke to a brilliant guy, Dr. Tom O’Bryan, that deals with a lot of [inaudible 00:17:39]-

Dr. Weitz:            Oh, yeah. I know Tom well.

Kashif:                 Yeah. So what he told me is that 66% today of what he sees is inhalation based, what we’re breathing.

Dr. Weitz:            Huh.

Kashif:                 One hour of LA traffic is equivalent to a pack of cigarettes.

Dr. Weitz:            Wow.

Kashif:                 So if that’s what you’re doing on your drive home every day and you’re creating that level of inflammation, if you have the APOE34, that may be the trigger that causes the inflammation for which you don’t transport the lipids that well. So again, go to the why. This is your… Genetics is red flag. You need to focus here. Functional genomics says, “Well, what do we do about it?”

Dr. Weitz:            Right.

Kashif:                 Right. “80% chance of Alzheimer’s. Good luck,” is not enough of an answer.

Dr. Weitz:            Do we know what kind of diet is going to be best for somebody who is APOE44?

Kashif:                 Well, it depends on what the actual trigger is. So if it’s-

Dr. Weitz:            Okay.

Kashif:                  So for example, if it is the inhalation-based, diet may not be their problem. Right?

Dr. Weitz:            Ah, okay.

Kashif:                  For a lot of people, it’s insulin based. So low insulin, low glycemic index. There’s some people that don’t metabolize fat so efficiently and [inaudible 00:18:50].

Dr. Weitz:            That’s exactly the question I was going to ask, because I know some people employing a keto diet to help reduce risk and other people are employing vegetarian, low-saturated fat diet to reduce risk. And you’re saying it depends on what other genes-

Kashif:                  Yes.

Dr. Weitz:            … are involved.

Kashif:                  There’s a lot of people we work with that got on to Keto and they felt amazing in the first three or four weeks. It’s impossible to not feel amazing because you start burning your fat as fuel and you get ketones firing in your brain. Everything feels good. But then you get five, six week in into it and you start feeling sluggish and like, “Well, what else do I need to change? There’s something…” Because you felt so good, you don’t blame it on the keto. But if your APOA2 gene, a different gene, is off, you don’t metabolize saturated fat so well. And five, six weeks into it, you’re going to feel horrible.  And that can actually drive an insulin response, by the way. We don’t think of fat driving an insulin response, but ultimately if you eat too much fat, it turns into glucose anyway and it can drive an insulin response. So yeah, we can be hyper precise on the exact plan.

Dr. Weitz:            Interesting. So fats can drive an insulin response. I’ve not heard that before.

Kashif:                  And the reason you haven’t heard that, and I’m going to poke fun at you for some time right now.

Dr. Weitz:            That’s fine.

Kashif:                  Medical research is all done on Western European white males. It’s designed for you. It’s not designed for my pigmented skin. It’s also not designed for women. This is why dark people and women suffer more in our healthcare system than Western European white men. So the truth is that the genetics of South Asian people, brown people, we get an insulin response from fat.

Dr. Weitz:            Interesting.

Kashif:                  It’s not spoken of anywhere. And it’s not just South Asians. There’s other ethnicities as well. So we have a global medical model that was designed on one cohort of people, which great. You’re going to do well. But the uniqueness, the bioindividuality is there. We’re not all the same, and we’re starting to understand that. That’s part of what we’re pioneering, is how do we make this thing unique to the individual? It’s not about one set of research for everybody.

Dr. Weitz:            Right. And it’s not even about one set of research for a race either. We don’t want to just make a simplistic conclusion and say all Asians should follow this program or something like that.

Kashif:                  Yeah. So China is not Asian and it’s not Chinese. There’s two races that make up China, and they’re very different. So if you look and… Picture this. People from China either look like Bruce Lee or they’re big like [inaudible 00:21:41] the panda bear. And that’s what you get. There’s nothing in the middle. And there’s actually two major races that make up China, these highly androgenized, testosterone-dominant, rippled muscle 90-year-old grandma walking around doing her own groceries or these big, thick people that have a lot of fat on them and big heads. Those are the two races.  So even between those two races, it’s not the same answer. And we’ve learned this genetically that the uniqueness of how people… And why. These people are highly estrogen dominant. These people are highly androgen dominant. Eventually at some point, they came together and formed China. So you can’t give the same answer to those two people even though they both think they’re Chinese.

Dr. Weitz:            Huh. It’s all based on their genetic differences.

Kashif:                  Yep. Exactly.

Dr. Weitz:            What about the relationship between genes and mood?

Kashif:                  Oh, huge. So that’s the first place we always start. It’s very hard to support someone in their health journey if they don’t understand how they think.   So first of all, the way they think things are happening and their perception versus what’s really happening, and there’s no good or bad to that. There’s just always a gap. Everybody has some unique perspective.

                                Also, as a coach or a healthcare practitioner, how do you actually guide this person? So how do they seek reward? What motivates them? Do they burn out? Do they procrastinate? Do they have highly reward-seeking tendencies, the opposite, where they may overdo it? Are they highly skeptical, and then do they only learn experientially? They need to go through it. You can’t just tell them, “Go do this,” and they’ll do it.

                                So everything about if… Let’s just say this. If I had your DNA in hand, I don’t ever need to speak to you to understand your personality and habits to a T. I can describe you and who you are, whether you should be an accountant or whether you should be an entrepreneur to a T, and it’ll blow your mind. Why? Because we spent three years clinically studying 7,000 people.

                                So one by one by one, we interviewed 7,000 people, sometimes a single interview to many months of work depending what they were dealing with, and we understand how the neurochemicals drive behavior. And it’s indisputable, because this chemical causes you to feel like this. And this is how you make it. This is how you bind it. This is how you clear it, so this is how long it lasts. I can now predict how you deal with that. And there’s multiple things we look at. And now all of a sudden, here’s your personality map. I know it. It’s very, very clear.

Dr. Weitz:            That’s amazing. I saw somewhere where you said the COMT gene plays a role in altruism.

Kashif:                 Yeah, so the COMT gene clears-

Dr. Weitz:            Does altruism actually even exist? I have my undergraduate degree in philosophy.

Kashif:                 Well, here’s what I believe about all mood and behavior and behavior traits. They are based on your context. So we are all wired to do something. We’ve inherited our ancestral genetic legacy. Take me, for example. I have what we call warrior genetics. I need to be on the frontline fighting. Whatever I did yesterday is not good enough anymore. And if you look at my ancestral lineage, it comes from Afghanistan from some level of royalty, let’s call it, that were constantly fighting for the throne. Right?

Dr. Weitz:            Okay.

Kashif:                  So stress was just part of life. Fighting was part of life. The status quo is not good enough. That causes depression for me because I can’t experience pleasure like the average person. I need to fight.  So when it comes to COMT, COMT clears your neurochemicals. Not all of them, but a couple of key ones: dopamine and noradrenaline. And so your ability to experience emotional recall is based on noradrenaline. And if you clear it quickly, you may be a little bit confused about what things actually mean and then what they feel. Your recall may be a little off. But the opposite is also true. If you clear it very slowly, you’re really deeply connected to the impact or the emotion that you had in any given scenario, and you use that as a tool moving forward. And that’s your filter.

                                So now when you’re dealing with people, you may have more empathy. You may have more EQ. You may be able to read them and understand exactly what they need and want, and then they perceive you as that person. And it becomes a superpower. But put it in a different context where, god forbid, there’s a car accident, every time you go down that street it’s trauma because you’re remembering the feeling, not just the information.

                                So this innate understanding of how you’re wired, whether we use words like anxiety, depression, addiction, is based on what context you’re using that tool in. The same thing that can cause depression for me can also cause addiction because my baseline ability to feel pleasure and reward is very, very low. So if I just go do the average thing, I’m going to be depressed. If I find the thing that gives me pleasure, I’m going to be addicted. If I find the thing that gives me reward, because dopamine powers both pleasure and reward, I’m going to achieve. And guess what? I’ve experienced all three of these things. So context is key. Understanding who you are first and what the ideal context is and knowing what the more deleterious context is and what may cause you a problem, then you can choose how you feel.

Dr. Weitz:            Interesting. We screen for vitamin D quite often with our functional medicine clients. I find most people, we have a tough time actually getting the vitamin D up to a really target level. So depending upon the person, 50 to 70, 60 to 80. And then yet a few people, we give them a modest amount of vitamin D. What I consider a modest amount, 5,000. All of a sudden, it goes over 100. And I saw an article where you were talking about how genes control vitamin D metabolism and why most people are vitamin D wasters.

Kashif:                  Yeah. So what’s going on there, of all the micronutrients, vitamin D has the most complex metabolic pathway, the genes that drive it. Because again, ancestral traits, our ancestors weren’t indoors on Zoom calls. They were outdoors most of the day. Agricultural. They were outdoors doing stuff, which means that they were overexposed to vitamin D so their bodies had to learn how to mitigate that exposure.

                                And so what do we do? The first gene takes D2 from the sun and converts it into D3 and gets it into the blood. Step one, I need to metabolize it and turn it into the active form that I can use. Then once it’s in the blood… And this is why the measure of what’s in the blood is not enough of a measure. That’s only step one. That’s only telling you how much the person metabolized.

                                There’s a second gene that then takes that D3 and transports it to the cell. So picture these little taxi cabs that are moving it along and getting it to where it needs to be. Once it gets there, there’s a third gene that binds it and gets it into the cell. And any one of these can be off.

                                So you might have somebody that metabolizes vitamin D really well, but they don’t transport and bind it really well. So that person needs multiple doses because if you give them 5,000 IU, they will only use 1000 of it. They just can’t efficiently get it there and fast enough and bind it fast enough.

                                The opposite could be true. They may be really efficient at binding and transporting, but they don’t metabolize. So they might need 10,000 IU. They might need a lot more, especially in the winter, depending where they live.

                                So you can be really precise. And of all the micronutrients, the number one priority is vitamin D. That’s where you need to focus. Of the 22,000 genes that make up your genome, all of these little instructions in your cells, 2000, so almost 10% of your biochemistry, is dependent on vitamin D. So these genes don’t express if you don’t have the right vitamin D, which is why it affects-

Dr. Weitz:            Wow, wow.

Kashif:                  … anything from mood to skin, everything. So it’s really more so… And you know this. It acts more as a hormone than it does a vitamin.

Dr. Weitz:            Yeah.

Kashif:                  And so it’s key to be precise there, and this is why we built that specific pathway because it really… My niece is a perfect example. She was almost being prescribed a anxiety pill. She was getting anxiety attacks and couldn’t breathe, and I figured out all it was is because she was being homeschooled during COVID when schools were locked down and she got zero vitamin D. She hadn’t been outside in five months.

Dr. Weitz:            Oh, wow.

Kashif:                 And her vitamin D pathway is horrible. And she just needed more vitamin D and a little bit of L-theanine to boost her dopamine levels. That was it. And she was being prescribed an anxiety pill, which she would’ve probably still been on today.

Dr. Weitz:            Right. That’s awesome. Couple more questions. How do our genes tell us about our ability to fall asleep?

Kashif:                 Sleep is… That’s one question, how do I fall asleep, then there’s also how do I stay asleep? And there’s also how do I sleep through the night and actually feel rested? [inaudible 00:31:23]-

Dr. Weitz:            How do I get quality sleep? How do I get good deep sleep? How do I get good REM sleep?

Kashif:                 And those are all different things genetically. So the first one is based on circadian rhythm. So how efficiently does my clock work? So if my clock… There’s two genes. There’s literally a gene called CLOCK, which makes a CLOCK protein which allows your body to understand what time it is. And then there’s BDNF, brain-derived neurotropic factor, which also heavily regulates circadian rhythm. And so if you’re not doing well there, then your body is going to need a very strict routine to be able to fall asleep on time, which means waking up at the right time, getting sunlight and vitamin D at the right time, pausing to breathe a few times during the day, some kind of light sauna or stretching type activity in the evening, no blue light, turning off the TV a couple hours before. We can be very precise about your sleep problem and why you can’t fall asleep, but that same problem doesn’t affect why you can’t stay asleep. That’s a different problem which is more based on serotonin and cortisol.

                                Those are very different problems where if your serotonin is dysregulated, which means your brain is more sensitive to stimulus, it notices everything. And you make your serotonin in the second half of the night in your gut, and your body uses serotonin to wake you up. And it’s literally waiting for sunlight to say, “Okay, time to get up. Let’s bind that serotonin.” But if your brain can’t prioritize stimulus because your serotonin pathway is off, then it’s responding to everything in that second half of night. When the temperature changes, when there’s a smell, when the hubby pulls on the blanket and it touches your skin, every little stimulus in that second half of the night your brain confuses for the sunlight coming through the window and you get up, go to sleep. Get up, go to sleep. Get up, go… So it’s a different problem to solve.

Dr. Weitz:            Right. Interesting. What are some of the strategies to combat some of those?

Kashif:                  Well, for the second one, so this is actually… All of these things that we see as problems are actually our ancestral superpower. So think about the caveman who had to not be eaten by a wolf while he was sleeping.

Dr. Weitz:            Right.

Kashif:                  Right? So the person who was able to have that hypersensitivity to stimulus would survive because they would hear that branch breaking far before the wolf arrived, right?

Dr. Weitz:            Right.

Kashif:                  So that trait is designed to wake you up, but our context is not aligned to the sleep cocoon we actually need, which means heavy weighted blankets so that your body feels safe. Head to toe, the skin is signaled. There’s this weight on me. It is sleep time right now.        Cooling of the mattress. So there’s mattress coolers you can actually get that mimic what it meant to sleep on a cave floor, right?

Dr. Weitz:            Yeah. We use one.

Kashif:                  You use one? Yeah. So it’s an amazing hack that completely changes your sleep because if you have the heavy blanket, a couple hours in you’re going to overheat. How do you mitigate that? You get the cooler, right?

Dr. Weitz:            Yeah.

Kashif:                  Zero light leakage. If there’s light, that’s signaling serotonin to bind. And depending where you live, the light may start at 4:30 AM, which is not the right time. So zero, zero light leakage, potentially an eye mask.  You potentially may have a separate blanket from your spouse. You cannot have that stimulus. So those are the things to consider. How do you make that sleep cocoon?   And now if we know that serotonin is the gene pathway is off, you can also modulate serotonin with the right supplements. So 5-HTTLPR is the gene. There’s a supplement called 5-HTP which helps regulate your serotonin level so you can take one before going to sleep. You know?

Dr. Weitz:            Right.

Kashif:                  There’s things you can do, these adaptogen type things that help you get into a deeper sleep state. So there’s a lot of things available. You just need to know, again, what your body needs. Where do I start?

Dr. Weitz:            Right. Let’s see. One more question. What about our genetics and weight control?

Kashif:                  There’s so much. We need an hour just for that.

Dr. Weitz:            And obviously, obesity is such a big, big risk factor for chronic diseases, or maybe is a chronic disease itself.

Kashif:                  Yeah. So let me give you the fast bullets.

Dr. Weitz:            Okay.

Kashif:                  Hormones is one of the areas that is where people get stuck. So I’m going to the gym. I eat properly. Why can I not lose these last 20 pounds? Hormones. Are you estrogen dominant? Are you androgen dominant? Maybe you don’t have enough fat or enough muscle. You can’t get bigger. You can’t put on the muscle. Maybe not enough of the estrogens. So hormones is a first area, and it’s very easy to use basic supplements to change these gene pathways and change your body.

                                Second one is your brain perception and what you think you’re eating versus what you’re actually eating. Your addictive tendencies, your binging tendencies, your emotional eating tendencies, and these things that never get counted in your calorie count. So that’s another big one.

                                Then there’s actual gut and mouth brain connection, which we talked about a little bit earlier, and understanding your ability to actually feel satisfied and how to hack that. So if you are the person that has the palate need of variety, you have to create it. Give yourself a little bit of cheese, dark chocolate, nut, grape, all the textures and varieties right when you’re with done your meal so that you hack your brain to get the variety it’s desiring. Another big one that nobody looks at is-

Dr. Weitz:            Or you just take Ozempic.

Kashif:                  Or you take Ozempic. Yeah, that’s another way around. And then you get off Ozempic and you balloon up like never before. Yeah. And-

Dr. Weitz:            We’ll call that the Ozempic balloon.

Kashif:                  Yeah. It’s sad, but the federal government went on 60 Minutes and said like a week before Ozempic was released, coincidentally, that 80% of obesity is genetic.

Dr. Weitz:            Wow.

Kashif:                  That’s what they said. They said it’s not lifestyle. This was on 60 Minutes. I don’t remember the name of the person, but it was some health advisor for the Biden Administration went on and said that “We believe that obesity is 80% genetic. It’s not lifestyle or nutrition based.”

Dr. Weitz:            Pharmaceuticals will solve all our problems.

Kashif:                  Yes. A week later, Ozempic gets released. Pure coincidence.

Dr. Weitz:            Yeah.

Kashif:                  Right? So now, yes it’s true that 80% of it is genetically driven if you’re making all the wrong choices, but it’s absolutely false that you don’t have control and that it’s going to happen, that it’s innate. There are genetic conditions like sickle cell syndrome. There’s a gene that’s broken, and you have it-

Dr. Weitz:            Right.

Kashif:                  … [inaudible 00:38:25]. Obesity is not something that you have. It’s something that’s caused. There are some people that have genetic obesity. That’s a tiny fraction of the people that are actually obese.  So the other big one, sorry, I was going to say is environmental toxins. So we’re so overburdened by environmental toxins, what we breathe constantly, that our body is storing fat as a place to deposit the toxins. So if somebody that goes for a run every day in Manhattan that can’t understand why they can’t lose that little bit, because you’re running and breathing in pollution every day and you might not have the right detox pathways to deal with that. And so your body’s trying to protect you by storing fat to deposit that toxin to keep it away from your organs.

Dr. Weitz:            Interesting.

Kashif:                  And that may be your number one thing. That could just be the one thing you have to work on.

Dr. Weitz:            Right. Great. So how can patients get your DNA test done? Is there an option for practitioners to become providers or is this a direct to consumer, or are both options available?

Kashif:                  Yeah, for sure both. So we do work with functional medicine, chiropractors, naturopaths, everybody in that sort of wellness space that thinks the way we think, and a few MDs that have learned about life and what they need to change. So we do work with practitioners. It’s very easy. You open an account. We send you some kits. There’s training if you want. There’s free training. There’s paid training, depending how deep you want to dive.

                                And then for consumers, it’s thednacompany.com. You simply go there. The test is called the 360. The way it works is you get shipped a kit. You spit in a tube. You ship it back to the lab. We extract your DNA. A few weeks later, you’re going to get an email to access your reports, and the reports are very, very easy to use rather than “Hey, you have this gene, the MTHFR CC.” Nobody knows what that means. It’s more like, “Here’s how your body deals with cholesterol and inflammation. Here’s how you deal with anxiety. Let’s speak in the context you actually can apply this stuff.” And there’s recommendations built right in. So where do you actually supplement? What do you actually change in your diet, et cetera?

                                Beyond that, there’s some people that have the need for clinical support. I have breast cancer and how do I deal with this? So we do have functional genomic-certified coaches that can take on patients and help them through programs, and we can also train practitioners to do the same. So all of the above.

                                So it’s thednacompany.com, the 360 test. And to work with us as a practitioner, you can also send us an email through there. You can find us on Instagram if you’d like. It’s my… K-A-S-H-K-H-A-N official. A lot of news and stuff that we put out there. Think about things like Ozempic. So you can keep learning. Yeah, but all of the above. We’re here to support.

Dr. Weitz:            What if the patient already has their DNA run by 23andMe or Ancestry? Can they send that in, or are your tests more extensive or different?

Kashif:                  We would love to be able to do that because there’s 80 million people out there that have done those tests, and business wise it would make a lot of sense. The challenge is that they don’t test for what we test for.

Dr. Weitz:            Oh, okay.

Kashif:                  So remember, these are data collection companies. Their business is sell something on the front end that’s infotainment and then sell the data on the back end to a pharma company. That’s where they make their real money. So they have to build the product in a way that serves that customer, the real customer which is a mass data dump, a bunch of SNPs for the practitioners that are on here. It’s the spelling mistakes in genes.  When it comes to the major pathways that we need to understand, there’s things called copy number variations, where it’s far more complex than a SNP. It’s like, “Do I even have the gene? Am I completely missing it?” You have to test for that separately.

                                When it comes to things like APOE, I can’t tell you how many customers have called us and complain and said, “I have my 23andMe done, and your APOE result is different. And you guys are a scam.” And then we have to explain to them that APOE, we sequence the entire gene. We treat it as an independent test because it’s so complex. So there’s one thing to look for a SNP, and there’s one thing to look for all 20,000 letters in that gene. We test for a lot less, but we are going a lot deeper in those genes that actually are meaningful, the functional genes that drive the main pathways.

Dr. Weitz:            I don’t quite get that one on the APOE. So aren’t you just either an APOE34 or 33 or 44? What else is there?

Kashif:                  The way you determine that is not as simple as it seems.

Dr. Weitz:            Oh, okay.

Kashif:                  And have you heard of Dale Bredeson?

Dr. Weitz:            Yeah, of course.

Kashif:                  [inaudible 00:43:30].

Dr. Weitz:            I’ve had him on the podcast.

Kashif:                  Yeah. So in his book on reversing Alzheimer’s, he says something like, “23andme is something like 65 or 70% accurate,” and that’s why he refuses to use genetics, because genetics isn’t as simple as run a test and get a result. There’s a lot of science behind what that result actually means, and that’s why you see variability between different testing companies.  So what we do, again, we test for less. We’re not looking for thousands and thousands of genes. We’re looking for the 100 that actually matter that are functional, but we go a lot deeper on each gene to make sure it’s accurate and that we inform more. It’s not just a SNP. It’s a copy number variation. It’s also the indel. An indel means that a whole paragraph might be missing or there’s a extra paragraph, not just a letter or a variant. We’re deeper on what matters, and APOE’s a perfect example. You can assume by looking at certain markers or you can sequence the entire gene from beginning to end and be certain, and that’s what we do.

Dr. Weitz:            Fascinating.

Kashif:                 Yeah.

Dr. Weitz:            Awesome. Okay, thank you very much.

Kashif:                 Oh, It’s a pleasure. Good talking to you, man.



Dr. Weitz:            Nice talking to you. Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five-star ratings and review. That way, more people will discover the Rational Wellness Podcast.   And I wanted to let everybody know that I do have some openings for new patients, so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardiometabolic conditions or for an executive health screen and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way. And that usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective. So if you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111 and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.




Reversing Multiple Sclerosis with Dr. Terry Wahls: Rational Wellness Podcast 308

Dr. Terry Wahls discusses how to Reverse Multiple Sclerosis 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

2:00  Dr. Wahls was diagnosed with Multiple Sclerosis 23 years ago, so she went to the best MS center in the country and saw their best physician and took the recommended latest drugs. Three years later she was going downhill and she was in a tilt, recline wheelchair despite taking the newest, disease modifying drugs, including Tysabri and Novantrone.  For her, these drugs did not help. She continued to worsen, as did the electrical face pains that she had.  She decided to dive deep into the research on her condition and she concluded that the mitochondria are the drivers of disability and she created a supplement cocktail for her mitochondria.  She changed her diet from vegan to paleo to provide protein and additional nutrients. She also discovered a study using electrical stimulation of muscles and added that to her physical therapy.  She then discovered the Institute of Functional Medicine and took their course on neuroprotection and developed a longer list of supplements.  Her condition was improving but she was not where she wanted to be. She then had an aha moment and decided to redesign her paleo diet to be able to get all of these nutrients in the supplements from her food. She did more research and then figured out the Wahls Paleo diet by December. At that point, she was so weak that she could only sit up for about 10 minutes in a regular chair before she had to be either in bed or a zero gravity chair and she could only take a few steps with walking sticks.  Her electrical face pain was much worse and she was beginning to have trouble with brain fog.  She started eating this way on December 26th. By the end of January, her pain is less, her brain fog is less, and her fatigue is also less. By the end of February, her physical therapist noticed that she was getting stronger, so he advanced her exercise. By the end of March, she was walking with walking sticks. And by the end of April, she wanted to try riding her bike and she had an emergency family meeting with her wife Jackie and her two children.  Her 13 year old daughter and her 16 year old son jogged along side on either side of her bike and she rides around the block on her bike and they are all crying.  And then every day she rides her bike more and more.  And in October, Jackie signs her up for the Courage Ride, 18.5 miles, which she completed.  This fundamentally changes how Dr. Wahls thinks about disease and health and it changes the way she practices medicine and it will change the focus of her clinical research.  She has now we’ve conducted seven clinical trials and she is now conducting her eighth clinical trial on multiple sclerosis. We’ve published over 70 peer reviewed posters, abstracts, scientific papers and nearly 30 of them in multiple sclerosis. And she has really made it her mission to let people know there is so much that we can do that can change the course of this disease. 6:50  Dr. Wahls was able to regain her health using a Functional Medicine approach focused on diet, lifestyle, and physical therapy.  Dr. Wahls noted that she is an academic doctor who believes in the best and newest drugs, technology, and devices. And she treated her disease very aggressively because she did not want to become a burden, but she continued to go downhill. When she read the package insert in the drugs she was taking, it said that she had a 2% risk of getting leukemia each time she took the drug.  She took Tysabri and it did not help, but her program of diet, targeted supplements, and electrical stimulation of muscles enabled her to achieve a remarkable level of function.  With the guidance of her neurologist, she was weaned off the drugs and has been off these disease modifying drugs since the spring of 2008.  She has continued to get stronger and she now jogs on her treadmill for 20 minutes a couple of times per week.

8:48  The mitochondria. Dr. Wahls explained that most of her colleagues in the MS world focus on the immune function and the relapses and exacerbations. But the slow, relentless loss of brain volume and loss of spinal cord volume is what drives neurodegeneration. Her interpretation of the basic science literature is that the driver of that disability is probably mitochondria.  The mitochondria are not generating enough ATP for the robust energy needs of the axons, of the myelin of the neurons. And that’s driving cognitive decline for dementia, for Alzheimer’s, in Parkinson’s.  She figured out that her mitochondrial supplements were making her feel better and when she didn’t take her supplements, she couldn’t get out of bed and go to work.  While they were helping her a lot, they weren’t getting her out of her wheelchair.  The magic really happened when she  redesigned her food around her supplements.

15:05  The most important nutrients. Low vitamin D is associated with more relapses and disability and worse quality of life.  Dr. Wahls recommends an ideal vitamin D levels of 60-80 ng/mL.  Omega 3 fatty acids important and low omega-3 fatty acids are associated with more relapses and more disease progression.  We do also need omega 6 fatty acids and arachidonic acid, but most of us do not get enough omega 3. We should have an omega 6:3 ratio of 4:1 and 3:1 is also good, but 2:1 may be too low.  But most Americans are at 20:1 or 30:1 or even 45:1. That level is very inflammatory.  We would like to see homocysteine levels between 4 and 7.5 and most people are much higher than that.  This is lowered by taking the right forms of B vitamins. With homocysteine above 10 there are higher rates of neurodegeneration as well as higher rates of heart disease.  We want to get plenty of carotenoids, including zeaxanthin, meso-zeaxanthin, and lutein that are present in green leafy and colored veggies.  There are many beneficial compounds in mushrooms that help to lower rates of anxiety, depression, and cognitive decline.  Both greens and beets can raise nitric oxide levels, which is really good both for blood vessel health, for cardiac health, and also for neurologic health.  Fermented vegetables like Kimchi and sauerkraut are also beneficial.  She also recommends nut milk and coconut milk kefirs.

20:45  Dr. Wahls prefers the paleo diet for neurodegenerative conditions.  She explained that while there are many diets out there: vegan, vegetarian, keto, paleo, fasting mimicking diet, fasting strategies and there are a variety of clinical trials testing these diets, a consistent finding is when you put people on a intervention diet compared to the usual diet, the dietary intervention always improves.  One of the reasons for that is when you have less sugar and less added processed foods, the quality of the diet improves. Dr. Wahls was a vegetarian following a low fat diet for about 20 years prior to her MS diagnosis and for her this was not the right diet. She had her remarkable health transformation following the change to the paleo diet and she has been using the paleo diet in her clinical trials and has been achieving remarkable success.  To follow the paleo diet means to try to emulate what our ancestors might have eaten in the region of the world where we live, which means to eat meat, poultry, fish, nuts, seeds, greens, tubers, berries and fruits.  It also means not to eat sugar, grains, legumes, and dairy because those foods were foods that humans added eight to 10,000 years ago.  While we do not have enough research to prove what the best diet is for humans or for each person, Dr. Wahls recommends to patients to pick a diet that speaks to your heart and give it at least three months.  If Dr. Wahls puts a patient on a paleo diet and their cholesterol goes too high, she may make it a lower fat version or she may put them on a Mediterranean diet.  If they are developing insulin resistance, then she may lower the carbs or use a ketogenic diet.

25:27  Insulin resistance.  Insulin resistance is an important for multiple sclerosis, just as it is with Alzheimer’s and Parkinson’s.  If Dr. Wahls has patients with insulin resistance, she may put them on a lower carb diet and she may even put them on a ketogenic diet. She may recommend intermittent fasting and she may use Prolon kits for 5 days per month. 

26:31  Protein.  The muscles are a vital endocrine organ for maintaining good blood sugar and good blood lipids. It’s really important to maintain muscle mass when facing a neuroimmune condition like MS.  You need to do strength training and building muscle requires protein and our protein requirement goes up as you get older.  Dr. Wahls said that she is eating more meat and more fish in order to hang onto her muscles.  Organ meat, such as heart, liver or tongue, is an incredible source of vitamin A, B vitamins, and minerals and Dr. Wahls recommends eating 4-8 oz. of organ meat per week.

30:00  Toxins.  Toxins can play a role in neurological and autoimmune diseases and flouride is one example of that that can play a role in demyelinating nerves.  There are 80,000 plus synthetic chemicals that are in our environment, and it would be very difficult for any of us to not have an abundant number of toxins, heavy metals, solvents, plastics, the forever chemicals stored in our fat.  The fatty guts of meat are likely to have the most stored toxins, so you should make sure to eat organ meat from an organic animal and not to overdo it.  Rather than routinely screening patients for toxins, Dr. Wahls assumes all of her patients are toxic, though she will sometimes test them for mold toxins.  To facilitate detoxification, she will recommend eating greens, cabbage family vegetables, and onion family vegetables to stimulate the production of glutathione and she may recommend taking glutathione or NAC and lipoic acid, which are glutathione precursors.

33:31  Dr. Wahls recommends 9 cups of vegetables per day: 3 cups of greens, three cups of sulfur containing vegetables in the cabbage, onion, mushroom family, three cups of deeply pigmented carrots, beets, berries, peppers, tomatoes.  This is for men and tall women. If you are smaller, then 6 cups might be appropriate. There is no reason to overeat beyond what your appetite will tolerate.  You should not be hungry. If you’re hungry, then eat more protein.  If you’re full, as long as you’ve had your 6 to 12 oz of meat and you’ve got proportionately the greens, sulfur and color veggies, then you’re fine. 

34:48  Exercise. Strength training is very important for MS and it should be hard enough that you can’t do 3 sets of 12 reps of an exercise.  You need to progressively increase the resistance either with more weight or more bands or it is with bodyweight, then doing it slower. You want to rotate which parts of the body you work on on different days. You should also do balance exercises so you decrease the likelihood of falling. Dr. Wahls said that when she showers she will stand on one leg and count to 50 and then do the other leg.  If you want to live to 120, then you need to have great balance in your 70s, 80s, and 90s.

37:17  Electrical Stimulation.  Dr. Wahls finds that electrical stimulation is very helpful for patients with MS to help regenerate the muscles. It makes recovering your strength easier and it also helped her mood and her mental clarity.  We now know from animal model studies and human studies that when you add electrostimulation to exercise, you make more nerve growth factors and muscle growth factors locally for your muscles, but you also make more nerve growth factors in your brain and you make more endorphins in your brain.  Dr. Wahls uses a 10 seconds on, 20 seconds off protocol for the electrical stimulation and she co-contracts her muscles at the same time.  The muscle contractions need to be really forceful to get results. 

42:58  Nutritional Supplements.  Dr. Wahls also takes some nutritional supplements and is constantly keeping up with the research and tinkering with different supplements and she reads about 200 scientific papers per week.  She takes vitamin D with K, fish oil, a variety of mushroom supplements, and she has recently added urolithin A.  She is taking bergamot, which she really likes. She takes lipoic acid, NAC, beet root, and curcumin.  She makes a smoothie with phosphatidylcholine, plasmalogen, omega-3s, omega-6s and a cocktail of spices, which she will rotate that may include beet root, inulin, curcumin, and ginger. 

46:10  Clinical Research.  Dr. Wahls has so far completed 7 clinical trials and these have shown that the diet, exercise, and lifestyle  approaches that she recommends are helpful for patients with MS.  She is now recruiting volunteers for a new trial that compares a ketogenic diet with a paleo diet and a usual diet.  They are looking at changes in fatigue and quality of life, but also at changes in walking function, hand function, vision function, and how well we think.  They are also looking at brain volume over time because patients with MS experience brain shrinking at 3 times the rate of other patients.  They will also be looking to see if there are reductions in brain fog, anxiety, and depression.  participants will need to come to Iowa at month zero, month three, and month 24.  She has already recruited 83 people but they still have room for 72 additional volunteers.  Dr. Wahl’s team has published about 70 abstracts and posters and 45 peer reviewed scientific papers of which 26 are related to the multiple sclerosis research.  Those interested should go to TerryWahls.com/MSStudy.


Dr. Terry Wahls is a clinical professor medicine at the University of Iowa Carver College of Medicine where she teaches medical residents and does clinical research and she has published over 60 papers.  She conducts clinical trials that test the effect of nutrition and lifestyle interventions to treat MS and other progressive health problems.  She is the author of The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles and the cookbook The Wahls Protocol Cooking for Life: The Revolutionary Modern Paleo Plan to Treat All Chronic Autoimmune Conditions.

Dr. Wahls was a patient with relapsing remitting Multiple Sclerosis in 2000 and by 2003 she had progressed to secondary progressive multiple sclerosis.  She was in a wheelchair because her back muscles were too weak to hold her up. She was taking the standard of care medication, which included chemotherapy, and yet she continued to go downhill until she took matters into her own hands and started researching MS and she looked for vitamins and minerals that might help.  She created a list of nutrients for brain health and began taking them, which slowed her decline.  In 2007 she discovered the Institute of Functional Medicine and she developed a longer list of nutrients and then she redesigned her diet so that she could get these nutrients from food rather than just from supplements.  She also started to use electrical stimulation to help strengthen her muscles.  She restored her health and vitality and she now rides her bike to work and teaches and researches at the University of Iowa.

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 website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.

                                Hello, Rational Wellness podcasters. Our topic for today is multiple sclerosis with Dr. Terry Wahls. Dr. Wahls is a clinical professor of medicine at the University of Iowa Carver College of Medicine, where she teaches and does clinical research, and she’s published over 60 papers. She’s currently conducting clinical trials that test the effect of nutrition and lifestyle interventions to treat multiple sclerosis and other progressive health problems. She’s the author of The Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine, the Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles, and the cookbook, the Wahls Protocol Cooking for Life: The Revolutionary Modern Paleo Plan to Treat All Chronic Autoimmune Conditions. Dr. Wahls herself was a patient with multiple sclerosis, first diagnosed in 2000, and by 2003, she was in a wheelchair and going downhill until she took matters into her own hands and started to employ a functional medicine approach to healing herself. I’ll stop there because I’d like to let Dr. Wahls tell us about her story herself. Dr. Wahls, thank you so much for joining us today.

Dr. Wahls:           Hey, thank you, Dr. Ben. It’s a privilege to be here.

Dr. Weitz:            Absolutely. Please tell us about your personal journey.

Dr. Wahls:           Yeah. I’ll tell it in real time. 23 years ago, out walking with my wife Jackie, a half mile from home, my left leg grows weak. Dragging it home. I see the neurologist. And while I’m going through the workup for the next three weeks, I think about the 20 years of worsening electrical face pain that I have, and I’m praying secretly for a fatal diagnosis. Now, three weeks later, I hear multiple sclerosis. Being a physician, I do my research, find the best MS center in the country, see their best physician, take the newest drugs. Three years later, I hear the words tilt, recline wheelchair.

Dr. Weitz:            Wow.

Dr. Wahls:           I take Tysabri, I take Novantrone. None of these drugs help. I continue to worsen. My electrical face pains continue to worsen. My 10 year old daughter hugs me as tears streamed down my face. And that’s when I asked myself am I doing all that I can. I go back to reading the basic science. I’m studying in PubMed night after night. I decide that mitochondria are the driver of disability and I begin creating a supplement cocktail for my mitochondria. I discover a study using electrical stimulation of muscles. I ask my physical therapist can I add that, and we add that to my physical therapy. And then I discovered the Institute for Functional Medicine. I take their course on Neuroprotection. I have a longer list of supplements. I add all of them.

                                And not a lot’s happened yet. Then I have a really big aha. And actually, Ben, I’m sort of embarrassed now about how long this took me to have this because I’d already been doing a paleo diet for five years. But now I think what if I redesign my paleo diet based on the supplement cocktail. If I get my nutrients from the food as opposed to from supplements. And so that’s more research. And in December, I redesigned my paleo diet. Now, at that time, I am so weak I cannot sit up in a regular chair like I am now. I can only sit up for about 10 minutes. I can take just a couple of steps using two walking sticks. Otherwise, I’m either in bed or in a zero gravity chair with my knees higher than my nose. My electrical face pain is much worse and I’m beginning to have trouble with brain fog.

                                Start this new way of eating December 26th. By the end of January, it’s clear that my pain is less, my brain fog is less, my fatigue is also less. By the end of February, my physical therapist is saying, “You know what, Terry, you’re definitely stronger.” And he advances my exercise. And by the end of March, I’m beginning to walk with walking sticks. And by the end of April, I’m telling my family I really want to try riding my bike. Now, I haven’t ridden my bike in six years. We have an emergency family meeting because on Mother’s Day, two weeks later, I really want to ride my bike and Jackie tells my son, who’s 6’5″, “Zach, you jog alongside on the left,” my daughter Zeb, who’s 13, “You jog alongside on the right,” and she’ll follow. And we all get in a position, we push off and I bike around the block. And that big 16 year old boy, he’s crying. The 13 year old, she’s crying. Jackie’s crying. And when I talk about that now, I begin crying. And then every day I bike a little bit more. And in October, Jackie signs me up for the Courage Ride, 18.5 miles.

                                And once again, when I cross that finish line, my family’s crying, Jackie’s crying, and I’m crying. And this fundamentally changes how I think about disease and health and it will change the way I practice medicine and it will change the focus of my clinical research. And now we’ve conducted seven clinical trials. We’re doing our eighth clinical trial. We’ve published over 70 peer reviewed posters, abstracts, scientific papers. Nearly 30 of them in multiple sclerosis. And I’ve really made it my mission to let people know there is so much that we can do that can change the course of our disease.

Dr. Weitz:            That’s amazing. Able to regain your health without really drugs, using a functional medicine approach, diet and lifestyle. It’s amazing.

Dr. Wahls:           And I’m a academic doc. I certainly believe in the best technology, the best drugs, the newest devices, the newest technologies. And I treated my disease very, very aggressively because I didn’t want to become a burden. And despite that, I continued to go downhill. And I was taking drugs that when I read the package, insert 2% risk of getting acute leukemia each time I took the drug. So I was all in. I treated my disease very aggressively, but it didn’t help. I even took Tysabri. Did not help. And then what was remarkable, I used my diet, targeted supplements, electrical stimulation of muscles, and I recovered a remarkable level of function. And when I walked into my neurologist’s office, he was very excited and I said, “I really would like to go off my disease modifying drug treatment.” He goes, “Yes, I think that’d be fine. We need to taper you off because you have made this dramatic recovery. The toxicity of the drugs are substantial.” And with his blessing then in the spring of 2008, he weaned me off my disease modifying drugs, and I’ve been off disease modifying drugs since. I continue to get stronger and in fact, I now jog on my treadmill 20 minutes a couple times a week.

Dr. Weitz:            That’s awesome.

Dr. Wahls:           It’s been a journey. Absolutely. A big journey.

Dr. Weitz:            So why is the mitochondria so important for understanding autoimmune diseases like MS?

Dr. Wahls:           Well, most of my colleagues really focus on the immune function and the relapses and the exacerbations, but you have a relapse and you recover function. Most of it. That slow, relentless loss of brain volume, loss of spinal cord volume is what drives neurodegeneration. My interpretation of the basic science literature is that the driver of that disability is probably mitochondria. The mitochondria are not generating enough ATP for the robust energy needs of the axons, of the myelin of the neurons. And that’s driving cognitive decline for dementia, for Alzheimer’s, in Parkinson’s. And when I was reading the basic science early in my MS journey, I had very few relapses. It really had a degenerative process, and so I was like mitochondria are key. And I did figure out early on with my mitochondrial supplements that I felt a little bit better taking my supplements. When I didn’t take my supplements, I really couldn’t get out of bed and go to work. So they weren’t getting me out of my wheelchair, but clearly they were doing a lot for me. And then it is pretty interesting when I redesigned my food around my supplements, that is when the magic happened.

Dr. Weitz:            And do you think that’s because you got additional phytonutrients that maybe we haven’t even figured out what the benefits are that are present in the fruits and vegetables that-

Dr. Wahls:           Absolutely.

Dr. Weitz:            Aren’t necessarily present in the capsules?

Dr. Wahls:           I think if you focus just on what’s in the capsules … And it’s a great way to do animal model studies. It’s a great way to do basic science and to move our understanding forward. So they’re very helpful. But food is very, very complex. We have easily 80,000 food molecules that are really important to our health, probably many more than that. And so all of those molecules have a role to play in my chemistry, in your chemistry. And so I think it’s very hard to create a molecule by molecule nutrient program that’s good for us. But our ancestors over the 200,000 years that we’ve been homo sapiens and over the 150,000 years that we’ve been out of Africa, humans have been eating a wide variety of food stuffs as we go into all these different ecological spaces. So anyone says there’s only one food that is correct or one nutrient that is correct is wrong. Our evolutionary history would say there are a lot of foods that work, there are a lot of different foods that work, and so there’s only one food that we know is really terrible for us and that’s the standard Westernized diet.

Dr. Weitz:            Correct. And then we are certainly not going on the right path when it comes to pharmaceuticals for treating these neurodegenerative diseases. I’m sure you’ve probably seen the recent research that came out, I think last week, that the leading drugs that shrink the amyloid plaque for Alzheimer’s actually lead to a shrinkage of the brain. So not only are-

Dr. Wahls:           I saw that.

Dr. Weitz:            They not making people better, they’re making them worse.

Dr. Wahls:           Correct. An amyloid is sort of like the sticky fly paper. So I think there’s some protection for amyloid and I’m not sure that we’re going to find these dementia treating drugs in the end to be very useful.

Dr. Weitz:            It may be, and Dr. Bredesen has mentioned, is that maybe if we do all the functional medicine stuff first, if you eliminate the reasons why the brain is laying down the amyloid plaque and you get rid of the inflammation, the toxins, you balance the nutrients, you do all the other things to improve the health of the brain, maybe at that point if you were to remove the amyloid, it might be beneficial, but not until you’ve done all that.

Dr. Wahls:           Correct. And we don’t know. We don’t know. And I have variations of this debate for MS. We have 20 different drugs that are really great and they have to be great at reducing the number of enhancing lesions, therefore also they often reduce the number of relapses and that’s how you get FDA approval. So they’re very good at that, but they’re not at all good at slowing the rate of brain volume loss. They aren’t really good at reducing anxiety, depression or fatigue. And I think that yes, we absolutely want people to stop having the enhancing lesions, the relapses, I agree, but you have to do all of the diet and lifestyle stuff so you can address brain volume loss, address anxiety, address depression, address fatigue. And that’s what our programs have been very good at.

Dr. Weitz:            So what do you think are some of the most important nutrients, vitamins, minerals, phytonutrients for brain and nervous system health?

Dr. Wahls:           I think the research is really excellent. When we do network meta-analysis in terms of combining multiple studies, we see consistently that low vitamin D is associated with more relapses, more disability, worse quality of life. So making sure your vitamin D is certainly above 40, and in my clinical practice, I want to see that in the top half of the reference range.

Dr. Weitz:            So you’re talking about 50 to 100? Is there an ideal target?

Dr. Wahls:           50 to a 100 and 60 to 80 would be my ideal.

Dr. Weitz:            60 to 80. Okay.

Dr. Wahls:           But 50 to 100 I think is certainly acceptable. Below 30, that’s definitely a big problem. And below 20, that’s a severe problem. Then the next nutrient that I’m thinking a lot about is the omega-3 fatty acids. Again, low omega-3 fatty acids are associated with more relapses, more disease progression. And people want a badmouth arachidonic acid and omega-6 fatty acids. However, if your arachidonic acid and omega-6 acids are low, that’s a problem too because we also have a lot of arachidonic acid and omega-6 fatty acids in our brain as well. They are also important in myelin formation. So you need both omega-3 and omega-6, but you want them in about the same ratio, or I should say a ratio of four to one. Four omega-6 to one omega-3. Three to one is okay, two to one is getting a little bit low. But many of us, because we have so much fast food that is deep fried-

Dr. Weitz:            We’re at 20 to one or 30 to one.

Dr. Wahls:           20 to one, 30 to one, 40 to one, 45 to one. That is definitely very inflammatory.

Dr. Weitz:            Do you like to see a higher DHA omega-3 for neurological?

Dr. Wahls:           Yeah, I’d rather see a little higher DHA. Although interestingly, some of my psychiatrists would rather see more EPA. So it may depend on what conditions you’re trying to treat.

Dr. Weitz:            Okay.

Dr. Wahls:           Then I’m thinking about homocysteine levels and I’d like to see that homocysteine between four and 7.5.

Dr. Weitz:            Wow, that’s really low.

Dr. Wahls:           Yeah. I’d rather have it in that range. Now, some people may go up to nine, may go up to 10. Ten’s, I think, high. Certainly above 10, you’re going to have higher rates of neurodegeneration, higher rates of heart disease. And I want to have plenty of carotenoids, total carotenoids. Zeaxanthin, meso-zeaxanthin, lutein. These are the greens in green leafy vegetables. And we know in my retina, those are the compounds that protect me from the ultraviolet light that is coming into my eyes when I’m out in daylight. And it turns out that those same compounds are really good at protecting me from cognitive decline. So green leafy vegetables, really good. Then there’s all these compounds in culinary mushrooms and those are the mushrooms we can eat without being poisoned by eating poisonous mushrooms. So those things we’re beginning to understand a little bit more what are some of these molecules. From a epidemiologic basis, we know the more mushrooms you eat, the lower the rates of anxiety, depression, cognitive decline.

Dr. Weitz:            I picked up some lion’s mane mushroom just today at the co-op to add to my eggs tomorrow.

Dr. Wahls:           Oh my God, they are so tasty. And then having more greens, having more beets. We’re beginning to realize that that stimulates my nitric oxide, which is really great for blood vessel health. We’ve known that is really good for blood vessel health, cardiac health. Now we’re beginning to realize that nitric oxide is very important for neurologic health as well. So I think that’s another reason why greens and beets are so good for us. Fermented vegetables. Kimchi, sauerkraut. We’ve known for some time that if you eat more fermented vegetables, you have less influenza, you have less pneumonia, you have fewer colds, and you’re less likely to be hospitalized during this coronavirus pandemic. So I like to have people eat fermented vegetables, and I also encourage fermented keifers and yogurts, preferably nut milk and coconut milk keifers and yogurts.

Dr. Weitz:            Okay. So you like the paleo diet for neurodegenerative diseases. Why the paleo diet? Some would say why not the vegan diet?

Dr. Wahls:           Oh, yeah. There are many diets out there, vegan, vegetarian, keto, paleo, fasting mimicking diet, fasting strategies, and there are a variety of clinical trials testing all of these diets in a wide variety of clinical studies. I think a very consistent finding is that when you put people on a intervention diet compared to the usual diet, the dietary intervention always improves. I think some of the reasons for that is when you have less sugar, less added processed foods, the quality of the diet improves. Historically, I have my own personal health transformation using the paleo diet. I’d been a vegetarian 20 years. I followed a low fat diet for that, and so this would’ve been considered a really phenomenally great diet. For me, it obviously was not good for me. I had a remarkable transformation. It’s the diet I’ve used in my clinical trials and we’ve had remarkable success.

                                From an evolutionary standpoint what the paleo diet does is it says, given your locale where you are in the world, we want you to try and emulate what our ancestors would’ve been eating in your region. So eat meat. Poultry, fish, nuts, seeds, greens, tubers, berries and fruit that’s in your area. Don’t eat sugar, grains, legumes, and dairy because those foods were foods that humans added eight to 10,000 years ago. And from our evolutionary history when we separated from primates six million years ago, when we became a distinct species 250,000 years ago, and when we got out of Africa about 150,000 years ago, those were the kinds of foods that we ate. We didn’t start adding grain, legumes or dairy until recently. Now, I think there are many, many versions of the paleo diet that you can find in Europe, Scandinavia, in Asia, in Africa, in the US, that will all be a little bit different because hopefully we’re all adapting that to our local region.

Dr. Weitz:            Yeah. I guess one of the typical arguments I hear against the paleo diet is even though that’s the way humans ate for hundreds of thousands or millions of years, that doesn’t necessarily mean it’s the best diet for long-term health.

Dr. Wahls:           Well, that’s true, and we have no idea what is the best diet, and nor do we have any idea what’s the best diet for Ben Weitz or for Terry Wahls. What I counsel everyone to do is pick a diet that speaks to your heart, paleo diet, vegan diet, vegetarian diet, a ketogenic diet, and try it out and see how you feel. If you feel like your health is improving, that’s fine. Stay with it. If your health is not improving, then I invite you to give it at least three months, but do it really well. Then talk to your physician, talk to your family, and decide, okay, I tried the paleo diet, it’s not really working for me. I want to try a ketogenic diet, or I want to try a Mediterranean diet. Then go ahead and try that.  There will not be one diet that is great for everyone. In my clinical practice sometimes I will recommend a paleo diet. Their cholesterol is going up too high. We make modifications to make it a lower fat diet, and I may make further changes. So I may even put them on a Mediterranean diet in response to what I see happening to their lab values if I’m not pleased. Or I may put them on a ketogenic diet because I’m worried about them developing insulin resistance. You want to have a starting point, assess their response, follow the labs, and make adjustments.

Dr. Weitz:            I know how important insulin resistance is for working with patients with Alzheimer’s and Parkinson’s. How about for MS?

Dr. Wahls:           It’s very important. People with MS and other neuroimmune conditions, we have higher rates of insulin resistance than the general public at the same weight. And so is that part of the same disease processes?  Likely yes.  And so I want all of my MS patients to have a blood sugar and an insulin level, so I can see are they developing insulin resistance?  If they are, I put them on a lower carb diet and we continue to monitor things. And I may in fact put them on a ketogenic diet. I may put them on a program of intermittent fasting. I may even use Prolon kits, one kit every month to try and improve their insulin sensitivity.

Dr. Weitz:            How important is it to have high quality sources of protein like animal protein and organ meats for maintaining and regenerating neurological tissue?

Dr. Wahls:           Well, let me come back a couple things. My muscles are really a vital endocrine organ for maintaining good blood sugar and good blood lipids. And so it’s really important to maintain muscle mass. So please do strength training even if you have MS or a neuroimmune condition to maintain those muscles. And the more strength training you do and the more male you are, the more protein you’re going to need in your diet than a female who’s not strength training or a petite individual. As you get older, and you see I have some gray hair, I’m now over 65, my protein requirement has gone up, and so I’m eating more meat and more fish, because I really want to hang on to my muscles. I’m spending more time strength training. I mentioned earlier that I’m jogging just twice a week because I’m strength training more because I so value those muscles.

Dr. Weitz:            That’s great. And how about organ meat?

Dr. Wahls:           Organ meat. Our ancestors valued organ meat as the highest, much more valuable than the steaks and the muscle meat. Brains were the most valuable, then bone marrow, then heart, liver, testicles, kidneys, lungs, and then muscles. So if there was a lot of meat around, a lot of carcasses, they would take the organs and leave the muscle meat behind. And they’d take the long bones. So traditionally, about a third of the animal carcass is what we’d consider organ meat. And when we do an analysis of the nutrients of the B vitamins, the minerals, its highest in the heart, liver and organ meat, higher than in the muscle meat. Having said that, as much as I love liver, I think it’s a delicious meat, I still want you to have only, me, about six ounces of liver a week. You can have about eight ounces a week.  A petite person would be maybe four ounces a week. Because it has so much vitamin A in it. Super good for you. Heart, tongue, also super good for you and super, super delicious. Brains used to be a delicacy that was tremendously valued. I have my great-grandmother’s Compendium of Cookery and Modern Book of Knowledge from 1889, and she’s got recipes in there for brains and eggs that look like that would’ve been really quite delicious. But I can’t tolerate eggs because it triggers my face pain. And of course, no one’s going to feel comfortable eating brains anymore because of some of the prion diseases in brains.

Dr. Weitz:            Jakob Creutzfeldt’s disease. Mad Cow disease. So a liver contains a lot of toxins, and we know toxins can play a role in neurological and autoimmune diseases. Dr. Perlmutter had a dentist on, and he was mentioning how fluoride can actually play a role in demyelinating neurons, and demyelinating nerves. And-

Dr. Wahls:           Yeah, fluoride is not good.

Dr. Weitz:            So I’m sure there’s got to be a lot of toxins in everyday life that are playing a role.

Dr. Wahls:           There are 80,000 plus synthetic chemicals that are in our environment, and it would be very difficult for any of us to not have an abundant number of toxins, heavy metals, solvents, plastics, the forever chemicals stored in our fat. And I want to correct something. Your liver processes through phase one, phase two reactions, the synthetic chemicals that we have, and then excretes it into the bile. It goes into the gallbladder. And then as we eat fat, the gallbladder releases bile into the small intestine. We absorb, digest the fat and recycle the bile. So eating liver isn’t going to give you a higher toxin load. Eating your bacon, however, might because the fat is in the bacon and if you fry things in lard and duck fat, the toxins are really in the fat much more so than in the liver.

Dr. Weitz:            I see. So good to eat liver from a healthy animal, not-

Dr. Wahls:           From a healthy animal.

Dr. Weitz:            Maybe to eat a liver from a standard American diet eating person with fatty liver.

Dr. Wahls:           Correct. So I certainly want you to have liver from an organic animal. I don’t think you have to be afraid of liver. Six to eight ounces is okay. The fatty cuts of meat, the bacon, it’s the fat that has the toxins. So you have to be worried about the fat.

Dr. Weitz:            Right. Do you screen patients for toxins?

Dr. Wahls:           Well, I assume everyone is toxic. So in my VA clinics, we assumed everybody was toxic. I put them all on a protocol to reduce their toxin exposure and to make it easier to excrete their toxins. In my clinics, again, I assume everyone is toxic and we do the same. Now, depending on their clinical circumstances, I may screen them for mold toxins, for-

Dr. Weitz:            Heavy metals.

Dr. Wahls:           Heavy metals. And we may have a more specific program for them.

Dr. Weitz:            What about incorporating glutathione to help with detoxification?

Dr. Wahls:           Well, certainly you would like to make sure they have plenty of sulfur containing amino acids, such as NAC, N acetyl-cysteine, lipoic acid. You may give them some glutathione. You could also stimulate the production of glutathione by eating these radical things known as the greens, the cabbage family vegetables, the onion family vegetables, because those foods will up-regulate my glutathione synthetase.

Dr. Weitz:            Now your recommendations for diet, I believe include nine cups of vegetables a day.

Dr. Wahls:           Nine cups of vegetables a day. So it’s three cups of greens, three cups of sulfur containing vegetables in the cabbage, onion, mushroom family, three cups of deeply pigmented carrots, beets, berries, peppers, tomatoes. And the way you can think about that is if you take your dinner plate and you cover it so you can’t see the bottom, that’s three cups of vegetables.

Dr. Weitz:            Okay. And that’s for the average weight person?

Dr. Wahls:           And you might think about that. That’s for men, tall women. I’m six foot tall. If you’re a petite woman or a petite man, then maybe six cups would be appropriate. There’s no need to over consume beyond what your appetite will tolerate so I just want to be sure that you’re not hungry. If you’re hungry, eat more protein in those greens, sulfur and colors. And if you’re full, as long as you’ve had your six to 12 ounces of meat and you’ve got proportionately the greens, sulfur and color, then you’re fine.

Dr. Weitz:            Okay. So which forms of exercise are most beneficial? You mentioned strength training and there’s particular recommendations, parameters for strength training?

Dr. Wahls:           So ideally you want to have things be hard. Hard enough so that you can’t do three sets of 12 of that exercise times three. If you could do that, then you could advance the rigor of that exercise. Either more resistant bands, more weights, slower version if it’s a body weight exercise. And you want to do your arms, your core, and your walking muscles. And ideally I rotate so I’m doing arms one day, core one day, legs another day so that I’m getting my whole body trained. I’m also doing balance exercise. Because as we age, our balance declines. And so I don’t want to fall. So I’m doing exercises and I teach people how to maintain balance. And you might start, get my hands out there, so that your feet are wide apart and you gradually get them closer and closer. Then you gradually get so you’re standing on one foot and toes down, then eventually just on one foot.  And when you can do that, then you turn your head side to side. And then when you can do that, then you can close your eyes. In that way you can gradually improve your balance. So routinely when I shower, I’ll do standing on one leg counting to 50, and then I do the other leg counting to 50, and I take turns drip drying so I can maintain my balance. Because falling becomes increasing hazard the older we become. And my goal is to be 120 and thriving so I want to have great balance in my 70s, 80s, 90s, and 100 plus.

Dr. Weitz:            That’s great. Great job of multitasking, getting your shower in, your balance training. Put the cold water on, you can get your cold water immersion at the same time.

Dr. Wahls:           Absolutely.

Dr. Weitz:            So how important is electrical stimulation? It sounds like it was very important for you to help regenerate some of those muscles.

Dr. Wahls:           It was super helpful. Fortunately, I had gone to a physical therapist who had an athletic practice and physical therapists who treat athletes have been using electrical stimulation for decades to help their athletes recover from injury more quickly. And at that time, remember, I could not sit up more than 10 minutes. I could do just a 10 minute very basic mat exercise program. We added electrostimulation to my mat exercise program and gradually increase that and that let me grow muscles more quickly. We now know from animal model studies and human studies that when you add electrostimulation to exercise, you make more nerve growth factors and muscle growth factors locally for your muscles, but you also make more nerve growth factors in your brain and you make more endorphins in your brain. And I could certainly tell very early on that the electro stimulation did great things for my mood and my mental clarity, and it I’m sure accelerated my recovery. It’s not a requirement. It’s simply a way of accelerating the speed of recovery, particularly for people who have severe disability. So people who need a cane, a walker or walking sticks, or in my case, the tilt, recline wheelchair.

Dr. Weitz:            Now I’m very familiar with the electrical stimulation. As a sports chiropractor, we use electrical stimulation in the care of the patients. Specifically for neurological diseases like MS, can you talk about particulars? What is the protocol? How many seconds of contraction? How many seconds of rest? How many reps? Do you use contraction by moving the joint at the same time?

Dr. Wahls:           So when you’re using electrical simulation, one of the things that it will do is you’re going to get current going through the pads into the motor nerve, into the muscle driving contraction. And it was used originally for people with spinal cord injury who were never going to walk. And it was a great tool to reduce the harm of inactivity. To improve blood sugar control and blood lipid metabolism. And then we did it on me and my athletic physical therapist said, “Terry, we don’t know if your brain’s going to be able to talk to this muscle so you have really got to build this connection. When that current is going, you contract your muscle as hard as you can. It’s going to be 10 seconds on, 20 seconds off. You got a two second ramp up and ramp down and dial it up to as much pain as you can tolerate.” I’m a former athlete. By God, I was going to leave nothing on the table, so I would dial it up. I would be in a sweat from the intensity of the current.

                                And I was doing all this, Ben, not to get better because I knew I couldn’t get better. I knew I had progressive MS, that functions once lost were never coming back. I was doing all this to slow my decline. But I was getting stronger. And they said, “Okay, 10 minutes, twice a day. 15 minutes, twice a day, 20 minutes twice a day, 30 minutes twice a day.” And then he goes, “Well, Terry, it’s 45 minutes a day to build stronger muscle. You’ve got a lot of weak muscles. How much time you have in the day, go ahead and stimulate.”

Dr. Weitz:            So 10 seconds contraction, 10 seconds rest you said?

Dr. Wahls:           No, 10 contraction, 20-

Dr. Weitz:            20 rest. Okay. And then for what? 10 reps?

Dr. Wahls:           Well, I can’t remember. He gave me a set of exercises to do. It was 10 minutes. And I don’t remember what we started with at that time because I did belly, then I did back and butt. So there was three sets of muscles that I did at first. And so it was probably just 10 reps at first. And then it was 10 reps times two, then 10 reps times three. And then I am like, okay, if I’m going to get my electrodes here and here, so I had a two channel machine, I’m going to do isometrics for 30 minutes. So 10 second isometric on, 20 second off. And so I’d have my machine with me at work and I’d have 10 seconds of … Okay, I can work now for 20 seconds. 10 seconds of …

Dr. Weitz:            Hard to record a podcast like that.

Dr. Wahls:           And so if I was staffing residents, I had to dial the current back so I could have a conversation and no one would know that I was stimming. But if I wasn’t staffing residents, then I could dial it all the way up.

Dr. Weitz:            Cool. Now, I know you’ve tried to get everything you can from food, but do you still employ some nutritional supplements?

Dr. Wahls:           Yeah. Actually I take a bunch of supplements. I feel better when I’m taking my supplements. And then I continue to read the basic science and I tinker. I see a new interesting study and I’m like, okay, what would that do? And plus, it’s interesting, I probably go through about 200 different papers every week, maybe 250 to scan, see what looks interesting to try out.

Dr. Weitz:            So what nutritional supplements are you taking right now?

Dr. Wahls:           Well, I’m certainly taking vitamin D, fish oil.

Dr. Weitz:            You take D with K?

Dr. Wahls:           Yeah. I always take D plus K. I’m taking a variety of mushroom supplements. I’ve recently added urolithin A. That’s been very interesting. And then I-

Dr. Weitz:            Are you doing NR or NMN?

Dr. Wahls:           I am not.

Dr. Weitz:            You chose not to or?

Dr. Wahls:           It’s not hit the top of my list yet of things to try.

Dr. Weitz:            Okay. Okay.

Dr. Wahls:           I’m taking bergamot. I like that a lot. I like lipoic acid.

Dr. Weitz:            NAC?

Dr. Wahls:           Oh, we take lots of NAC.

Dr. Weitz:            Tocotrienols?

Dr. Wahls:           I have in the past. I’m not currently.

Dr. Weitz:            Okay. Other antioxidants, polyphenols?

Dr. Wahls:           Well, I certainly am taking beet root. I’m taking a variety of mushroom products. I am taking curcumin and I take a-

Dr. Weitz:            What’s your favorite form of curcumin? Because that constantly changes. Which one is best or the latest?

Dr. Wahls:           Well, what I do is I’ll make a phosphatidylcholine, plasmalogen, and a omega-3, omega-6 fatty acid smoothie. Then I’m adding curcumin in a cocktail of my favorite spices and I just rotate through which spices I’m adding. I’ll add beet root and some inulin, curcumin, ginger, and I’ll make that into a smoothie. Then I’ll add chia seed, and I will have that in a quart jar. And I will have that once a day. And I eat every other day. I’ll have my PC smoothie blend every day. And I’m not calculating how many calories are in that. And then-

Dr. Weitz:            What’s the PC smoothie?

Dr. Wahls:           Oh, that’s the phosphatidylcholine, plasmalogen, essential fatty acids. The various spice blend, curcumin, ginger. I’ll put together.

Dr. Weitz:            Can you tell us about some of the ongoing research you’re doing about MS?

Dr. Wahls:           Okay. We’ve done seven clinical trials and so far they’ve all consistently show that people can implement the diet and the study protocols that we use. That if you’re overweight, you lose weight generally without being hungry, getting back to a healthy weight. Fatigue is reduced. Quality of life is improved in 75 to 80% of the individuals. Now think about that. That is really remarkably effective. Even the very best drugs for everything, including infections, generally don’t have 70 to 80% rates of helping people. We have a new study that I’m super excited about. The efficacy of diet on quality of life. We’ll be comparing a ketogenic diet, a paleo diet to usual diet. And we’ll look at changes in fatigue, quality of life. And those are our primary outcomes. But we’re also looking at changes in walking function, hand function, vision function, and how well we think. And what I think will be the most interesting part of this study, Ben, is we’re looking at brain volume over time. Because people with MS, our brains as a group are shrinking three times as fast as what happens in healthy aging. So it’s about 1% per year, which is why we have much higher rates of anxiety, depression, cognitive decline, early frailty, early need to quit our jobs, go to assisted living and nursing home care. Even as very young people.

                                And because clinically we’re so effective at reducing brain fog, reducing anxiety, depression, I’m very optimistic that we’ll be able to get a significant number of our folks back into the healthy rates of brain aging. And although it’s not the primary outcome, so it’ll be one of those other manuscripts that we add, but I predict it’ll be groundbreaking. It’ll be very, very exciting. Because while disease-modifying drug therapies have to show that they can reduce the number of new enhancing lesions compared to control, and therefore they often reduce relapses compared to control. And so they’re very good at inflammation, but they don’t address neurodegeneration. They don’t address mitochondria. And therefore they don’t have much impact on anxiety, depression, cognitive decline, or brain fog.

                                So I don’t know what we’ll find, but I am super excited. People need to come to Iowa at month zero, month three, and month 24. We have 83 people that we’ve consented and are in the process. That means I have room for 72 more. And I expect that we’ll finish that recruitment in the next 12 months. And so really it’s three more years of steady activities to get all this stuff going. And so it’s ’23, that means in 2026, we’ll be wrapping things up at the end of the year. In 2027, we’ll be analyzing the data and presenting it at the MS Scientific meetings. And then the papers will start coming out. Now, in the meantime, my team has published about 70 abstracts, posters. We have 45 peer reviewed scientific papers of which 26 are related to the multiple sclerosis research.

                                And I’m really a unique, Ben, because I do the research to change the standard of care, but I know what it’s like to be facing terrible prognosis, terrible disability, and I am committed to at the same time that I’m doing the research to change the standard of care, to teach other clinicians how to think the way I think, and to teach other patients like me that there’s a whole lot you can do that can change your disease course. And yes, talk to your physician about how disease-modifying drugs fit into your care plan. But whatever you decide, we should all be working to improve our diet, asking for physical therapy, asking for stress reducing practice, making sure we’re sleeping well and being connected with our friends and family.

Dr. Weitz:            And what’s even more remarkable is that the disease modifying drugs that are available don’t reverse the condition, don’t actually make people better. At best, people get worse at a slower rate.

Dr. Wahls:           Exactly. At best, all they need to show is they have fewer lesions in the MRI. They don’t really have to show any change on anxiety, depression, mood, clinical function. And it’s wonderful that they’ve done this. They’ve taken the time from diagnosis to wheelchair and have moved it out five years. And for everyone with MS, those five years … It’s great to get five more years away from the wheelchair. But wouldn’t it be even better to never have to need the wheelchair? Wouldn’t it be even better to have no anxiety, no depression, no cognitive decline? I can now jog on my treadmill.

Dr. Weitz:            Right. That’s one of the amazing things is none of these disease modifying drugs can actually give you any hope of going from a wheelchair to not being in a wheelchair and yet the functional medicine approach that you’re pioneering has that potential.

Dr. Wahls:           And so we see people. I think it’s really important to stop the decline, use the functional medicine approach to stop the decline, and then find a practitioner who has a very close relationship with a rehab center, rehab minded physical therapist who will work on that rehab potential. I have close relationships with folks who are big champions of electrical stimulation of muscles. They treat our patients like athletes, recovering athletes. We work hard, we have big goals, and we realize this is going to be a several year process for those people who are like me, profoundly disabled and wheelchair dependent. But we have other wonderful stories. It’s not just me getting out of the wheelchair. But the people who are most successful are the former athletes and the people who are willing to say, “I’ll treat this athletic training. That I realize this is a long row that I’m going to be hoeing and I’ll be doing it the rest of my life. And I am down for that journey.”

Dr. Weitz:            That’s awesome. And so how do they contact you to find out about the getting involved with the study?

Dr. Wahls:           The simplest way to do this is go to terrywahls, that’s T-E-R-R-Y, Wahls, W-A-H-L-S.com/msstudy. There’ll be more information about the study, a short little video. There’ll be a yellow box. Click there to take the survey. You’ll put in your contact information, answer a few questions, and then we will begin the process of confirming your diagnosis, putting you in our patient registry. Because we’ll have more studies that we want everyone to hear about. And then for those who are eligible for the study, we will contact you and begin the process of confirming the diagnosis, telling you in more detail what’s involved in the study in getting you enrolled. So 72 folks. We’d love to help get you in the study and help transform your life.

Dr. Weitz:            And I understand that all your studies are privately funded. You’ve yet to have the National Institute of Health provide funding.

Dr. Wahls:           Correct. We’ve been funded by individuals, by family foundations, the MS Society, which is a nonprofit. They have funded us. And so we’re very grateful for them. A grateful patient whose life we transformed is funding the really big study, the Carter Chapman Shreve Family Foundation. And my university, which at first thought I was a bit eccentric, a bit odd, now they’re like, “Dr. Wahls is a rockstar.” Because I’m getting funded through the grateful patients at a level that is really quite extraordinary.

Dr. Weitz:            That’s awesome. Thank you for the work you’re doing, Dr. Wahls.

Dr. Wahls:           Well, I am so grateful. In 2007, I had such a terrible future. Bedridden, demented, in continuous electrical pain. That was the future that I thought I was facing. Now I’m pain free. I consider my trigeminal neuralgia a gift because I know if my brain’s inflamed moment to moment. I don’t have fatigue, I don’t have mental clarity. I’m traveling the world. And I just am so grateful that I have this amazing future.

Dr. Weitz:            That’s awesome. And others can potentially have that future too, if they make the right diet, lifestyle changes as well as doing the standard of care.

Dr. Wahls:           Correct. Correct. So we’re not anti-drug. That’s a great conversation to have with your treating specialist. We just want to be sure that you have support to do all that you can of the things that we control. Our actions, our diet, our self-care routine.

Dr. Weitz:            Do you have training programs available for practitioners who want to-

Dr. Wahls:           Yeah, we certainly do. We train physicians, chiropractors, physical therapists, registered dieticians, health coaches. Anyone with a health related license or certificate. The training is online. We also have sessions via Zoom. Once you’re trained, it’s about 20 hours worth of training, there’s a test that you’ll have to pass. And then we have monthly calls with me discussing cases. Sometimes I bring in a guest lecturer as well. And we have people, I believe, in 24 different countries around the world. And because we do this online, my mission, we want to train as many clinicians as I can so we can make this way of taking care of people more readily available around the world.

Dr. Weitz:            And do we go to terrywahls.com to find that practitioner training?

Dr. Wahls:           To find that you go to terrywahls.com/certification.

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

Dr. Wahls:           And thank you for all that you are doing.

Dr. Weitz:            Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review. That way more people will discover the Rational Wellness Podcast.  And I wanted to let everybody know that I do have some openings for new patients so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardio metabolic conditions, or for an executive health screen and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way. And that usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective. So if you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111, and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.



Adrenal Transformation Protocol with Dr. Izabella Wentz: Rational Wellness Podcast 307

Dr. Izabella Wentz discusses her Adrenal Transformation Protocol 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

0:37  Adrenal fatigue as a concept was first proposed by Dr. James Wilson in 1998 in his book of the same name.  This concept was dismissed by the medical world but embraced by the Functional Medicine community, but now it has been discredited and seen as invalid even in the Functional Medicine world since the adrenals never lose the ability to secrete cortisol.  On the other hand, there are many patients with symptoms like fatigue, brain fog, intolerance to exercise, feeling overwhelmed, etc. and salivary cortisol testing often shows reduced cortisol levels or cortisol not being released at the proper time, which we will call adrenal dysfunction

3:15  Dr. Wentz suffered with Hashimoto’s thyroiditis and she got off gluten and dairy and started taking thyroid medications T4 and T3.  This made her feel better, but she still struggled with brain fog, fatigue and anxiety, and unrefreshing sleep even though I was sleeping a lot after having made these changes.  She had heard about adrenal fatigue and had heard that it didn’t exist as a condition.  Eventually she tried the recommendations for adrenal fatigue and they helped her to feel better.  Her brain fog and fatigue improved and she started to have refreshing sleep. Her anxiety also improved due to balancing her adrenals. Most patients with Hashimoto’s (hypothyroid) have some degree of adrenal dysfunction where they either have too much cortisol, cortisol at the wrong times of day or not enough cortisol.

8:12  The adrenal/thyroid connection.  Patients with hypothyroidism will generally break down their cortisol slower.  Cortisol may supply some of the energy that the body lacks from the lower thyroid hormone levels.  Or patients who get put on thyroid meds may feel better at first but then may crash and this may be because they start clearing their cortisol quicker and now they have too little cortisol.  Dr. Wentz noted that about 60% of those tested for adrenals with Hashimoto’s have a low cortisol level all day long.  You should also measure reverse T3, since higher levels of stress and cortisol can lead to T4 being converted into reverse T3 instead of into T3.  Some of these patients will do better with a natural desiccated thyroid that contains some T3 as well as T4.   

18:18  Recommendations for adrenal dysfunction.  Patients should follow a paleo-like diet by getting rid of the most common inflammatory foods, including gluten, dairy, soy, as well as grains.  This diet should be higher in protein and fat and perhaps a few more carbs at night to help lower cortisol to help with sleep.

19:25 Nutritional Supplements.  Dr. Wentz offers a minimalist approach to help patients with adrenal problems turn their health around in a short period of time.  To help with digestion, she sometimes recommends sea salt to stimulate digestive enzyme production or thiamine to stimulate digestion and hydrochloric acid production.  Dr. Wentz does recommend adrenal adaptogens, magnesium citrate, saccharomyces boulardii, and myo-inositol. As far as adrenal adaptogenic herbs, the ones she likes the most are Ashwaganda and Rhodiola. Ashwaganda can also help normalize thyroid hormone.  Maca and Shatavari are two herbs that can help with libido. She also recommends B complex and vitamin C.  Dr. Wentz also recommends magnesium citrate, which can help with anxiety, with sleep, for pain, and for constipation.  Magnesium can also help us to produce GABA.  Dr. Wentz also recommends saccharomyces boulardii as a probiotic to improve gut health and improve our natural defenses and help to clear out candida, protozoans, and some pathogenic bacteria.  Myo-inositol is another important supplement that Dr. Wentz recommends for adrenal issues at a dosage of 600 mg. and it can also help with thyroid, blood sugar, anxiety, and obsessive compulsive disorder.  The final supplement that Dr. Wentz recommends for patients with adrenal problems is L-carnitine at a dosage of 2000 mg per day and this helps to relieve brain fog. It can also help to remove ammonia from the body.  



Dr. Izabella Wentz has a Doctor’s of Pharmacy degree and she is an internationally acclaimed thyroid specialist.  She has dedicated her career to addressing the root causes of autoimmune thyroid disease after being diagnosed with Hashimoto’s thyroiditis in 2009. She is the author of three books on Hashimoto’s: Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause, Hashimoto’s Food Pharmacology, and Hashimoto’s Protocol, which became a #1 New York Times bestseller. Today we’ll be discussing her new book, ADRENAL TRANSFORMATION PROTOCOL.  Her website is Thyroidpharmacist.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 website, drweitz.com. Thanks for joining me and let’s jump into the podcast. Welcome to our podcast interview today with Dr. Izabella Wentz, where we’ll be discussing her new book on adrenal dysfunction.

                                This is a topic that has been much debated within the medical community for some time. The idea of adrenal fatigue was first proposed by Dr. James Wilson in his book of the same name in 1998. However, the concept was initially dismissed by traditional medical doctors who said that if you had low functioning adrenals and low cortisol levels, you had Addison’s disease. And if your adrenal glands produced too much cortisol, then you had Cushing’s syndrome, and there was nothing in between.  This concept of slightly underperforming adrenal glands, which Wilson discussed, was taken up by functional medicine practitioners. And then in recent years, the idea of adrenal fatigue has been widely discredited as an invalid concept since the exception of Addison’s disease, which is rare. The adrenal glands never truly lose the ability to secrete cortisol.  Despite this, many patients continue to experience fatigue, brain fog, intolerance to exercise, feeling overwhelmed, and other symptoms, ensure reduce cortisol levels or cortisol not being released at the proper time on saliva testing. That is typically performed a number of times a day.  Today, we’ll be diving into this topic with Dr. Wentz and exploring the nuances of what we call adrenal dysfunction and its impact on our health.

                                Dr. Izabella Wentz has a doctor’s pharmacy degree, and she’s an internationally acclaimed thyroid specialist. She has dedicated her career to addressing the root causes of autoimmune thyroid disease after being diagnosed with Hashimoto’s thyroiditis in 2009.  She’s the author of three books on Hashimoto’s, Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause, which by the way is the most incredible book on thyroid and I’ve got it underlined and highlighted, and I’ve referred to that book so many times. Hashimoto’s Food Pharmacology and Hashimoto’s Protocol, which became a number one New York Times Bestseller. Today, we’ll be discussing her new book, Adrenal Transformation Protocol. Dr. Wentz, thank you so much for joining us.

Dr. Wentz:          Thank you so much for having me, Dr. Ben. It’s a pleasure to be here with you.

Dr. Weitz:            Great. So since so much of your professional focus was on thyroid, why did you decide to focus on the adrenals in this new book in your new program?

Dr. Wentz:          I felt called to really focus on adrenal health because healing my adrenals was part of my thyroid journey. I initially got on thyroid meds, which were helpful, so we want to make sure we’re optimized on T4, T3. That’s a big game changer for people. I got off of gluten and dairy, which was life-changing for me as well, and I recommend that for others with Hashimoto’s and hypothyroidism. Sometimes the condition can go completely into remission when we just do these things, but I still struggled with brain fog, fatigue and anxiety, and unrefreshing sleep even though I was sleeping a lot after having made these changes, right?

Dr. Weitz:            Right.

Dr. Wentz:          So I kept hearing the term adrenal fatigue, adrenal fatigue, and being like a skeptical pharmacist, I looked up the term and then I saw that it didn’t exist. It doesn’t exist, and I was like, “Okay, so I don’t have this.” I went about, tried other things, and finally it was like the 15th person that mentioned adrenal fatigue to me and I was like, “Okay, I will give this a try.” And sure enough, I tried the interventions for it and they helped. So I had this thing that didn’t exist and nothing was going to help, even if it did exist. And then the things that these crazy people were recommending. And then I felt so much better.   So the brain fog improved. The fatigue was so much better. I could wake up in the morning and be full of energy, and I also had refreshing sleep, and I didn’t need to sleep so much. My anxiety was gone. Haven’t had a panic attack in 10 years, and they used to be a very frequent, unwanted part of my life prior to balancing my adrenals. And it’s like, “I can’t believe it’s been 25 years since Dr. James Wilson was talking about this condition.” And people are still saying, “It doesn’t exist. It doesn’t exist.”

                                I’m like, “Can we please just stop gaslighting the people that are going through these very real symptoms and help them get the help that they need?” In my experience, just about everybody that I’ve worked with, with Hashimoto’s has some degree of adrenal dysfunction where they might have too much cortisol, cortisol at the wrong times of day or not enough cortisol produced. And there’s a way to get into balance from that.  It’s not Addison’s disease. It’s not Cushings. It’s not a disease per se. This is a very predictable way that the body responds to stress. And not just people with thyroid issues, but other people who are struggling with all these symptoms. They’re presenting with this as well, and they’re walking around without a diagnosis. They think they’re crazy or lazy or just really anxious, edgy people.

Dr. Weitz:            It sort of reminds me of the issue with diabetes, where medical doctors, your blood sugar could go from 80 to 90 to a hundred to 110. Everything is fine. Everything is fine. All of a sudden it hits 125, now you got diabetes. Maybe it was a gradual process where you weren’t handling glucose quite as well as you should have. And if you had recognized it earlier, you could have helped some of these people not end up with frank diabetes.

Dr. Wentz:          I mean, yes. And it’s like the same with the thyroid gland. It’s like sometimes the person will have the reference range is 4.5 for TSH, and they’ll have a 4.4. Your thyroid is fine, right?

Dr. Weitz:            Right.

Dr. Wentz:          With really a healthy person should have a TSH somewhere around 0.5 to two if they don’t have a thyroid condition. And with the adrenal glands, it’s the same thing. So you don’t manifest with Addison’s disease until 90% of your adrenal glands have been destroyed. And you can also have other reasons for inadequate cortisol production, and part of it could just be this stress adaptation. So your adrenals may be perfectly healthy. You may not have an autoimmune response against your adrenals, but because your body is overwhelmed by stress, there’s going to be a disconnect between the hypothalamus and the pituitary and the adrenal glands and the hormones they secrete.  It’s like the boy who cried wolf. You go enough times and say, “Okay, we’re stressed, we’re stressed, and more cortisol please, more cortisol, please.” Eventually the body is going to adapt and say, “We just can’t have this much cortisol produced at this high level all day every day. We really need to start shutting down production. And this is what happens with receptors when they get overwhelmed by certain messaging, they become desensitized to the message.

Dr. Weitz:            Absolutely. So let’s talk a little more about the connections between thyroid and adrenals and how adrenals affect thyroid and thyroid affects adrenals.

Dr. Wentz:          It’s definitely a two-way street. So in my experience, people who have hypothyroidism will generally break down their cortisol slower. So they end up with more cortisol in their body and more cortisol metabolites. It’s a protective mechanism. So the body is like, “Oh, you’re not making enough thyroid hormone? Let’s help you out by keeping cortisol around a little bit more.” And then you end up feeling more edgy and wired, but you get your cortisol kick from the adrenals, which isn’t the best type of energy, but it’s energy, right?

Dr. Weitz:            Right.

Dr. Wentz:          And end up getting a diagnosis of maybe hypothyroidism. You get put on thyroid meds, which can be incredibly helpful if you’re hypothyroid, but they can also uncover a low cortisol issue that maybe you didn’t know when your body was compensating because then your cortisol clearance normalizes. So that means it increases if you had been hypothyroid.  And then a person will say, “I felt better at first with the thyroid meds, but then all of a sudden I crashed.” And I’m like, brain fog fatigue, all of that got worse. What is happening? And many times it’s like this uncovered low cortisol state. About 60% of the people that I’ve tested with Hashimoto’s that were symptomatic were actually in the low cortisol state where they had low cortisol all day long, and most of them were on thyroid meds.  In this situation, it’s not more thyroid to overcome the fatigue, it’s less support to your adrenals to get back into balance. Now, the other part of the pathway, and I always ask people, what was going on in your life before you got sick? And usually they’ll say, “I was on a period of a lot of stress.” Stress can make us produce a type of thyroid hormone we don’t want. It’s known as reverse T3. Again, this is the body’s feedback loop where. The body is like, “There’s too much of this. We need to slow down this.”

                                Reverse T3 is the inactive thyroid hormone where that will sit inside of our thyroid receptors and block them instead of activating them. And then this usually goes along with low levels of active T3. And so people will say, “I take thyroid medications that are supposed to be converted to T3. The active hormone, levothyroxine is T4 and the less active thyroid hormone that normally should get converted into T3 in the body, but it doesn’t for a variety of reasons.   So people will say, “I’m taking this medication, but it’s just not working.” And sometimes they do better on a natural desiccated thyroid that contains some of the three directly, and that’s because of that stress and cortisol component that drives up the reverse T3 production. This can even happen in people without a thyroid issue. So you can have a perfectly healthy thyroid without the immune system messing with it, but you just have all this cortisol and stress on board, and you’re going to end up with hypothyroid symptoms because of that reverse T3 blocking your thyroid receptors.

                                This has been a subset of my clients as well as as some friends reaching out to me that said, “Izabella, I have all these symptoms. I know you help people with Hashimoto’s that have these symptoms. I don’t have Hashimoto’s. Right?” But they can definitely have these symptoms and this is where something like a reverse T3 test or testing free T3 would be-

Dr. Weitz:            And most of them probably haven’t had a reverse T3 test because that’s not a test that’s typically done.

Dr. Wentz:          It’s not typically done. And if a person comes to me with Hashimoto’s, I’m not necessarily going to do it because I’m like, “I already know you have a thyroid problem and I already know you have an adrenal problem,” so let’s not-

Dr. Weitz:            Get right to the treatment.

Dr. Wentz:          Yeah. Let’s go right to the treatment options. We don’t need to feed the vampires with all this blood, but with a person who maybe has these symptoms, then I’m really looking at what’s going on in your body. And if they were open to doing testing, I would do something like an adrenal saliva test or maybe a Dutch test and some reverse T3. But also in my book, I just talk about the symptoms people can utilize to assess themselves because the testing is not always accessible. Sometimes the functional test can take weeks to get back. And by that time you could have really worked on your health.

Dr. Weitz:           Typically, a couple of weeks to get test results back for functional medicine testing.

Dr. Wentz:          Right. And the protocol can work in four weeks where within a… I’ve had patients and clients, and I’m sure you’ve had them too, where you give them a test and they’re like, “Yes, I’ll take this test.” And then three months go by and it’s like the test is still sitting at home and it’s collecting dust on a shelf.

Dr. Weitz:           For sure. We make those calls all the time. You got to do the test.

Dr. Wentz:          Yeah, absolutely. So I wanted to give people more of a streamlined approach where they can really get to know their symptoms and learn about what their body is trying to tell them and how to care for themselves to get themselves in the best state. So whether they’re working with a practitioner, hopefully they are, they found somebody really good to work with that can support them. Or even if they’re trying to do things on their own for their own health, a lot of the strategies are safe and effective. We’re not talking about using hormones in my book, we’re really focusing on solid lifestyle things people can do.

Dr. Weitz:           Right. I noticed in your book you talk about the relationship between cholesterol and adrenal function. And right now in health, we seem to be focused on trying to drive cholesterol levels as low as possible to stop heart disease and we’re constantly being told that, “That’s fine. There’s not going to be a problem with the brain function or anything else because all those other tissues make whatever cholesterol they need.”

Dr. Wentz:          So cholesterol is responsible for making our hormones. And from a pharmacist perspective, it is a category X for women who are pregnant because their body is needing to have hormones, and it can be associated with a lot of damaging effects when we suppress what the cholesterol lowering drugs are. So when we suppress cortisol… Sorry, I’ve been talking about cortisol all day. When we suppress cholesterol production too much, we can potentially suppress the production of other hormones.   And it doesn’t happen to everybody, but it can be something to be on the lookout for.  The other thing to consider is cholesterol, high cholesterol actually can be a symptom of hypothyroidism and even low T3. So part of how we make hormones out of cholesterol is utilizing thyroid hormones, specifically T3.  So getting your thyroid hormone in check and your adrenal glands in check can be a way to optimize your cholesterol levels. It’s like your body can drive up… Your body is like, “Okay, we’re under stress. We need to make more cortisol.” So cholesterol sits at the top of the pyramid and it turns into pregnenolone which is our mother hormone that gets turned into progesterone and cortisol and DHEA and our sex hormones and all these beautiful hormones downstream. But if the body’s like, “I need more cortisol because I’m in a lot of stress,” cholesterol can be gone up.  And when we balance that stress response, that need for cortisol, that need for these other hormones, then we can actually help with balancing cholesterol levels as well.

Dr. Weitz:            Cool. You talk a lot about helping your body to feel safe in order to heal and how to send safety signals to your body. What’s the importance of this concept?

Dr. Wentz:          One of the reasons why people get stuck in this adrenal dysfunction is because their body gets the message that we’re under stress or we’re in the presence of a threat right now. We have these beautiful ancient bodies that respond to modern signs of normal life and they’re still interpreted by our caveman, cavewoman genes. So if we’re doing things like over exercising or overworking to a caveman or a cavewoman, they wouldn’t be doing that. Right? So it gets interpreted as in some cases, as stress. And if we get too many of these stress and threat signals, we shift into that survival mode.  We shift into our sympathetic mode where we are in our fight or flight system. We’re in a catabolic state where the body is breaking itself down for fuel rather than being in our parasympathetic state where we are resting, digesting, healing, and thriving. We do need a balance of both. I’m not saying one is good and bad. We do need to spend time in both of these systems, but what can happen when people with adrenal dysfunction, they’re spending more time in that catabolic fight or flight state, rather than having a good balance of breaking your body down and building it back up.

Dr. Weitz:            Right. Because the adrenal gland is our major stress gland, and that’s where adrenaline and cortisol comes into play that are secreted by the adrenals?

Dr. Wentz:          Exactly.

Dr. Weitz:            So let’s talk about the recommendations for how to feel better with adrenal dysfunction. Let’s start with diet. What’s the best nutritional approach?

Dr. Wentz:          I really love focusing on a paleo-like diet. So we’re getting rid of the most common inflammatory foods, gluten, dairy, soy, as well as grains because they can be problematic for blood sugar issues. This is a 30-day plan and generally people can introduce some of the foods if they feel okay with it, such as the grains after a time period. But a lot of people do find that they feel significantly better. We’re generally going to be doing more protein and fat than the average person, a bit lower carb throughout the day, maybe some more carbs at night.   Carbs can lower cortisol, so that can be helpful for people to getting to sleep. And then we’re also utilizing a lot of nutrient dense foods. One of the issues people can have when they’re in that stress response is they can have trouble digesting foods. So I utilize a lot of smoothies in the morning.

Dr. Weitz:            Okay. What about digestive enzymes? I guess that’d be another way to get around that.

Dr. Wentz:          Absolutely. It’s a four-week plan that really focuses on kind of a minimalist approach to get the maximum dose of improvement. And that’s those four short weeks. I use sea salt as a way to stimulate digestive enzyme production. But the back of the book also has advanced strategies such as using digestive enzymes or using thiamine to help drive energy production as well as hydrochloric acid production. It depends on the person. There’s so many options for ways to heal the body, and I didn’t want to give people sure too many choices at first, because I know one of the main symptoms of adrenal dysfunction is overwhelm. So I wanted to create a very straightforward and easy to do plan.

Dr. Weitz:            Sure.

Dr. Wentz:          And the whole second part of the book-

Dr. Weitz:            You don’t want to overwhelm them with 20 supplements to take.

Dr. Wentz:          Exactly. But I do have a section in the third part of the book on additional things to consider, such as doing more testing or additional deficiencies in what symptoms may indicate that you may need additional support.

Dr. Weitz:            Right. You talk about targeted supplements and the supplements that you focus on are adrenal adaptogens, magnesium citrate, saccharomyces boulardii, myo-inositol. There’s adrenal adaptogens are these herbs that can help modulate adrenal and other function in the body, but there are a lot of them. Which ones do you think are the most important?

Dr. Wentz:          I list out a few of them in the book, and some of my favorites are Ashwaganda. They can be very, very helpful for people with thyroid issues. They can actually normalize TSH in some cases. So I always recommend checking your thyroid hormone when taking that one. Rhodiola is another one of my favorites. It’s been studied in anxiety and depression.   Then there are ones that such as Maca and Shatavari that may be especially helpful for libido issues. So I would say those are some of the more common ones I use. I really like Reishi for people, especially in the evenings. It can be very helpful for giving people a little bit more energy, but also for helping them sleep well at night.

Dr. Weitz:            I’m assuming you’re using some formula that contains a combination of these?

Dr. Wentz:          Generally, for the average person that’s not sensitive to supplements, I may recommend something that contains adaptogens, B vitamins, and vitamin C in it so that they can have a really kind of just one supplement to take. For nursing moms or people that tend to be more sensitive to supplements, then I might recommend utilizing one adaptogen at a time like Holy Basal or Tulsi tea is a really fantastic adaptogenic herb that can be utilized by nursing moms. Although I always recommend checking in with a midwife or a lactation consultant.

Dr. Weitz:            And mag citrate?

Dr. Wentz:          This is going to be something that can be incredibly helpful for anxiety, for trouble sleeping at night, for pain in the body, for constipation. And generally, magnesium is involved in so many processes in our body, and it can be helpful for producing neurotransmitters for helping us produce GABA, which is our internal chill pill for helping us produce L-tryptophan so we can rest and sleep better at night. It is something that works so well for attention and cramps in the body.

Dr. Weitz:            And then saccharomyces boulardii, so this is a healthy yeast probiotic product.

Dr. Wentz:          This is one of my tweaks because a lot of times one of the triggers for getting in that stress response, not a lot of people are aware of, but it’s actually having gut infections. Whenever we’re stressed out, our secretory IGA in our gut is lowered. This is our natural defense layer in the gut. So saccharomyces boulardii helps to raise that natural defense naturally.   So then we can overcome these infections that are there. We can become less sensitive to the foods that we’re eating. We’re not as likely to catch infections. It’s helpful for candida. It’s helpful for various protozoa. It’s helpful for clearing out mold out of the body as well, and some pathogenic bacteria.

Dr. Weitz:            And then myo-inositol.

Dr. Wentz:          Myo-inositol is something that’s been really making the headlines in the last few years.

Dr. Weitz:            I typically have always thought of it as something for PCOS.

Dr. Wentz:          It has been used in PCOS, and it can be very helpful for that. In recent years, it’s been studied for people with thyroid issues as well. So it’s been shown to normalize TSH levels and get Hashimoto’s antibodies into remission. Now, not everybody, and it’s not going to happen for everybody, but it is such a profound effect that I always recommend testing if you are already taking thyroid meds. Because in some cases, especially in the early cases of hypothyroidism, this can help with normalizing that TSH.  It is something that can balance blood sugar, and that’s why it’s so helpful for adrenal issues, which are oftentimes correlated with blood sugar swings. It’s helpful for anxiety. It’s helpful for obsessive compulsive disorder as well. Generally, people will say they take it and they sleep better throughout the night because they’re not having as many blood sugar swings. So this is something that it’s become a recent favorite of mine. And there’s been a lot of incredible studies with all the benefits of this nutrient.

Dr. Weitz:            What is the dosage that you like for myo-inositol?

Dr. Wentz:          Around 600 milligrams for the adrenal purposes. There’s been doses higher than that, that have been used for things like obsessive compulsive disorder. For the purposes of the program, I’ll use about 600 milligrams. And that’s the dose. 600 to 700 milligrams has been studied in hypothyroidism.

Dr. Weitz:            Okay. I know for PCOS, a lot of products have a combination of myo-inositol and D-chiro-inositol.

Dr. Wentz:          Absolutely. I have a little bit of a note in my book that talks about utilizing that for PCOS too.

Dr. Weitz:            Oh, okay. Let’s see. You also mentioned L-carnitine.

Dr. Wentz:          Yes. Yes. So L-carnitine is a mitochondrial supporting supplement. It is incredibly helpful for people who have brain fog. It’s been studied in thyroid fatigue, about 2,000 milligrams per day or so is what we’re dosing it at. A lot of the people in my program, I’ve had about 3,500 people go through it. We have about a 92% relief improvement in brain fog in just those few-

Dr. Weitz:            That’s fantastic.

Dr. Wentz:          A lot of people do credit the carnitine for that because what it does, it does a lot of things, but it helps to move fatty acids into our mitochondria. So the mitochondria can produce energy. It helps us remove ammonia from the body. A lot of times we can have ammonia buildup from gut infections, from constipation, from gut dysbiosis, certain gene variations. And ammonia can be incredibly neurotoxic and cause brain fog. Carnitine can help with clearing that out of our bodies.

Dr. Weitz:            I listened to your interview with Hyman and that’s the first time I heard about ammonia as being an issue. That’s interesting. In Los Angeles, we not only have chlorine in our water, we have ammonia. It’s chloramine. If we’re drinking tap water and not purifying it like I do, we’re actually drinking ammonia. So I wonder if that could be a big issue as well.

Dr. Wentz:          Oh my gosh, I had no idea. I’ll have to look into that. I know it can be generally definitely produced internally, but potentially external sources. I always do recommend filtering water because you never know what’s going to be in your water supply.

Dr. Weitz:            You’re right. All the stuff we don’t know about, but that’s when they actually tell us they put in. You talked about mitochondrial support, and I noticed that the acronym of your book is ATP, which I’m sure is not by accident.

Dr. Wentz:          Oh yes, absolutely. So ATP is our body’s energy source, body’s energy exchange, how our mitochondria makes energy. Right? So this book is all about transforming your energy, all about transforming your life, creating vitality in your life. It’s a new take on adrenal. So I really focus on a lot of the nutritional aspects, some of the foundations that I’ve taken from old adrenal protocols, but I also have a big piece of mitochondrial support that I utilize.  And then transformational, personal growth techniques that really help us rewire that stress response. So we can take all the supplements we want and we can eat a super healthy diet, but if our mind is still stuck in survival mode because of past trauma or some of our wiring then we’re just-

Dr. Weitz:            Or if you spend all day on Twitter or in social media.

Dr. Wentz:          Or watching the news, right?

Dr. Weitz:            Right.

Dr. Wentz:          You’re going to be constantly getting this source of stress and danger, and that can be just from your own mind or from your own habits. So I really wanted to have a comprehensive plan for people to truly transform their stress response. So I have had adrenal dysfunction three times myself and I don’t want to have it again. A big part part of that has been really transforming my brain function and supporting my body and my mind.

Dr. Weitz:            That’s great. How can listeners find out more about you, your book, and your programs?

Dr. Wentz:          My books are available on Amazon, and Barnes & Noble, wherever fine books are sold. And then my website is thyroidpharmacist.com. I have a ABC’s guide for adrenals guide if people go to thyroidpharmacist.com/abc that I’d be happy to share with everybody.

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

Dr. Wentz:          Thank you so much for having me, Dr. Ben.



Dr. Weitz:            Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five-star ratings and review. That way more people will discover the Rational Wellness Podcast.  I wanted to let everybody know that I do have some openings for new patients so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardiometabolic conditions, or for an executive health screen, and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way. And that usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective. So if you’re interested, please call my Santa Monica White Sports Chiropractic and Nutrition office at 310-395-3111 and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.



Managing a Healthy Menopause with Dr. Fiona McCulloch: Rational Wellness Podcast 306

Dr. Fiona McCulloch discusses Managing a Healthy Menopause at the Functional Medicine Discussion Group meeting on April 27, 2023 with moderator 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

5:35  Perimenopause usually starts around age 39 till 55 or so and this is when we start seeing irregular cycles and lots of symptoms and increases in chronic health risks.  Perimenopause is a time of fluctuation.  Women are born with all of the follicles in their ovaries for their entire life. the follicles house the eggs and each egg is housed by cells that make hormones.  Over the lifespan the pool of follicles decrease and when you get to the end of the reproductive years, there are far fewer follicles and hormones are released abnormally and inconsistently.  During a normal menstrual cycle the granulosis cells in the inner follicle make estrogen and when the egg comes out, it ovulated and the shell of the egg makes progesterone for two weeks.  During perimenopause we have follicles on their last legs and they make estrogen all the time but not in a normal pattern and there is almost no progesterone.  The adrenals do make small amounts of progesterone but the ovaries make massive amounts of progesterone.  Perimenopause is marked by wildly fluctuating wild estrogen levels up and down and pretty much no progesterone for the majority of the time.

10:37  Diagnosis of Perimenopause. The pituitary gland is involved with the complex control of ovulation.  When estrogen levels start to drop, the pituitary senses that and then sends FSH down to the ovary to make an egg and then you get increased estrogen.  When estrogen levels get irregular but generally higher, the brain will stop making FSH, so some measure FSH as a way to diagnose perimenopause. But FSH is not consistently low, so it is not a good way to diagnose perimenopause. The best way to diagnose perimenopause is not to test hormones but based on age and that the menstrual cycle gets shorter, irregular. Women will get insomnia, have mood changes, etc.  Testing can be useful for treatment but not for diagnosis.  Menopause is easy to diagnose, since it is diagnosed when it has been 12 months since the last period. 

14:32  Stages of Perimenopause.  During the first stage of perimenopause, the cycles become shorter because there are less follicles and they make less anti-müllerian hormone, which slows them down from ovulating too early.  In the later stages of perimenopause we see highly unpredictable cycles and lots of heavy, long bleeding. Some of the common symptoms that may occur in menopause include hot flashes, insomnia, anxiety, depression, low libido, vaginal dryness, autoimmunity, insulin resistance, loss of bone density, increased cardiovascular risk, and increased Alzheimer’s risk.   

20:12  Hormone testing.  Different modalities of testing are more or less effective for different reasons. Serum or blood spot is the most common form of hormones testing and it is good at picking up topical estrogen, oral and vaginal hormones.  Topical progesterone is not seen very well in a serum test, but it is seen in a blood spot or in saliva testing.  Urine testing is good to look at the metabolites of estrogen and cortisol and Dr. McCulloch will typically use DUTCH testing.  But urine testing is not as good to monitor topical hormone replacement therapy or vaginal HRT, since this can end up in the urine directly.  Saliva is helpful to look at the diurnal rhythm of free cortisol and is good for picking up topical progesterone.  For saliva and blood spot testing she will use ZRT Labs.

24:28  Other labs that Dr. McCulloch will often order besides hormones include the following: 1. Lipids, 2. ApoB, 3. Homocysteine, 4. HOMA-IR, 5. HBA1C, 6. Glucose, 7. OGTT with insulin, 8. Liver: AST, ALT, GGT, 9. CBC, 10. Ferritin, 11. Iron panel, 12. Thyroid, 13. Cortisol, 14. AMH may be useful in differentiating irregular cycles from PCOS, 15. FSH and LH.

28:33  Diet.  Dr. McCulloch often recommends a low glycemic Mediterranean diet with lots of cruciferous vegetables that helps with estrogen metabolism and preventing breast cancer. They also contain antioxidants like sulforaphane that helps with CVD, insulin resistance, cellular overgrowth, and cancer prevention. Lignans and flax seeds and sesame seeds can mimic estrogen and have other benefits. Women should avoid processed foods, alcohol, and high glycemic carbs.  Calcium, magnesium, vitamin K2, and boron can help to prevent osteoporosis. 

29:51  Dr. McCulloch feels that soy is healthy as along as it is organic and non-GMO and the person is not sensitive to it. 

30:25  The Women’s Health Initiative study, which was first published in 2002, Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal WomenPrincipal Results From the Women’s Health Initiative Randomized Controlled Trial.  When this study was published it pretty much scared all women and doctors from using Hormone Replacement Therapy because it increased the risk of heart attacks, blood clots, and cancer.  One of the problems with this study is that they used oral, conjugated equine estrogen and synthetic progestins.   Another problem is that the average age that these women started to take it the hormones was 63 years of age.  Another issue is that 50% were current and past smokers, 35% with hypertension, 70% were obese, and there was no control for atherosclerosis.  And the group of women who took this dangerous kind of estrogen–the conjugated equine estrogen–without the synthetic progestins had no increased risk.  It’s the synthetic progestins that really increase the clot risk and these are in birth control pills, Provera and Depo-provera. They are orders stronger than natural progesterone and they don’t act like progesterone anyway. We are not sure why initiating hormones 10 years after menopause, but it may be because such women will tend to develop plaques once the estrogen drops and then when they start taking hormones, estrogen may soften some of these plaques and increase the risk of an event.

33:12  What we know now from research is the following:

1. Topical estrogens (patches, gels, creams) are safer than oral estrogen. We have known for years that oral estrogens cause blood clots. 

2. Topical estrogen and progesterone (even synthetic progestins) do not increase breast cancer risk up till 5 years after the last menstrual period.

3. While synthetic progestins increase the risk of clotting, this does not occur with micronized progesterone.

4. While starting hormones more than 10 years after menopause may increase the risk of cardiovascular disease (CVD), especially in those who are obese, smokers, or have high blood pressure, initiating topical estrogen and natural progesterone within the first 10 years after menopause  is protective against CVD.

41:33  Topical estrogen. Many doctors recommend a compounded form of topical estrogen called Biest that includes both estrodial and estriol, with the thought that estriol is a weaker but safer form of estrogen.   The trend used to be to recommend 80/20 with 80% being estriol, but then you have to give higher dosages to control symptoms, so 50/50 Biest is best.  Dr. McCulloch will titrate the dosage to the amount of estradiol being absorbed, since that is the estrogen that modulates the symptoms, while estriol is essentially there to possibly mitigate risk.

43:15  Vaginal hormones.  For women who may be at increased risk for breast cancer or who are afraid of that possible risk, but who would like to improve vaginal dryness and atrophy, is it best to use vaginal estrogen or can vaginal DHEA work as well or even vaginal testosterone?  Vaginal DHEA has been shown to work really well. In the US, the Bezwecken DHEA Cubes work really well and these are over the counter, though they are not available in Canada. The other option is to use vaginal estriol plus hyaluranic acid, which also retains water and helps to lubricate the vagina. 

45:50  The clinical differences between estrogen and progesterone. 


Benefits of bioidentical estrodial: 

1. Very effective at reducing hot flashes, while progesterone can help with hot flashes, but not that much.

2. Estrogen has the most effect on vaginal dryness and atrophy.  If vaginal estriol with hyaluranic acid or DHEA don’t work, low dose estradiol vaginally works amazingly.

3. Improves bone density.

4. Promotes better mood/less depression.

5. Libido is primarily driven by estrogen and not by testosterone, as is commonly thought. 

6. Cognition.

Over replacement.

Taking too much estrogen or having too much estrogen because the ovaries are still putting out some can result in breast tenderness, mood swings, sadness, crying, irritability, acne, spotting, bleeding, weight gain around the waist and hips.  Using Canadian units at the beginning of the cycle, the estrogen’s about 100 and at ovulation it’s about 800.  In the Luteal phase, it’s about 400.  When we use topical bioidentical estradiol we are putting women’s estrogen somewhere around 150-250.  But if they are in perimenopause, sometimes their ovaries will bust out an egg and estrogen levels might surge to 1500, which will cause overreplacement symptoms.


Benefits of Bioidentical Progesterone: 

1. It opposes estrogen and it thins the lining of the uterus and prevents endometrial cancer. You don’t need to use progesterone if they don’t have a uterus.

2. Menorrhagia. Progesterone is amazing at reducing heavy menstrual bleeding. 

3. Sleep. It improves the depth of sleep, though it doesn’t help with the hot flashes that can wake women up as much as estrogen does. Progesterone turns into allopregnanolone, which crosses the blood brain barrier and it improves calmness, stimulates GABA production, and promotes sleep. This is also why oral progesterone should be given at night.

4. It also improves bone formation.

5. It improves cardiovascular disease and promotes the health of the arterial endothelium. It is anti-inflammatory and reduces coronary artery disease.  

Over replacement.

Too much bioidentical progesterone can make women feel groggy, drowsy and retain water. 


52:58  Synthetic Progestins, like MedroxyProgesterone, Norgestrel, and Norethindrone, are not Bioidentical Progesterone.  Synthetic progestins all behave differently but some can cause clotting and proliferation of breast tissue, while bioidentical progesterone does not cause these.

53:52  Androgens.  Menopausal women may have a relative increase in androgens because while androgens will slowly decline with age, estrogen and progesterone levels will drop drastically.  Thus the androgens tend to become more dominant and they can cause hair loss on the head and hair growth in other areas and exacerbate symptoms for patients with PCOS.  Progesterone is actually anti-DHT, so it is an anti-androgen. It can lower LH, so this will tend to lower androgens.  There are also some herbs like saw palmetto that can help.  On the other hand, some patients can benefit from taking testosterone or DHEA, esp. if their levels are really low.

55:41  Herbs.  The first category of herbs are the Endocrine Adaptogens.  These herbs help the endocrine system to adapt to change. Some herbs are androgenic herbs, including maca, tribulus, Panax ginseng, damiana, epimedium, bacopa and Gotu kola.  These herbs tend to help with low libido, fatigue, and energy and they tend to stimulate testosterone. There are other herbs that are estrogen and progesterone types of herbs, including Shativari, black cohosh, wild yam, siberian rhubarb, red clover, Vitex agnus castus, kudzu, Dong quai, and hops. Shativari is an Ayurvedic herb that is helpful during perimenopause for mood, skin, hair, hot flashes, and for energy. Black cohosh is famous for both perimenopause and menopause. It used to be thought of as being a phytoestrogen, but now we believe it works in the brain. We often think of wild yam as mimicking progesterone, but it has to be converted into progesterone in a lab, so just taking the ground herb will not convert and it actually has more estrogenic effects in the body.  Siberian rhubarb, Estrovera from Metagenics, is the top recommendation for hot flashes besides taking estrogen.  Red clover is another phystoestrogen.  Vitex is often thought to be progesteronic, but it is not, though it can encourage ovulation in certain situations, which increases progesterone. Vitex actually acts on dopamine and prolactin in the brain. Vitex can be especially helpful if the patient has amenorrhea and stress, which is usually related to high prolactin. Kudzu is another phytoestrogen that is quite strong and can also help with hot flashes. Hops is also a phytoestrogen. Dong quai is from traditional Chinese medicine and it is a tonic that is similar to shatavari.

1:01:00  Adrenal Adaptogenic Herbs.  Adrenal adaptogenic herbs include Ashwaganda, (Withania somnifera), Holy basil, Eleutherococcus, Rhodiola, Panax ginseng, and sage.  Ashwaganda is a good herb to be given in the daytime for anxiety and irritability. It is also a very calming herb that can be given at bedtime to keep people from waking at night from a cortisol spike.  Holy basil is a good mood booster in perimenopause and it also has nice effects on skin and hair.  Eleutherococcus is an adaptogen that helps to manage stress and it helps energize patients. Rhodiola is a very uplifting herb that can help with low cortisol or depression or fatigue, dopamine problems.  It can also help with attention, brain fog. Panax ginseng actually is quite similar as it is an uplifting, stimulating herb.  Sage is really good for mood, energy, and overall cortisol balance.

1:02:55  Sleep and Mood. Supplements that can help with sleep in perimenopausal and menopausal patients include magnesium, melatonin, valerian, skull cap, passionflower, Zizyphus, and ashwaganda.  Dr. McCulloch likes the Ayur-Ashwaganda from Douglas labs 2 caps before bed is really helpful for preventing the 3:00 AM wake up.  For mood, esp. for anxiety and irritability, GABA, threonine, phosphatidylserine, taurine, Ashwaganda, St. John’s wort, and Vitex can all be very helpful.  It should be pointed out that you can’t combine St. John’s wort with SSRIs.


Dr. Fiona McCulloch is a board certified Naturopathic Doctor and founder of White Lotus Integrative Medicine in Toronto Canada, serving thousands of women with hormonal conditions since 2001. Dr. Fiona’s best selling book 8 Steps To Reverse Your PCOS, offers well-researched methods for the natural treatment of Polycystic Ovary Syndrome. Fiona is also a medical advisor to and developed the nutrition methodology for the OpenSourceHealth PCOS project which analyzes molecular, genetic, metabolic and hormonal markers in women with PCOS. As a woman with PCOS herself, Dr. Fiona feels fortunate to serve as a guide, providing trusted information that empowers women to manage their own health.  Her website is DrFionaND.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:                            Okay. Hello, everybody. I’m Dr. Ben Weitz and welcome to the Functional Medicine Discussion Group Meeting tonight. We’ll be discussing the health challenges and successful strategies and treatments that functional medicine practitioners like us can employ to help women with women’s health expert, Dr. Fiona McCulloch. I want this meeting to be interactive, so please participate by typing your questions into the chat box, and then I’ll either call on you or ask Dr. McCulloch your question when it’s appropriate. May 25th, we have Dr. Mark Pimentel and we’ll be discussing SIBO and IBS. I’m working on June 22nd. I’m thinking about possibly doing one in person. Details still to come on that, probably on adrenal.

                                                July 27th, we have Dr. Dale Bredesen on Alzheimer’s disease. If you’re not aware, we have a closed Facebook page, which is for practitioners only, the Functional Medicine Discussion Group of Santa Monica that you should join so we can continue the conversation when the evening’s over. I’m recording this event and I’ll include it in my weekly Rational Wellness Podcast, which you can subscribe to on Apple Podcast, Spotify, or YouTube. If you enjoy listening to the Rational Wellness Podcast on Apple Podcasts or Spotify, please give me a five-star ratings and review. The latest podcast is an awesome interview with Jeffrey Smith on the dangers of GMO foods and glyphosate and it’ll really blow your mind, so you got to listen to that one. That’s out now.

                                                I want to thank our sponsor for this evening, Integrative Therapeutics. Usually, Steve Snyder’s able to join us, but he’s not able to. He’s attending a naturopathic conference, so I want to tell you about a few Integrative products. Integrative offers several products that help with estrogen metabolism, including Indolplex, which is an enhanced absorption form of DIM. They also have a very good formulation of calcium D-glucarate. They also have a very good quality and reasonably priced Vitex Extract. Finally, Integrative now has an even more advanced form of curcumin with even greater absorption than their Theracurmin, which is currently my favorite form of curcumin. This new product is called Curalieve, and it is an amorphous, solid dispersion of curcumin.   Apparently, curcumin forms crystals, and that’s one of the reasons why it’s difficult to get absorbed. So, this is a solid, amorphous form. I’m not even sure what that is and apparently has way higher absorption rates.

Dr. Fiona McCulloch is a naturopathic doctor and founder of White Lotus Integrative Medicine in Toronto, Canada, serving thousands of women with hormonal conditions since 2001. Dr. Fiona’s best-selling book, Eight Steps to Reverse Your PCOS, offers well-researched methods for the natural treatment of polycystic ovary syndrome.  I’ve referred to that book a lot when dealing with patients with PCOS. It’s really an awesome book. Dr. Fiona is also a medical advisor too and developed a nutritional methodology for the Open Source Health PCOS Project, which is a women’s health technology platform. All the way from Canada, Dr. Fiona McCulloch.  Thank you so much for joining us.

Dr. McCulloch:                   Thanks so much for having me. I always love being on your podcast and presenting. Of course, I love everything about hormones, so I’m really excited to present on this topic.

Dr. Weitz:                          That’s great.

Dr. McCulloch:                   Yeah, so I’m just going to start off talking about perimenopause and menopause. I always find it very hopeful to differentiate between these two, because they’re actually quite different and they need different support, but they both cause lots of different issues. Sometimes perimenopause is actually worse and is often missed altogether. So, yeah, I am Dr. Fiona McCulloch. I’ve been practicing in the area of hormonal health for 22 years in Toronto. I’m a naturopathic doctor and I’m a board member of the Endocrinology Association of Naturopathic Doctors. So, I’ve prescribed lots of hormones. The majority of my practice is polycystic ovary syndrome, menopause, thyroid, adrenals. So, yeah, I really love this topic.

                                                So, first, I just want to talk about the different stages that we see in the lifespan in women. So, the first stage is premenopausal. This is when patients are having regular cycles. It’s generally from the time they have their first period up until usually around 40 or so. Some people have this a little earlier, but for the most part, it’s around this age that we see perimenopause happening. So, around age 39 to 55 is usually perimenopause. We start seeing irregular cycles, changes in cycles, and that’s when lots of symptoms begin as well. Menopause is defined as 12 months past the last menstrual period, and this is where we see a lot of the chronic health risks rising. So, they’re both very important times. They have different sets of problems to deal with.

                                                So, the first thing to know is that perimenopause is a time of fluctuation. So, its very nature is change. It is very chaotic hormonally. I’ll show you what goes on there and why it is so challenging. A lot of the time patients will come in unaware that their symptoms are from perimenopause, because they’re still having periods. A lot of patients believe that until they actually stop having periods that it can’t be related. So, this is something that can be missed a lot of the time. A lot of these patients are diagnosed with anxiety, depression, and things like that. Meanwhile, they’re actually in perimenopause. So, it’s really important to be able to figure out if that’s what’s going on here. So, what is it that causes that to happen hormonally?

                                                So the first thing is that women are born with all of the follicles in their ovaries for their entire life, and the follicles basically house eggs. So, each egg is housed by different cells that make hormones, and these follicles basically are ovulated. There’s an ovulation that occurs every month from one of the follicles. Over the lifespan, the pool of follicles decreases. As you get to the end of the reproductive years, there are far less follicles. When that happens, we start seeing some irregularities. These follicles don’t behave normally. There’s less of them. They release hormones abnormally, and many times they don’t ovulate. So, these are basically the end of the road of the ovulation process, and we’re seeing a lot of inconsistent hormone production as a result of that.

                                                So, if we look at what actually happens on the left side in a reproductive cycle, on the left, this is a normal healthy menstrual cycle where we’re seeing the very beginning of the cycle. A lot of people are not that aware that the estrogen is actually made from the follicle during the process of ovulation. So, at the very beginning of the cycle, over on the left side here, there are these very tiny follicles and they’re not really active. They’re sitting there quite mostly dormant, and the brain will then start to grow a follicle to get ready for ovulation. The inner part of this follicle makes estrogen. That’s called the granulosis cells, and the outer part actually makes estrogen and the estrogen actually will spike up quite high as the follicle enlarges.   So, it makes a lot of estrogen that stimulates the process of ovulation. The egg comes out, it’s ovulated, and then the shell of the egg makes progesterone for two weeks. This is where the vast majority of our progesterone comes from. If you look at the beginning of the cycle there, see how there’s so little? That’s the amount that comes from your adrenal glands. It’s almost nothing compared to how much comes from the ovary. The ovary makes massive amounts of progesterone. The adrenal makes tiny amounts of progesterone. So, throughout the reproductive lifespan, we have large amounts of progesterone for two weeks, very little progesterone for two weeks, but then estrogen goes through this lovely pattern where it’s up and goes up in that pattern to ovulation and then another little bump around the gluteal phase.

                                                Perimenopause, what we see over here is that we have all these follicles. They’re not really functioning normally because they’re old. They’re on their last legs and they’re about to sputter out. So, basically, they just randomly make estrogen. They make estrogen all the time, but they don’t make it in a normal way. Sometimes they make a lot, sometimes they make none. It’s up and down and all over the place. Progesterone only happens when you ovulate. So, you have this little bit from the adrenals, but then that large amount is just not there most of the time. Only when ovulation occurs, two weeks of progesterone are made. That’s random in perimenopause and when it does happen, sometimes it’s way less than you would see. So, you’ve got all this estrogen, almost no progesterone, definitely not that normal half and half pattern that we’re used to having. So, that’s a huge change that we see in perimenopause. So, the two big things are really fluctuating wild estrogen levels up and down and pretty much no progesterone for the majority of the time. We do get some sometimes, but unpredictable.

So, let’s talk about why these wild fluctuations happen in the first place. If we look at what the pituitary gland does, the pituitary gland is involved in very complex control of ovulation.  Whenever your estrogen levels are very low, the brain sees that and says, “Oh, we need to make an egg. Let’s grow an egg.”   It basically sends FSH right down to the ovary, starts to grow the egg, and that’s what makes the estrogen. So, basically the stimulus to grow an egg is low estrogen. Whenever estrogen’s low, the brain’s like, “Push an egg.” So as you can imagine, that drop will make the brain push out an egg. Then we get a big burst, and then maybe that exporters out drops. So, now we get this back and forth, up and down between the brain and the ovaries. So, once the estrogen goes up to the brain, then it stops making FSH. So, sometimes the FSH will be low, sometimes it will be high depending on what’s happening at the time. So, it’s quite random. This shows you what happens when there’s high estrogen. So, high estrogen, the pituitary gland will shut down FSH.  Basically, we don’t need to make an egg. We already have one. The times that that occurs are really right around ovulation. We wouldn’t be growing an egg at that time because we’re already ovulating. We wouldn’t be doing that in the luteal phase, second part of the cycle, it’s already lots of estrogen. So, at those times, we don’t want to grow an egg and that’s totally normal. If someone is pregnant, also, high estrogen, don’t need to grow an egg. In perimenopause though, it’s high randomly all the time. So, basically it’s up, the brain is like, “No FSH,” then it’s down, and then the brain’s like, “Yes, FSH.” So it’s basically up, down, all because of these eggs that are really burning out and not able to do their normal function of ovulation.  So, this is basically this back and forth process, up and down estrogen. Basically, it’s a very bumpy ride. It’s very unpredictable. The reason I’m showing you that is sometimes people test FSH to diagnose perimenopause. That often can be very misleading, because sometimes it’s high, sometimes it’s normal, sometimes it’s low. It’s just all over the place. It’s totally random. So, it’s something to consider, but I certainly wouldn’t say, “Oh, that person has normal FSH, they’re not in perimenopause.” So these are really important things just to understand diagnostically. So, yeah, perimenopause, we see this up, down of these hormones, very random, up and down of FSH, up and down of estrogen.

                                                So, how do we actually diagnose perimenopause given that we can’t actually test these hormones and know if that’s the cause? Really, it’s very easy to tell. So, you use clinical case taking basically if a patient is between 40 and 55 years old and they’re really having persistent changes to their menstrual cycle. So, they’ve always had a 28-day cycle. Now they’ve got a 25-day cycle. Now it’s a 24-day cycle. They have insomnia, they feel different, they feel weird, they’re having mood changes. This is perimenopause. That’s really all you need to know. There’s no test that will tell you more than that. It’s the age range and these symptoms and these changes to the cycle. Menopause is very easy as well. It’s 12 months since the last period.  But in menopause, we do have a very consistent testing to look at. So, the FSH knowledge are extremely high, usually over 30 for FSH.  Estrogen, progesterone will be very, very low. So, yeah, in menopause, you can use these tests. However, it’s also very obvious because the person’s not having periods. So, testing is useful for treatment, but not for diagnosis, because you can diagnose it just by talking to somebody and figuring out what’s happening.

The next thing is that there are different stages of perimenopause to know about, and the first stage can be a little bit subtle. What usually happens is the cycles become a little closer together. So, if somebody had a 28-day cycle, now it’s 25, 24, 23 days, that often goes on for a few years before the next stage of perimenopause.  This whole thing can last around 10 years, but the first stage can be quite long actually, where those cycles are shorter. Then ovulation is occurring early in that first stage. The reason for that is when there’s less follicles, they make less of a hormone called anti-müllerian hormone, which is basically something that slows them down from ovulating too early. So, you just start ovulating earlier and earlier and there’s just less regulation inside the ovary. It just starts pumping out eggs that are maybe working sometimes, maybe not at other times. We also in the later stages, start seeing highly unpredictable cycles. So, the cycles might be months apart. They might be two in a month. They might be bleeding for three weeks straight.  It’s just so unpredictable and chaotic, but definitely, we see a lot of the heavy, heavy long bleeding in this stage and that can be very problematic. That’s where a lot of patients in the old days would be given a hysterectomy, second stage of perimenopause, because unfortunately, they didn’t have treatments for that which we have now. Sometimes it’s still done, but there’s so much more that can be done now. So, we don’t have to have a hysterectomy just because of this last stage of perimenopause. So, the symptoms in perimenopause, if we think about perimenopause as the left side of this graph where the right side is menopause, perimenopause still has estrogen. So, you’re not going to have constant estrogen deficiency symptoms.

                                                They’re going to be fluctuating, but you’re also going to have a bit of chaos and mayhem in how people feel. They feel up and down, mood swings, insomnia. It comes and goes. We see lots of autoimmunity happening here, because the immune system has to respond all the time to these up and downs of hormones, especially estrogen really causes a lot of changes to the immune system. So, migraines, it’s almost like PMS times a million all the time. It’s just up and down, all over the place. So, yeah, a lot of patients come in this stage and they’re like, “I just feel really tired. I have anxiety, I have depression. Something is wrong.” Then nobody ever brings up that they might be in perimenopause. So, this is often misdiagnosis, something else in this stage.

                                                But just to keep an eye out for these imbalance symptoms where heavier periods, irregular cycles, mood changes, sleep changes, a general change in how people feel. It’s all very common. I am sorry, I don’t know why it has gone back there. One second. The menopause stages are really estrogen deficiency symptoms. So, this is where if we’re looking at that right side. There’s really no more estrogen. That’s where you really start seeing things like hot flash. I mean you can have them in the first stage, but in the second stage, the hot flash is really stark, because there’s no more estrogen, insomnia, anxiety, irritability, depression. But these symptoms tend to improve gradually, those top three a little bit as time goes on.

                                                They find in menopause, women, generally, their mood gets better if they’re given a little bit of time compared to perimenopause. But some of the symptoms and risks actually start accumulating from the lack of estrogen. So, that would be things like cognition, cardiovascular risk, insulin resistance, bone density. So, all of those things just continue and get worse over the years, and those are really caused by estrogen deficiency. We also sometimes see androgen excess symptoms like hair growth on the face, hair loss from the scalp. I’ll show you why that happens, because a lot of people are confused in that the testosterone’s actually quite low. So, why is this happening? There’s actually some reasons for that and everyone’s a little different. It depends on their predisposition there.

Dr. Weitz:                          Can I ask, do we understand why hot flashes occur from low estrogen?

Dr. McCulloch:                   So they don’t 100%, but some of the thinking or the newer information is suggesting that people who have high estrogen previously have more hot flash and they don’t 100% understand why that is.

Dr. Weitz:                          I mean, what is the body trying to do or compensate for?

Dr. McCulloch:                   They don’t actually know unfortunately. Yeah, it’s neurological in some way and there’s some pre-programming related to estrogen, but they haven’t been able to figure it out. It’s like a neurological circulatory element. Yeah, there isn’t really good answers on that unfortunately, because some people just have them like their whole life and it’s interesting. But I definitely see it in the patients that have high estrogen. Once they go through the final stages, they often have bad hot flash. It’s a different treatment process to go through those stages. The types of hormone testing that we can do. So, in perimenopause, although we cannot really diagnose it with testing, we certainly want to do testing to understand how we can help these patients because everyone’s a little bit different.  Everybody has different aggravating factors and I find that people’s predispositions are always worse in this phase. So, whatever they have already, it just gets worse.

So, there are different types of testing. I just want to briefly review them. There’s all different possibilities for tests. I mean some of them have pros and cons and it really depends. Sometimes it’s convenience. Sometimes it’s a combination of different tests that will make you choose between one or the other, but blood spot and serum testing is definitely probably the most common type of testing that’s done. It is really good at picking up endogenous hormones.  So, hormones that we make in the body naturally. It is also good at picking up topical estrogen, oral and vaginal hormones. We just have a lot of data on that and what those levels look like in serum. Topical progesterone is not seen very well in a serum test, but it is seen in a blood spot test, because it’s found in capillary blood more so. If you ever do progesterone cream and you run a blood test, you’re not going to see it much there at all. You’re going to see a tiny bit, but if you do capillary blood spot or saliva, you’ll see the progesterone cream.

Dr. Weitz:                          Wow, that’s an interesting pearl right there.

Dr. McCulloch:                   Yeah, it’s one of those things that they don’t actually know how it’s actually absorbed, but they believe might be lymphatic and that’s why it’s showing up that way. But nobody’s actually studied that properly to find out because they believe the progesterone cream isn’t absorbed. So, they won’t study it, but it is. You can pick it up in these tests. So, it is observed and I see that it is different. They’re just different forms. I think in the future, hopefully, that will be studied more so, but urinary metabolites are also very useful. Those show something a little bit different. So, those are going to pick up excretion and break down products of hormones. It can help us understand metabolites.

                                                So, if somebody has a risk of breast cancer, we can understand, “Do they make harmful metabolites of estrogen?” It’s not as good for a topical HRT assessment, because it is excretion and vaginal HRT, it can actually land in the urine. So, those are not really good. It’s not really a good way to assess how is the level in the person’s system, but it’s extremely helpful for adrenal issues because you can understand metabolites of cortisol, total cortisol free. You can do diurnal rhythm. So, it’s a great test for cortisol really, and saliva. So, saliva is interesting in that it’s very good at picking up topical progesterone. It can give you an instant measurement of adrenal free cortisol. It’s easy to do at home, so you can do diurnal. So, yeah, so that is basically saliva.

Dr. Weitz:                          For urinary, do you have a preference for dried urine versus 24-hour urine?

Dr. McCulloch:                   Yeah, I usually do dried urine. Yeah, I usually do that, but I have done 24-hour, just like if some patients don’t want to do the whole dried urine thing. I’ve done that, but I just find that’s good for just total cortisol.

Dr. Weitz:                          In Canada, do you have some of the same testing companies that we have here?

Dr. McCulloch:                   We do.

Dr. Weitz:                          You have the DUTCH testing. Okay.

Dr. McCulloch:                   Yeah, that’s what we use for, this is primarily the DUTCH test. We use ZRT also, but mostly the DUTCH test for the urinary metabolites.

Dr. Weitz:                          Okay. What about for saliva and bloodspot?

Dr. McCulloch:                   For saliva and bloodspot, I use ZRT. They have great tests actually. I really like ZRT. So, yeah, they have a lot. They’re adding more and more too. So, really good company.

Dr. Weitz:                          Cool.

Dr. McCulloch:                   Yeah. So, yeah, it really depends on what you want to know, which tests to do. There’s just many different reasons to choose each one. Lab panels, so these also would be selected for the patient and their risks. So, basically whatever you’re seeing here, don’t get too stuck on it. I see sometimes people doing the DUTCH test and they’re like, “Oh, you have no estrogen,” and then the person’s having periods not regularly, but they are. So, obviously, they have estrogen, but then it has to be understood that these hormones change all the time and that’s normal.  If it’s low, it’s low, but that tells you that sometimes it’s low. That’s all tells you. Other times, it might be high. If they’re having periods, they have estrogen. So, it’s really this understanding, you can look at it under, get a snapshot, but knowing that it changes is very important.

Dr. Weitz:                          Have you used the cycle testing where you test it every day of the month using DUTCH?

Dr. McCulloch:                   I have. I also have the fortune of working with a lot of fertility patients who go through cycle monitoring at fertility clinics. So, I get that, which is really cool, because then it’s repetitive. They’ll do a bunch of them, so I get to see that too. We do the cycle testing, so it just depends, but a single cycle’s really only a single cycle too. So, sometimes it just depends on what I’m trying to learn from that. Sometimes it is useful to figure out what’s going on. So, yeah, the estrogens, progesterone. So, the strong estrogen is estradiol. The other estrogens are estrone and estriol, and then there’s progesterone. So, all of these can be measured in blood spot and metabolites. The androgens can be measured.  I often do that in patients who have PCOS, because there’s a group of patients with PCOS whose androgens actually go up in perimenopause. Their DHEA shoots up through the roof and they get high testosterone and then they have all kinds of problems. They’ll lose all their hair or something like that very suddenly. So, those patients, I always test their androgens. Other patients, usually they’re going to be low, but there’s this category of PCOS patients where it goes up quite high actually, which is not fun for them, because they’ve gone through their whole time and now again, they have to deal with this problem. So, it’s good to make sure that’s what’s happening.

                                           The cardiovascular elements, I always test that, lipids, ApoB, CRP, homocysteine, insulin resistance, so HOMA-IR, A1C, glucose. Oral glucose tolerance test with insulin or even just fasting insulin can be really helpful. Liver enzymes to look for fatty liver, especially ALT, can be quite sensitive for that. Iron panels can be really helpful too in understanding fatty liver and then iron deficiencies in perimenopause are very common with the heavy periods and a full thyroid panel because a lot of people develop Hashimoto’s in this phase. Cortisol is really important. I really do like to do the diurnal cortisol whenever possible. Sometimes I’ll just screen it if the patient doesn’t want to pay for that test, but I’ll screen it with serum.

                                                Metabolites are really useful for someone with a complex condition. Other considerations, anti-müllerian hormones. So, sometimes say if a patient’s 36 years old, they’re too young for menopause, but they’ve had regular cycles, now of a sudden they’re irregular. If you want to find out, “Are they in perimenopause early?”, you can run AMH and that will tell you they have a very low egg reserve. They’re probably having those symptoms from perimenopause. FSH and LH, again, they’re high in menopause. In peri, they’re up and down all the time. Sometimes they look totally normal and sometimes they look really high, but they just move around. So, yeah, the labs are all very individual.

So, nutrition generally, of course like anything, a lot of different nutrition plans can work.  I don’t believe in any particular nutrition plan. I’m like, “What works for this patient that’s the healthiest way that they can eat according to their lifestyle?” But a Mediterranean low GI diet or an adaptation of that is often very helpful in this category for cardiovascular disease. Cruciferous vegetables, lots of those will help with estrogen metabolism, preventing breast cancer, but also antioxidants with sulforaphane, that really helps with cardiovascular disease, insulin resistance, cellular overgrowth and cancer prevention. Lignans and flax seeds, sesame seeds, they mimic estrogen.  They can have some really good benefits. CalMag mineral formulas are really critical. So, many patients will start to develop osteopenia as soon as their estrogen starts dropping. So, these are really important. Usually, they should have all the minerals and vitamins that go along with calcium and magnesium, like vitamin K2, boron. So, all of these micronutrients are really important.

Dr. Weitz:                          Steve asked about soy. What do you think about soy? Soy?

Dr. McCulloch:                   So soy, if it’s non-GMO and organic and the person doesn’t react negatively to it, is not sensitive, I’m actually fine with it. I think what the research shows is it’s beneficial. As long as it’s not GMO and not sprayed with tons of glyphosate. If it is, you don’t need it. Yeah, it’s sprayed with a lot of glyphosate, conventional soy. Still controversial though, right?

So the next thing I’m going to talk about is this study, the WHI 2002 study. Probably everybody remembers this study because they ring the alarm bells. They stopped this study. It was all over the news. HRT’s going to kill you, give you a heart attack and give you breast cancer and we need to stop it right away. I remember that very well. I remember being afraid of it and being shocked, because I had just graduated school at that time.  “Oh, wow, this is really dangerous” was my thought at the time. That thought has persisted. So, basically, it was the oral estrogen and synthetic progestins were reported to increase the risk of clot and cancer. However, what they said was HRT will give you heart disease and cancer. What we know now is that the statistical analysis and breakdown of that and the updated research has showed us that that was quite unfounded and also that there are very specific things to know about HRT that really are involved in that risk that we saw, but something to consider is that in that study, the average age was 63 years old. 70% of the patients were aged 60 to 79, 10% were aged 50 to 54.  It was using conjugated equine estrogen, which is synthetic oral estrogen, and synthetic progestin, which is oral hydroxyprogesterone. These are very different than what we use now. 50% were current and past smokers, 35% with hypertension, 70% were obese, and there was no control for atherosclerosis. So, so many flaws, just to say across the board. This causes heart disease. No, this is a very confounded study with lots of things that weren’t controlled for. So, even just looking at that alone tells us that needs more analysis. But if you want to go through this chart later, this is the breakdown of those studies and actually what the conclusion was.

                                                What you’ll see if you look through that is that really, even with these CEE estrogens, the most dangerous kind, there really isn’t an increase in the risk unless the progestin was added to it. So, that’s very important to know in that even the worst kind of estrogen did not have that risk in particular. Now, we just know so much more even that we would never use that estrogen now. So, I’ll show you the breakdown of what we know as a summary. So, this is just a summary of everything. All the research that we have now, topical estrogen, so transdermal patches, gels, creams, these are much safer than oral estrogen. The oral estrogen turns into metabolites in the liver that cause clot and thrombosis. We see that with birth control pills.  We’ve known that for many years that they cause clot and thrombosis. So, it’s really not a surprise that the oral estrogens cause that. Transdermal does not seem to cause this. So, this is really good news. Transdermal estrogen and progesterone together, and this is using a synthetic progestin because they haven’t got enough research yet, even on micronized progesterone, natural progesterone. But even that combination does not increase breast cancer risk up to five years past the last menstrual period. Synthetic progestins clearly increased clot risk. We’ve always known that. They’re in birth control pills, Provera, Depo-Provera. All these things we’ve already known, they increased clot risk. So, it’s absolutely no surprise that they do that in menopause and they’re very strong.

                                                Compared to natural progesterone, they’re like orders stronger. So, it’s not necessary to take something like that. Plus, it doesn’t act like progesterone anyway. But we don’t see that risk with micronized progesterone. They have not found any thrombotic risk with that. We do need more research to understand long-term safety, but so far, it really looks quite safe, which makes sense considering this exact form our body makes. Initiating HRT after age 60, so this would be not being on any HRT at all, going completely with no hormones for maybe 20 years. Sorry, not 20 years, maybe something like 10 years. The average age is about 50, 51.  If they were to initiate it 10 years later, there was an increase in cardiovascular disease, breast cancer in obese, smokers, and hypertensive people. Why is that? We don’t know 100%, but what we think is that those people have a lot of plaques on their arteries in particular. They just develop lots of plaques in that time and then the estrogen softens those plaques and that can cause a risk. So, for that group of people, it does seem to be a bad idea to start it after 10 years. That being said, we still need more evidence on that, but for those people, it’d be best for them not to wait. They might just be accumulating so much risk. Oh, I am sorry about that. I do not know why.

Dr. Weitz:                            So interesting. So, you’re saying in particular women who have calcified plaque might potentially be at more risk because the estrogen might make the plaque less stable.

Dr. McCulloch:                   Yes, it softens it. So, if they initiate it within 10 years, though we don’t see that risk. It’s only if it sets in for that time and it’s only in these risky groups. So, they already have a lot of plaque and then they’re probably rapidly getting a lot of plaque in that 10 years and then the estrogen softens it and may cause an event.

Dr. Weitz:                            So I wonder what you would think about a woman who’s suffering with the beginning stages of Alzheimer’s, let’s say she’s 65 or something and has not been on hormones and now we think that perhaps going on hormones might be beneficial. I guess you have to weigh both factors.

Dr. McCulloch:                   You’d have to weigh it. What I expect to see is that we will learn how to do that. There’s probably a way to initiate it or a dose to initiate with in people with cognitive, but it’s hard to know. If they don’t have those other risks, maybe it will be fine for them. It’s just like for the safety data, it’s going to take time to get that. Yeah, I personally think for cognition, it’s going to be continued quite a long time once we get the data on that.

Dr. Weitz:                            Yeah.

Dr. McCulloch:                   Yeah, initiation within 10 years of the last menstrual period is protective against cardiovascular disease. So, it actually reduces the risk of cardiovascular disease across the board. So, it’s a great idea to go on anytime within that 10 years. That’s quite a long time. Obviously, if you can go on it immediately, that’s great, but you don’t have to. So, lots of protective effects there. In patients with a uterus, it’s very important that whenever there is estrogen, there absolutely must be progesterone added as well. It has to be oral or vaginal, because transdermal progesterone is not strong enough to consistently deal with the lining and reduce the risk of endometrial cancer.   So, it has to be something like oral micronized progesterone or vaginal progesterone. I tend to use vaginal progesterone in patients with extreme heavy bleeding in perimenopause because it works really well. Outside of that, I would use oral micronized progesterone just because it’s great for sleep.

Dr. Weitz:                            Do you cycle the progesterone two weeks and in two weeks now, or do you have women take it every day of the month?

Dr. McCulloch:                   So I always cycle it in reproductive age women. In perimenopause, if their cycles are highly irregular, I find cycling it actually causes more bleeding problems off and on. So, I just tend to do it continuously, especially if they have heavy bleeding. In menopause, once they’re past full that full year, unless the progesterone’s helping them, you can do it 12 days a month. If they feel good on it though, you can do it every day. If they’re like, “I sleep better on the progesterone,” they can do it every day, but a minimum of 12 days, we’ll deal with the lining risk.

Dr. Weitz:                            Steve is asking, “Do you use ultrasound to check uterine lining thickness if on progesterone?”

Dr. McCulloch:                   Yes. So, I do. Because I deal with a lot of patients with PCOS, I have a lot of patients who’ve had endometrial hyperplasia and cancer in my practice. In perimenopause, most of the time that there’s bleeding, it’s not endometrial hyperplasia, but if a woman is past menopause and you see a bleeding, that is not normal. So, definitely do an ultrasound. I always do a baseline ultrasound anyway, just to have a good look and make sure nothing else is going on, especially if they have just dysfunctional bleeding. But I find in perimenopause, once they’re on really consistent past three months, you don’t really see a lot of dysfunctional bleeding.  As long as they have estrogen in their body naturally and their eggs can have any capacity to make them, you will still see spotting, bleeding. So, yeah, peri and menopause are a little different that way, but yeah. Contraindications and this is from North American Menopause Society, undiagnosed vaginal bleeding. So, obviously, if somebody’s just hemorrhaging and you don’t have an ultrasound, it’s important to do an ultrasound just to make sure nothing is wrong. So, obviously, before starting estrogen, if somebody’s having three-week long periods, do an ultrasound. First, diagnose. It doesn’t mean that you can’t give because progesterone will solve that problem for a lot of people. Yeah, but do the ultrasound first.

                                                Suspected or known BRCA genes really should not be taking any estrogen. Estrogen dependent cancers of any sort should not be taking estrogen. Acute liver disease, this is more for oral estrogen, but it’s implied in the packaging. It doesn’t mean that somebody can’t take this if they have fatty liver disease, for example. This would be something where the person is actually very sick at the time with something and then venous thromboembolic disease. It’s just a contraindication. So, that’s somebody with like a DVT or a PE at the time really.

Dr. Weitz:                            What about particular types of topical estrogen? So for example, estradiol versus estriol. Some people feel that estriol is safer, has less risk for maybe somebody who’s at higher risk for breast cancer.

Dr. McCulloch:                   Yeah, so compounded HRT is often called Biest, which is a combination of estriol and estradiol. The trend before used to give a large amount of estriol, so 80/20 where you were giving a lot of this estriol and the thinking was that estriol is protective against cancer. Estradiol is the bad estrogen and it’s going to cause cancer. But now, we actually have learned differently in that if you give too much estriol, it can block the receptors for estradiol and then you have to give more estradiol and you’re ending up giving much more than you need to. You’re just basically giving way too much.  So, now, mostly, they are 50/50 if you’re doing Biest. So, usually 50/50. I always target though to the estradiol when I’m looking at the dose, because that’s the one that makes the person feel better is generally estradiol. The estriol is there to mitigate risk and it can possibly help with some symptoms, but it’s very subtle compared to estradiol, which has a massive clinical effect for people. They used to have Triest, which was estrone, which is now not a good thing at all. Yeah. So, things have changed quite a bit with that.

Dr. Weitz:                          Well, in the category of women who are nervous because they feel like they have an increased risk of breast cancer, what about women who are afraid of taking estrogen, but they want to do something about the vaginal dryness and atrophy and stuff and they want to do something topically?  Some people have recommended topical intravaginal DHEA, intravaginal testosterone versus intravaginal estrogen and estradiol versus estriol. What do you think about what is the best and safest?

Dr. McCulloch:                   Yeah, those are all great. Actually, I have a slide on this. One second.

Dr. Weitz:                          Okay. Sorry.

Dr. McCulloch:                   No, I’m going to bring it up now because it’s like a perfect time too. But yeah, the DHEA actually is really a great option for vaginal tissue. So, it really can be used vaginally. It definitely can make a difference. The other thing is you can do just estriol with hyaluronic acid. That is a really good combination I use a lot. It’s very moisturizing, the hyaluronic acid. So, it retains the water and fluid. Then the estriol does have an effect in the local area. There’s also low dose vaginal estrogens like Vagifem, the very tiny amount. That works amazingly well. So, if it’s really just vaginal atrophy, dryness, that can be great. So, any of these can be awesome.  I think there’s the brand, they’re called something cube, I’m sorry. It’s in the US. We don’t have it here, but I wish we did. There’s these cubes. I think they’re called something cubes, and they have DHEA progesterone. I’ll get the name for you, but you can order them. They’re all vaginal, Bezwecken. They’re called Bezwecken Cubes. So, they have all these different types of vaginal treatments that are basically a variety of these different types of options that don’t have estradiol in them.

Dr. Weitz:                          Are those over the counter or those prescription?

Dr. McCulloch:                   They’re over the counter.

Dr. Weitz:                          Wow.

Dr. McCulloch:                   In the US. Yeah, they are. So, they’re really cool and they’re quite popular. Patients will say they’re very good. We just don’t have them in Canada, but I’ve heard a lot of the US patients tell me about that.

Dr. Weitz:                          Cool.

Dr. McCulloch:                   Yeah, so if I go to this slide, I just want to talk about the difference between estrogen and progesterone clinically and what you would expect to see because they have actually different effects. So, the estrogen, what you can expect to see that have an effect on hot flash, it’s like the best thing for hot flash by far. Some people will say progesterone helps with hot flash and it can, but not that much. It’s estrogen that really helps with hot flash. When someone is on estrogen, their hot flashes go away. It’s very intense on in its effect that way, even not at a very high amount. So, it really does help with that.

Dr. Weitz:                          Maybe you’re going to get to this, but what about supplements that might be beneficial for hot flashes?

Dr. McCulloch:                   I do have. Yeah.

Dr. Weitz:                          Okay. Well, hold the question there.

Dr. McCulloch:                   There are certain ones that are really good for hot flash.

Dr. Weitz:                          Okay, we’ll hold it.

Dr. McCulloch:                   Yeah. The vaginal dryness, really estrogen is the one for vaginal dryness, but you can do local estrogen like these Vagifem or these cubes or suppositories. You can do estriol. If estriol and something like hyaluronic acid or one of these other ones doesn’t work, you can try the low dose estradiol vaginally. So, vaginal dryness, it works amazingly. Bone density, same thing. So, mood is a big one. Estrogen really lifts the mood. It’s helpful for depression especially. So, a lot of people will feel their mood is so much better and they have more energy.

                                          I should have mentioned in this section two, libido in women is primarily driven by estrogen. A lot of people think it’s testosterone, but it’s actually estrogen that drives a lot of the libido in women. So, sometimes with the patients, you’ll give them testosterone or DHEA or something, because in women, DHEA turns primarily into testosterone. They don’t have any change, but you give them estrogen, all of a sudden, their libido’s amazing.

Dr. Weitz:                          Where does that myth come from that women’s drive comes from testosterones?

Dr. McCulloch:                   I mean, I think part of it does, but I think more of it is from estrogen.

Dr. Weitz:                          Steve says that’s because information comes from men.

Dr. McCulloch:                   Right, yes. That’s probably part of it. But if you think about estrogen rises at ovulation, that’s when you have a massive spike of estrogen. Right at ovulation, there’s a little rise in testosterone, but a massive rise in estrogen. It’s like that combination is probably what does it. So, yeah, but I always bring that up because sometimes people don’t think of estrogen that way. Then cognition, for us to say with 100% certainty, it does help that. We don’t have enough evidence, but there was another study that came out. It really looks like it is going to be a big thing for preventing Alzheimer’s and improving cognition. Too much estrogen replacement will cause breast tenderness, mood swings, sadness, crying, irritability, acne spotting, bleeding, weight gain around the waist and hips.

                                                So, those are over replacement. That being said, when you’re using topical estrogen in these amounts, which are not very high, it’s not that common to have that. Often, it’s just that you haven’t balanced it properly with the progesterone. Sometimes the high estrogen is actually coming from the person’s ovaries. The estrogen replacements we do in our Canadian units. I’m sorry, I don’t know the US conversion, but I’ll use the Canadian ones. Say at the beginning of the cycle, the estrogen’s about 100. At ovulation, it’s about 800. In the luteal phase, it’s about 400. So, when we’re using these topical estrogens, we’re putting people’s estrogens somewhere about 150 to 250. So, they’re nowhere near any of these reproductive levels.

                                                They’re at a low level, but sometimes their ovaries bust out an egg and makes a 1,500 of estrogen. That’s what causes those problems more so rather than these replacements. So, that’s where you’ll see it. It’s endogenous estrogen in perimenopause. Progesterone is essential with estrogen in anybody who has a uterus. If the person has their uterus removed, you don’t need to use progesterone. It’s not necessary to prevent the cancer risk. However, also, it has a lot of benefits. So, the first thing is it does oppose the estradiol. So, it thins the lining and prevents endometrial cancer. It is amazing for heavy bleeding. This is my top treatment for heavy bleeding. I use it all the time. It works so well.

                                                Vaginal or oral micronized progesterone and this is in perimenopause, I’ll often start with that and using a high enough dose that it’ll eventually stop the bleeding or turn it into light spotting. Once that happens, then you can start looking at estrogen if it’s needed, but it’s so amazing for menorrhagia and can prevent so many patients from having surgical procedures or going on other types of treatments. So, it’s something I use all the time. It’s great for sleep. It improves the depth of sleep. There’s a metabolite it turns into called allopregnanolone that can cross the blood brain barrier, and it does improve calmness, GABA, sleep. It’s very relaxing. So, a lot of patients will say, “Oh, I just slept so much better.” It doesn’t deal the hot flash as well as estrogen that wakes people up, but it definitely is very calming.

                                                So, the combination can be amazing for sleep. It does increase bone formation. Estrogen does a little bit more that way, but it definitely does that too, cardiovascular disease. So, it is really good for the endothelium. It’s anti-inflammatory. It also prevents coronary artery disease. Because of its anti-inflammatory effects, that’s most likely. So, it’s actually the opposite of synthetic progestin, which increases the risk of all of these problems. Over replacing bioidentical progesterone, it’s very interesting. The first month that you give somebody this, there’s something called crosstalk. If they have a high estrogen and they’re going to have more symptoms in the first month, that’s because their hormones…

                                                I always just explained to some that your hormones are ironing themselves out. They’re resetting. Hormones are complex because they’re all made by the ovary. These eggs have been going through different things ongoing. You have to wait for them to burn out and for the next stages to start. So, the over replacement symptoms are not often actually over replacement. They’re just initiation of progesterone in a high estrogen state. Secondly, too much progesterone could cause that in certain people, but we always give progesterone at bedtime, because consistently, oral progesterone makes people feel groggy and tired. It’s just the metabolites it turns into. So, vaginal does that far less and so does cream, but oral is quite likely.

                                                But when it’s given that bedtime, people are sleeping, so that’s great, they just sleep better. Then water retention sometimes, but that tends to resolve in time as patients get used to it as well. Then I just want to mention one more time that progestins are not the same as progesterone. There’s something called hydroxyprogesterone that sounds like progesterone. It really does, and even pharmacists can be confused about this. So, it’s really absolutely not the same thing as micronized progesterone. Very different altogether. So, always just make sure that it is actually micronized progesterone. Synthetic progestins, they all behave differently depending on the kind they are.

                                                Some of them actually proliferate breast tissue, and whereas natural micronized progesterone does the opposite. So, many of them increase the risk of clot. So, they’re all different, but they’re just substances that basically will thin the lining in the same way, but will not really improve the other elements that progesterone does. Androgens are a little complicated. So, because a lot of my practices in polycystic ovary syndrome where people have high androgens throughout their life, I actually see a lot of these patients who go through menopause. But what you’ll see is a lot of menopausal patients, even if they don’t have PCOS, they start to get androgenic symptoms. The reason for that is testosterone does decrease with age, but it’s gradual. Whereas these other ones, it is just like blam, none at all really compared to before.

                                                I mean, there’s a little bit left, but not much at all. But the testosterone’s still there. So, it becomes a more dominant hormone in the skin, for example, where it can exert things like hair loss or hair growth here. So, sometimes patients have this relative excess of testosterone, and sometimes you need to treat the DHT in the skin or treat it another way. Interesting thing is that progesterone is anti-DHT, so it is an anti-androgen. It can lower LH, which tends to encourage more testosterone. So, if a person has a lot of those types of symptoms, you can use progesterone as one of the treatments or things like saw palmetto, other types of herbs like that. But then there are some people who really do benefit from androgen replacement, DHEA, especially if they have very low DHEA, very low testosterone.

                                                If they don’t have these side effects, they can do really well with it. So, it just really depends on the person I find. I don’t want to be it too high in testosterone compared to the other hormones generally. The next one here was the DHEA. So, we already chatted about that, but this is a study, if you’d like to read it, just about DHEA and vaginal tissue. I’m just going to go into some of the herbs. There’s a category of herbs that I like to call endocrine adaptogens. So, that means that they basically help the endocrine system adapt to change. So, just adaptogens with the adrenals that help us adapt to stress and changes in cortisol, we also have herbs that either mimic hormones, fit into hormone receptors, or have hormone effects.

Dr. Weitz:                            If you don’t mind taking a question, Rosita is asking, “If a patient complains about weight gain when starting HRT, what can be done?”

Dr. McCulloch:                   Oh, yeah. So, normally, people lose weight when they start HRT. So, I would say I would look at what they’re taking firstly and be like, “Are they on a synthetic progestin?” Because that causes weight gain for sure. For most people, Provera causes weight gain guaranteed for almost everybody, like 10 pounds. Birth control pulls are the same. So, I would be like, “What’s their progestin? What kind of estrogen are they taking? Is it transdermal? Secondly, do they have something else going on their thyroid, for example?” Because estrogen affects the thyroid quite a lot. When you give estrogen, it binds thyroid. Thyroid binding globulin goes up when estrogen goes up. So, sometimes just the menopause and then going out of it will bring up that element.  So, I would just assess every single thing and see why that might be happening. Because normally, they should actually lose weight on estrogen, especially. Yeah.

So, these are our endocrine adaptogens. These affect our hormones. So, the sex hormones primarily, estrogen, progesterone, testosterone, these ones here. So, the left-hand side, these are androgenic herbs. They have androgen promoting effects primarily in women, which are different than in men. So, some of the herbs that we’ll see for men and women are just a little bit different because androgens can have dimorphic effects. So, they’re like maca, tribulus, Panax ginseng, damiana, epimedium, bacopa and Gotu kola. These tend to be more like stimulating testosterone types of promoting herb. So, people who have low libido, fatigue, energy.   On the right side are the kinds of estrogen, progesterone types of herbs that really help with these symptoms related to those problems. So, hot flashes, vaginal dryness, menstrual symptoms, insomnia and mood, any symptoms of estrogen deficiency. So, shatavari is tonic generally from Ayurvedic medicine. It’s a really great herb I find for perimenopause, for mood, skin, hair, hot flash energy. Black cohosh is very famous for perimenopause and menopause. It used to be thought of as being a phytoestrogen, but now, actually, they believe it works in the brain and not as a phytoestrogen. Wild yam, dioscorea is often thought of as mimicking progesterone, but it actually has to be converted into progesterone in a lab.  It can be, but it is not progesterone. In fact, it seems to have effects on estrogen primarily. Siberian rhubarb is one of the phytoestrogens that is most effective for hot flash. So, that is my top one that I usually recommend for a hot flash right now. So, I really like Estrovera by Metagenics for this, and they actually have a guarantee. If it doesn’t get rid of the hot flashes within two months, I think it’s two months, they’ll give you your money back or reduce them. It does work, I find, not as well as estrogen, but for people that can’t take it, I find this extract is pretty good for hot flash. Red clover is another phytoestrogen. Vitex is probably one of the most misunderstood herbs. It’s thought of as being progesterone, but actually, Vitex is not directly progesteronic. It’s those that research is because it can encourage ovulation in certain situations, which increases progesterone. But for the most part, Vitex acts on dopamine and prolactin in the brain. So, if somebody has amenorrhea and stress, often they have high prolactin. If they have hypothalamic amenorrhea, this is a helpful herb. So, if there’s like a mood component and a change in cycles, it can be helpful, especially with prolactin being high. Kudzu is another phytoestrogen. It’s quite strong, I find. So, for hot flash, it can be useful. Dong quai is from traditional Chinese medicine, Angelica. I find it similar to shatavari. It’s like a tonic generally. Hops is another phytoestrogen.

                                                Okay, and the next section is the adrenal adaptogens. I like to include these because they’re super important. They’re just a little bit different than the endocrine adaptogens. The first one is Ashwaganda, Withania somnifera. This is my favorite adaptogen for stress and sleep and for anxiety. It’s a very calming adaptogen. It takes it down a few notches. It’s great to give it bedtime, to keep people from waking up in the night from a cortisol spike. So, that is my favorite way to use Ashwaganda, or I also give it in the daytime for people with anxiety, irritability. Holy basil is a really nice herb because it really is a good mood booster in perimenopause. Plus, it has some really nice effects on skin and hair. So, a lot of patients like it.   Eleutherococcus is a really great adaptogen. I always think of it as a stress shield. So, if life is stressful and you’re on eleuthero, you will not feel the stress as much. It gives energy. It’s a really good tonic. It’s great for people who want to start working out. So, I do really like an eleuthero. Rhodiola is a very uplifting herb, so I find it’s very good for people with low cortisol or depression or fatigue, dopamine problems. It can help with attention, brain fog. Panax ginseng actually is quite similar to it’s uplifting, stimulating. For people who have more anxiety, it might not be the right fit, but for people with a lot of fatigue and low testosterone, it’s a really good one. Then sage is really good just for mood, energy, overall cortisol balance.  So, often it’s added into formulas, herbal formulas.

                                                  The next slide, sleep and mood. So, sleep and mood, I want to include some of the natural treatments here because it’s probably one of the most common complaints. So, on the left side, I have some of the treatments I tend to use for insomnia. Now, of course, HRT is going to have the biggest impact on this because it just resolves it so well for so many people. So, I always start with progesterone if they’re open to it because it helps so much. But magnesium, melatonin, these melatonin with sleep onset. Magnesium is just something that is one of those general supplements that everybody should be on if they’re having a sleeping problem because most people are deficient in magnesium and the herbs.  So, there are many herbs that you can use for sleep, valerian, skull cap, passionflower. Zizyphus is one of my favorite herbs for sleep. It’s often not even considered, but it’s a great herb from traditional Chinese medicine for sleep. Then Withania, so Ashwaganda. So, I use that a lot at bedtime. I really like the Douglas Labs’ Ayur-Ashwaganda, so I just find that extract really good. Two of those at bedtime is really helpful for preventing the 3:00 AM wake up. Anxiety and irritability, so of course there’s so many options here too, but we’re looking at all of these nutrients like GABA, threonine, phosphatidylserine, taurine.  Again, Ashwaganda, St. John’s wort, which you can’t combine with SSRIs and Vitex actually helps quite a bit with irritability and anxiety and other kinds of mood effects. That is all that I have presenting to present today. So, do you have any questions? I’m happy to answer.

Dr. Weitz:                          Yeah, no, that was great. Excellent. Good information.

Speaker 3:                         I got a question, Ben.

Dr. McCulloch:                   Yes.

Speaker 3:                         My wife is on 0.0125 Vivelle-Dot estradiol, and she’s on compound microdose pharmacy 100 milligrams of progesterone. She’s been on that since menopause. She’s doing fantastic. The question is about pulsing that. Some people say not to, some say to do it. We haven’t done it. She’s doing great as she is. Is there any problem with that Vivelle-Dot? She’s doing great.

Dr. McCulloch:                   I don’t think that there’s any reason that we’ve ever learned that it should be pulsed. Sometimes that makes people bleed and spot. So, they used to be like, “Oh, the receptors.” But what we know is that reproductive age women always have estrogens. The receptors don’t go away just because the estrogen is at a certain level. When the estrogen goes away, the receptors go away. So, keeping the estrogen there is probably better for the receptors, but they’re very-

Speaker 3:                         How long will she have to be on this, the rest of her life far as I’m concerned? I mean, when she’s 95, we’ll stop it.

Dr. McCulloch:                   Well, right now, what we know is that it’s safe up to 10 years. It’s safe up to five years after the last period with progesterone if it were a synthetic progestin. We don’t have enough data to say that natural progesterone is safe past that, but it probably is because it’s never been shown to cause clot. So, they’re going to have to have the research to show that it’s safe to 10 years like estrogen and then we don’t know beyond that point actually.

Speaker 3:                           Wow. So, she’s going over 10 years. Oh, wow.

Dr. McCulloch:                   There’s lots of people on it past 10 years and they’re generally doing very well. I think this is just the research has to be done.

Speaker 3:                         Thank you.

Dr. McCulloch:                   Yeah. When I graduated school, there was doctors doing HRT in our city and they have had patients on it for decades doing well. So, yeah.

Speaker 3:                         Thank you.

Dr. Weitz:                          What about, is there value in tracking the estrogen metabolites through the urine testing to see how they’re metabolizing it and then using particular supplements to try to influence that to make sure that they’re metabolizing it along the safest possible pathways?

Dr. McCulloch:                   Yeah, exactly. So, I think you can do the DUTCH test, take a look at what’s happening there, if there’s anything risky. Breast cancer is complex. It’s not estrogen. It’s the entire situation and then estrogen just feeds it, but that can be done. Then just the dose is generally so small in these groups. We don’t use large doses. The older people get, the less these large doses are ever going to be needed. So, it’s like a tiny baseline just to prevent the receptors from going away and give that little bit of stimulation. So, there’s probably lots of ways to make it very much safer.

Dr. Weitz:                          I mean, I know there’s a concern that as women go through menopause, there’s an increased risk of bone density. Do you recommend particular strategy, supplements during that period to maximize bone density or limit bone loss?

Dr. McCulloch:                   Yes, 100%. So, the HRT definitely is a huge thing that is the top thing. Then a really good bone mineral formula, something that has the whole array of nutrients, something like we have here, Ortho Bone, but there’s so many other products like this out there. I know we have a lot of Canadian products, but one of those bone formulas that has a good quantity. Then exercise is critical. I recommend exercise for everybody. Even if someone isn’t that mobile, there’s also whole body vibration that’s been shown to have a lot of effect on osteoporosis.  Anyone can do that really. You can get the plates at home. Even somebody who’s disabled can do that. So, there’s lots of things like that that can be done and phytoestrogens might help, but it’s not a lot not compared to estrogen.

Dr. Weitz:                            Rosita asked about using DIM for estrogen dominance or PMS symptoms.

Dr. McCulloch:                   DIM is a really good supplement to lower high estrogen. So, somebody consistently has high estrogen and perimenopause, it can be really good. It can also direct it down a less harmful pathway to be eliminated. Making sure no constipation is very important too, so that it doesn’t get reabsorbed back in the gut. You can use calcium D-glucarate to make sure that that happens too, because it keeps it from breaking down basically in the gut and getting reabsorbed. So, someone has a gut issue, high estrogen, you probably want to deal with constipation and add D-glucarate with the DIM too.

Dr. Weitz:                          Now, I have talked to some doctors who say every time they put women on HRT, they automatically give them DIM and calcium D-glucarate and iodine or something like that.

Dr. McCulloch:                   Yeah. I don’t tend to do that because DIM lowers estrogen. So, sometimes that can be not a good thing and that you’re giving it and it’s going out. So, you have to know what’s the reason for that. Because DIM as a concentrated supplement is very different than eating those vegetables that have I3C. So, I usually do that in a response to something very specific I’m seeing.

Dr. Weitz:                          Right, yeah. Treat each case specifically. Allison is asking about AMH levels in perimenopause.

Dr. McCulloch:                   So AMH levels in perimenopause are always low. They’re never going to look good unless someone has PCOS. In some cases, they actually still have really good AMH, so they tend to go through menopausal later. But for most people past age 40, there’s really not a lot of point of testing AMH because it’s just going to look low. You can already tell from their age and their pattern of their cycles if they’re in perimenopause, but in a younger woman, sometimes you can’t tell that’s what’s going on. It might be they have stress, they lost weight or something else.  It’s causing the cycle irregularity. In perimenopause, it has a pattern like it’ll shorten and it’s consistent. It doesn’t go back. It just continues that way, marching along towards the end. So, you can do it and it just depends on the situation. If you’re really not sure, you can definitely do it, but it should be very low.

Dr. Weitz:                          Okay. So, I think we’ll conclude. Thank you so much, Fiona. It was awesome.

Dr. McCulloch:                   Thanks. I’m glad it was helpful.



Dr. Weitz:                            Yes, absolutely. Thanks, everybody, and we’ll see you next month. Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five-star ratings and review. That way, more people will discover the Rational Wellness Podcast. I wanted to let everybody know that I do have some openings for new patients so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardiometabolic conditions, or for an executive health screen and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way.  That usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective. So, if you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at (310) 395-3111, and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.



The Dangers of GMOs and Glyphosate with Jeffrey Smith: Rational Wellness Podcast 305

Jeffrey Smith discusses The Dangers of GMOs and Glyphosate 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

2:27  Jeffrey Smith has been dedicated to speaking out about the potential dangers of genetically modified organisms since he heard a lecture 27 years ago by a genetic engineer who was blowing the whistle on Monsanto that was about to release its first genetically modified crops into our food supply.  Jeffrey runs the ResponsibleTechnology.org website and if you go to ResponsibleTechnology.org/takeaction before May 21 you can take action and add your voice to the discussion in the U.S. Department of Agriculture about how to regulate genetically modified organisms so we can prevent an apocalypse. Now Jeffrey is also speaking up about the dangers of GMO 2.0, which is the subject of the documentary Don’t Let the Gene Out of the Bottle, which is a 16-minute film, which happens to be at the website above.

6:26  GMO Foods.  Traditional GMO foods have a gene from another species transferred into that plant, but we now have have GMO 2.0, which utilizes the new gene editing tools to knock out genes or gut the genome in a place or two and hoping that when the thing gets reattached, it either adds what you want in or leaves out what you want and doesn’t bring anything in extra that you don’t want.  This involves a lot of wishful thinking and obviously a lot could go wrong.  Jeffrey has a six minute film at responsibletechnology.org/takeaction that discusses some of these dangers: Seven Reasons Why Gene Editing Is Dangerous and Unpredictable.  The biotech industry has been licking its wounds because the movement to limit and ban GMO foods has been successful at informing consumers, and doctors that it is not safe that we have been able to contain it to 12 genetically engineered food crops as opposed to Monsanto’s stated goal by this time to have 100% of all commercial seeds genetically engineered and patented.  What’s even scarier is that it used to take a long period of time and was expensive to genetically engineer foods, but now you can buy a gene editing kit from Amazon for a few thousand dollars and create your own GMO every day.

9:41  Monsanto convinced the White House that GMOs were safe and that GMOs were going to increase US exports and domination by the US in world food trade and they should be allowed on the market.  Monsanto were able to get a former attorney of theirs–Michael Taylor–into the FDA to create a pro GMO policy.




Jeffrey Smith is a global thought leader on the health dangers of genetically modified organisms for over 27 years. He has written 2 bestselling books, Seeds of Deception and Genetic Roulette, directed 5 documentaries, the most recent of which is Don’t Let the Gene Out of the Bottle in 2023 and Secret Ingredients in 2018. Jeffrey has given thousands of lectures all around the world and has counseled world leaders on six continents.  He is the founder and CEO of the Institute of Responsible Technology and he is now sounding the alarm not only about about GMOs and glyphosate but about GMOs 2.0.

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 website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.

                                Hello, Rational Wellness podcasters. I’m very excited to dive into the topic of genetically modified foods and glyphosate, which are topics I’ve been wanting to discuss for a while, but did not have the right guest and now will be joined by the most prominent voice talking about the potential dangers of genetically modified organisms, Jeffrey M. Smith. Jeffrey is a global thought leader on the health dangers of genetically modified organisms for over 27 years. He’s written two best-selling books, Seeds of Deception, and Genetic Roulette. He’s directed five documentaries, the most recent of which is, Don’t Let the Gene out of the Bottle in 2021 and Secret Ingredients in 2018. Jeffrey has given thousands of lectures all around the world and has counseled world leaders on six different continents. He’s the founder and CEO of the Institute of Reasonable Technology.

Jeffrey:                Responsible Technology.

Dr. Weitz:            Oh yeah, Institute of Responsible Technology. Yeah, sorry. He’s now sounding the alarm not only about GMOs and glyphosate, but about GMOs 2.0, which I’ll explain. Genetically engineered foods have had their DNA changed using genes from other plants or animals. Scientists take the gene for a desired trait in one plant or animal, and they insert that gene into a cell of another plant or animal. Currently, in the US the main GMO crops are soybeans, corn, sugar beets, canola, and cotton. There are currently two approved GMO animals, the AquAdvantage Salmon and the GalSafe pig. Jeffrey, thank you so much for joining us today.

Jeffrey:                Thank you. Thank you, Ben. Great to be here.

Dr. Weitz:            What is your background, and how did you get involved in this particular field?

Jeffrey:                Well, I’m going to first say that a number of times during our conversation, I’m going to talk about some short films that we did and things that people can do to take action. So right at the top, I’m going to give the URL so that people can go back and realize it’s at the beginning.

Dr. Weitz:            Absolutely.

Jeffrey:                You don’t have to find it in the middle. So responsibletechnology.org is the mothership website, and if you do a /takeaction, then you’ll find out why I’m going to ask you to take action and what’s there, and there’s some films there and there’s some ways that we can prevent a apocalypse, things like that. All right. So you asked me the question, how I got into it. 27 years ago I was in a lecture by a genetic engineer who’s blowing the whistle on the technology Monsanto was about to release it in our food supply officially, and the genetic engineer said, “There is no way that Monsanto or any scientist on Earth could predictably genetically engineer anything and put it in the food supply without possibly causing allergic reactions, toxins, nutritional problems. There’s just no way. In addition, once you release it outside, it’ll cross-pollinate, and you have no way to recall it so you have just changed the gene pool forever. This technology is not ready for prime time and will not be any time in the seeable near future.”  So I decided to chip in a little and help with messaging and education and marketing and strategy, which is where I like to contribute. 27 years later and speaking in 45 countries and training 1500 people to speak on it, I contributed a little, and I continue to. We’re going to talk not only about what you introduced terms of GMOs and health and the environment and also glyphosate, but GMO 2.0 and how that actually puts us at risk in a cataclysmic way. I mean, way beyond anything that I’ve been talking about for 25 years. That’s a subject of Don’t Let the Gene Out of the Bottle, which is a 16-minute film, which happens to be at responsibletechnology.org/ takeaction.

Dr. Weitz:            I went there and I watched it.

Jeffrey:                Okay. Now I am ready to go deep. When I say deep, I mean, when I’m speaking at a medical conference, for example, or even at just a general health conference, and it’s a breakout session. So you get to choose. A lot of people go, “Well, I know GMOs are bad. I don’t need to go and hear about that.” If I am in a keynote and everyone has to hear what I have to say, then it’s like, “OMG, I had no idea. I thought I knew the dangers of GMOs. I thought I knew that they were bad, but I didn’t know this bad.” So we’ve convinced tens of thousands of practitioners to prescribe organic diets. We’ve had tremendous, tremendous impact. But it’s not like, “Oh yeah, GMOs, that’s another thing that could go bad.”  We’re going to look at some charts today that I’ll describe for those that are listening just by audio, and it’s going to be like, “I had no idea that switching to organic was the number one, the number one step for getting your health together,” and far distant from number two. I mean, we’re going to talk about all these very popular diseases that everyone’s getting and talking about and how they may be directly linked to your consumption of GMOs and the glyphosate, which is the chief poison in Roundup, in your food. So we’re going to raise some eyebrows today for people that haven’t heard this.

Dr. Weitz:            I just talked briefly about what genetically engineered foods are. Maybe you could put some more meat on those bones. Explain what genetically modified organisms are, why they were first developed.

Jeffrey:                Sure. First of all, you mentioned transferring genes from one species. That’s the traditional way, but there’s another GMO in town, and it’s gene editing. You don’t have to be transferring genes from other species. They’re still GMOs, but you’re going in there and you’re knocking out genes or cutting the genome in a place or two and hoping that when the thing gets reattached, it either adds what you want in or leaves out what you want and doesn’t bring anything in extra that you don’t want. So there’s a lot of wishful thinking. Another film, which is just six minutes called, Seven Reasons Why Gene Editing Is Dangerous and Unpredictable is also at that one page, responsibletechnology.org/takeaction because right now, just as an FYI, the biotech industry was licking its wounds because we have been so successful for these 25 years convincing and explaining to consumers why this stuff was not safe, and to doctors, to consumers.

                                People realized, half the world’s population realized that GMO foods were not safe, and it contained to about 12 genetically engineered food crops as opposed to Monsanto’s stated goal by this time to have 100% of all commercial seeds genetically engineered and patented. We’ve been able to keep it that way through education. So they come along and say, “Okay, squirrel, look the other way. We are using gene editing, but it’s not GMOs. In fact, we don’t use any foreign genes. We put it in there and it’s safe, it’s predictable, it’s even natural. In fact, it’s just what nature would do automatically, only we do it better.”   This concept that gene editing should get a pass has been the subject of a multi-million dollar gang-up lobbying campaign that convinced the American government, the British government, the UK, convinced Japan, convinced India, Australia, convinced Brazil, Argentina. They’re trying to create that same situation in the EU.   So all of the incredible benefits and successes that we’ve had over 25 years are at risk because … Now here’s an interesting thing, Ben. It used to take so long to genetically engineer and expensive and a lot of expertise. You can buy a gene editing kit for $2,000 and create your own GMO every day. We’ve given the keys to the kingdom to virtually everyone. Now, I’m getting a little ahead of myself.

Dr. Weitz:            I heard you say that. I’m still in shock over that possibility. I can’t believe that that’s legal. How is that legal?

Jeffrey:                Because of lies. I mean, if you go back, all right, we’re going to go back to the original GMO 1.0. Okay. How is it that something which, and I’m going to explain how it’s related to so many diseases that, I mean all the major diseases, how it’s possible that they could have allowed that on the market. Same question you asked just now.  It turns out Monsanto convinced the White House … They had a lot of friends there … That GMOs were going to increase US exports and domination by the US in world food trade. So the White House told the regulatory agencies, “Allow GMOs on the market very, very quickly. In fact, here what you’re supposed to do, FDA is bring in this man called Michael Taylor,” Monsanto’s, former attorney who had the plan. They created a new position for him. They never had a position of the Deputy Commissioner of Policy. They created it for Michael Taylor. When he was in charge, he was to create the GMO policy. He also created the FDA policy on Monsanto’s bovine growth hormone. So he created basically, fox in the chicken house.  The policy that the FDA created that’s still good today or still bad today, is that the agency isn’t aware of any information showing that GMOs are different than non-GMOs. Therefore, no testing is necessary, no labeling is necessary, and companies like Monsanto could put GMOs on the market without even telling the FDA. If they do tell the FDA, there’s a meaningless exercise at the end of which the FDA writes a letter and reminds them, “It’s your job to determine if your foods are safe, not ours.” So that is the policy created by Michael Taylor based on that sentence saying, “We know no difference.” That was all a fraud.  We realized … The policy came out in May 1992, and in 1998, my friend, Steve Druker, pioneered a lawsuit against the FDA. They were forced to turn over 44,000 secret internal memos. Then we realized that the overwhelming consensus among the scientists working at the agency was exactly the opposite. That GMOs were different, were dangerous, needed to be tested and should never have been approved.      Their predictions came true, their predictions that in fact this stuff is very dangerous and that people would just have the expectation that it’s been done 1000 times before, so no one really needs to test it, and that’s all the current situation. So we have gathered all the evidence that we could, and it’s like a smoking shotgun of evidence showing that GMOs and the Roundup sprayed on them … I’ll explain that in just a minute … Are probably driving tremendous number of diseases in the United States. We know that when people switch to organic, which doesn’t allow either, they get better from the same type of diseases.

Dr. Weitz:            Yeah, I went to the FDA website. This is what the FDA website states. “GMO foods are carefully studied before they are sold to the public to ensure they are as safe as the foods we currently eat. These studies show that GMOs do not affect you differently than non-GMO foods. Further,” the FDA website says, “GMO foods are as helpful and safe to eat as their non-GMO counterparts. Some GMO plants have actually been modified to improve their nutritional value. An example is GMO soybeans with healthier oils that can be used to replace oils that contain trans fats. Since GMO foods were introduced in the ’90s, research has shown that they’re just as safe as non-GMO foods. Additionally, research shows that GMO plants fed to farm animals are as safe as non-GMO animal food.”

Jeffrey:                This is basically fiction. This is a fictional story. Chapter one, once upon a time … Let me tell you what the actual FDA scientist said. We have the memos. This was from Linda Kahl, the Compliance Officer, summarizing the experience of the 17 scientists that were handpicked to create the policy on GMOs, which was overruled by Michael Taylor. She said, “The process of genetic engineering is different than conventional breeding and according to the technical experts at the agency leads to different risks. By trying to say that it’s the same is forcing a square peg into a round hole.”   Then Louis Pribyl, a microbiologist from FDA, when he got back the latest version from Michael Taylor, said, “What’s become of this document? It’s basically a pro-industry document that doesn’t address any of the side effects. It’s what do I have to do to stay out of trouble type document.”

                                Then the toxicological evaluation, the head of the toxicological department said that it’s justified to have at least a partial human toxicological studies on every GMO. Charles Guest, who was the head of the Division of Veterinary Medicine said, “The milk and meat from animals fed GMOs is different and can have specific unique risks.” Talking about bioaccumulation and things like that. They were very specific. What happened was even this completely sanitized pro-GMO version written by Michael Taylor, ignoring all the science, was sent up to the White House, the Office of Management and Budget, and the White House Counsel and another person came back and said, “No, no, no. It raises too many issues. It has too many pages dedicated to the environmental issues. We should emphasize that GMOs are safer.” As it went up the political chain of command, GMOs got safer and safer until we end up with this complete absolute moronic fiction.

                                I mean, I can give you some examples that are … I mean, when I speak to medical conferences, I’ll start off at the beginning and say, “Okay,” or any conference, “Tell me what percentage of organic foods you eat. How many, zero to 20, 20 to 40,” and I get a chance to see everyone’s hands up. For the practitioners, I say, “How many of you prescribe organic diets?” Very few people usually raise their hand. So at the end of 40 minutes of pictures of rat tumors and this thing and that thing and epidemiological evidence and plausible causative pathways between GMOs, Roundup and different diseases, I say, “And now, what percentage of your diet will be organic going forward? Zero to 20?” No one raises a hand. “20 to 40?” Everyone’s like 60 to 100%. “How many of you will prescribe organic diets?” All the hands go up.

                                I went back to some conferences where the doctors had actually started prescribing organic diets, and they said it worked. Our patients got better. I went to their offices, interviewed the patients, and it worked. Went to the farmers who took their pigs and cows off of GMOs and their animals got better. I looked at veterinarians both in terms of livestock and in terms of pets, and we also have the animal feeding studies.  So we have a bunch of diseases, which I’m happy to introduce at any time that we think are related to GMOs and Roundup, and we have a bunch of individual reports and clinical trials, clinical experience of people getting better from these same diseases or their precursors. We have the animal feeding studies and the experience of the vets and the doctors. I can describe why we think GMOs and Roundup are driving diseases like nothing else, and the main thing is switch to organic.

Dr. Weitz:            Right. So let’s go into that. My understanding is a lot of these genetically modified foods are, like the corn and the soy, are genetically modified to be resistant to Roundup so then they can just indiscriminately spray this herbicide all over the food.

Jeffrey:                Yeah, let me explain that. Well described. Roundup kills virtually all the plants. It also kills a lot of microbes. It’s an antibiotic. If you were to spray it over your field of soybeans or corn normally, you’d kill it all. So you have to spray it before the emergence of the crop or just spot spray it on weeds. But Monsanto’s patent on glyphosate, which was the chief poison in Roundup, was going off in 2000. They wanted to maintain sales so they genetically engineered seeds, soy and corn, then cotton, canola, sugar beets and alfalfa to create plants that would withstand and not die when sprayed with Roundup. So they call them Roundup Ready. So the Roundup Ready soy, as a farmer, you buy the seeds, you sign a contract, “I’ll only use Monsanto’s glyphosate based herbicide.” So they ended up continuing their domination of glyphosate even though it’s off patent.

                                Now the farmers can weed really easily. They can weed after their crops are growing, and then new weeds come up and they just spray right over the top. One application, two applications, three applications. Now, glyphosate by itself is not as toxic as Roundup because Roundup has all sorts of other things, including a surfactin that drives it into the tissues of the plants. Now, it also drives it into human skin. It also can drive it through clothes, even through boots.

                                In fact, Monsanto was required to turn over evidence of how much absorption into human skin was taking place. So they took the human cadaver skin and they put Roundup on it, and they found it was over three times the allowable level of absorption. So they threw that information away, hid it illegally from the EPA, and then they decided to do a Monsanto version of a study. I love how Monsanto science is. This is typical. This is typical, Ben. Monsanto took human skin from a cadaver and baked it in an oven. Now you know what happens when you bake meat? It gets harder and harder and harder. It wasn’t good enough. They probably tried it. It wasn’t good enough. They took this baked, overcooked human skin and then they froze it.  Then they took this leather-like result of human skin and applied Roundup, and there was hardly any absorbed. So they reported those numbers to the EPA, omitting that, I don’t know, that inappropriate fact that they had baked and frozen human skin before they applied the Roundup. That was hidden. They never mentioned that there was no asterisk, by the way, this has no resemblance to human skin. So this is a Monsanto type study.

Dr. Weitz:            So it potentially would not have even gotten approved if they-

Jeffrey:                Oh, no. Oh, no. There’s so many ways that they manipulated data that none of this stuff would’ve gotten approved. So now you spray it over the crop and it drives the glyphosate poison into the soybean plant. Then it gets 15% or so in through the roots, damaging the soil below, and about 80-85% that stay in the plant, mostly in the food. Now, we eat that food. Now, glyphosate is no friend to the human body. Now you’re a physician, and I’m going to describe some of the things that glyphosate does, and you’re realizing that I’m actually checking off a checklist of the foundations of health and that any one of these could lead to many diseases, if not a vast number.

                                Glyphosate was originally patented as a chelator to descale industrial boilers and pipes. So it grabs onto minerals and doesn’t let go. So the first thing it is is it deprives our body of minerals. Second, it creates leaky gut. Third, it kills off beneficial gut bacteria, but not the nasty stuff. Four, it can block the production of serotonin, melatonin, and dopamine. Next, it can damage aromatase, which sets the balance between the estrogen and testosterone. It can damage and collapse the structure of mitochondria, which are the energy centers in our bodies. It can cause gap junctions, which is the way cells intercommunicate. It knocks that out by 50%. It blocks the detoxification pathways of the body, both the NRF2 going down 30%, and the P450 cytochrome pathway, CYP enzymes that operate in the liver. It causes damage to the microvilli in the intestines. It blocks the production of, not completely, but it suppresses the production of enzymes in the gut to break down food. It causes birth defects, oxidative stress, and genotoxicity, and is declared a Class 2 carcinogen by the WHO.

                                Now, that’s like you name a foundation of health, and it’s taken care of by this Darth Vader chemical. It is just slashed and burned. So now when you’re spraying soybeans or corn, Roundup Ready corn, with Roundup and you feed it to rats like Monsanto did, and there was 50 statistically significant changes that they said, “Oh, they’re not a problem,” and it was only 90 days and they sent it to Europe. This guy, Seraline, who was reviewing for France, said, “This is a lot of problems, and these show preliminary evidence of damage to liver and kidneys and preliminary evidence of a lot of things.” But they cut the study off in 90 days, and they didn’t do all the tests that they should have done to see if these things were serious. In fact, they did pretty superficial studies.

                                So he took the same type of rats, the same rat size group, the same amount of GMOs in the food supply sprayed by Roundup and fed them for two years. They had multiple massive tumors. The tumors started at 120 days right after they finished the 90 days, the first tumor started. So they had multiple massive tumors. Some of them were like 25% of the body weight. They killed the animals because it was considered suffering after that point. They had organ damage and they died early. Now, was it the corn, the Roundup Ready corn or the Roundup? They figured out before they even started to have more than one experimental group. So one group were fed the Roundup Ready corn sprayed with Roundup. Another group was the Roundup Ready corn that was never sprayed with Roundup. A third group, actually, many groups had just Roundup at varying levels in the drinking water, eating natural corn, and then they had a control.

                                It turns out all of the groups had multiple massive tumors, early death and organ damage, whether it was the Roundup alone, the GMO alone, or the two together. The only group that didn’t was the control group. So we understand more about how Roundup does the killing and whatnot because there’s more research on it, all those things I just described. For GMOs, because the FDA said we don’t need any testing, there’s just a handful of studies. But that handful of studies show potentially pre-cancerous cell growth in the digestive tracts, smaller brains, livers and testicles, partial atrophy of the liver, damaged immune system changes in virtually every organ and every system studied. So we have an idea. So what I’d like to do, Ben, with your permission, is walk us through some of the evidence.

Dr. Weitz:            Absolutely.

Jeffrey:                All right.

Dr. Weitz:            Please do.

Jeffrey:                So I’m going to share a screen in just a moment, and this is a amount of Roundup sprayed on soy and corn in the United States in a graph showing the slope. Other slides that I’m going to show, it’s both the amount of Roundup sprayed on there, and also the amount, what percentage of GMO soy and corn there are because it’s basically the same. You only spray Roundup on soy and corn if it’s GMO, at least the volume that we’re talking about.

Dr. Weitz:            I just want to say to all the listeners. Anybody who’s listening to this on your phone, when you get home, go to YouTube and watch a YouTube video and go to my Weitz Chiro page and you can see the slides.

Jeffrey:                These are plotted against rises in specific diseases. So for those who are not going to see it, and I haven’t started showing it yet, the correlation is pretty tight. A perfect correlation is one. These correlations are like 0.9. I’m looking at one like 0.93, 0.97, 0.96. It looks like the two are sloping up together. All right, so let me share my screen.

                                What we’re seeing first is inflammatory bowel disease. You could see this is the discharge rate per 1000. Now, I’m going to go through a lot of charts very, very quickly. I’m going to name the disease, and you can just look at the slope. For those that are not looking, I’m just going to name the disease. Your friends watching, their jaws are dropping going, “OMG.” Just acknowledge that these things do look like they’re related.

                                Here’s deaths from obesity, anxiety, diabetes, deaths from Alzheimer’s, deaths from Parkinson’s, deaths from high blood pressure, autism in six-year-olds, insomnia, celiac disease, acute kidney injury, death from kidney failure, kidney and pelvic cancer, liver cancer, liver and bile duct cancer, thyroid cancer, that’s from acute myeloid leukemia, breast cancer, that’s from intestinal infection, deaths from disorders of lipoprotein metabolism, peritonitis, hepatitis C, dementia, deaths from senile dementia, ADHD, schizophrenia, suicide by overdose, birth defects, and there’s a lot of birth defects here, heart defects, newborn metabolic disorders, newborn genitourinary disorders, skin disorders, newborns with lung conditions, eye disorders, blood disorders, plus general [inaudible 00:29:28] anemia, lymph disorders, deaths due to stroke. In this final slide, and I’m going to come back to this in just a minute because I want to introduce this, so first of all, all of those charts are devastating, but they don’t prove causation.

                                You can run two things together and say, “Hey, see. A causes B,” but you can’t tell that A causes B. So you need other information. If we just have that, it would be kind of weak evidence. It would be stunning in its coincidence, in its correlation. But you can look at those particular disorders, and we can find supporting evidence from animal feeding studies showing often the precursors to those when animals are fed GMOs and Roundup. You can find plausible causative pathways. What is it about GMOs and Roundup that are causing that? For example, you saw insomnia. Insomnia is often governed by the amount of melatonin you have. Melatonin comes from the amount of serotonin available. Serotonin is created by L-tryptophan, which is produced by your gut bacteria in a metabolic pathway called the shikimate pathway. The shikimate pathway is disabled by glyphosate. Straight line. Straight line.

                                If you don’t have enough serotonin, that could explain some of the ADHD and the anxiety and all that stuff. When we talk about digestive problems, there’s probably 40 or 50 things influencing that. Speaking of digestive problems, in 2009, I went to the American Academy of Environmental Medicine. I’ve been speaking there every year. The GMOs and Roundup influence on different diseases. Each year they focus on a different disease, allergies, cancer, and I was just basically putting all the evidence together, showing is it possible that GMOs and Roundup might affect those diseases. Sure enough, there was a lot of evidence. So a lot of these doctors started prescribing non-GMO diets, and they’re the ones that first told me this was influencing people. Before then I was, I’m embarrassed to say, I didn’t really believe people when they came and said, “I can notice if I’m eating GMOs or not.”

                                But these doctors are saying, “Oh, no, it’s quick.” In fact, this one doctor, Dr. Emily Lindner, had put 5,000 patients on non-GMO diets and said, “Yeah, anxiety and depression goes away kind of right away. Asthma and allergies, three to seven days. Digestive disorders within about two months, and then you have to rebuild it. So maybe two years for the digestive.” I was blown away, and I interviewed some of her patients. So I started getting bold. Around 2012, when I came out with Genetic Roulette, I started asking audiences, “Okay, how many of you who are in the 60 to 100% non-GMO, how many of people noticed changes in your health?” A bunch of hands went up. Almost everyone in that category. All right. “What did you notice?” People would tell me, “Oh, I got acid reflux that went away,” or less weight or kidney disease.

                                I’d always say, “All right, who else noticed a change in this area?” I’d get a sense of the number of hands. In 150 lectures, including about two dozen medical conferences where they were referring to their entire practices’ results, the number one result was always digestive disorders. The number two was always the combination, I’d say increased energy and reduced brain fog, always number two. There was about 28 different conditions that I tracked. So I wrote it up in a survey and sent it out to … At the Institute for Responsible Technology we have subscribers, and 3,258 people responded.

                                This particular screen that I’m now to share is the summary of what we found in those 28 different conditions. 85% reported improvement in digestive problems. This was peer-reviewed and published in the International Journal of Human Nutrition and Functional Medicine. 60% said reduced fatigue, 55 reduced obesity, 52 reduced brain fog, 52 reduced anxiety and depression, 50 food allergies and sensitivity. Then below 50% going down to just 1.4, you have memory and concentration at 48, joint pain, seasonal allergies, gluten sensitivity, insomnia, skin conditions other than eczema, hormonal problems, musculoskeletal pain, autoimmune disease, eczema, high blood pressure, asthma, menstrual problems, diabetes, mental disorders other than anxiety and depression, underweight, cancer, kidney disease, infertility, autism, Alzheimer’s and Parkinson’s.

                                So it’s interesting that many of these are the same ones or similar to the ones that are on the rise in the US population now. That’s basically the general population that eat more than their body weight in GMOs every year going up with the increased use of GMOs and Roundup in the United States. These are people who opt out of that experiment and get better from many of these same disorders. Then we have veterinarians like Barbara Royal, who’s Oprah’s vet, she said when she went to veterinary school, they didn’t even talk about dog cancers or dog allergies. Now it’s all over the place. One out of every 1.6 dogs have cancer, I’m told. She said, “I got a sense that maybe it’s the food and the GMOs and the Roundup. So very tentatively, I’m kind of scared. I put the animals on a organic diet, and now everyone goes on an organic diet,” or at least the diet that doesn’t have GMOs and Roundup, and she said, “80 to 90% are all managed by the next visit. They don’t even need anything.” 40%-

Dr. Weitz:            That’s incredible.

Jeffrey:                Completely healed. What I’m saying is if people don’t know whether what they’re experiencing, and that they may have been part of this disease list, maybe they’re not, if you switch to organic, you may be fixated on, “Oh, I want to lose weight,’ or, “I’ve got diabetes, so I’m going to check my blood sugar,” or, “I’m going to check insomnia.” You may be focused on one thing. I suggest that you focus on everything by taking notes. Get a spreadsheet and start with what percentage of your diet is organic. Start today, zero or whatever it is. Put your energy level, your mood, one to 10, and all your symptoms, the date. Then the next day, percentage organic everything, Move right along. Three or four weeks, see what happens.  Some people will notice that if they go on vacation and they cheat and they go out to eat, things go back. In the movie I did with Amy Hart, Secret Ingredients, these doctors say they got excited when their patients cheat because then their autoimmune disease symptoms come back, their joint pain comes back, and then they don’t cheat again because they realize that was the reason. So you don’t have to get to that level. You can just do it and see what happens. I would say that is one experiment where the payoff is huge.

Dr. Weitz:            Not only when you consume these genetically modified organisms, corn, soy, et cetera, but they spray Roundup on a lot of crops just to dry it out before we eat it.

Jeffrey:                Exactly. So that’s why, Ben, I used to say to people, “Eat non GMO, and if you can, eat organic because you’ll avoid the other poisons.” Now I say, “Eat organic, and if you can’t, at least eat non-GMO, but also avoid the foods that are sprayed with Roundup heavily that are not GMO.”

                                So let me unpack this. I think it was about 2006, Monsanto was looking to sell their Roundup herbicides to other farmers. They said, “Okay, wheat farmers. Spray your wheat three to five days before harvest.” Now guys, we’re spraying something that’s going to kill your wheat, but it’s going to kill it slowly, and it’s first going to dry it down. So when you dry it down, it actually helps in terms of not getting moldy, but also the plants start to die and they say, save our kids, send all the energy to the kids, which is the grain. So it forces the ripening of the grain. So it fast paces the ripening, it dries down the harvest, it kills all the weeds for next year. It’s called staging, and then you just harvest it and feed it to people with a massive amount of glyphosate in the wheat.

                                So right now, wheat is not GMO, except there’s a crop that came out of Argentina last year. Don’t eat Argentinian wheat unless you know it’s organic and non-GMO. But in other cases, it’s not been GMO, but it often is sprayed with Roundup. One of the worst is oats because it’s like a sponge. Then you have the lentils and the mung beans and the chickpeas. Don’t eat hummus unless it’s organic. You see, organic does not allow either GMOs or Roundup to be used, so that’s why I keep emphasizing organic. If we just said non-GMO, you’d still be having bread and oatmeal and hummus and things like that that could be loaded with Roundup. If you go organic, you also avoid other things like atrazine and all these other nasties.

Dr. Weitz:            I did a little research, and not only is there glyphosate, but there’s also heavy metals like arsenic present in Roundup.

Jeffrey:                Oh, yeah. The surfactin is about 1000 times or maybe 10,000 times more toxic than glyphosate alone. Some of these other co-ingredients are hormone disruptors and are toxic. Yeah, it’s pretty nasty stuff. I mean, the impact of glyphosate alone though cannot be understated. They had parts-per trillion that caused non-alcoholic fatty liver disease in rats. This was the most sophisticated research showing that it was causal. Not like it suggests, but glyphosate causes non-alcoholic fatty liver disease, and at tiny amounts. So tiny in fact, that if you calculate the amount per body weight of these rats per day, the EPA allows 437,000 times that amount in our water supply.  So we’re eating it. Now 30, 35% of the US population has non-alcoholic fatty liver disease, and they have glyphosate in their urine. Those that have the worst version of the non-alcoholic fatty liver disease have more glyphosate in their urine. That’s another study.

Dr. Weitz:            Wow. We’re expecting Americans to have a tsunami of liver failure as a result of this increase in the non-alcoholic fatty liver.

Jeffrey:                Absolutely. And liver cancer, cirrhosis, all that stuff. It’s a pretty remarkable world that I live in because I hear, maybe more than anyone, people with such a variety of diseases and disorders coming to me saying, “Guess what happened to my,” whatever. “My restless leg syndrome went away.” heard that. It was like someone says, “I can tell there’s a change in my urine just whenever I eat a GMO. I could see the bubbles.” It’s like the veterinarian could see the difference in the processing of his kidneys when he eats a GMO or not, and instantly.

                                So yeah, I mean, I’ve heard this from so many people, and I would say, you don’t have to understand the details. In fact, I don’t go slow enough in an hour-long conversation with you so that people can rationally expect to understand all the details if they understand the patterns and they see the plausible causative pathways between the shikimate pathway and the neurotransmitters, and they see the pathway between the genotoxicity and the oxidative stress and the leaky gut and the gap junctions and cancer. All those are cancer-causing.

                                You see, and we know, for example, Non-Hodgkin’s lymphoma is deeply connected, and that’s from the bone marrow, and that’s where the glyphosate residues end up and hang out there for a long time. So we can break it down. My main point is I’m not trying to give people the ability to give a talk on it. I do do that, and it takes eight hours to really understand it all. I just am wanting to give people enough information to go, “Oh my God, did you hear that? We have to make a change in our diet.” The number one convincer is the movie, Secret Ingredients at secretingredientsfilm.com. That shows people who are on the spectrum, who are no longer on the spectrum or infertile, who now have kids, who were overweight, who had brain fog, who had allergies, and they transitioned out and they went, it was organic A to B. Boom.

Dr. Weitz:            I learned from your website that I remember back in the ’80s when the FDA took tryptophan off the market and it’s still off the market, and that was actually a result of genetically modified, the way they produced a tryptophan.

Jeffrey:                Well, it is back on the market. But here’s an interesting thing. The FDA, if you look at the documents that were made public because of that investigation, they were trying to promote pharmaceutical drugs and tried to suppress the sales of competing herbs and amino acids and other things. So they were wanting to get tryptophan off the market, but they couldn’t. Then along comes a genetically engineered variety from a company called Showa Denko KK out of Japan that caused about 5,000 to 10,000 people to fall sick, and about 100 people died from this horrible disease. It was only that company’s brand that was causing the disease, and only that company was genetically engineering the bacteria that was producing the tryptophan. So what did the FDA do? They blamed it on all tryptophan. When they testified before Congress, they never mentioned that genetic engineering was involved.

                                Tryptophan was used for calming and insomnia. That was taken off the market. Then comes Prozac, or I think that was the thing that came in at that time. Sales come up heavily, and the FDA took it off the market saying, “Oh, that was causing the problem.” They didn’t even take it out of baby formula or IVs. It was like, if it’s going to really cause problems, you’ve got to really take it off the market. So it was even a bad coverup. They never got the strains and brought them over to the US to see, because there was five to six contaminants that were found that were between 0.1 and 0.01%. I mean, we looked at that. In fact, one of my friends who passed away, Bill Crist, was the chief investigator for years and turned over all of his notes to me before he died. I published that in my book, Seeds of Deception, and then summarized it in Genetic Roulette. What’s interesting here, Ben, and I do want to jump to the GMO 2.0 before we run out of time.

Dr. Weitz:            Yes.

Jeffrey:                But what’s interesting is, it was causing an epidemic, and it was an epidemic with 5,000 to 10,000 falling sick. The only reason that it was discovered was because the disease had three simultaneous characteristics. It was fast-acting, it was acute, and it was rare. Now, if any of those things were not in place, if it was not fast-acting, if it took months to show up, no one would link it to a food supplement on the market. If it was not rare, someone just got more colds or something, kidney disease, something that’s already out there, they were just treated. People don’t say, “What supplements are you taking?” They don’t pay attention.

                                It was acute and it was serious, so it forced people to go to the hospital or to doctors, and this had all three. It was a absolute disastrous disease that caused paralysis that progressed, pain that was off the charts, and no one had ever seen it before, and it was still almost missed because no one was talking about in the literature. It just happened to be that one doctor had two patients with it. That coincidence. They checked everything they were taking. There was one thing that both were taking, and that was L-tryptophan. In fact, if one of them had an L-tryptophan from a different company, they wouldn’t have gotten sick.

                                But anyway, that was what caused the investigation to identify it. So that means that the foods that are on the market, the GMOs and whatnot, may be causing diseases and have been just as was predicted or concerned by the FDA scientist, massive diseases, all this whole list of diseases could be going up because of GMOs and Roundup, but it’s not fast-acting, acute and rare. These are common diseases that are happening. So it’s not that it’s easy to figure out the cause when it’s a food, because when you go to the doctor and say, “I have cancer,” they don’t say, “Oh my God, what have you been eating?”

                                They don’t look for that. There’s a certain set of circumstances that will then cause an investigation, and then research and then additional research. There’s a certain way that it becomes epidemiologically identified. But if it’s simply in the food supply, it can be missed forever. So the main takeaway of this L-tryptophan is that that demonstrated that genetic engineering might cause serious diseases and that they can be missed.

Dr. Weitz:            I’ve been preaching organic for years, and people say, “Well, can I really trust organic?” My answer’s usually, “Look, I’m sure it’s not perfect, but it’s going to be a lot better.”

Jeffrey:                I would say that is an excellent, excellent answer. There is occasional fraud. But if you go to responsibletechnology.org, you can actually see a glyphosate residue report. The FDA tests all the insecticide and herbicide residues on foods except for glyphosate because they’re friends in Monsanto convinced them that it was harmless. So we have to basically take our studies and other NGO studies, non-profit studies, we put them all together in one database, go to our site, and you can look at all at the foods. Those that are organic are almost always very slight amounts of glyphosate or non-detectable. Now, why would it be slight? Because there’s so much glyphosate being sprayed. It’s in the air, it’s in the water, it’s in the rain. The US Geological Survey founds glyphosate in 60 to 100% of the air samples and rain samples in the Midwest. In Mississippi, it was 75%. So you can’t avoid it completely, but you want to minimize it.

Dr. Weitz:            Very, very scary. So let’s go into GMO 2.0.

Jeffrey:                All right. Now I think we have given the problem and we’ve given a solution, and the solution is eating organic. This has been the focus of our institute to get consumers to realize-

Dr. Weitz:            And also try to contribute and lobby to have genetically modified foods taken off the market and be labeled, et cetera.

Jeffrey:                Right. That’s in addition. But for those listening, the first thing is protect yourself and your family. If you have energy left over and time and money, contribute to the cause, et cetera. So that was sort of the messaging for 25 years. Then along comes GMO 2.0 and it’s given a free pass by all these governments.  One of the examples of 2.0 is gene editing. You’ve heard of CRISPR. Now CRISPR may ultimately be useful for clearing off a defective gene for someone that has a genetic disorder. It has all these side effects, so much so that the prominent journal, Nature, called the side effects chromosomal mayhem. I mean, massive damage, and they’re going to try and fix it, and maybe they will. I’m not against the use of this when it’s applied to an individual with consent who’s aware of the dangers. Sometimes human gene therapy does work, and sometimes it kills people.

                                But we’re now using the same accident-prone technology … The most common result of genetic engineering is surprise side effects … And we’re putting it into the food supply. We’re putting organisms into the environment where they cannot be recalled. Now gene editing is so cheap, it’s like a gene rush, Ben. We know what a gold rush is. You have all these people going out in a Wild West scenario. Now we have all these individuals, companies, students, well-wishers, wanting to genetically engineer things, to patent them and to solve problems of nature. The thing is, if you multiply all of this enthusiasm into actually giving people these kits and these labs, and you give them the keys to the kingdoms and they change the gene pool, then eventually maybe this generation, we will have fully corrupted nature’s gene pool, replaced nature, and no future generation can inherit the products of the billions of years of evolution. But instead a hybrid somewhere between nature and manmade constructions. Now, this is a potential catastrophe.

Dr. Weitz:            Yeah. Very, very scary.

Jeffrey:                Of all of the organisms that you can genetically engineer, I’m going to ask you a question, which do you think are the most dangerous?

Dr. Weitz:            Well, I don’t see what could go wrong if we were to modify the DNA of a virus.

Jeffrey:                Yeah. Why not?  All right, so let’s make it even a broader class. Let’s talk about microbes. So we take microbes. You know and many of your listeners know, they hear the word microbiome and they go, “Oh, that’s important. That’s the thing. That’s the in thing now.” We’re discovering after the millennia of our history that this micro Jedi army inside us is largely responsible for the state of our health, whether we’re fat or skinny, even some of our desires, our moods. 80% of diseases I’m told by my friend Karen Christian, who’s an expert, comes from changes in the microbiome. It turns out Roundup kills off beneficial stuff in the microbiome in such a way that I went through these same 28 different conditions with Karen Christian. I said, “Can the changes that you saw in the human gut from Roundup explain any of these?” All of them. All 28 of them.

                                So now we realize the microbiome is mission-critical for humans. When there’s less microbes in the brain when we reduce them, IQ goes down according to my friend Dietrich Klinghardt. Now, the microbes in the soil sequester carbon, promote health, create nutrient density. Algae’s a microbe. It produces 70% of the Earth’s oxygen. That’s a lot. The fungi on the soil shuttles nutrients between trees and allows the small trees that don’t have sunlight to grow because the mother trees give them the nutrients. How? Through their friends, the fungi, which are microbes. The microbes are amazing. Now, they have co-evolved with us so much that we actually have a situation where in the second trimester of humans, milk-digesting bacteria move into the birth canal to inoculate the newborn, and then a lot of the milk that comes from the mother is indigestible by the infant. It’s designed to feed the microbes, and the health of the baby is reflected in the salivary microbes, which feedback through the breast to the mother, which change the formula.

                                I mean, it is so important that these nuanced changes are mind-blowing, and I haven’t even gotten into some of the details. So this co-evolution is such that we have outsourced 90% of our everyday metabolic and chemical functions to these critters. We can get away with a measly 23,000 genes, less than earthworms because we use the genetic information of 3.5 million genes in the microbes living inside us. There’s 10 times more than, actually more than 10 times, compared to the cells inside our body.

                                Now, along comes a high school student, a high school student who has a CRISPR lab in his biology class, and he can order from 10,000 different microbes online or 120,000 different targeted gene sequences to tell the CRISPR where to cut. Or he can order his own gene sequence, or he can pick up microbes from his own gut or his own poop. Or he can take it out of the swamp near his house. Then he can CRISPR it and then take it for a walk. Now, let’s suppose it survives, lives long, thrives, multiplies. First of all, they replicate faster than cows. They replicate very, very quickly. They travel. We know that. We didn’t need a pandemic to know that microbes travel and mutate.

                                Most people don’t realize that microbes also exchange genes. They’re very promiscuous. Just bacterial sex. It’s actually this flow of genetic information through the microbiome that allows the entire microbiome to adjust and adapt to support ecosystems and to be supported by them. So the same random act of weirdness by a high school student now ends up in 10,000 different types of microbes and 100,000 different ecosystems, including inside human bodies, making changes that were never part of the co-evolution, causing possible human health issues or collapsing ecosystems in the environment.

                                Then you have companies like Bayer Monsanto … Bayer bought Monsanto, whose joint venture with Ginkgo Bioworks is creating nitrogen-fixing microbes for the soil. Now, there’s many reasons why you don’t want to release genetically engineered nitrogen-fixing microbes. Now, one is, what happens if it gets washed into the Mississippi and then it transfers those nitrogen-fixing microbes into algae, and now you have algae that can produce its own dead zones? We don’t know if that’s a possibility, but we may end up with nitrogen-fixing microbes inside us. Or what about the survival mechanism built into those nitrogen-fixing microbes, which probably kill off other microbes and have antibiotic resistance so that they survive? That’s like a tank. So you put the trait inside the tank, now the tank gets transferred inside our gut bacteria, and now it’s surrounding a pathogen killing off other bacteria, resisting the death by antibiotics, and you’ve now changed the population of our pathogens in our gut because of this nitrogen-fixing microbe.

                                Now, it gets worse. If you go to, guess what that URL is, it’s responsibletechnology.org/takeaction. If you go to, Don’t Let the Gene Out of the Bottle, as you saw, there’s some well-meaning scientists that said, “Let’s take a natural soil microbe that’s on the roots of every plant on the planet and turn it into a alcohol production factory and give it to farmers so they can rake up their crop residues and put it in tanks with the genetically engineered bacteria and turn it into alcohol to run their tractors and put the nutrient-rich sludge on the bottom on their fields.” Well, as you’ll see, I’m not going to be a complete plot spoiler, but according to a scientist involved, if it hadn’t been stopped by research results of her graduate student, that seemingly well-meaning thing might have ended terrestrial plant life on planet Earth. I hate when that happens.

                                But we don’t know if it would’ve happened. We don’t know if the other one mentioned in there would’ve altered weather patterns forever, but it’s potentially there. So now what I’m talking about is if every high school has a CRISPR kit and all these college students use CRISPR and all these entrepreneurs and organizations use CRISPR, and they’re releasing these microbes in the environment, millions of varieties each year, what’s going to happen to our nature? What’s going to happen to our health? Right now on responsibletechnology.org/takeaction, we have a response to the USDA’s draft guidance on how to get a permit to genetically engineer microorganisms. Their take on what’s considered to be safe is so 50-year-old science. Maybe, all right, I’ll give them the benefit of doubt. 20-year-old science. Maybe.

                                They have a comment period, and I want to suggest that everyone go there and add your name to the comments so they see it’s not just the Institute for Responsible Technology, but it’s 1000 of our closest personal friends or 10,000 of our closest personal friends, and we’re going to send you also after that updates and other action steps because we have even bigger fish to fry because we’re now starting a new global movement to protect the microbiome. We’re going to have various opportunities for people to use their networks to support us, et cetera. I do strongly recommend people make a recurring donation. For the healthcare practitioners who are listening, very shortly, maybe by the time you visit the site, we will have a healthcare practitioner program. So you support us and we give you all this information, train you how to speak, give information for your practitioners.

                                If you’re a company, we have a way of getting information out to your customers. You can be part of [inaudible 01:01:20]. We have all sorts of things we’re working on now, and we’re just held back right now by the amount of staff we can afford. So we need a little more money to get a little more staff so we can get a lot more money, so we can get a lot of staff, so we can get a big global movement. Now, here’s the good point, Ben. Which movements out there might be good allies to us? Which movements and campaigns are needing a healthy microbiome? Certainly human health, certainly regenerative agriculture, certainly carbon drawdown for climate change, because most of the heavy lifting are the soil microbes, certainly all the environmental groups including the oceans. Even the Indigenous people who think GMO means God Move Over, they are on our side.

                                Even national defense is freaking out about the availability of CRISPR kits and the ability for some purposeful or random accident. So we have an opportunity to create a movement of movements at a time just after microbes wreaked havoc on the world population and economy. The receptor cells of the planet are open just at this time when we need to lock down GM microbes and say, “Not on our watch.” In fact, never should we allow the random release of GM microbes in the environment knowing what we know about the nature of microbes, the nature of microbiomes, their supportive ecosystems, and the accidental and unpredictable nature of genetic engineering.

Dr. Weitz:            So what’s the possibility that we could stop letting all these groups and individuals have their own CRISPR technology?

Jeffrey:                Well, I’m guessing, Ben, that in the last 12 minutes, when I started talking about, maybe even eight minutes, when I started talking about the microbes, that nearly everyone who was not distracted by driving in traffic understood what I was talking about. They’re like … In my day, there was a TV commercial, the Memorex commercial, where someone would listen to Memorex and their hair was going straight back like they were in a windstorm. I could see people after hearing this, they’re like, “Oh my God, we’re doomed.” But the thing is, one of our greatest assets is that it’s so easy to explain. It’s not as hard as climate change. It’s not as hard as DET, glyphosate. It’s like microbes are running the universe here. They run our health. You release a microbe, it may change it in ways that are unpredictable. We don’t even know what 99% of the trillion microbes out there are doing, and yet we’re going out to make permanent unrecallable changes. Probably not a good idea. That took a minute. Right, right. Here’s an example of something that almost took us down.

Dr. Weitz:            And that’s if the humans that have this CRISPR technology actually have good intentions. As we know, human beings would never try to harm each other.

Jeffrey:                Oh, no. Well, fortunately, we’re all well-meaning people that are ethical. Maybe Monsanto may … Anyway, so the point is, we have to go after the governments to make changes. If it’s me knocking at the doors of government and it’s Monsanto Bayer with its massive lobbyists, I’m not going to get very far. If it’s these movement of movements with popular culture supporting and school curriculum enlightening the children and creating an awareness of this, then we get to make a change in human collective consciousness, which is absolutely necessary right now. As a physician, you are most clearly aware that sometimes a very serious diagnosis or prognosis becomes the wake-up call that turns into the person’s biggest blessing.

Dr. Weitz:            Correct.

Jeffrey:                This is one of those. This is like guys, we have now reached that inevitable time in human civilization where we can irreversibly redirect the streams of evolution for all time, ending biological evolution as we know it. Even a single one of us who goes to high school can make the wrong move and cause the cataclysm. So now that we realize that we have that capacity, it means that we have a new responsibility. That new responsibility means we have a new relationship with nature. We can’t just be going side by side saying, “Yeah, whatever. Just continue.” We have to be stewards. We have to be protectors. We have to protect it in such a way that it becomes a permanent feature of human civilization.   That’s why I talk about curriculum, so that just like every child reads about pollution and climate change, now every child needs to know about we cannot play with the gene pool in this haphazard way. We have to protect nature. So this is an opportunity to influence collective consciousness. I don’t believe that consciousness is linear or local. I think that we’ve seen times in human history where civilization jumps up, leaps forward with new inputs and a certain number of people getting it. I think it’s happening quickly right now, and I think this is an example of something where we need to leap forward. So all of a sudden, in some short time people say, “Oh, remember that time when we were simply allowing anyone with a CRISPR kit to introduce an organism? Wasn’t that silly?” We haven’t gotten there yet, but that’s what we’re going for.

Dr. Weitz:            Yeah, we’ve got to put the gene back in the bottle soon too.

Jeffrey:                Absolutely.

Dr. Weitz:            Well, this has been awesome, Jeffrey. Thank you so much.

Jeffrey:                Ben, I’m passionate. Can you tell?

Dr. Weitz:            I can tell. [inaudible 01:07:18] you.

Jeffrey:                The thing is, I’m also very optimistic. I mean, when I started off on the GMO issue in 1997, no one wanted … Actually, it was ’96 … No one wanted to talk about the health dangers. None of the NGOs. It wasn’t a consumer thing. They were all talking about environment and whatnot. I’m saying, “Guys, this is really important.” Now 48% of the world’s population, 51% of America at a minimum, believe that GMO foods are unsafe. We’ve built a movement, we’ve seen the impact. We are enormously successful, and now we have to build a whole new movement, but we don’t have 27 years to wait.

Dr. Weitz:            Right. So everybody go to … What’s your website again?

Jeffrey:                It’s responsibletechnology.org/takeaction, and please make a donation. Sign up, give your name, support the comments to the USDA. That will also put you on our list unless you tell us not to, and we can give you updates and more information, ways that you can support us by getting the word out, giving you more knowledge, et cetera. Then please make a donation, ideally recurring so we know it’s coming each month. So that gives us the confidence to say, okay, we have a budget to this and this and this. We were able to get by with so much less money when it was a consumer education campaign, but now we have to change governments, create international treaties, national laws, and that’s expensive.

Dr. Weitz:            Right. Awesome. Thank you so much, Jeffrey.

Jeffrey:                You’re welcome, Ben. Safe eating.



Dr. Weitz:            Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five-star ratings and review. That way more people will discover the Rational Wellness Podcast.  I wanted to let everybody know that I do have some openings for new patients so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardiometabolic conditions, or for an executive health screen, and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way. That usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective. If you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at (310) 395-3111, and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.



Natural Insights Into Cancer with Dr. Dominic Brandy: Rational Wellness Podcast 304

Dr. Dominic Brandy discusses Natural Insights into Cancer 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

2:25  Dr. Brandy explained that his journey started in September 2017 when he and his wife were on a Viking cruise and he read the book, How Not To Die by Dr. Michael Greger.  How Not To Die has lots of scientific references and shows that eating a plant based diet is associated with lower rates of cancer and other chronic diseases, including diabetes, cardiovascular disease, and dementia. Gregor also discusses the Blue Zones where Dan Buettner looked at regions in the world where people lived the longest, including Loma Linda, California, where most people are Seven Day Adventists and they are vegetarian, don’t drink alcohol, and exercise a lot. The average woman there lives 10 years longer and the average man lives 14 years longer than the average American.  Dr. Brandy started right then to eat a plant based diet.

6:25  When Dr. Brandy came home the last week of September he was doing a surgery case and he felt a pop in his right collarbone.  This pain then got worse and worse and on November 10th he went to pick up a container of water and his clavicle cracked in half.  He went to the Urgent Care center and got an x-ray. Then he got an MRI and his orthopedic surgeon told him that he either had multiple myeloma or a cancer metastasis. He had a biopsy and lab work, which confirmed IgA multiple myeloma free Kappa chain. Dr. Brandy’s oncologist recommended a triple drug regimen of a common medication for myeloma, a corticosteroid and Velcade, a proteasome inhibitor. Dr. Brandy accepted with the first two medications but rejected Velcade, because its common side effects include peripheral neuropathy, which is bad for a surgeon.  Then Dr. Brandy researched every thing he could do from a diet, lifestyle, and nutritional supplement perspective and started employing them.  He started taking various herbs, employed exercise, stress reduction, sleep, intermittent fasting, detoxification, and every month his numbers kept getting better and by six months he was in a complete remission.



Dr. Dominic Brandy is a plastic surgeon and anti-aging expert, but after being diagnosed in 2017 with multiple myeloma, an incurable blood cancer, he plunged himself into cancer research. He is now coaching cancer patients.  In addition to conventional therapy, he has adopted a natural approach to fighting cancer that includes a whole food plant based diet, daily exercise, and targeted nutritional supplements.   And now he has written a book, Beat Back Cancer Naturally, and he wants to share his approach with patients looking to prevent or treat cancer.   His website is NaturalInsightsIntoCancer.

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 website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.

                                Hello, Rational Wellness podcasters. I’m very excited today that we’ll be speaking with Dr. Dominic Brandy, and he will be giving us some natural insights into cancer. Dr. Brandy is a plastic surgeon and anti-aging expert, but after being diagnosed in 2017 with multiple myeloma, he plunged himself into cancer research. In addition to conventional therapy, he’s adopted a natural approach to fighting cancer that includes a whole food, plant-based diet, daily exercise, and targeted nutritional supplements, and he’s written a book, Beat Back Cancer Naturally, and he wants to share his approach with patients looking to prevent or treat cancer. Dr. Brandy, thank you so much for joining us today.

Dr. Brandy:          Hey, great being here. Thanks for the invite.

Dr. Weitz:            Absolutely. Cancer’s such an important topic. Perhaps you can tell us a bit about your personal journey.

Dr. Brandy:          Well, just to give your listeners a little background about me. You mentioned I had a plastic surgery practice. It was a plastic surgery slash med spas slash anti-aging center, had it for over 40 years. About three years ago, we had a venture capital group come in and they made an offer to buy the practice.  At that point, I had over a hundred employees.  We were ranked number five in the country by our  Botox. So it was quite an operation. We had four different clinics, one in the Columbus, Ohio, and three in Pittsburgh.  So since that point, I have devoted my life to cancer lifestyle coaching, and the way I got into that, you mentioned, I was diagnosed with multiple myeloma about five and a half years ago. It was November 10th of 2017. Actually, my journey, interestingly, started in September of 2017, which was two months before that. My wife and I were on a Viking cruise. It was a two-week cruise. I’ve read well over 300 books on health and nutrition in my career because I have this anti-aging center, I was always interested in it.  So when I’m on vacation, first thing I do is I look for a health and nutrition book. So the first book I pulled up was How Not To Die by Michael Greger. I don’t know if you’ve ever read it, but it’s a phenomenal book. If anyone’s ever read the hard back, I mean, it’s literally two inches thick and about an inch of it are scientific references. I don’t know how many scientific references are in there, but there’s got to be over 6,000 or 7,000. Being a medical doctor, as I was reading this, that was the thing that really super impressed me.   What the science was showing over and over again was that cultures and research cohorts that ate more of a plant-based diet had much lower incidence of cancer, cardiovascular disease, type two diabetes, dementia, and really all cause mortality. Then he got into the Blue Zones where these are the five areas of the world where people lived the longest. Ikaria, Greece, Sardinia, Nicoya, Costa Rica, Okinawa, Japan, and right here in the United States, Loma Linda, California, and that’s where there’s a predominance of Seven Day Adventist, and they are either vegan, vegetarian, they don’t drink alcohol, they exercise a lot.  What’s interesting about Loma Linda, and I always like to use them because they’re in our culture. Some people will say about the Blue Zones, well, that’s a different culture. It’s not like the United States, but in Loma Linda, the average woman lives about 10 years longer than her American counterpart, and men actually live 14 years longer, which is interesting, but if you look at all the Blue Zones, they all eat anywhere from a 90% to 95% plant-based diet, and if they do eat meat, it’s usually the size of a deck of cards. They might have it once to four times a week.

                                Recently, really, I started reading a book called Healthy at 100. It’s by John Robbins. You should read it. It’s really interesting. Dan Buettner is the one that wrote the Blue Zones book, but Dr. Alexander Leaf, he was the Dan Buettner in the 1970s, and National Geographic put him to the task to find the longest living areas of the world, and he looked at the Acacians, the Vilcabamba, they’re in Peru, and then the Hunzas, you probably have heard of them, and then the Okinawans.  In fact, I was reading it last night, it was interesting. They had the breakdown of their diets, and the Hunzas, their diet is 99% plant-based. They eat 1% animal products. They eat about on average about 10% to 15% protein and anywhere from 10% to 15% fat, but that’s about how the other ones are too. Once again, when he did his research into these areas, they were basically anywhere from 90% up to 99% plant-based. So I always look at that as the preponderance of evidence along with a lot of the scientific studies.  So anyway, I’m on this cruise and I tell my wife two days in, “Trina, I’m going to start eating whole food plant-based,” and she thought I was out of my mind because we’re on this cruise, there’s all this meat and dairy and desserts, I mean, you name it, but I’m one of these people type A personality, “Hey, you know what? I’m just doing this.” So from September till now, I have been totally plant-based.

                                So when I came home, this was the last week of September, I was doing a surgery case and I remember feeling a little pop in my right collarbone. I didn’t think anything of it, but then it just kept getting worse and worse. Then by the time I got to the last week of October, it was starting to keep me up at night. I literally asked my wife, I said, “Trina, do you think I have bone cancer?” and she said, “Oh, you’re the healthiest person. I know you’re fine,” and I kind of slapped it off, but on November 10th, which was about a week and a half after I said that to my wife, we were watching TV, I accidentally knocked over a container of water, I lunged for it and my bone just cracked right in half.   Went to the urgent care center, it was completely displaced. Went to a friend of mine who’s an orthopedic surgeon. I said, “Hey, what’s going on here?” He said, “We need an MRI.” So that happened, I cracked my bone on a Sunday, he called me on a Friday evening and he goes, “Nick,” Nick’s my nickname, he said, “Nick, I think you have a tumor in there.” He said, “It’s either multiple myeloma or some kind of metastasis,” and I must tell you, I was totally blown away. I’m sure you deal with cancer patients, but I don’t think anybody can predict the way they’re going to react to it because your world is totally rocked.

                                So anyway, from there, I had biopsies. They did all kind of blood studies, and they came up that I had what’s called an IgA multiple myeloma free Kappa chain. If you go on the internet, there’s three different basic types of myeloma. There’s IgA, IgG, IgM, and myeloma, for your listeners, is a cancer of the plasma cells. So they’re the cells that make your antibodies. If you look through the research, IgA, the one that I was diagnosed with, is definitely the most aggressive. Because of that, when I went to my oncologist, he wanted to put me on this triple regimen of two oral medications, and then there was a drug called Velcade, which is a proteasome inhibitor, where I would have to go into the hospital every week and get an injection into my abdomen.  As I was researching this, I was learning that just about everybody that gets this drug gets a pretty bad peripheral neuropathy. I’m a surgeon, I didn’t want to risk that. Told my oncologist, “Hey, listen, I don’t think I want to do the Velcade.” He was upset. He pulled me into a side room. There was a patient over there that actually finished the Velcade treatment. He tried to get him to talk me into it. In fact, that guy’s actually a good friend of mine now, we go out to lunch all the time, and he calls me when he has a question about his treatment and so forth, but I came back to my oncologist.

                                Remember, at this point I had already been eating whole food plant-based for two months, and I was 100% sure it was going to help me in this battle. So I told my oncologist, I’m not doing it. He said, “I don’t think you’re going to get into remission.” He was upset with me, but we just went ahead. I would just take these two oral medications, 21 days on, seven days off.  At this point, I started to do a deep dive into the scientific literature. I wanted to know every single thing that I could do from a lifestyle perspective. I researched every herb that I could possibly take. I looked into exercise, stress reduction, sleep, intermittent fasting, getting rid of toxins, how all these things would affect my final result. Well, every month, my numbers just kept getting better and better, and by the sixth month, I was in a complete remission and my doctor was blown away by it. He never thought I was going to get there, and to get there in six months, he was totally befuddled, but I really wasn’t because I knew everything that I was doing was helping.

                                So a year after I started treatment, I started treatment January of 2018. January of 2019, I decided I was going to give a lecture at one of the local hotels because I was learning all this stuff and I said, “I need to share this with people, especially cancer patients.” So I scheduled a hotel and I’ve given a lot of interviews in Pittsburgh with various news stations for plastic surgery, anti-aging, med spa. There was one anchor that I’ve gotten to know really well, Michelle Wright, and I gave her a call. I said, “Hey, Michelle, can you do a little story on all the different lifestyle things I’m doing, my cancer diagnosis, and so forth? I’m doing this lecture. Maybe we can get some people there.”

                                So she did it. In fact, that whole interview is actually on my website, naturalinsightsintocancer.com. So it was a really great program that she did. We figured we were going to get maybe 50 people there. So we opened the doors and these people are flooding in. I mean, we were pulling chairs out of the restaurants. It was crazy. We ended up with 125 people, which was amazing.

                                So I gave this lecture. I thought it was going to be an hour. It ended up being two hours. People kept asking me questions as I was giving the lecture, and then afterward, I had a standing ovation. I’ve never had a standing ovation for anything in my life. I don’t know if it was because they felt sorry for me because I had cancer or it was because they thought the lecture was good, which I don’t think was that great, but I thought it was pretty good, but I think the reason they gave me that standing ovation is that there were a lot of cancer patients out there, and I think they felt that they were at the mercy of surgery, radiation, chemo, and there really wasn’t anything else that they could really do.

                                In fact, I had quite a few people come up to me after the lecture. One I remember very vividly, she was a multiple myeloma patient, and she was definitely overweight. I would say probably even obese. She said, “Hey, Doc. When I talked to my doctor, I asked him, ‘Should I change my diet?’ and he said, ‘Oh, no, just keep eating the way you are. You’ll do just fine.'” She told me, she said, “I just knew that wasn’t right, that that could not be right,” and I think that’s how a lot of these people felt.

                                So I think when I gave that lecture, I really empowered them. From that point, I had monthly meetings in one of my med spas, and we would pack anywhere from 50 to 100 people in these little med spas. We had these chairs. People were standing and I’d bring other speakers in and people started asking me then, “Hey, Doc. You need to write a book. You have so much knowledge.”

                                So on Memorial Day, this was 2019 or 2018, I’m sorry, every morning I would wake up and I would write for one to two hours, and by Labor Day, I had the book completely done. I mean, I had to do a lot of research and so forth. I had it on Amazon first week of November. I had a book launching the second week of November, and I developed a website, Natural Insights Into Cancer, an Instagram site, Cancer Veggie Doc, and I started doing virtual consultations for people to help them, when they have cancer to get through it, how to make different lifestyle changes. I make supplement recommendations and so forth. So that’s how I got to this point. I know it was a little long-winded, but I think it’s important for your listeners to understand how I actually got to this point.

Dr. Weitz:            Absolutely. Thank you for sharing your story with us. So let’s start with how you got to the plant-based diet as the best anti-cancer diet. So I’m going to challenge you a little bit on that. I think the idea that fruits and vegetables and herbs contain these powerful anti-cancer phytonutrients, I think is without question, and I’ve been looking at the research on that. I think absolutely no doubt at all that there are many powerful health-promoting anti-aging, anti-inflammatory, anti-cancer factors in fruits and vegetables, herbs, maybe nuts and seeds.   The question is, should we include some animal protein in the diet, and what about things like grains and beans and et cetera, oils, I guess? So fat’s a whole issue. I’ve interviewed a number of people in the cancer world, and Dr. Thomas Seyfried wrote the Metabolic Theory of Cancer, and he advocates a ketogenic diet due to the fact that cancer cells predominantly produce energy through the glycolytic pathway through sugar, and so therefore, if we’re on a ketogenic diet, which gets the carbohydrates as low as possible, we’ll starve cancer cells of their source of energy.

                                I’ve also interviewed Al Danenberg, Dr. Al Danenberg, who was diagnosed with multiple myeloma in 2018 and he was given a few months to live, and he’s still alive using his carnivore diet. So I guess one of the questions would be, can there be different anti-cancer diets for each person? So anyway, let’s see where we go with that.

Dr. Brandy:         Well, once again, I look at the preponderance of evidence. Once again, when I went through Dr. Greger’s book, I mean, and I advise everyone to read that book because there’s thousands of scientific references. There’s a journal article, the British Journal of Cancer, where they looked at people’s eating habits in England over a 10-year period, and they found that people that ate more plant-based had much lower incidence of cancer, especially blood cancers. That was the one that was … Then there was another one in JAMA Internal Medicine. It came to the exact same conclusion, and there’s a lot.  In fact, recently in 2017, there was a meta analysis of many different studies, and they found that those that ate plant-based had much lower incidents of cancer. Also, the EPIC-Oxford study, the AHS-2 study showed exactly the same thing, that people that ate more plant-based have much lower incidence of cancer.

                                So what I always tell patients to start off, just to get rid of all the esoteric crap. The National Cancer Institute recommends nine servings of fruits and vegetables, and they recommend it for a reason. The studies show over and over that people that eat more fruits and vegetables have much lower incidence of cancer. So what I tell patients, “Listen, if that’s what the studies show to prevent cancer, if you have cancer, you should be eating a hell of a lot more than nine servings of fruits and vegetables per day.”  In fact, this weekend on Saturday, I’m giving a lecture at one of the wellness expos, and I have a couple lectures on my website about the synergy of these phytochemicals. The way they work is that when you combine … Two plus two doesn’t equal four. Two plus two equal seven. I go through several studies that show this remarkable synergy with these phytochemicals.  For instance, there was one study that was done with breast cancer cells where they applied a grape extract that killed about 25% of the cancer cells. Then they did onion extract, killed about 50%. Then you would figure if you would do a combination of both, you’d get maybe 35% destruction of the cancer cells. No, it was 75%.  There was another study with carotenoids. It was a tomato extract with turmeric, and then vitamin E, which vitamin E, actually, the cancer actually grew faster with the vitamin E. It was against prostate cancer cells, but when they combined the three, it increased the anti-cancer activity by almost 10 times.

                                Now, one of the things that I stress in my lectures and in my book at the beginning, I talk about my philosophy on how cancer gets started. I personally think it’s the accumulation of DNA mutations over your lifetime. When I first got diagnosed, I read an article in Nature by Nikhil Munshi. He’s a world renowned myeloma researcher. This article actually upset me because he found that by the time you are diagnosed with multiple myeloma, you have about 5,000 DNA mutations in that cancer cell, and by the time you relapse, you are up to 12,000.

                                I think a lot of those mutations are probably from the chemo drugs. There’s a lot of free radical activity that’s causing a lot of DNA mutations. If you look at plant foods compared to animal products, plant foods have 63 times the antioxidant power compared to animal products. So if I have a patient in remission, and I can honestly say at this point, I was on a podcast and someone asked me, I never really thought about it. I have never had a patient that was in remission that came to me that came out of remission.

                                I really think one of the reasons is we’re increasing their antioxidant activity. What I recommend for supplements, they’re almost all herbal supplements, I do not recommend individual vitamins. If I do, I do it as a drug. For instance, vitamin D is really more of a hormone. I think everybody should take that. I really try to get people up to 80 to 100 nanograms per mil. If you’re eating whole food, you have to take a vitamin B12 supplement. I mean, that is really a given, but we know that there are over 100,000 phytochemicals in whole food plant foods.

                                I listened to a podcast, Simon Hills podcast with Jed Fahey, and Jed Fahey is a world renowned expert on phytochemicals. I mean, he actually feels there’s over five million phytochemicals in edible plant foods. We have only studied about 150 of them. When we study these phytonutrients, and there are things like curcumin. People have heard a lot of these things, daidzein, isoflavones. When we studied these, they all have four common elements. They have very powerful antioxidant activity. They have very powerful anti-tumor activity, very powerful anti-inflammatory activity, and they have an amazing epigenetic effect that is really mind-blowing.  In fact, on my lecture, I have this one diagram where I have all these different phytochemicals and the way they either upregulate or downregulate certain genes. For instance, curcumin is one that I show in my lecture, and there’s an arrow that goes up to the BRCA gene. BRCA gene is a DNA repair gene for the cancer cell. Angelina Jolie made that famous, the BRCA DNA repair. Well, curcumin actually upregulates the BRCA gene through epigenetics, so does soy.  A lot of people think you shouldn’t take soy with breast cancer, but it’s the exact opposite. There are many studies that show that women that actually intake a cup of soy every day over a five-year period actually have about a 36% lower chance of relapse. The the way it works, soy works, it actually, the breast cancer actually methylates the BRCA gene, which it downregulates the BRCA gene. So it’s not working as well, can’t repair the DNA. With soy, it actually methylates it. So now the BRCA gene is working properly.

                                So these phytochemicals, and then the other thing I show how it downregulates, for instance, the P53 tumor suppressor gene when it’s mutated. So for your listeners, what basically happens with cancer is that you get all this free radical damage. We have three innate antioxidants in each one of our cells. We have catalase, glutathione peroxidase, superoxide dismutase, and they can pretty much keep free radical damage under control, but most of us overload the system.  I mean, smoking’s probably the worst thing you can do, but all the pesticides that we eat, [inaudible 00:23:27] radiation, pollution. I mean, there’s so many, the water that we drink, there’s so many things that we do that create excessive free radical activity that a lot of times our body just cannot neutralize these free radicals. So these free radicals damage, remember I talked about that P53 tumor suppressor genes, proto-oncogene. So a proto-oncogene is supposed to protect you from cancer. You get enough DNA mutations of that proto-oncogene, it actually becomes an activated oncogene. So instead of protecting you, it actually promotes cancer growth.  So the turmeric, the curcumin actually downregulates that activated oncogene, so it’s not as active as it was before. So the bottom line is I try to get as many phytonutrients in the patient as possible. I document all the ways that phytonutrients work. I mean, turmeric alone has been shown to disrupt 80 plus cancer cells signaling pathways.

Dr. Weitz:            Yeah, no, I’ve seen some of the charts with all the different arrows on all the different cancer pathways. Curcumin’s amazing.

Dr. Brandy:         Sometimes I take 30 plus herbal supplements, and when I-

Dr. Weitz:            I do too. It’s interesting. You and I, even though I don’t have cancer, have similar regimens except that I also include some animal protein in my diet.

Dr. Brandy:         Yeah, I mean, that’s fine. Like I said, the people in the Blue Zones eat 90%, 95% plant-based. I try to use the word, for people that don’t have cancer, I like to use the word plant strong, plant predominant because-

Dr. Weitz:            Rather than use the word vegan, which is politically charged to say.

Dr. Brandy:         I don’t use the word vegan at all because I think vegan is more of a political term. Most people that use the term vegan, they’re usually animal rights activist or they believe it’ll cure climate change, whatever. I really don’t go there at all. I talk about the health benefits. In fact, I don’t know if you’ve ever read The Starch Solution by Dr. McDougall.

Dr. Weitz:            I have not.

Dr. Brandy:         He has a character called the Fat Vegan, and it’s somebody that’s eating potato chips all day, Doritos, muffins, frosted flakes, drinking Coke all day.

Dr. Weitz:            Absolutely. I have had more than a couple of vegans come in my office who were overweight for nutrition and were eating very few vegetables.

Dr. Brandy:         I mean, honestly, that diet is the … I’d rather somebody eat a carnivore diet than eat that to be honest with you because that is the most unhealthy diet that you could eat. So I always use the word whole food plant-based or whole food plant strong. When you use the word plant strong or plant dominant, it really doesn’t freak people out as much. It’s like, “Hey, you know?” Why don’t we … In fact, when I take people that are eating like the average American, which is about 65% processed food, 25% animal products, and probably anywhere from 5% to 10% fruits, vegetables, whole grains, legumes, et cetera, I tell them, “Listen, if we can take you from maybe 10% to 30%, why don’t we start there? At least I’ll be tickled pink if we can do that, and then if we can get you up to 60%, that’s even better.”   So I try not to freak people out too much, but I think we know, and like I said with the National Cancer Institute, the studies show that the more plant foods you eat, it definitely has an anti-cancer effect. The way these phytochemicals work, and I’ve done a lot of research on this, not only do they affect the cancer cells signaling pathways, they actually fragment DNA, they inhibit angiogenesis, which is the blood vessel growth that these cancers need to progress. It’s a proteasome inhibitor like Velcade, the drug that I was supposed to inject in my abdomen. In fact, turmeric is a very potent proteasome inhibitor, so the cancer cell can’t get rid of unwanted protein, so it actually dies because it’s all infested with all these abnormal proteins, but it affects the cell division, the cancer cell division at varied phases of the cell cycle.

                                I get into all these. It really helps chemo and radiation actually work better and it prevents chemo resistance. So I document all of this in the book. The big thing, I think, is the fact that we really need to keep the amount of free radical activity minimized. Like I said, plants have 63 times the oxidant power.  The other thing about these carnivore diets, and I will just tell you this, in fact, I just did a post on Instagram a couple days ago, and I have these two studies actually in my book. I really try to alkalinize these patients. I mean, we know that the pH should be between 7.35 and 7.45. Your body just keeps it there automatically, but I really like people to be leaning more towards 7.45. So I have a chart, it’s actually in my book, and I send it when I do a consult, I send it to all my patients. It was done by Dr. Jaffy. That was really the work that he did for his PhD, and it’s really the best alkaline base chart I have ever seen.

                                I actually came across this. I was at an anti-aging meeting, and I came across it and I’ve really kept it and I give it to everybody, but cancer really struggles in an alkaline micro environment. Cancer loves high acidity, it loves high inflammation, and it likes an environment of low oxygen. So I have this chart, and basically, it has the most alkaline foods, it has the most acidic foods, and has all these in between. I try to get people started with eat 70% on the alkaline side, and they’re most all plants. On the acidic side, it’s mainly meat, sugar products, but there are whole foods that are more acidic, legumes, carrots, corn.

                                So there’s certain foods. I just tell patients, “Look at this. Try to memorize it.” For instance, before I go to bed, and I know this would freak your people out to do these carnivore diets, but before I go to bed, I actually eat pineapple and watermelons, They’re two of the most alkaline foods. So they would probably think, “Oh, man, he’s going to have all these cancer cells going out of control.” I’ve been in remission for 5.5 years, and I take very low doses of those two drugs. Myeloma isn’t curable, so I’m likened what they call a functional remission, but I live a very, very full life. I exercise every single day. I do resistance training every day. I ride my bike every day.

                                We can get into exercise because that’s probably the second most important thing next to a whole food plant-based. In fact, exercise, in one of the studies, I think it was into cancer research journal, it showed that exercise actually increases oxygen in the microenvironment, the cancer microenvironment. So the anti-inflammation in the cancer microenvironment, we take care of that with more of a whole food plant strong diet. The alkalinity, we increase that through eating more foods on the alkaline inside. I do have my patients check their urine pH every morning. I really like it to be between 6.5 and 7.5. As soon as I wake up in the morning, that’s what I do. I have this little strip. You can get it on Amazon and patients just pee on it first thing in the morning, and it should be pretty green. When people start, they’re usually about 5.5. I mean, I am consistently 7.2, 7.3.

                                Then we want to keep the oxygen content up, and that’s really, really daily exercises, so, so critical to that, but these people eating these carnivore diets, I mean, their pH is so acidic. I’ve never measured it on somebody with a carnivore diet, but I will just tell you, it’s got to be, if they check their urine pH, it’s probably 4.5 or something, and that does have a negative effect on your bones. Your bones will release certain minerals to try to neutralize some of that acidity, and it’s really hard on the kidneys. These animal proteins cause what’s called hyperfiltration, and it really is very stressful on kidneys. It’s really the branched amino acids in animal proteins that cause that hyperfiltration, and it’s also the branched amino acids that actually send a signal to the liver to release IGF1, which is a very potent growth stimulator.  I mean, we know that IGF1 is a growth stimulator in patients that have cancer. Remember I talked about how the DNA mutations increase with age? You do not want high DNA mutations when you’re 50, 60 years old and be having all of those DNA mutations exposed to a gross stimulator like IGF1 or mTOR. That’s just a recipe for disaster. mTOR-

Dr. Weitz:            Right, but in terms of longevity, we know that being able to maintain levels of growth in the body so you can repair and regenerate cells and tissues that have broken down, you want to maintain your bone density, you want to maintain your muscle mass, you want to maintain your strength, your balance because all those things can affect longevity. So it’s not necessarily the case that we want to drive the IGF1 levels as low as possible, right? We need a certain amount of growth still occurring for us to maintain our health, don’t we?

Dr. Brandy:         I don’t know if you’re familiar with the work of Dr. Valter Longo.

Dr. Weitz:           I am.

Dr. Brandy:         I don’t know if you’re familiar with the Laron dwarf syndrome.

Dr. Weitz:           I am, yeah, I’ve read about that.

Dr. Brandy:         Laron dwarfs, their IGF receptors are screwed up. So they really don’t have IGF1 levels, and there’s never been a reported case of Laron dwarf ever having cancer. If you go through the literature, high IGF1 levels in adults is actually correlated with increased cancer incidents. In fact, if you look at Valter Longo’s work, and I try to keep people’s IGF1 levels between 120 to 160. Remember, we’re talking about cancer patients. I’m not talking about somebody that’s a body builder or wants to be. I probably eat about 100 grams of protein per day, and I work out every day. I mean, I’m 70 years old and my muscles are like when I was 25, 30 years old. You do not need excessive protein to build muscle. In fact, once you get over 30 grams of protein per meal, your body doesn’t even utilize that. When you get to about 30 to 50, it starts to plateau, but the first 30 grams are really what’s utilized for protein synthesis.

Dr. Weitz:            I would totally agree with that, but it’s not easy to get 30 grams of protein eating just a plant-based diet without any animal proteins.

Dr. Brandy:         It’s so simple. I’ll just give you an example. I don’t know if you Dr. Joe Mercola. I follow his website. One day when I read it, he talked about what he had for breakfast, and it was a 12-ounce steak with six eggs, and there was ghee butter and all this saturated fat. I was befuddled by it, to be honest with you. Then a month later, he was talking about how he has to blood let every month to get rid of the excess iron. I mean, actually, he tried to keep my ferritin levels really … My ferritin’s about 11. I want to keep that low because that is definitely a pro-oxidant.  So what I did is I compared what he has for breakfast compared to me. So he was eating, just with the steak and eggs, he was eating 1300 calories. There was 1,550 milligrams of cholesterol. There was 30 grams of saturated fat, there was zero fiber, zero phytonutrients. There were high levels of carnitine. We can get into carnitine and choline because that’s a whole another issue with TMAO and-

Dr. Weitz:            By the way, I’m pretty skeptical about that whole concept, but yeah, let’s keep going.

Dr. Brandy:         No, I tell you what, there was a recent study came out at Cleveland Clinic. If somebody comes into the ER with chest pain, if you do a TMAO level, you can pretty much predict that they’re going to have heart attack in 30 days.

Dr. Weitz:            I’ve also read a meta analysis saying people who eat a vegetarian diet had much higher levels of TMAO than people who eat meat.

Dr. Brandy:         That’s definitely not true. I don’t know where you got that information, but that’s definitely not true.

Dr. Weitz:            I’ll send you this.

Dr. Brandy:         It’s the hungatella bacteria that, in fact, I don’t know if you’re familiar with this article. It was really a land breaking article in Nature 2014 where they put one group on a completely carnivore diet. They put another group on a plant-based diet. They evaluated the microbiome and they wanted to see what kind of changes were going to occur. Very quickly, the microbiomes started … After five days, it was dramatic, but each day they could see a dramatic difference. So the people that were eating carnivore diet, the more pathogenic bacteria was increasing. The prevotella and their subspecies were decreasing in the plant-based group. The prevotella good bacteria in their 500 subspecies were increasing and the pathogenic bacteria were decreasing.  The one bacteria that started to increase immediately was hungatella, and hungatella is the one that primarily converts choline and carnitine to trimethylamine. It goes to the liver, it’s converted to trimethylamine oxide. The studies show that trimethylamine oxide definitely is correlated with cardiovascular disease, type two diabetes, really all cause mortality. It just increases your inflammatory levels extremely high.  I told you about the study about the people that come in with chest pains. Choline is higher in eggs, seafood, and cheese, and vegans get plenty of choline. You get plenty of choline and now carnitine is made in your liver. So you don’t need more choline or carnitine. When you’re eating meat products, you’re actually getting an excess of those, and that’s really what we don’t want in this situation, but everybody has a different view. I think I’ve done a lot of research on this. I think I’m very knowledgeable on it.

Dr. Weitz:            Fish is actually the highest source of TMAO, and we know that fish is consistently associated with lower risk for cardiovascular disease.

Dr. Brandy:         I recommend a fish oil supplement for all of my patients. In fact, I take about six grams of EPA/DHA. I recommend that for all my patients. I do check their omega-6, omega-3 level. Here’s the problem with fish. I would say a hundred years ago, fish was great. I think the waters are just so contaminated right now that when you eat fish, you are getting a crap load of toxins. In fact, there was an article-

Dr. Weitz:            What water do you think is being used? What water is being used to water the plants? It’s the same water. Our planet is polluted.

Dr. Brandy:         Oh, yeah, but there was an article in the International Journal Environmental Research, and what they did, and this study blew my mind, they took wild-caught salmon outside of Seattle and they wanted to see what kind of chemicals were bioaccumulated into the fat tissue. I mean, it was mind blowing. They were birth control pills, antidepressant sedatives. I don’t believe all the stuff that’s in there, and then they’re loaded with these microplastics right now. So I don’t recommend that.  In fact, Dan Buettner, who wrote the Blue Zones, who I very much respect, he did a post probably about a month ago, and he’s basically saying what I said. He goes, “I just stay away from fish products.” They have some of the highest PCB levels also of any animal product. So I do think you need the EPA/DHA. I think that’s one area where vegans or whole food plant-based people don’t get enough of that. When I say fish oil to them, some of these vegans freak out.   I don’t think algae supplements are adequate because they’re high in DHA and they’re very low in EPA. The fish oil supplements are high in EPA and a little bit lower in DHA. So I think they’re really good. The one that I take new age I think is really good. Each one has about 900 milligrams of the EPA/DHA. So I take three of those in the morning, three at night, and I always take those before I take my turmeric because you really do need fat to be able to absorb all the phytonutrients in the turmeric.  Hey, one thing about turmeric that I do want to mention, I’ve listened to some of your podcasts and I think everybody agrees that you need to take some fat with your turmeric. One of the things I don’t do, I actually look for turmeric supplements that are not standardized for 95% curcumin. There was a study, I think it was in Cancer Research Journal, where they compared curcumin versus turmeric, the whole root. They actually looked at it against seven different cancers. What they found at every single cancer, the turmeric actually worked better than the curcumin.   It gets back to that synergy effect that I was talking about. There’s over 300 phytochemicals in turmeric. So there’s turmerone, zingarone. There’s all these different phytonutrients in there, and they all work synergistically. So I think that’s why you get a greater anti-cancer effect. So when I recommend a turmeric supplement, I use one by Carlyle. All the supplements that I recommend you can get on Amazon. I do heavy research on these. I go to consumerlab.com. I don’t know if you’re familiar with that website.

Dr. Weitz:            I am, yeah.

Dr. Brandy:         Yeah, but I always try to go there to see what the deal is. That’s a good thing for your listeners to know about because, for instance, I was doing olive oil. My wife and I were doing this Carapelli olive oil, extra virgin olive oil, and I thought it was a good olive oil, and then I went on there. I found out 25% of it was rancid. There wasn’t even any olive oil in the olive oil. So we use a Lucini organic now. That was their top pick, but in soy milk, Silk was their top pick. So I go on there a lot when I’m looking at supplements, but when I recommend turmeric, I recommend actually a Carlyle supplement. Each capsule has one gram of turmeric. So I have people do four of those in the morning, and I have them do four in the evening with the fish oil. Those do have a little bit of the BioPerine, the black pepper extract, which increases the bioavailability. Some people that might upset their stomach, but I think that’s such a low dose, it doesn’t. I do have them do a black pepper extract on top of that to increase bioavailability. I have them do 20 milligrams of a Carlyle supplement with-

Dr. Weitz:            Yeah, I’m constantly reading about some-

Dr. Brandy:         Some people get stomach upset from that, so you have to watch that. If they do, you just cut it.

Dr. Weitz:            Yeah, that’s interesting topic. I’m constantly reading about a new form of curcumin or turmeric that’s better absorbed because it’s in a fat soluble form, in a water soluble form mixed with certain other things. So everybody’s trying to find a way to get turmeric or curcumin at a higher absorption rate since I think naturally has a low absorption rate.

Dr. Brandy:         I actually go to the study that, I don’t know if you’re familiar with the study that Golombick and group did in Australia on MGUS. So my type of cancer goes from MGUS to smoldering myeloma to myeloma. I probably had MGUS 20 years ago, I didn’t even know it. So MGUS and also early prostate- 

Dr. Weitz:            What does MGUS stand for? That’s an acronym I’m assuming.

Dr. Brandy:         Yeah. I think it’s myeloma of undetermined origin or something like that. It’s something like that, but 3% of the population actually has MGUS. So if you have MGUS, you have a 1% chance every year that you’re going to turn into myeloma. So there’s a ton of people walking around with MGUS, they don’t even know, and they’ll probably die with it. In fact, my dad was 91 years old. He had MGUS. He died with MGUS. My brother actually has a IgM MGUS. So they say it’s not genetic, but when I told my oncologist that, he was like, “Hey, boy, that’s interesting.”  [MGUS stands for Monoclonal gammopathy of undetermined significance]

Dr. Weitz:            It is interesting.

Dr. Brandy:         The three men of the family have-

Dr. Weitz:            Exactly.

Dr. Brandy:         … a plasma cell issue, but what Golombick did, she did an interesting study, and the reason I used eight grams is because that’s what she used in her study. She gave these people, and she did two different studies and they both came out the same way. It was eight grams per day of turmeric, and they had a 33% drop in their M spike. So the M spike measures the amount of this paraprotein that’s released by this abnormal plasma cell. Also, the free Kappa chains came down and also their bone density biomarkers improved, but most people with myeloma really get severe osteopenia or osteoporosis due to the fact that nobody really knows exactly how it happens, but myeloma, it downregulates your osteoblasts, the cells that actually make bone and it upregulates your osteoclast, the cells that actually break down bones. So that was an interesting study. I always go over that.  The other good study that people need to know is really a landmark study in the Journal of Urology. Dean Ornish did it. I think it was in 2005. He did it with Elizabeth Blackburn, who’s a Nobel Prize winner, and they basically took people with early prostate cancer. They put them into two different groups, plant-based group, and then the standard American group, and then they looked at their PSA levels over a year.

                                The plant-based group, their PSA levels came down 4%. Standard American group, they went up 6%. Then what they did through heat map technology, they looked at the epigenetics that we were talking about before, and they did it through heat map technology. What they found was there were 48 good genes that were upregulated and there were 453 bad genes that were downregulated. Then five years later, they looked at the telomeres, and this is Elizabeth Blackburns claim to fame. That’s how she won the Nobel Prize. They wanted to see what happened to the telomeres. With the people that in the plant-based group, the telomeres actually got a little longer, and then the standard American group, the telomeres shrunk significantly. So I mean, that was some really interesting-

Dr. Weitz:            As I recall it, in addition to the plant-based diet, I believe they also had them exercised and do some stress reduction.

Dr. Brandy:         Yeah, there was lifestyle.

Dr. Weitz:            It was a whole lifestyle program. Yeah.

Dr. Brandy:         Yeah, and that’s what I recommend to people. My whole thing is a whole food plant strong or plant-based diet. I think for cancer patients, if they can lean a little-

Dr. Weitz:            What’s the best form of exercise for cancer patients? Is there a best form?

Dr. Brandy:         Well, I do think resistance training is really important. I recommend aerobic something, brisk walking. For instance, there’s one study in my book just to show the power of exercise, even brisk walking. In this one study, these were breast cancer patients and women that just did brisk walking even five days a week, they lowered their relapse rate by 24%. If they jogged two-thirds of a mile per day, they decreased their relapse rate by 40%, and if they ran 2.3 miles per day, they lowered it by 95%. I mean, I don’t think a chemo drug can even do that.   So it has this amazing effect on your immune system. I have in my book, there’s an article that I researched where just fixed minutes of exercise increases your natural killer activity by 50%. So anytime a patient tells me, “I don’t have time to exercise,” I go, “Do you have six minutes? Go through a little break.”

Dr. Weitz:            I remember being in 2015, IFM had a cancer conference, and Keith Block was there, and he showed a picture of a patient hooked up to a chemo IV on a treadmill.

Dr. Brandy:         Yeah. Well, one of the reasons he may be doing that is exercise actually makes your innate antioxidants more efficient. So it makes your superoxide dismutase, your catalase, your glutathione peroxidase actually more efficient. I know you’ve had some other people on your podcast that talk about fasting before chemo treatments. I do think that is really powerful, and not everybody can do it, but I do. Right now, I’m dealing with a bunch of patients that are in a metastatic stage four cancer and they’re getting chemo, and I really try to encourage them, “If you can at least calorically strict one to two days before you get your chemo treatment and then the day of the chemo treatment and then the day after,” and they can even do Valter Longo’s fast, mimicking five-day program through prolonfmd.com if they wanted to get that that way, that they’re at least eating something. I think it’s about 600 calories per day. It’s a plant-based keto, essentially.

                                What he’s shown, he started with rodent studies and he found that as he fasted them before they got the chemo, the results are dramatic. In fact, I have the graph on some of my posts on Instagram. I mean, they’re actually mind-blowing. If you just fast even, cancer cells really struggle because they need a lot of nutrients to keep multiplying at this incredibly fast rate. If you just fast, it can have a negative effect. Then if you’re fasting and then all of a sudden you give chemo and they’re struggling, those cancer cells are going to be more in a weakened state and they’re going to have a chance of getting eliminated a lot easier if they’re more in a fasted state.

Dr. Weitz:            Yeah, absolutely. There’s some integrative cancer experts that for quite a period of time have done insulin potentiation, where they’ll actually give the patient insulin to drive their glucose really low before their chemo and find that that’s beneficial as well.

Dr. Brandy:         Yeah. I’ve read that. That is something that you could basically do. In fact, one of the things that I really try to do with all of my patients is try to make them more insulin sensitive. We were getting into exercise. Resistance training is really the most important thing for developing insulin sensitivity because as you lose muscle mass, your cells definitely do not accept insulin as well. The receptor doesn’t work as well. Then you’ll get accumulation of sugar and you’ll also get accumulation of insulin.   I don’t know if you know this, but insulin is the most potent growth factor. So that would be the one thing that I wouldn’t like, giving insulin while you’re getting chemo, because insulin is the most powerful anabolic hormone in your body. In fact, when they do studies with cancer cells growing in a Petri dish, to get them to grow faster, guess what they add to it? They add insulin and they start going totally out of control.   So we really need to keep insulin sensitivity. There are four supplements that I always recommend for people to really keep their insulin sensitivity high and keep their blood sugar levels low. I will tell you, I eat whole food plant-based. I eat a ton of whole grains. I eat a ton of legumes. I think they’re the most important two that you should eat. I know paleo people don’t eat those. I mean, the longest lived people, like the Hunzas for example, I mean, whole grains are a major part of their diet, and whole grains do not cause glucose spikes.

                                Actually, before, I get blood work every week, every month, I’m sorry, but before I go in, I actually drink a giant smoothie. My fasting blood sugar’s never been over 80 when I go in there. It just never has because the fiber actually slows down the absorption of the sugar. There’s four supplements. Amla is one that really helps keep the sugar down. Berberine, I think every cancer patient should be taking berberine. I think it’s super, super important. Gymnema sylvestre, I don’t know if you’re familiar with that, but that’s a supplement that definitely has a very potent effect on blood sugar, and then garlic.

                                I like to do the whole herb. I get it through. I think it’s called herbal roots. I recommend that for patients. Once again, when I recommend herbal supplements, I usually like the whole root rather than something that’s standardized for a certain chemical in the herb because of the synergistic effect. In fact, one of the things I do that it’s in my book, I am really big into freeze dried powders. In fact, first thing I do in the morning, and I do time-restricted eating, I eat my last meal at eight and I don’t eat until noon. In fact, right now it’s noon, I still haven’t had breakfast yet, but I woke up at 6:00 this morning, I have a special coffee drink that I do, and I put 12 different freeze dried powders in there.

                                I also put about 20 shakes of cinnamon. I put a couple little shakes of clove. I always put baking powder in the sugar because coffee is very acidic and cacao is the main thing that I put in there to give it a hot chocolate taste. Then I put soy milk in there. I also had a little scoop of a protein powder. It’s called So Clean So Lean, which is a really great protein powder or vegan protein powder that I put in there.

                                What I tell patients to do is look at the blueberry freeze dried powder. It has a 50 to one ratio on there, and what that means is one gram of that freeze-dried powder, blueberry powder is like eating 50 grams of blueberries. So the ones that I do are blueberry, blackberry, raspberry, strawberry, goji berry, cranberry, acai berry. There’s a 10 mega mushroom that I put in there.

                                So I put all these together. I use a 247 ounce coffee cup. That takes me up about a quarter of the way up. When I do my coffee, I do an organic light roast. Takes me about halfway. Then I do a cup of soy milk, and then as I do my work in the morning, my research, my writing and so forth, I’m drinking that. I sip it during the day.

                                Now, the way that I look at that, I talked about all the different ways that these phytochemicals actually kill cancer cells. I still consider that I’m still in my fasted state. So way I look at it, I’m in a fasted state at that point, and I’m drinking all these phytochemicals. I look at it like it’s almost like a chemo infusion that I’m doing while I’m doing that first thing in the morning, and then when I get ready, take a shower and get ready and so forth, I have a five concoction tea that I do. It’s camomile, dandy lime, hibiscus green tea and red clover, and I put those all together. I add some organic lemon juice, organic lime juice. I put a cinnamon stick in there. Cinnamon has amazing anti-cancer activity, by the way, and cinnamon also has significant blood sugar lowering effects. That was the fourth thing that I really recommend for lowering the blood sugar.

                                Then I fill that cup all the way up, and then I basically sip that as I’m getting ready. Then when I take my supplements, I basically take a handful of nuts and I do 12 different nuts. I know this sounds obsessive compulsive, but it gets into that synergy thing. I do 12. I do two walnuts, two almonds, two pecans, two cashews. I do all these different, and there’s studies that I have in my lecture where I show the most potent nuts against a cancer. There was a study done at Cornell University. They looked at the 10 most common nuts in which one had the most potent effect against liver cancer. Walnuts and pecans were definitely by far the most potent.

                                Then there was another study that actually looked at antioxidant activity, and it showed that pecans and almonds had the highest antioxidant activity also. I don’t know if you’re familiar with some of Keith Block’s work with molecular probe technology, but he actually showed that when an antioxidant gets into a cell in the environment of high iron and high copper, which most cancer cells have very high iron and high copper levels, it actually turns into a pro-oxidant through the fenton reaction. It actually kills the cell through free radical damage. So it’s interesting that the higher the antioxidant food, the more potent its anti-cancer activity. I think maybe that’s even the way IV vitamin C works when they give it to patients.

Dr. Weitz:            100%, yeah. IV vitamin C has a pro-oxidant effect, absolutely.

Dr. Brandy:         Yeah. So it actually becomes a pro-oxidant once it gets into the cell in the environment of high iron and high copper. So it’s really interesting. So I take my supplements actually with that tea and I get about halfway, I put it in the fridge, I cover it, and then in the evening before I go to bed, I take all my supplements. In fact, I take my supplements with my Revlimid. I get in arguments all the time with oncologists. They say, “Oh, you shouldn’t-“

Dr. Weitz:            That was going to be my next question. Patients taking ongoing chemo and the oncologist is telling them, “Whatever you do, don’t take any antioxidants couple with your chemotherapy.”

Dr. Brandy:         Yeah, I get in arguments all the time with these guys, and it is a knee jerk reaction. It’s not based on any science. Keith Block wrote a really good meta analysis. He looked at 965 articles, and these were people that were taking antioxidants with chemotherapy or radiation. What he found was that it actually made the patients finish their treatments better, they had less side effects, they actually got better results. There was only one side effect. One person overdosed on vitamin A, which is a fat soluble vitamin. If you’re taking a fat soluble vitamin, you need to make sure you monitor it so you’re not getting overload. There was another study, I actually have it in my book, did the same thing, looked at 280 studies. It was a meta analysis, and they came up with the same result.

                                The other thing I always … There’s a drug called Amgen. I don’t know if you’re familiar with it. It’s an IV antioxidant that was approved by the FDA 20 years ago, and it was approved so that it could prevent damage to the normal cells when people were getting radiation in certain times of chemo. What they found in that study, and there were many clinical trials for that to get FDA approval, that it had no negative effect on the final treatment and it did protect a lot of the normal cells that were around the area of radiation.

                                So anytime an oncologist gives me a hard time with that, I go, “Well, you know what? Why did the FDA approve this IV antioxidant that’s way more potent than any antioxidant in turmeric or vitamin C or green tea?” I mean, it’s not even close. So that whole thing is really, I really feel it’s a total knee jerk reaction because you know as well as I do, most medical doctors know nothing about nutrition. Zero. I mean, we get two weeks in medical school and honestly, it’s like a junior high school health class. It’s like if you don’t get vitamin C, you’re going to get scurvy. If you don’t get vitamin D, you’ll get rickets. I mean, even fruit loops is probably fortified with vitamin D. People don’t get scurvy nowadays.  I really do, talking about these phytonutrients, I think a lot of these people in these carnivore diets and so forth, nobody ever talks about this, but we don’t have any acute deficiencies. But I think a lot of these people over time are going to have phytonutrient deficiencies that develop over time.

Dr. Weitz:            I would totally agree with that. Even Paul Saladino, I think, didn’t Paul Saladino changed and start incorporating some vegetables or something now?

Dr. Brandy:         Yeah, and you know what? I don’t know if you’re familiar with the American Gut Project by Robert Knight. He’s the premier microbiome researcher in the world, and he has the American Gut Project. You basically send your stool sample in with all these … There’s a questionnaire, ask you all these different questions, and they’ve analyzed over 10,000 stool samples at this point. What they’ve found is people that eat 30 or more different plant foods in a week have the most diverse, healthiest microbiome compared to people that eat 10 or less. The people that eat 10 or less have some antibiotic resistance bacteria. The people that eat 30 or more didn’t have any.

                                It’s probably because the people that are eating 30 or more per week are probably plant-based. People who are 10 or less probably are eating maybe paleo or keto and they’re getting some of these antibiotic resistant bacteria from the animal products that they’re eating, but that’s one thing I stress, and it’s really not that hard to do. When I’m doing a consult, I show people the salad that I eat every day. I really never knew how many vegetables I had in there until somebody asked me. I actually count. I had 25 different vegetables in that salad.

                                So I tell people, “Listen, when you eat a salad, don’t put a bunch of greens in there and then maybe little carrots and onions and a tomato, but two radish, put two broccoli, put two cauliflower, put some corn in there, put some peas, and get that diversity in that salad.” Then as far as getting up to 30, the Blue Zones kitchen and I give patients probably about 15 different cookbooks and websites that they can go do to get some amazing recipes.

                                My wife is an amazing whole food plant-based cook. She’s always in different cookbooks, but there’s some really good ones in the Blue Zones kitchen, some really good soup. So just in that soup, there’s usually 15 different vegetables, legumes. So if you make that in a big instant pot, put them in some little mason jars, you can just pull that out. You do the same thing with your salad. You just put them in little mason jars and you just pull them out. It’s really not that hard to do. Then supplement that with fruits, whole grains.

                                Every morning, I start with steel-cut oats, with all the berries. I put cinnamon and I put soy milk with that alone. I was telling you by Joe Mercola, what he eats in the morning. I compared what he was eating to what I was … So with that, I was getting, I think it was like 680 calories. I was getting 25 grams of fiber just with that one breakfast. I will tell you, with that drink that I do in the morning, I’ve calculated what I get just with that. I actually get 25 grams of protein and 12 grams of fiber just with that drink that I do in the morning.

                                People think, “You don’t get enough protein.” I probably get 1.5 grams of protein per kilogram. Honestly, I really don’t even want to be that high, but I am very active. I do think the more active you are if you’re doing resistance training and so forth, you need to get above that 0.8 grams per kilogram, but I looked at what I was doing, I’m getting thousands of phytonutrients. I was getting about 25 grams of fiber. In that, I was getting almost 40 grams of protein just in that morning breakfast that I’m eating because I’m using that soy milk, that Silk soy milk. One cup alone has eight grams of protein and two grams of fiber just in the soy milk. That’s why I like Silk. I think that is the best brand.

                                I’m getting all these phytonutrients and I’m getting all this plant diversity with that. Dr. Mercola was getting zero fiber or he is getting zero phytonutrients. He’s not getting any plant diversity in there at all. He’s getting a ton of saturated fat. He’s getting, as I said, 1,550 milligrams of cholesterol. What I was surprised at, it was 1,600 milligrams of sodium. I was surprised by that, and then 130 grams of protein, animal protein.

                                As I told you, once you get over 30 grams of protein, it’s really all it’s doing is really acidifying your pH, putting a heavy load on your kidneys. It’s creating very high iron levels, which are very pro-oxidant. In fact, I told you he actually blood lets himself every month. So I just think that people that are eating these carnivore or Paleo or keto diets really got to be careful because the preponderance of evidence does not show that that is going to have long-term results. You might have some short-term results, you might feel better, but long term we know you have to look at the preponderance of evidence over many years, you have to look at the Blue Zones, you have to look at the work the John Robbins did with Be Healthy at 100.

                                The preponderances evidence is that people and cultures and research cohorts that eat more plant-based definitely live longer and they have less lower incidents of cancer. In fact, I don’t know if you’ve read Fiber Fueled, you really should read that book. In fact, you should get him on your podcast, Will Bulsiewicz. He’s a board certified gastroenterologist, and his book is amazing, and he’s a great podcast host, if you ever get a chance, and I think he’s really amenable to doing podcast interviews, but he went over a study that came out, Lancet 2019. They looked at 185 prospective studies, 58 clinical trials. It was a meta analysis, and it was 135 million people years. They found the highest fiber consumers compared to the lowest fiber consumers actually lived 30% longer.  So we know that when you eat more fiber, you’re healthier. In fact, there was a 2014 study. It looked at 1.7 million people, I think had followed them over 14 years, and they found for every 10 grams of increase in fiber, you lower your mortality by 17%, premature mortality. 10 grams of fiber, just got to give you an example, if you eat a half couple lentils, that’s 10 grams of fiber. If you have a cup of navy beans, that’s basically 10 grams of fiber. So it’s really not that hard to do, but the average American only gets 15 grams of fiber.  If you look at the NHANES report, men 30 to 50, 0% eat 30 grams of fiber, 0%. In women, it was 3%. So the American diet is really sorely deficient in fiber, not protein. I’m not worried really about protein. If you’re getting enough calories, you’re getting enough protein. That’s my feeling. Now, if you’re doing a lot of weight training and you want to increase muscle growth, you’re probably going to need a little bit more protein, but I will tell you, when I look at eight grams per kilogram, it’s about 52 grams. I mean, I always get over 100 grams. I’ve checked on consecutive days. I don’t really want to be that high, but it’s really not that hard to get up to 100 grams on a whole food plant-based diet. With the nuts and seeds I do, I eat legumes every day, I eat whole grains, have a lot of protein. I do a lot of whole grains. I do Ezekiel bread this morning, I had it with walnut butter with a little bit of jam. So I think whole grains are extremely important.

Dr. Weitz:            Sounds great, Doc. This is a fascinating discussion. I’m really enjoying it. However, I’ve got a patient here, so I’ve got to run.

Dr. Brandy:         You got to take care of that patient, man.

Dr. Weitz:            Tell everybody how they can get your book and learn more about you, your website, et cetera.

Dr. Brandy:         Yeah. My book is called Beat Back Cancer Naturally. You can get it on Amazon. It’s in hardback, paperback, audio, and in Kindle. You can also get it on my website. My website’s naturalinsightsintocancer.com. If you get it there, I do give you a signed copy, and it’s about the same price as if you go on Amazon. I have a Instagram site. It’s called Cancer Veggie Doc, and I have over 36,000 followers on there. I make sure I do a post every single day. In fact, the post I did last night was how a ketogenic diet. It was a study in cell cycle. It actually increased breast cancer by 2.5 fold. So you can take a look at that. I’m always looking at studies on different diets and how they affect cancer growth, but that’s basically the best ways to get me.

                                Then if they want to do, I do extensive lab testing. I do 70 plus biomarkers request. I check all the vitamin levels, mineral levels. I check C-reactive protein, heavy metals, the omega-6/omega-3 ratio, hemoglobin A1c. I always check their IGF1 levels. I think it’s really important. What I find, and I will tell you this, almost every single person has messed up mineral levels. I mean, I’ve never had anybody had a normal molybdenum level. So I do recommend people take a liquid colloidal mineral supplement every day because our soil is just so messed up right now. In fact, I was reading a book last night and I guess 50 years ago, our top soil was about 16 inches thick and now it’s 20% of that. So our soil is really super depleted.

                                Then I also do microbiome testing through Doctor’s Data, and I check 173 different toxins from the urine through Great Plains Laboratory. So they can get all that on my website. They get a virtual consultation there. I also have 24/7 availability to me through email, text, and phone, and patients absolutely love that. I have a lot of these patients going through metastatic stage four cancer and I’m in contact with them almost every day through text message because they’re nervous, they’re scared, they’re reading articles. So I’m with them day in and day out. I mean, I get enundated with text messages.

Dr. Weitz:            That’s awesome, Doc. I do have to run. I really appreciate it.

Dr. Brandy:         Okay. All right. Take care, Dr. Ben.

Dr. Weitz:            Thank you. Thank you.



Dr. Weitz:            Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five-star ratings and review. That way, more people will discover the Rational Wellness Podcast.  I wanted to let everybody know that I do have some openings for new patients so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardiometabolic conditions or for an executive health screen and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way, and that usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective.  So if you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111, and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.



Mast Cell Activation Syndrome with Dr. Tania Dempsey: Rational Wellness Podcast 303

Dr. Tania Dempsey discusses Mast Cell Activation Syndrome 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

0:30  Mast cell activation syndrome.  Mast cells are immune cells found throughout the body that contain granules that contain various chemical mediators, including histamine and heparin.  Mast cells are involved in allergies and in various inflammatory and immune functions, including wound healing, angiogenesis, immune tolerance, and defense against pathogens. In mast cell activation syndrome, mast cells are inappropriately and excessively release chemical mediators, resulting in a range of symptoms that are grouped into cardiovascular, dermatological, GI, neurological, and respiratory in nature.  These include flushing, hives, a reddish complexion, itchiness, burning, lightheadedness, dizziness, arrhythmia, diarrhea or constipation, stomach pain, nausea, acid reflux, difficulty swallowing, headaches, fatigue, lack of concentration, and other cognitive problems, congestion, coughing, and even anaphylaxis.

2:47  Dr. Dempsey first started to focus on mast cell activation syndrome (MCAS) when researching trying to understand a patient who had a flare of this condition.  She spoke with Dr. Lawrence Afrin, who was a recognized expert on mast cell activation syndrome, who explained the mechanism for this condition.  She recognized that patients she had treated in the past probably had some elements of this condition as well.

12:05  MCAS is a multisystemic process and the most common symptoms include genital urinary complaints, hormonal complaints like endometriosis, painful periods, and excessive bleeding, migraines, interstitial cystitis, pain syndromes, high or low blood pressure, etc..

13:36  Diagnosis of MCAS.  One test that Dr. Dempsey will do with patients is to take a tongue depressor and scrape it across the back of the patient.  If there is a skin reaction, that indicates that mast cells are releasing histamine and that the patient may have MCAS.  This is called dermatographism.  The lab testing for MCAS is tricky, since some of the mediators that can be measured are very short lived, so she has a refrigerated centrifuge in her lab to be able to specially process the samples.  There are a number of markers but there is no one marker that is definitive for making a diagnosis. Tryptase, histamine plasma or whole blood, chromagranin A, and C-reactive protein are markers that can be measured.  If the patient has had an endoscopy or colonoscopy, we can biopsy a sample of the intestinal mucosa and see if there are more than 20 mast cells in the field. You may see elevated eosinophils.

21:52  The QEESI is a validated questionaire that Dr. Dempsey recommends, that stands for The Quick Environmental Exposure and Sensitivity Inventory that is available here: QEESI.





Dr. Tania Dempsey is an internationally recognized expert in chronic disease, autoimmune disorders and mast cell activation syndrome.  Dr. Dempsey received her MD from Johns Hopkins and she is Board Certified in Internal Medicine and a Diplomate of the American Board of Integrative and Holistic Medicine.  Dr. Dempsey is the founder of the AIM Center for Personalized Medicine, in Purchase, New York, where she practices with Dr. Lawrence Afrin.  Her website is DrTaniaDempsey.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 website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.

                                                Hello, Rational Wellness Podcasters. Today we’re going to be speaking about mast cell activation syndrome with Dr. Tania Dempsey. What are mast cells? Well, mast cells are immune system cells found throughout the body that contain granules that contain various chemical mediators, including histamine and heparin and a bunch of others. Mast cells are best known for their role in allergies, but they’re involved in various inflammatory and immune functions, including wound healing, angiogenesis, immune tolerance, and defense against pathogens. In mast cell activation syndrome, mast cells are inappropriately and excessively release chemical mediators, resulting in a range of symptoms that are grouped into cardiovascular, dermatological, GI, neurological, and respiratory in nature.  These include, among many others, flushing, hives, a reddish complexion, itchiness, burning, lightheadedness, dizziness, arrhythmia, diarrhea or constipation, stomach pain, nausea, acid reflux, difficulty swallowing, headaches, fatigue, lack of concentration, and other cognitive problems, congestion, coughing, and even anaphylaxis.

                                                Dr. Tania Dempsey is an internationally recognized expert in chronic disease, autoimmune disorders, and mast cell activation syndrome. Dr. Dempsey received her medical degree from Johns Hopkins, and she’s board certified in internal medicine and a diplomat of the American Board of Integrative and Holistic Medicine. Dr. Dempsey is the founder of the AIM Center for Personalized Medicine in Purchase, New York, where she practices with Dr. Lawrence Afrin. Dr. Dempsey, thank you so much for joining us.

Dr. Dempsey:                    Thank you for having me.

Dr. Weitz:                          Great. Let’s jump into how did you first get involved in mast cell activation syndrome as an area of focus for you?

Dr. Dempsey:                    My interest was always in understanding patients whole being, right, and I always looked at patients in a holistic manner, and I always spent time with patients, even when I was doing straight internal medicine, and I was always interested in the why, why a patient had this symptom, why a patient had that symptom, how these different symptoms fit together. And the more that you think about those things, and the more time I spent with patients, trying to understand how all the pieces fit, the more you start to question, is there some root cause that we haven’t thought about before? Is there something that could explain these constellation of symptoms that are multisystemic? And what was that?  So I was on a hunt.  I had one patient in particular who really sort of had what I would call a major flare. I started seeing her when she was relatively well, and then she had a flare, which we then later realized was consistent with past flares, but it was before I knew her, but all we always saw was an acute episode of her getting worse and not understanding how all the different symptoms she had fit together.        And so one day, I just spent hours, like I typically do, I’m very invested in my patients and I will research until the nth degree to figure out what’s wrong with them. And so I was on PubMed, I was on Google, I’ll admit it. I was trying to figure out how I can put this together, and I remember seeing something about this condition, this relatively new condition at the time, mast cell activation syndrome. So some of the publications about it were coming out around 2012, when it was really starting to be recognized and there were people looking at how to diagnose it. So this was, this patient, it was about 2014, 2015. And so there was stuff, just new stuff, the buzzwords. And I remember talking to her and saying, “I think this could be this mast cell activation syndrome, and in fact, if this is what you have, then I think a lot of my other patients probably have this, too. So let’s figure this out.”  And so it was sort of serendipity. She somehow knew someone who knew Dr. Afrin and he was in Minnesota at the time, Lawrence Afrin and I got on the phone with him and I said, “I want to hear everything about mast cell activation syndrome. How can I help my patients?” And I think we spent an hour on the phone and I was hooked because everything he said just resonated with me, made me understand that these patients, that some things help. There are different modalities that we’ve tried and they get better, but they don’t fully get better. That’s where I started thinking about, okay, I think this is the tip of the iceberg. I think this is a bigger issue than we’ve ever recognized. And I think what’s really interesting for me is that I really started my career in the women’s health arena, looking at polycystic ovarian syndrome and the like.

                                                And what I was noticing, back then, 20 years ago, that these women also very often had allergic-like phenomena. They could have asthma, eczema, they often had things like irritable bowel syndrome or interstitial cystitis, endometriosis. So I always understood that these women had this collection of other disorders that were being affected, but I didn’t understand what the connection was. And then once I started to understand MCAS, then I was able to look back at my career of 20 years and saying, “Oh, intuitively, I’ve known this all along, but now I understand that the root is really in this dysfunctional mast cell.”

Dr. Weitz:                          So I just wanted to point out, you mentioned MCAS, and that’s an abbreviation for Mast Cell Activation Syndrome, M-C-A-S.

Dr. Dempsey:                    Thank you. Yes.

Dr. Weitz:                          So how would you describe, I know I gave a definition, but how would you describe what mast cell activation syndrome is?

Dr. Dempsey:                    Yeah, I think you did a great job. That was perfect.

Dr. Weitz:                          Okay.

Dr. Dempsey:                    Yeah. Mast cell activation syndrome is a syndrome of abnormal mast cells that are reacting at baseline abnormally. So they are releasing these various mediators abnormally, and then when there’s additional triggers, there’s more activation, more release of mediators. So everyone has mast cells, everybody has mast cells that respond to infections or other triggers. If someone gets COVID or the flu or something, the mast cells get activated. It’s part of your innate, your primitive immune system, but the problem really is in patients who at baseline, their mast cells are already not working well, they’re maybe more reactive in releasing some of these inflammatory mediators, these chemicals at baseline. So they’re inflamed at baseline, and then they’re faced with an infection or a trauma or some other stressor, toxin, mold, and then their already-dysfunctional mast cells become more reactive, releasing more chemicals, and then they go into a bigger flare.  So that’s essentially what MCAS is, and it’s really a multi-system disorder. It’s not, and I think this is important to note that it’s not the patient who has allergy, let’s say, and only has allergy, but has nothing else. They don’t have mast cell activation syndrome. So it has to be multiple organs, at least two different systems involved. And so the mast cells can be reactive in different ways in different parts of the body.

Dr. Weitz:                            And so is mast cell activation syndrome something they just had, or it sounds like you’re saying that they got an infection or they got exposed to some toxins or mold and that triggered this over-activation. Is that what happens?

Dr. Dempsey:                    Well, it could be either, actually, or both. And so the vast majority of people who have this syndrome, MCAS, have a genetic potential. I would put these people in what I would call like an idiopathic, this is idiopathic MCAS. Primary MCAS is that if there’s a genetic vulnerability, and then there’s some process trigger that makes it evident in them. And then that’s all they have. And so yes, they can have other triggers, but their root cause, the root problem is that they were born with dysfunctional mast cells, and that’s primary. Secondary is when someone has normal mast cells, but then they have a major trigger that makes their mast cells react, and then their mast cells continue to react, and they don’t reset until you take away that trigger. That’s what we call secondary.   And theoretically, in secondary MCAS, when you take away that trigger, the mast cells go back to normal. Idiopathic is like that combination probably of both, where there’s a genetic vulnerability, there’s a trigger, but even if you remove the trigger fully, they won’t return to normal. They’ll return to a different baseline because their mast cells were already, I use the term mutated. In a sense, that’s what happens.

Dr. Weitz:                          So a percentage of these patients, and I don’t know if we know what percentages-

Dr. Dempsey:                    Yeah.

Dr. Weitz:                          … likely will never have normal mast cell reactivity.

Dr. Dempsey:                    Well, look, the number I can give you was based on some literature, some publications out of Germany in 2013. Gerhard Molderings published on the fact that the German population had about 17% incidents of mast cell activation syndrome. And if we assume that their population is similar to our population, 17%, which probably is an underestimate, so let’s say it’s maybe even closer to 20%. So one in five people have MCAS in some form. At one end of the spectrum, they may not even know they have this. They have mild symptoms that they’ve lived with. Maybe they have migraines, maybe they have and they deal with it. They take a pill. Maybe they have women suffering from painful periods, but they go to the gynecologist and they get a birth control pill. But underlying it is probably mast cell activation syndrome.  On the other hand of the spectrum are people who are really debilitated from it. So the reality is it’s hard to know how many people are really sitting at the mild end and how many are at the more severe end, but one in five people have the potential and possibly even the full spectrum of this disorder.

Dr. Weitz:                          So what are the most common symptoms that alert you to the fact that this patient sitting before you may have MCAS?

Dr. Dempsey:                    For me, it’s really not just about a particular symptom. It’s about a multisystemic process. So if I’m talking to the patient and I’m getting a sense that there are multiple organ systems involved, they have GI complaints, they may have respiratory complaints, they may have genital urinary complaints, they may have endocrine hormonal complaints. And once I start to see that it’s multisystemic, then this is going to be on my radar.  Women’s health issues, certainly there are some buzzwords. I hear endometriosis, I hear painful periods, I hear excessive bleeding, things like that. They sort of make me K kind of go in this direction. Migraines, interstitial cystitis, pain syndromes in general, people with pain and sometimes with unknown origins to me, always make me think that this could be it. But really it’s about the fact that these patients often have multiple things going on. They might have high blood pressure and they don’t know why. Sometimes it’s high, sometimes it’s low, sometimes it’s dizzy. Sometimes their heart rate goes up. And then when they say that these are the patients that come in and say that no one else can figure them out, then I know that this is one area that I have to look at.

Dr. Weitz:                          So in terms of trying to diagnose patients with MCAS, I saw some doctor on YouTube and he took a tongue depressor and rubbed it on this guy’s back and it was a profound skin reaction and that he felt was an indicator that the patient might have MCAS.  Is that something that makes sense?

Dr. Dempsey:                    It’s not diagnostic for MCAS.

Dr. Weitz:                          Right.

Dr. Dempsey:                    It’s diagnostic, it’s a called dermatographism. That’s what the dermatologist would call it.  And that reaction basically is stimulating mast cells in the skin to release histamine.  So if you can see it in other mast cell issues like allergy and eczema, you can see it in mast cell activation syndrome.  So when I do that test in patients, and I do it when I see new patients-

Dr. Weitz:                          Okay.

Dr. Dempsey:                    … if they don’t have this reaction, it doesn’t mean they don’t have MCAS. And if they have the reaction, I’m thinking it could be MCAS, but I might think allergy, I might think other things as well. So it’s an interesting response. It does suggest that the mast cells are releasing histamine, but not everybody with MCAS has a histamine problem, so you may not see it.

Dr. Weitz:                          So what’s the best way to diagnose mast cell activation syndrome?

Dr. Dempsey:                    Yeah, that’s the million-dollar question, actually, because it’s a little complicated.

Dr. Weitz:                          Yeah, the lab testing seems to be very problematic.

Dr. Dempsey:                    It can be. I mean, the good news is that we have figured out, Dr. Afrin and myself, we have figured out how to get the testing done. We have found the labs that need to be used for this. We have a refrigerated centrifuge in our lab that we’re able to process the samples specially. So we have, we’re in a very good position, but I think for a lot of others who are out there trying to do testing, it can be problematic. The way, basically, what you’re doing for MCAS is you’re trying to find the mediators that the mast cells make. That’s how you’re trying to justify the diagnosis. Mast cell activation syndrome means that the mast cells are activated. So in order to have this syndrome, you have to have an abnormal level of those mediators, either in the urine or the blood.

Dr. Weitz:                          But there’s a number of these, so you know, you can test for histamine and that may not be the mediator that they have.

Dr. Dempsey:                    Correct. Correct. So you test for what we know you can test. And there’s several in the urine. There’s several in the blood. And the other thing we should mention is that there really are kind of two schools of thought on the diagnostic criteria. So I published, along with I think it was like 41 other co-authors, on the diagnosis of cell activation syndrome using a consensus criteria that we put together called the consensus-2. So what I’m talking about is based on what we’ve published, but there are other publications on other ways that others use to diagnose it. So it’s still not quite clear. We don’t use tryptase as the only mediator to diagnose MCAS. And there are groups out there that are using tryptase as one of the mediators to identify activation. And unfortunately, it’s not a great measure, so we do measure it. We just don’t rely on it fully for the diagnosis.  And then lastly, quite honestly, probably the best way to make the diagnosis is so many of our patients have had endoscopies or colonoscopies. So you can look for mast cells on biopsy samples, and if they have more mast cells in certain areas on these biopsies, then that is a very good indicator that they may have mast cell activation syndrome. So if I can get a biopsy sample, they’ve already had had biopsies, if I can get them stained in a certain way, we call it CD117 staining, and if we can see that there’s more than 20 mast cells in this field, then we can use that as one point of support for the diagnosis.

Dr. Weitz:                          I’m assuming your typical gastroenterologist is not looking for mast cells.

Dr. Dempsey:                    Correct. They’re not. So they’re doing these biopsies and they’re looking-

Dr. Weitz:                          And what happens when you ask them to do it?

Dr. Dempsey:                    Well, it depends. So the GI docs that we work with, we have a form that we usually give them, and they’re already aware that they’re going to talk to the pathologist. It’s really not up to the GI doctor. They’ll do the biopsies, but the pathologist has to be the one, they’re the one that stains it. So we have a form that we usually give our patients that if they’re going to go for a procedure, we want to make sure that they can do the staining right away. But let’s say the patients already have done the testing, the GI doctor said everything looked great. What we do is we request the slides, they have to be unstained, and we have a pathologist we work with, we’ll send her the slides, and we’ll say, “Now stain them for CD117 and see if you find mast cells.” And then these are normal results that they’ve gotten from their GI doctor. And then we get it back and we see, with a special stain, we see all the mast cells light up.

Dr. Weitz:                          Cool. Okay. So are there any, for a conventional doctor who doesn’t want to try to do these complicated labs that require having a centrifuge in the refrigerator and getting these samples to the lab chilled and kept chilled the whole time, and the likelihood of a conventional lab actually handling it in the right way is not that great?

Dr. Dempsey:                    Correct. Correct.

Dr. Weitz:                          Are there any just conventional indicators on labs that might give you an idea? Like does a CBC tell you anything?

Dr. Dempsey:                    Yeah. Yeah. So again, it wouldn’t maybe give you the full diagnosis, but could it give you a picture? Absolutely. You can see hemoglobin’s high, hemoglobin is low. You can see eosinophils. Sometimes they have eosinophillia. If they don’t, it doesn’t mean that they don’t have MCAS, but these are some things that I could look at. You could check out plasma histamine. That’s a really easy test. You can even do a whole blood histamine. Yeah, if histamine is one of their issues, you might find it. Chromogranin A also is a very-

Dr. Weitz:                          But the plasma histamine, the sample has to be kept cold, right?

Dr. Dempsey:                    It does, but it’s not as sensitive as some of the other-

Dr. Weitz:                          Oh, okay. Okay.

Dr. Dempsey:                    So it’s still worth testing.

Dr. Weitz:                          Right.

Dr. Dempsey:                    Heparin in the blood is more problematic. That’s going to be really another conversation, but histamine, chromogranin A, and tryptase, just in case the tryptase comes back, that you can look at the blood counts. I think C-reactive protein is not specific for MCAS, but we certainly see in some patients because they have inflammation, sometimes the inflammation translates to an elevation in inflammation markers, sometimes it doesn’t, surprisingly.

Dr. Weitz:                            Okay.

Dr. Dempsey:                    But those are some things that I think, look, there we have an MCAS questionnaire that’s been validated in the literature. So docs can give the patients the questionnaire or fill the questionnaire out with the patient, and it asks specific questions about certain types of symptoms and certain types of testing that they may have had done. And then they can do some of this rudimentary testing so they have an understanding of the patient’s symptoms, where they fall on the questionnaire.  I also encourage the use of the QEESI questionnaire, the Q-E-E-S-I questionnaire, which is a chemical sensitivity questionnaire that’s also been validated. And since we’ve published on the association between mast activation syndrome and chemical intolerance, you can give them this chemical intolerance questionnaire, you can give them the MCAS questionnaire, you could use some blood work, and then sure, you could do that scratch test on their back and see if they get a red line. And then I think you can make a case for whether they have this or not.

Dr. Weitz:                          So this MCAS questionnaire has been validated?

Dr. Dempsey:                    Yeah, it was published. Gerhard Molderings published this along with Dr. Afrin in 2015, I believe.

Dr. Weitz:                          Okay.

Dr. Dempsey:                    And it is in the literature. We’ve taken it, we produced it for our patients. It’s easier.

Dr. Weitz:                          Would you be willing to share that with me that I can put in the show notes?

Dr. Dempsey:                    Absolutely.

Dr. Weitz:                          Sure. That’d be great.

Dr. Dempsey:                    Absolutely. Yeah, of course. And the QEESI questionnaire, which people can get at queesi.com, I think, or qeesi.org. Oh, it’s qeesi.org. And that questionnaire is readily available and I encourage people to take that one as well.

Dr. Weitz:                          And that you said is for chemical toxicity.

Dr. Dempsey:                    Correct.

Dr. Weitz:                          What kind of chemical toxins do you find that are most associated or that come up a lot?

Dr. Dempsey:                    Yeah-

Dr. Weitz:                          Obviously we’re in a society awash with chemicals.

Dr. Dempsey:                    We certainly are. Claudia, Dr. Claudia Miller, who has really done, has been a pioneer in this realm, she has published on the association between organo phosphate pesticides and the impact on the development of chemical intolerance, and then really what we now understand is mast cell activation syndrome, so I think that’s a huge problem. But all the petroleum stuff, all the plastics, all the stuff that people are exposed to at some point, I think the fragrances, the scents, the disinfectants, we saw an uptick in chemical intolerance and mast cell activation syndrome during COVID, I think, partially, from COVID, like I think people, we were seeing that association between MCAS and COVID.

                                                So maybe people who had COVID or long haul COVID might have had underlying MCAS, but also because of the amount of disinfecting solutions that were used, people were more heightened. People were noticing they were going to the grocery store. Even with the masks, they were still being exposed. So it’s a problem. And for people who don’t have any issues with their mast cells, they might smell it, it may not be great, but when the mast cells are already probably at baseline, a little dysfunctional, but maybe they’re still okay, exposure to these chemicals can certainly bring it out fully.

Dr. Weitz:                          So you’re saying that drinking bleach probably wasn’t good for their health.

Dr. Dempsey:                    Right. No comment.

Dr. Weitz:                          Just kidding. Let’s get into some of the treatments-

Dr. Dempsey:                    Sure.

Dr. Weitz:                          … for MCAS.

Dr. Dempsey:                    Yeah.

Dr. Weitz:                          I know that I’ve heard Dr. Afrin in talks talk a lot about the use of antihistamines. Do you tend to use antihistamines as part of your treatment approach? Do you tend to use natural supplements or diet or a combination of all of the above?

Dr. Dempsey:                    Usually a combination because my background is integrative medicine, but I think the number one thing, and he’ll say, Dr. Afrin will say this as well, the number one thing is to eliminate the triggers. So if you are being exposed to something, if you have an infection and that’s run your mast cell, you’ve got to peel that layer away.

Dr. Weitz:                          Treat that infection.

Dr. Dempsey:                    You got to treat the infection. Or let’s say you’re taking a medication that has a dye in it and you’re dye-sensitive, and maybe that’s kicking things up, that has to be eliminated. So there’s a process that we go through with patients to educate them about their different triggers and what may be continuously making them sick. So that’s first, before you even treat them, you need to eliminate the triggers. Then we go through a process of going through what makes the most sense for the patient. Sometimes it makes sense to try Vitamin C or quercetin. Sometimes it makes sense to go right to an over-the-counter H1 blocker, antihistamine, and sometimes it makes sense then to go onto the H2 blockers that we use.

Dr. Weitz:                          Let me just point out. Vitamin C is often considered a natural antihistamine. Quercetin is considered a natural mast cell stabilizer.

Dr. Dempsey:                    Correct. Correct. They don’t always work for everyone. Some patients react to it, sometimes they react to something mixed in it in a supplement. So I want to be very clear that my suggestions have to be really personalized and individualized. Every patient is different. So what I’m starting with is going to depend on what I think they may react better to initially. Honestly, I think the antihistamines are a great way to start, a little bit more bang for the buck, the way I look at it. They usually do respond, especially if I know there’s histamine involved. It might take some trial and error to go through the different antihistamines to find the one that’s right for them, but I think it’s absolutely a great way to calm things down for some patients.

Dr. Weitz:                            And are you typically using one or several different antihistamines?

Dr. Dempsey:                    I’ll start with one. There’s a trial period, so they’re going to start one. They may increase the dosage depending on how they do. If they don’t do well with that, they go on to the next one. So we have four, let’s say, main ones over the counter, Loratadine, Zyxel, Zyrtec, Allegra, those are the brands. And then we have Benadryl. This is a fifth one, which is a more short-acting type of antihistamine. And then there are prescription ones available, too. But you could start with what’s over the counter, one at a time, trial them.

                                                Do I have patients who wind up needing two different antihistamines at the same time? Yes, but rare. Usually we try to find one antihistamine that’s going to accomplish the job. Adding an H2 blocker, so this is essentially an antihistamine that works in the gut, but by binding the H1 receptors from the regular antihistamines and then binding the H2 receptors with these other drugs, doing that together has a synergistic effect. So an example of an H2 blocker would be something like Pepcid or the old Zantac when it was on the market, Tagamet.

                                                So we can use them together to help to provide even better stabilization of the mast cell, but that doesn’t always work. And so then we have next in line and lots of different things to try. And what I’ve learned is that you have to keep going because you never know when you’re going to find the thing that’s going to help. And at the same time, I’m always looking at other root causes. I’m looking at their gut microbiome, which is a huge potential trigger for MCAS. We see so much candida in the gut, parasites, just dysbiosis, just bad bugs in the wrong place, not enough good bugs. We have tons of mast cells in our GI tract, so they’re going to be alerted to the mess that’s going on. And so, yeah, I can give all the mast cell drugs in the world, it’s not going to get better.

Dr. Weitz:                            So a lot of us who are treating these functional gut disorders, like SIBO and acid reflux and some of these other conditions, and most of us have found that some of the conditions resolve very well to simple treatment programs. Others are more complicated and take a long period of time and continue to recur. And that’s where we might start wondering, could mast cells be a factor in this functional gut disorder? And if that’s the case, what would be our first step? And then, how would we want to change our treatment plans?

Dr. Dempsey:                    Yeah, it’s a great question. Well, I think everything has to be happening almost simultaneously, but-

Dr. Weitz:                          Let’s say I have a patient with SIBO. I’ll just make up an example.

Dr. Dempsey:                    Yeah, give me an example.

Dr. Weitz:                          Patient saw a GI doctor, tested positive on a SIBO breath test, did two weeks of rifaximin, didn’t really help that much, came to see me. We also did a functional stool analysis and I put her on a protocol for reducing the bacterial overgrowth and, in my case, using basically herbal supplements, maybe some other digestive support, a natural prokinetic, maybe a digestive enzyme, a few things like that. And maybe they got better and they recurred in a month. And now I’m wondering, could mast cells be a problem? Because I think a lot of us are looking for the answer. Is it really fungal overgrowth? Did I miss the fungus? Is it just that there’s layers of bacteria and we got through one layer and we got to get through the next layer? Maybe the bacteria are encased in a plaque and we’ve got to break through that. What is the thing I’m missing? When would we think, okay, this might be mast cells and if we do think it’s mast cells, what do we do next?

Dr. Dempsey:                    So with that patient, right, I would’ve already screened for other symptoms because these patients are not just having gut symptoms. They’re also potentially having other symptoms. So if I already know that I’m treating SIBO and I’m treating their gut issues like you are, but I also know that they have other systems involved, so I’m going to be alerted already and I’m going to still do-

Dr. Weitz:                          So if they’re not having a lot of other symptoms, you would be less likely to think that this might be a mast cell issue, right?

Dr. Dempsey:                    Yeah, less likely, but sometimes I think patients underestimate what their symptoms are or they don’t feel like they’re that important or they’ve had them for so long, so they’ve really not even thought to talk to a doctor about it. And this happens all the time, which is why, with my patients, often I will repeat their history with them over and over and over again, especially if I haven’t figured out what’s going on. And I’ll say to them, “I know. I know you told me this whole story, but we’re going to do it again because I feel like we’re missing something.” And sometimes the truth really does come out, things that they hadn’t thought about because it’s been such a part of them. So my guess is that if they’re having SIBO that recurs or symptoms that recur, more likely than not, there’s something else going on elsewhere in the body that they haven’t mentioned. But let’s just say that-

Dr. Weitz:                          That’s an interesting clinical pearl. I remember being at a Institute of Functional Medicine seminar and one of the older doctors who started the Institute of Functional Medicine talked about how sometimes he would leave the room and come in and say, “Now I’m Doctor Somebody-Different,” and go through their history again and would end up with different answers.

Dr. Dempsey:                    Yes, yes, and I see this all the time. And so I have history, history, history. I cannot emphasize that enough because I have taken that same history on the same patient for a year until I figured out something that they didn’t say. This happens unfortunately more often than you would think. So the point being is that I would bet money that if they have recurrency that there’s something else there that they’re not talking about or that’s not in the front of their mind. They have so much discomfort from their GI tract, they’re not even thinking about the neuropathy or the migraines or visual issues or skin rashes. They’re not thinking about it because they’re just so focused here.

                                          So that’s the first step, is just to understand what else is going on elsewhere, and then understanding what else is going on there I think is important. I think I have a very similar approach to you. We’re thinking about, yes, did we miss the fungus? Did we miss the biofilms? Did we miss that… Absolutely. I do that all the time. But also the other part of it is that if I think there’s MCAS and I’ve, let’s say, I’ve diagnosed it or I’m close to diagnosing it, I might start a more mast cell targeted therapy regimen while I’m also trying to fix the other things because I might get further along with that approach.

Dr. Weitz:                          So how about diet? How often do you use specific dietary approaches considering that food sensitivities may also be triggers? Do you typically use a low histamine diet, another type of diet, and when in your protocols do you approach diet?

Dr. Dempsey:                    So, look, I think diet is critical. I think that food is medicine. There are lots of cliches about it, but I really think you are what you eat, that kind of stuff. So I think food is important, but I don’t think there’s one diet that works for everybody. And so I’m very always a little reluctant to say to patients, “You need to be on the low histamine diet. You need to be on the low FODMAP diet. You need to be on this diet,” because every patient’s going to be different and some patients are going to respond really well to one diet or another, and some patients are going to need some combination of them. So it’s a very personalized approach.

Dr. Weitz:                          So do you try the low histamine diet, see how that works? If not, try the low FODMAP diet or-

Dr. Dempsey:                    Sometimes, sometimes, but probably not alone. I usually don’t say, “Here’s a low histamine diet and you’re going to do that for a month and then we’re going to follow up.” Usually what I’m doing is saying, “Let’s go through your diet that you’re eating now. Let’s figure out if there are potential triggers in what you’re eating.” If the diet already is low histamine, then lowering it even more is not going to help. But if I think that too many carbs, if I think that they have insulin resistance, which we see quite frequently in MCAS, and I think it’s MCAS driving insulin resistance in insulin resistance in insulin issues, metabolic issues driving MCAS. So for them, it may not be the specific food, but it may be a food group, like carbohydrates, simple carbohydrates are not good for their body, or gluten or something else.

                                                So again, I take a very, very, very personalized approach, and it’s really trying to understand for the patient what is really going to be best to eliminate or to eat more of for that matter. Sometimes, and I’ll tell you, sometimes it’s not elimination. Sometimes it’s you’re not eating enough protein. Protein’s the number one thing that patients don’t eat enough of. They need it as they get older. They need it for their skeletal muscle, they need it for lots of enzymes and lots of metabolic functioning, fat also, but fat often you can get when you eat protein. So sometimes it’s just like you’re not getting enough nutrition. Let’s just get more food into you.

                                                And sometimes, and I’ll make a point, there are definitely patients who are exquisitely sensitive. They might only be able to eat three foods. That’s what their mast cells are allowing them to do, right? That’s a different scenario. I’m not going to eliminate anything. I’m going to try to figure out how to calm things down so that I can introduce more foods. So again, every patient is going to be very, very different.

Dr. Weitz:                          Let’s go through some of the natural strategies that might help move the needle. I’m just going to throw some out there. What about using DAO, which is a enzyme that helps to break down histamine?

Dr. Dempsey:                    Right, diamine oxidase-

Dr. Weitz:                          Right.

Dr. Dempsey:                    … is one of the ways that the body processes histamine and absolutely can be a great tool, especially if I think histamine is an issue for them. You lower the histamine load a little bit and yes, for some patients, I had one patient whose interstitial cystitis got better with DAO enzyme. It’s beautiful when it works like that, but the patients who don’t tolerate it for various reasons, and it doesn’t always work, especially if histamine is not their issue.

Dr. Weitz:                            What about some of the natural antihistamines? You mentioned Vitamin C, I know there’s stinging nettle, I know people have used bromine. Are there any natural antihistamines that you find can be helpful?

Dr. Dempsey:                    Well, in addition to the ones you mentioned, resveratrol, skullcap.

Dr. Weitz:                          Okay.

Dr. Dempsey:                    There are different types of skullcap, but sometimes it’s the Chinese skullcap, sometimes it’s-

Dr. Weitz:                          Right.

Dr. Dempsey:                    … the other one. Then ,off the top of my head, I mean they’re just like, I use a lot of herbs in general.

Dr. Weitz:                          Right, okay.

Dr. Dempsey:                    Some of these herbs have very, very-

Dr. Weitz:                          I think in one of your articles you mentioned ginger, thyme watercress, turmeric.

Dr. Dempsey:                     Correct.

Dr. Weitz:                          And then, of course, we got mast cell stabilizers, like quercetin and I think resveratrol would fit into there, too. What about Vitamin D? Is that something that can be helpful for mast cell patients?

Dr. Dempsey:                    Yeah. I’m so glad you brought that up because I think that’s really important. It’s probably my number one. Actually, I should say, “What do you do for your mast cell? Number one, vitamin D.” Because mast cells have the Vitamin D receptor on their surface and that’s part of what they react to. Those receptors help them read the environment. And so if they don’t have enough Vitamin D, that can be a trigger, absolutely. And you give them Vitamin D, you get them to good levels. And that alone could be mast cell stabilizing for some patients.

Dr. Weitz:                          I was just at a Chris Shade seminar and he happened to mention that mast cells express endocannabinoid receptors. So what about CBD?

Dr. Dempsey:                    CBD, PEA.

Dr. Weitz:                          Right.

Dr. Dempsey:                    Palmitoylethanolamide. Palmitoylethanolamide also binds the endocannabinoid receptor. So yes, sometimes the CBD seems to be better with THC. Sometimes it’s better without. It really depends on the patient’s mast cells. But yeah, the expression of a lot of these receptors really can change and dictate what direction you go to for treatment.

Dr. Weitz:                          What about LDN, low dose naltrexone?

Dr. Dempsey:                    Yeah. Yeah. And actually, LDN probably works through a few different mechanisms, and it may be modulating the immune system outside of its interaction with the mast cell. But yes, for some patients, it can be helpful. Yeah, there’s a whole host of natural and synthetic things that we use to-

Dr. Weitz:                          What are some of the other synthetic things you use? We went through the antihistamines.

Dr. Dempsey:                    Yeah, well, ketotifen is an interesting drug. It’s a partial H1 blocker. So it has some antihistamine properties, but it is also a mast cell stabilizer and it’s available, it has to be compounded to take it orally, but that can be a very helpful for a subset of patients. Cromolyn is another one, which is not absorbed, actually. It’s taken orally, usually in a liquid form or compounded in a capsule, and it works in the gut, so it can be helpful for the gut mast cells. But interestingly, I think the gut mast cells are talking to other mast cells and so many of these patients also have a reduction in some of their neurologic symptoms. So those are some quick go-tos that are pretty easy to get.

                                                And then yes, they’re a host of these other, I’ll call them a little more heavy duty. I don’t love to use these drugs, but some of my patients needed and have done well. Benzodiazepines, those are tranquilizers essentially, but the mast cell has receptors for them. And very small dosages can be helpful to stabilize things. And again, I can keep going. There are lots of things that we can try that, again, very often it’s about either blocking the things that are its making. So another example would be Singulair, which is a drug used for asthma. Ziflo is another drug, Accolade. There are few of them that block leukotriene. That’s another mediator that mast cells make.

                                                So if you test, the reason to test is that if you can measure and you know they have high leukotrienes or they have high prostaglandins, then you might target their treatment a little bit differently. Mast cells have COX receptors, COX-2 receptors, and COX-1 actually. So NSAIDs, anti-inflammatory drugs, can help. I think there should be some research, not yet, but I’m suspecting that it will be helpful, specialized pro-resolving mediators, SPMs, probably have some role here. Things like the drug formulation, Celebrex, Mobic, these are COX-2 inhibitors, they may have an effect as well. So again, the list goes on. And ideally, I’m working on the root causes and maybe I’m using herbs, maybe I’m using supplements. For some patients, maybe I can’t even do those things yet because they’re so sensitive now. And others, I’m combining.

Dr. Weitz:                            And maybe if patients, you mentioned chemicals, toxins playing a role in being triggers, maybe putting them on a detox to get rid of some of those chemicals might help reduce the mast cell over-activation.

Dr. Dempsey:                    I think you have to be careful with the term detox with these patients, especially the patients that I’m seeing.

Dr. Weitz:                          Okay.

Dr. Dempsey:                    Detoxing them could actually make their mast cells worse, could introducing that process. It’s a stressful process, detox, depending on what kind of detox you’re doing. So I’m always a little cautious about saying detox. There may be things that I’m doing that are in a way I know are helping with detoxification, but I’m also trying to understand how that particular patient is going to react to that. So they’re going to be patients who they cannot tolerate any C glutathione, any of the phase one or two supplements, you’re just not going to get them that way. But maybe you can get a binder into them if they have molds, maybe. Right? Or there are patients who thrive on glutathione and actually they feel like it helps their mast cells and they feel like when they detox with it, it’s better, but they may not tolerate something else. So yeah, it’s very complex.

Dr. Weitz:                          Interesting. What about the use of sauna or even exercise?

Dr. Dempsey:                    Yeah, well, theoretically, and I’m a big proponent of those things, and I’ve written articles on infrared saunas and things like that, but the problem is that some of these patients have heat intolerance. Their mast cells actually get worse with heat. Some patients it gets worse with cold, so they may not be at a stage where they’re ready to tolerate that. Or maybe they start with a minute, maybe they go to two minutes, maybe they do it slowly. Maybe they realize that it is helpful, but for some patients it’s going to take a long time to get them to the point where they could do that.

                                                Some of these patients have post-exertional malaise. They may have an overlap of ME/CFS, chronic fatigue. So post-exertional malaise, if I push them too much, if I say, “You know, you need to get outside and get vitamin D and walk,” but then the next day they spend the whole day in bed and they feel awful, then I’m not getting anywhere with them. So again, figuring out where they’re coming from, you know, you have to meet the patient where they are really and understand when you can really pull out the big guns, I call them.

Dr. Weitz:                            So now most of the patients that you put on antihistamines, are they eventually able to get off these or do they end up having to take these for their long periods of time?

Dr. Dempsey:                    Yeah, I think it depends. There are certainly patients that are in a flare, an MCAS flare, at a particular time in their life. And I think women are great examples because it does seem to be a little more prominent in women. And women have a cyclical nature to their life cycle. They get their period at a certain time, let’s say, then they may get pregnant, they go through menopause. So there are these certain time periods where the hormones are involved and we know mast cells actually have receptors for estrogen and progesterone, testosterone. So the changes in the hormones may trigger women more. So let’s just say that in a particular time in a women’s life, let’s say, at 13 when she gets her period, she is more reactive and she needs antihistamines and maybe she needs some other things to control her.

                                                She may actually get to a point where she has a good portion of her life where she’s fine. Again, maybe it’s 10 years, maybe it’s more or less, and maybe she doesn’t need anything. And then maybe she goes into another flare. Maybe she still hasn’t figured out she has MCAS, but she realizes some of these things work. So some of the patients have figured it out over time that there’s some things that they need. There are other patients where the flares are going to be longer and they’re never really going to go out of a flare 100%.

                                                They come down to a lower baseline, but they’re never back to their full lower baseline. So they might still need some support. They may need more support during a flare. So I never like to think that patients have to stay on medications for the rest of their lives. And then that’s not how we go about this, but if I think that staying on this medication is going to reduce their risk of going into a major flare, if I think it’s going to help them deal with their life and their environment better, then I say, yeah, maybe they do need it. But again, I think it needs to be looked after each patient.

Dr. Weitz:                          That’s great. So I think that those are the questions that I had prepared. Are there any other things you want to tell our audience about? Any thoughts you have about mast cell activation syndrome?

Dr. Dempsey:                    I think the most important thing really is just generally that patients listen to their body and they advocate as much as they can for themselves. And if they’re not getting the answers, I mean, that’s why people are listening to you. You’re putting out this information, which is amazing. It’s about people should try to educate themselves as best they can and try to find practitioners that will work with them to really get to the root cause and not accept the conventional way, which is sort of like, I don’t know how to help you. This is what a lot of these patients are told, that the doctors don’t have answers and they don’t know what to do with them.

                                                There’s always an answer. It may take a long time to figure it out. We may not have all the answers with our current medical technology, but we’re going to get there. But I think finding the help and continuing to look and trust your gut about your own health, I think is critical. And that’s the one thing that I see so much that patients need to be validated. I hate how some patients are treated in the medical profession.

Dr. Weitz:                          That’s great.

Dr. Dempsey:                    [inaudible 00:51:31] medical profession.

Dr. Weitz:                          Thank you. Okay, thank you, Dr. Dempsey. And how can listeners find out more about you and what you have to offer, your programs, et cetera?

Dr. Dempsey:                    Yeah, so I’m on social media, Facebook, Dr. Tania Dempsey, Instagram, drtaniadempseymd. Twitter, I think is DrTaniaDempsey. I don’t do a lot of tweeting, but I have a couple of websites, drtaniadempsey.com. And then my center, AIM Center for Personalized Medicine, is aimcenterpm.com. And what else? We’re in Purchase, New York.

Dr. Weitz:                          Okay. And I’m assuming you see patients remotely as well?

Dr. Dempsey:                    Yeah, we do. I mean, we do prefer to see patients for the first visit in person and then continue telemedicine after that. So we see patients from all over the world and country, and we’ve built a really nice center here. I’m really proud of what I’ve done. I have Dr. Lawrence Afrin with me, and we’ve been publishing papers. We have another publication about to hopefully be accepted and we’re going to be doing some research, maybe some phase two trials here. And I have another colleague that joined me two years ago, Dr. Colin Renaud. He’s a PA, but also a chiropractor by training, and he is doing good work here, too, so.

Dr. Weitz:                          That’s great.

Dr. Dempsey:                    [inaudible 00:53:06]

Dr. Weitz:                          Sounds good. Thank you.

Dr. Dempsey:                    Thank you. Thanks for having me.



Dr. Weitz:                            Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review. That way more people will discover the Rational Wellness Podcast.  And I wanted to let everybody know that I do have some openings for new patients so I can see you for a functional medicine consultation for specific health issues, like gut problems, autoimmune diseases, cardio-metabolic conditions, or for an executive health screen and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way. And that usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective. So if you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111 and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.



Essential Fatty Acids with Udo Erasmus: Rational Wellness Podcast 302

Udo Erasmus discusses Essential Fatty Acids 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

1:50  Udo first got interested in health after he had a personal health crisis–pesticide poisoning. He was into science in school. He left college and took a job spraying pesticides and he was very careless and did this for three years and got pesticide poisoning and he suffered with cramps, nausea, dizziness and severe fatigue. He saw a doctor and asked what she could do for pesticide poisoning and she said nothing.  So he researched it and realized that since 98% of the atoms in your body are removed and replaced, and he ended up focusing on the importance of fats for health. He read a study on the importance of omega 6 fats, which are essential and must be consumed and if you don’t get enough, you can die.  And then he saw studies showing that omega 6 gives you cancer and kills you.

6:29  Udo started looking into how oils are made and they are often treated with sodium hydroxide, phosphoric acid, and bleached. Then the oil goes rancid and smells, so they heat it to clean it up. This is called deodorization or molecular distillation.  You end up with a colorless, odorless, tasteless oil and some of the oil molecules are damaged by the heat. The oil industry admits that 1% of the oil molecules get damaged, but this actually translates to 60 quintillion damaged molecules.  It is more than a million damaged molecules for every one of your body’s 60 trillion cells.  And these are molecules that never existed in nature. These oils should be treated with extra care, since they are easily damaged. The omega-3s are particularly sensitive to damage.  The worst thing we can do with an oil is to put it in a frying pan and heat it, where it can be damaged by light, oxygen, and heat.

10:13  Many people are eating these damaged molecules and the average person consumes two to four tablespoons per day.  And omega-3s are damaged 5 times quicker than omega-6s.  And some of the most common oils like canola and soybean oil do contain some omega-3s. Both omega-3 and omega-6 are considered essential because the body cannot make them. And oils need a lot of care because they are easily damaged by light, oxygen, and heat. And we throw these oils into a frying pan where light, oxygen, and heat damages them at the same time, on top of the damage done by the industry already.  More health problems come from damaged oils than any other part of nutrition and more health benefits will come from the oil change your body needs if you dump the dirty oils in your diet and you replace them with oils made with health.  Udo dedicated himself to making oils with health in mind instead of shelf life. To make healthy oils you have to protect them from light, oxygen, heart from the time they’re closed in the seed through the pressing, the filtering, the settling, the filling until they are in the brown glass bottle. Plastic leaches into oil, so they need to be a glass bottle in a box in the fridge. They are refrigerated in the factory and in the store and at your home and you should add them to foods after they come off the heat and never use them for frying. 

20:35  While some would argue that fish oil is a better source of omega-3s than flax seeds, since the omega-3 in flax is alpha linoleic acid and only 5-10% is converted in the body into EPA and then converted into DHA. And the EPA and the DHA are the active forms of omega-3. But Udo argues that the body converts the amount that it needs.

31:27 And the worst thing we ever invented to do is learn how to fry. And I tell people, you got a frying pan at home. You probably have a frying pan in your house. Go get it out, turn it upside down, hit yourself on the head with it really hard so it’s associated with pain because that thing is going to kill you. Because when you fry anything, starch or protein or fat, you increase inflammation which is behind most degenerative conditions and pain, and you increase your risk of cancer, each one of them independent of the other when you overheat them. And the worst is oils because they’re the most sensitive.”


Udo Erasmus is a pioneer in the health and wellness movement for over 40 years. Udo co-founded the Udo’s Choice supplement brand starting with his Udo’s oil, which is a blend of omega 3,6, and 9 oils from flax seeds, sesame seeds, sunflower seeds, evening primrose seeds, and other organic sources that can be found in nearly every Whole Foods and health food store in the country. Udo is a sought after speaker and an accomplished author of several books, including Fats that Heal, Fats that Kill, which sold over 250,000 copies and his new book, Your Body Needs an Oil Change, soon to be published. Udo also offers a Healthy Fats and Nutrition Mastery course. His website is UdoErasmus.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 website, drweitz.com. Thanks for joining me, and let’s jump into the podcast. Hello, Rational Wellness podcasters. Today I’m very excited that we’ll be speaking with Udo Erasmus about essential fatty acid. Udo Erasmus is a pioneer in health and wellness movement for over 40 years. Udo co-founded Udo’s Choice supplement brand, including his Udo’s Oil, which is a blend of 0mega-3, 6, and 9 oils from flaxseed, sesame seeds, sunflower seeds, evening primrose seeds, and other organic sources, and can be found in nearly every whole foods and health food store in the country. Udo is a sought after speaker and an accomplished author of several books, including Fats That Heal, Fats That Kill With sold over 250,000 copies, and his new book, Your Body Needs an Oil Change, which is, I think, soon to be published. Is that correct, Udo?

Udo:                    That’s correct. We’re working on it.

Dr. Weitz:            Okay.

Udo:                     A work in progress.

Dr. Weitz:            All right. So thank you so much for joining us today.

Udo:                     Yeah, well, I’m glad that I don’t have to talk to myself in the bathroom mirror, so I appreciate you having me on to talk about what I talk about and think about.

Dr. Weitz:            Right. That’s great. So perhaps you can tell our audience a little bit about your personal history and how you got interested in health.

Udo:                     Yeah. Okay. The long story is I was born during the second World War, so that means I’m going to be 81 this year. And I got really interested in science because things were so unsafe. I felt so unsafe. I was always looking for how things work, because when you know how things work, they become more predictable. And so I got into science and I got into biosciences. I got into psychology. I got into medicine because I thought it was about healthcare, because we call that healthcare, but it’s actually about disease management. And I went back into biochemistry and genetics where you learn how normal creatures work in normal situations, which is kind of a definition of health. So I have a good background in health, but nobody calls that health. They call it biology, and they call it biochemistry and physiology and genetics, and I did all of that.  And then I left university, and eventually I took a job as a pesticide sprayer when my marriage broke up and I was really upset and wanted to kill something and sprayed pesticides for a living for three years, really careless, actually walked over the lawns that I’d sprayed barefoot and the skin peeled off the bottom of my feet. So then I was wearing rubber boots. And it was a summer job, so I wore a bathing suit because I’m fair skinned. I always wanted to be darker than I am.

Dr. Weitz:            Right.

Udo:                     Yeah. When you’re discontent, you always want different than the way you got it.

Dr. Weitz:            Right.

Udo:                     And three years, I got poisoned by the pesticides I sprayed. I ended up with cramps, nausea, dizziness. The biggest thing was no energy. I was 38 years old, and if I walked around the city block, I had to sit down and rest. I was like an 80 year old. I have more energy at 80 than I had at 38.

Dr. Weitz:            Okay.

Udo:                     And I went to the doctor and said, “What do you got for pesticide poisoning?” She said, “Nothing.” So at that point, I said, you know what? I have a background in biological sciences. I’m going to try and figure out what I need to do. And so I went into the research, read everything I could about health and nutrition, disease and nutrition because the body is made out of food, plus water, plus air.

Dr. Weitz:            Right.

Udo:                     And if something goes wrong with the body, the way to fix it is you raise the standard of what you put in it. Because every year, 98% of the atoms in your body are removed and replaced. So if I raise my standard, then in one year I will have rebuilt 98% of my body to a higher standard.

Dr. Weitz:            That’s great.

Udo:                     And I thought, oh, well, that’s cool. So then I was looking at everything, minerals, vitamins, amino acids, fatty acids, fats, proteins, carbs. I was looking at all of that, and I got tangled up with fats because one day I read an article that said, a research study that said, omega six is essential, which means you can’t make it. You have to have it. To live and be healthy, you have to bring it in from outside. If you don’t get enough long enough, you die. If you bring it back before you die in adequate quantities, then all the problems that come from not getting enough are reversed because life knows what to do, provided we take responsibility at our mouth to make sure all of the essential building blocks land in our body.

                                So omega-6 is essential by that definition. Researchers came up with that definition through experimentation, and the next study I read said, omega-6 gives you cancer and kills you. And it’s like… I was like, what? I have to have it to live and be healthy and it gives me cancer and kills me. There must be something missing here. You can’t have it both ways. And it drove me nuts. It drove me nuts. And it got to try and resolve why, why that would… If that was true, and that was true, there’s something else going on. That made me look behind how oils are made. And I found out that when the industry makes oils, they treat them as sodium hydroxide, add phosphoric acid, very corrosive basin in acid, and they bleach it. And then it goes rancid and smells bad. And now they have to heat it to frying temperature to clean it up. It’s called deodorization or molecular distillation. And then you end up with the colorless, odorless, tasteless oil. And the supermarket shelves are filled with those. And those are the oils that are used in the studies.

Dr. Weitz:            So molecular distillation is a chemical process because that is-

Udo:                     It’s a overheating process.

Dr. Weitz:            That’s usually described as a way to get rid of mercury and the other toxics that are found in the ocean.

Udo:                     Well, yeah, not mercury. You distill something off of the mercury, the mercury gets left behind. You don’t boil off the mercury. But you will boil off pesticides. Half of the pesticides are boiled off when you heat the oil to frying temperature.

Dr. Weitz:            Right.

Udo:                     And so they do that to clean up the mess they made. And I found out… So then I called the industry and I said, “Well, you’re doing a quarter.” They said a half to 1% of the molecules are damaged. So I called him and I said, “Well, if you know that your processing does damage to the molecules, why do you do that?” And he says, “Well, one of the reasons we do it is because we can boil off half of the pesticides in the oil.” That was not the right thing to tell me because I’ve been poisoned by pesticides. And I’m going in my head, “What do you mean? The other 50% of the pesticides stay in the oil.”  And so I said to him, “Well, why don’t you start with organically grown seeds, because then you don’t have a pesticide poison to deal with.”

Dr. Weitz:            Right.

Udo:                     And there was this huge silence at the other end of the phone. And I waited and waited. And when he got back, he was really angry. He said, “I don’t know what your problem is.” He said, “The oil is still 99% good. It’s only 1% damaged. And if you got 99% on an exam, you’d be damn happy, wouldn’t you?” So now I back off and I say, “Well, first of all, I used to get a hundred percent in genetics because I loved the topic.” But I backed off. I said, “Okay, well, if it’s only 1%, maybe that’s not so much. So then what do you do with that?” Well, do the math. So I said, “Okay, if I have a tablespoon of an oil that has been treated the way industry treats it, and is 1% damaged, how many damaged molecules will be in that tablespoon of oil?” And I’m asking you that question because I know you don’t know, and I want you to guess.

Dr. Weitz:            Well, I listened to a few of your other podcasts

Udo:                     Okay. Then it’s not fair. But when I ask people, always, when I ask live audience, I’ve been doing it for years and it’s really fun, they always estimate at least a billion times too low-

Dr. Weitz:            Sure.

Udo:                     … how many damaged molecules are in that oil? And so I’ll tell you. The number is 60 quintillion damaged molecules. That’s a six followed by 19 zeros.

Dr. Weitz:            Right.

Udo:                     How many is that? Well, it’s more than a million damaged molecules for every one of your body’s 60 trillion cells. And you think that’s not going to make a difference?

Dr. Weitz:            Of course.

Udo:                     These are molecules that never existed in nature. And you don’t just eat one tablespoon. Usually two to four is there is optimum intake, and they got pesticides inside of them. And depending on how many omega-3s are in the oil, like in canola oil, for instance, and soybean oil, there’s omega-3s in them. Omega-3s are damaged five times quicker than omega-6s. So you’ll get more damage to oils higher in omega-3s. And most oils don’t contain omega-3s, so you’re not getting omega-3s in your diet. In fact, it was established 1981 that omega-3 is also essential, just like omega-6. Every cell needs them.  They’re a nightmare to work with because they’re five times more sensitive to damage than omega-6s. There are only a few sources, and they need a lot of care. And of course, oils, which are the most sensitive of our nutrients because they’re damaged by light, oxygen, and heat, should get the most care, but we give them the least care. We throw them in a frying pan where light, oxygen, and heat damages them at the same time, on top of the damage done by the industry already, right?

Dr. Weitz:            Yeah.

Udo:                     And it turns out now that more health problems come from damaged oils than any other part of nutrition, and more health benefits will come from the oil change your body needs if you dump the dirty oils in your diet and you replace them with oils made with health. And I got to the point where I said, I can’t get healthy. The oils like this. I’ve been poisoned. I need something clean. We should be making oils with health rather than shelf life in mind. And then I began to develop the method for doing that because I came off a farm and we knew how to tinker. So you have to protect them from light, oxygen, heat from the time they’re closed in the seed through the pressing, the filtering, the settling, the filling until they’re their brown glass bottle, because plastic leeches into oil, so that’s another problem.   In a brown glass bottle, in a box in the fridge, in the supplement section, in the natural food stores. And then they’re refrigerated in the factory. They’re refrigerated in the store. You refrigerate them at home, and you add them to foods after they come off the heat. You never, ever, ever use these good oils for frying. So that’s what we created. So we created the industry of making oils with health in mind.

Dr. Weitz:            So can you describe exactly how you derive these oils without using all those harsh chemical processes that the other companies use?

Udo:                      Yeah. Okay, the first thing you do is you start with organically grown seeds. That takes care of the pesticide issue. And then what you have to do is you have to build a very tight system through which the seeds are pressed and all of that turned into oil, where no light and no oxygen gets to that system, and you keep the temperature low. That’s fundamentally… But oxygen are very small molecules and light is super, super small, so you literally have to do darkness and nitrogen atmosphere and you have to put nitrogen into that system and to keep oxygen out. And that takes some messing with the technology.

Dr. Weitz:            Okay.

Udo:                      That’s all. It’s not that complicated, but it requires care. Even when we ship, if it’s shipped for longer than two weeks, we even ship it refrigerated.

Dr. Weitz:            So which of the fats that are the healthiest for us? I know you said the omega-3 and 6 are essential, but so many other fats are beneficial as well.

Udo:                      Like what?

Dr. Weitz:            Like omega-9.

Udo:                      Okay. So if you look at all of the fats and oils in the world, the only two that you can’t make but have to have-

Dr. Weitz:            Right.

Udo:                      … that will kill you if you don’t get enough, long enough is omega-3 and omega-6. Omega-9, your body can make out of sugar and starch. It’s good fuel, but it’s not essential. Saturated, your body can make out of sugar and starch. They’re good fuel, but they’re not essential because your body can make them out of other things. Saturated fats have a bad reputation because they make platelets more sticky and they make you more insulin resistant. So they take you towards heart attack and stroke, but omega-3s make you more insulin sensitive. So they take you away from diabetes, and they make your platelets less sticky so they take you away from clots in arteries, from heart attacks.        And the problem isn’t the saturated fats. The problem is that 99% of the population doesn’t get enough omega-3s to protect from the saturated fats. So when saturated fats give you problems, it’s because your omega-3 deficiency. We’re blaming the saturated fats for what should be blamed on damaged omega-3s or not enough omega-3s in the diet. Okay? But the only thing that’s essential from the whole arena is omega-3 and omega-6 essential fatty acids.

Dr. Weitz:            Right. Now, your product contains omega six and omega-3s.

Udo:                     Yep.

Dr. Weitz:            And personally, I find that 98% of the patients that I see have too much omega-6 and not enough omega-3.

Udo:                     Right.

Dr. Weitz:            And so therefore I’m inclined to want to just use omega-3s to right balance them out.

Udo:                     It’s a mistake. I’ll tell you why. I developed flaxseed oil. That was my first oil. It’s the oil richest in omega-3. It has four times more omega-3 than omega-6 in it. I became omega-6 deficient on flaxseed oil. It’s not a well-balanced oil. I got dry-

Dr. Weitz:            Right, but most people-

Udo:                     Hang on, hang on, hang on. Let me finish.

Dr. Weitz:            Yeah. Yeah.

Udo:                     Okay. I got dry eyes skipped heartbeats, arthritis like pain and finger joints, and thin paper skin, fixed it by eating sunflower seeds, which only have omega-6s. So I brought the balance back. But the second part of that is that the omega-6s that most people get are damaged. And if I want to make you healthy, I want you off the damaged omega-6s and replace them with omega-6s that are also made with health in mind. That’s why the blend. We have twice as much omega-3 as omega-6. That’s higher omega-3 than omega-6, but not so high you become omega-6 deficient. And the omega-6s are also made with health in mind. That’s why we do that. We’re trying to get you into an oil change, not an oil addition.

Dr. Weitz:            Right. The problem is that so many people are eating food cooked in restaurants, they’re using commercial salad dressings. And even if they eat nuts and seeds are getting so much omega-6s that I think we need to focus on omega 3s to balance them out.

Udo:                     Yeah. Well, you can believe what you want. We did it that way because we’re trying to get people healthy. And I can’t get people healthy on flax oil that can make them omega six deficient.

Dr. Weitz:            Right.

Udo:                     Okay? And if you say, well, people get their other omega-6, yeah, they’re all damaged. So my duty as a truth teller is I need to recommend to you very strongly, don’t eat that garbage if you want to be healthy.

Dr. Weitz:            So how much…

Udo:                     We put them in, they’re not garbage, and we want you to get out of the garbage sources that are everywhere. And that’s hard. You have to make decisions. That’s not easy.

Dr. Weitz:            How much fat should we have in our diet?

Udo:                     How much?

Dr. Weitz:            Yeah.

Udo:                     If are they’re the right fats? You can go up to 60% of your calories from fat and stay healthy.

Dr. Weitz:            Okay.

Udo:                     And if you get too much omega-3 within limits, your body will increase metabolic rate and energy production and will blow them off as heat. You need more in winter than in summer, because in summer when it’s warm, you don’t need as much heat produced. In winter when it’s cold, quite a bit of it is burnt as heat, aside from the functions that it has, the other functions. It has in health and hormone production and regulating molecules and antioxidants, anti-inflammatory immune support and so on, right? So for most people, we recommend a tablespoon per 50 pounds of body weight per day of the blend we developed, the Udo’s oil blend. And most people, most adults would take two to four tablespoons a day, based on weight. And we like to measure what is optimum by how skin feels. When your skin is dry, you need more oil. Skin loses oil first and gets it last because the inner organs get priority on it because essential fatty acids are so important. You can live with dry skin. So skin gets them last, loses them first.  If your skin becomes soft and velvety because they form a barrier in the skin against the loss of moisture, then that the rest of your body is tanked up on what you need.

Dr. Weitz:            Now, isn’t fish oil a better source of omega-3s because flax seeds contain alpha linoleic acid, which is poorly converted into EPA and DHA with which are the active forms of omega-3s?

Udo:                     Yeah. Yeah. You’re saying all the stuff that I get told all the time I’ve been at… Just so you know-

Dr. Weitz:            I know you’ve heard all these.

Udo:                     Just so you know, I’ve been in the industry for over 40 years, right?

Dr. Weitz:            I know you have.

Udo:                     1980, I got poisoned. 1981, omega-3 was established as essential. And so the question about fish oil. Fish oil… Omega-3 is five times more sensitive to damage than omega-6. But did you know that EPA and DHA in the fish oils is five times more sensitive than ALA, the plant-based omega-3 essential fatty acids. And did you know that EPA and DHA are not essential fatty acids because your body can make them out of alpha linoleic acid if you get enough in your body. When we started with flax oil, the fish oil industry changed its advertisements and said the body can’t convert. There was already research that showed that the body does convert, but there are factors that enhance and factors that inhibit conversion.

Dr. Weitz:            But isn’t it somewhere around five to 10% or less?

Udo:                     What?

Dr. Weitz:            The conversion of ALA?

Udo:                     Yeah, the conversion into EPA is about five to 10% in men and women. It’s about five to 10% in women, but about 1%, or sometimes even less in men. But if you’ve measure the turnover of DHA, which is the critical, the one that they say isn’t getting converted, if you measure the turnover, it’s only 2.4 to 3.8 milligrams of DHA a day. And that means if you had one gram of alpha linolenic acid and the conversion rate was half a percent, you would still be making more than you need for your brain. So one is we don’t need as much. The second is, and what we’ve figured out way at the beginning, the issue isn’t that the body can’t convert because that’s not what the research said. The issue was that people are not getting enough starting material to make the conversion. So we said, Let’s give them the starting material, let’s make it with health in mind, and let their body in its tissues, whichever tissue it is, do the conversion itself based on what it needs and how much it needs, and where and when it needs it.” And so-

Dr. Weitz:            The other reason why it seems to me that fish oil is a better source because we test, and we look at omega-3 index, we look at omega-6 to 3 ratio, and I find that it takes quite a bit of omega-3 to get that level below four to one or two to one, whatever ideal level we think is.

Udo:                     Yeah, we don’t even know what the ideal level is.

Dr. Weitz:            Some people claim it’s 1:1 in primitive man.

Udo:                     Yeah, which is BS because if you were living in the Arctic or the Antarctic, you had more omega-3 than omega-6 in the diet. In the Mediterranean, you had more omega-9 in the diet. In the tropics, you had more saturated in the diet.

Dr. Weitz:            Right.

Udo:                     So the idea, the historical ratio is complete BS.

Dr. Weitz:            Right.

Udo:                     Yeah. So people put out this stuff, and they’re just making it up. Four to one is because the enzymes convert omega-3 four times quicker than omega-6. So they said, well, therefore, again saying, well, we should have the same amount of both, and so therefore we should get four times more omega-6. That’s not true either. The Inuit diet was two and a half times richer in omega-3 than omega-6.

Dr. Weitz:            Right.

Udo:                     And then the other thing is in different tissues, the amount of conversion required is different. And so what are you measuring when you measure conversion and ratios? They usually use plasma. You know why they use plasma? Because it’s easy to work with. They’re not even looking what’s in the brain. They’re not even looking what’s in your muscles. They’re not looking at what’s in your liver. They’re not looking at what’s your kidneys. They’re not looking at what’s in your bones. So they’re making it easy to do the work, but then they forget the context, and they don’t give you the context. Let me tell you-

Dr. Weitz:            So do you think plasma is not representative of the brain in the other tissues?

Udo:                     No, it’s not. Plasma, it’s highway, right? You’re carrying stuff from somewhere to somewhere, right? And it’s always cycling through the body. What are you picking up? Right? What do you need converted. If a cell somewhere in your body, if it needs a lot of conversion, guess what? It will create that conversion. If it’s a cell that doesn’t need much DHA, why would it make it? But you’re not measuring the cells, you’re just measuring the highway. You don’t know where those cars are going.

Dr. Weitz:            Right.

Udo:                     So something is going on, but you really don’t know what’s going on. And consistently, the doctors would send me their fatty acid profiles and say, “What does this mean?” Well, here’s the thing. Your plasma tells you one thing. Your red blood cell membranes tell you a different thing. Your fat tissues tell you another thing again. And what does it all mean? Nobody really knows. Seriously.

Dr. Weitz:            So you don’t really think that there’s a good way to measure our essential fatty acids?

Udo:                     Let me say, put it this way, if you’re measuring plasma fatty acids and then use, you make the assumption that the plasma tells you what’s going on in the brain, in the back of your eyeballs, in your sperm, in your butt, in your bones, in your liver, your kidneys, your lungs, and your cardio system, then you’re BSing yourself.

Dr. Weitz:            Okay.

Udo:                     Right?

Dr. Weitz:            What about red blood cell-

Udo:                     Yeah.

Dr. Weitz:            … fatty acids?

Udo:                     Red blood cell fatty acids tell you what’s going on over the last four months. Plasma tells you for the day. Fat tells you for 16 months. So you can have three different measures on the same diet for the three different tissues, right?

Dr. Weitz:            Right.

Udo:                     And that’s why when people sent me those fatty acid profiles, they don’t know what to make of them because they’re different. But why is that? Because if you were on the same diet, eventually that might level out, but not really. If you’re always on exactly the same diet, then eventually your plasma, your blood cells, and your fat tissue should become similar maybe, because maybe omega S are absorbed out of the plasma quicker than omega-6s. See, we don’t even know that, right? When you start looking at it, we know so little. We know so little. The biggest issue, in my view, because 99% of the population does not get enough omega-3s for optimum health, the biggest issue is we need to bring omega-3s in because they’re the most widespread essential nutrient deficiency of our time, 99%, followed by 80% for vitamin D and 80% for magnesium.  So we should bring those in. They need to be made with health in mind. That has to be done with great care because of how sensitive they are. And then let the body do what it needs to do. I’m going to be 81 this year. I insist on not using fish oils, or EPA and DHA. And the reason why, I know that on the SAD, the sad American diet, the standard American diet, people’s brain begins to shrink after 50. There’s research to say that. But what was that research done on? That research was done on the damaged oils, that line that everybody’s using.  I’m not using any of those oils.  I’m using only the blend, all plant-based.  I’m not cooking any fish oils, not any krill oil, none of that. My brain hasn’t shrunk yet.  And my brain has not shrunk and I have lots of energy. I have lots of energy. But I think what people have missed… And this is because the people who do the studies on oils get grants from the oil industry. So that puts them in a position where they can’t just badmouth the processing. Nobody talks about the processing. But when you look at where our degenerative diseases come from, mostly come from the results of processing. It’s either industry processing or the processing. We do in food prep. In nature, life’s mandate for creatures that eat was fresh, whole, raw, organic, and I would say for human beings, mostly plant-based. Because when we had rocks to hunt with, the great hunters only had rocks to hunt with, they came home without meat a lot. And when they had no meat, they ate vegetables because they don’t run away, they don’t fight back, and they’re easy to hunt down and kill.  So we weren’t hunter gatherers. We were mostly gatherer hunters. And when they did come home with something, oh, that was great because it was high concentration of food and high in iron. For instance, good protein, for instance, maybe some herbal stuff in the wild animals, we don’t get that any more from our cows that are standing in their feces and their urine and eat corn instead of grass, right?

Dr. Weitz:            Right.

Udo:                     Grass and wheat. So a lot of has changed from processing. Even how we grow the foods has changed. Fresh, whole raw, organic is what every creature eats, except us. And the worst thing we ever invented to do is learn how to fry. And I tell people, you got a frying pan at home. You probably have a frying pan into your house. Go get it out, turn it upside down, hit yourself on the head with it really hard so it’s associated with pain because that thing is going to kill you. Because when you fry anything, starch or protein or fat, you increase inflammation which is behind most degenerative conditions and pain, and you increase your risk of cancer, each one of them independent of the other when you overheat them. And the worst is oils because they’re the most sensitive.

Dr. Weitz:            But what if you fry at a lower temperature using a healthy oil?

Udo:                     Well, you wreck the oil. Fried oils fry health.

Dr. Weitz:            So even-

Udo:                     Fried oils fry health. Fried foods fry health.

Dr. Weitz:            Even at a lower temperature, even with an oil that has a high burning point?

Udo:                     High smoke point just means that you can do more damage before you notice. Seriously. Seriously. That’s just like… It’s an invention. It’s an invention. I’m sorry to have to break it to you, to your audience, right? There’s a lot of crookedness going on. It is so corrupt.

Dr. Weitz:            So how do you make eggs?

Udo:                     How do you make eggs? Well, a fox, if you’re foxy, then you break the shell and suck it out raw. Okay? We used to do that as kids, hole in one, hole [inaudible 00:33:00]. It’s kind of slimy and it’s like… But you can cook it in water. So you can soft boil it, you can hard boil it, you can water scramble it, and you could poach it. Do you need more than four methods to make eggs? You have to burn the egg and burn the oil? You have to do that?

Dr. Weitz:            No. The benefits of frying is that you can cook it up with a bunch of healthy vegetables, mushrooms, things like that.

Udo:                      Well, you could throw vegetables in your poaching water too. It’s not like… And I have to tell you. The worst thing we’ve ever invented to do to food regarding health-

Dr. Weitz:            When you throw-

Udo:                      … is learning to fry, and the oils that are the most sensitive nutrients that we damage the most in the frying pan.

Dr. Weitz:            But when you throw your vegetables in the water, you’re going to leach out a lot of the phytonutrients and you’re not going to get those [inaudible 00:33:55].

Udo:                     You’re going to leach out some minerals-

Dr. Weitz:            … in the water. Yeah.

Udo:                     You’re going to leach out some minerals in the water. So drink the water. Drink the damn water, right? And if you eat them raw, you’re not losing anything.

Dr. Weitz:            Right.

Udo:                     But if you cook them in water, you destroy the enzymes that help with digestion that are in the food. So you wreck those. You kill any probiotics on the food. So you need to replace those too, right? So cooking in water is already bad enough. When you fry an oil, you kill the probiotics, you destroy the enzymes, you lose a percentage of every one of your mineral, not the minerals, of the vitamins. You wreck some of the more sensitive amino acids, you completely trash the essential fatty acids, and then you burn the food. And all that yellow, brown, black turn into smoke stuff, that’s all toxic.

                                Some people say to me, “Oh yeah, I love the taste of burned steak.” And I just look at him and say, “No, you don’t. Because if you scrape that’s black stuff off a steak and you got a tablespoon full of that stuff and you eat it, it squeaks between your teeth like a chalk and a blackboard.” It’s [inaudible 00:35:19], it’s bitter, it’s scratchy, and it tastes disgusting. Now, why do you like burnt steak? Because you love your mother. Your was bamboozled by the industry to use oil for frying in a time when parents used to say, ‘Oh, the industry would never tell us to do anything that wasn’t good for us.'” There was a time like that. I’m old enough to know that, right? And we used to call… Cooking meant cooking in water, and then the other thing with oil. We call that frying and deep frying.

                                Now, cooking usually means in oil. So even the meaning of the term has changed, and all driven by an industry that wanted to make money on oils and have global markets. To get a global market, you need two or three year shelf life. And to get the shelf life, they have to treat the oils with sodium hydroxide, phosphoric acid, bleach them, and heat them to frying temperature. And then they keep for a long time, and they can take them around the world. So you have economies of scale, and they can also take garbage like they do with the fish oil. They throw the fish oil carcasses and the heads and the tails and the rectum and all of the inner guts and all that stuff. That’s where they get a lot of the oil from. They’re not getting it from, under the skin. Oh, add the skin when they take the skin off.   So they’re taking all that stuff, they throw it in a barrel, it rots. And they take all that stuff, they pull out the oil and they clean it up. And then you get the fish oil. If you get it in little bottles, you put it in the fridge. Once you open it, within two or three days, you can already smell the rancidity. That’s how fast that stuff goes rancid from reaction with oxygen once you open it.

Dr. Weitz:            Now, when you take fat supplements, yeah, essential fatty acids, should you consume tocotrienol, which is a form of vitamin E, or herbs or other antioxidants that keep the fats from going rancid?

Udo:                     Yeah. Okay. This is the first good question you’re asking. No. So here’s the thing. Sugar, starch, and fat, those are fuel foods. Would you agree?

Dr. Weitz:            Sure.

Udo:                     They’re fuel foods. Okay. And what is a fuel food? Fuel food is a food that burns in your cells and creates the fire of vitality, of energy, of life. Does that make sense?

Dr. Weitz:            Sure.

Udo:                     Okay. So you have those three foods. Here’s the thing. If you have a good fuel food and it gives you a nice roaring fire, that is your vitality and your juice, that fire will throw sparks, right?

Dr. Weitz:            Okay.

Udo:                     A good fire throws sparks, just like you make a fire in your fireplace. And if you really get it roaring, then you’re going to have sparks fly out, and you’re going to land on your carpet and burn holes in your carpet. So you put a screen in front of the fire. Well, in your body, the screen to pick off the sparks that a strong fire produces are called anti-antioxidants and anti-inflammatories, and those are found in whole foods. But when you make white sugar, all the antioxidants are in the pulp that you throw away. You get the fuel, you get the fire, and don’t get the spark control. That’s why sugar increases inflammation, because inflammation is caused by the uncaptured sparks.  And the same thing with white flour, and the same thing with what I call the white oils, because they take all the antioxidants out of the oil when they make those colorless, odorless, tasteless oils. So you’re getting fire without spark control. So I have really good news for you. We don’t take the spark control out of the oils we make. They’re unrefined. The spark control is still in there. But I have even better news for you. This is only recently that I figured it out. When you take omega-3s, about 80% of them are turned into fire. What happens to the other 20%? Well, they’re converted into EPA and DHA, so structural. Out of EPA and DHA, the body makes hormone like regulating substance called eicosanoids-

Dr. Weitz:            Right.

Udo:                      … prostaglandins, prostacyclins, thromboxanes, leukotrienes. And from DHA, the body makes maresins, which are anti-inflammatory for the immune system, and resolvins, which resolve inflammation, so they’re anti-inflammatory, and protectants, which are antioxidants, very powerful antioxidants, and endocannabinoids that make you feel good. So these are all made out of omega-3s. And omega-3 is the only fuel food that not only gives if the fire, but part of it is turned into spark control made out of the same omega-3s. How about that?

Dr. Weitz:            I’m not sure I quite follow you there.

Udo:                     Okay. Well, sugar is fuel food, but it’s not spark control.

Dr. Weitz:            Okay.

Udo:                     White flour is fuel food, but not spark control. Colorless, odorless, tasteless oils are fuel foods, no spark control. Well, here we have one molecule in the fuel care category, the only molecules that is not only turned into a great fire, but some of it is converted into its own spark control, made out of the same molecule. And when I heard that, when I got recognized this, I said, holy smokes, who came up with that? How incredibly genius is that, that you have something that makes a super fire. And omega-3s make the strongest fire in the body. Our athletes, when they use the blend at a tablespoon per 50, mixed in food spread out over the course of day for 30 days, and they do their sport to exhaustion, before they started and 30 days after they started, they go up 40 to 60% in their performance of their sport when they do it to exhaustion.   So huge, unbelievably good fire starter. They also turn on fat burning genes in the body, so they get your fats burning. So they help with weight management. They also turn on thermogenesis. So you blow off heat, you blow off overweight as heat, and they turn into their own spark control. And you know what? It doesn’t come better than that.

Dr. Weitz:            So some people would say, rather than consume the oils, why not consume the nuts and seeds? And I know that a lot of times, we’ll use flaxseed sometimes therapeutically. Flaxseeds help to lower lipoprotein A, and flaxseeds can help with metabolism of estrogen to go down the right pathway. But I typically tell people to get organic flaxseeds, and grind them and then consume them that way rather than the oil.

Udo:                     Yeah. There are some people who don’t trust anybody, so they go back to whole foods in nature. And by the way, this is not a new question for me, that one either, right?

Dr. Weitz:            I am not trying to-

Udo:                     And so the idea is that nature’s mandate is optimum health. That’s really what it’s based on, right?

Dr. Weitz:            Okay.

Udo:                     Isn’t that what question’s based on? Nature’s optimum health, therefore forget the oils, just eat the foods the way nature makes it.

Dr. Weitz:            Sure.

Udo:                     That’s [inaudible 00:43:53]

Dr. Weitz:            You can make another argument that if you have the flaxseeds, maybe you’re getting [inaudible 00:43:58] and the fiber-

Udo:                     Yeah. Yeah. Of course.

Dr. Weitz:            … the other things besides essential patty acids too.

Udo:                     Yeah. Yeah.

Dr. Weitz:            But, yeah.

Udo:                     Yeah. Okay, that too. So I was asked that question. And I started thinking about it and I said, well, is nature’s mandate optimum health? And my answer is no, not really. Nature wants you healthy enough to grow up, to reproduce, to be there till your kids don’t need you anymore. And when your kids don’t need you anymore, nature doesn’t need you anymore either. And then you get recycled, your body gets recycled. How do you get the body out of here when it’s time from nature’s point of view? Well, you never make it optimally healthy. So as your machinery runs down in your forties or early fifties, if you’re always suboptimally healthy, then recycling perhaps happens earlier.

Dr. Weitz:            Right.

Udo:                     So what I tried to do… But then I wanted to prove it, so what I did is I did got all my oil, I completely didn’t do any oils, only from fruits, and mostly obviously seed nuts because they have the most oil. So I took five tablespoons of flax seed oil, that’s all I could take, because they absorbed six times their volume and water, ground them up, and I took three tablespoons of sunflower sesame seeds. And that gave me the two to one ratio that we have in the oil. So that’s why I did it that way. So there I am with 33 tablespoons of stuff to get my optimum intake. Well, I was in California, and it was summer. In winter, I need about four tablespoons to get my skin soft and velvety. In summer, I only need two or three. I couldn’t even keep my skin from getting dry in summer in California where it was warm. Okay? So what I say to people is, look, seeds are nuts, are good foods. They’re lots of good things in them. And it’s true.

                                Flax has lignans in it. Flax has phytoestrogens that block the strong human estrogens, as well as the strong industrial estrogens.

Dr. Weitz:            Right.

Udo:                     So they block those. So that’s helpful. And they have protein in them, and they have some minerals in them, and they have some other vitamins in them.

Dr. Weitz:            Right.

Udo:                     So foods are good thing. Eat the foods, try to get the ratio. Ours, we say twice as much omega-3s, omega-6, both made with health in mind, not roasted and salted nuts, fresh seeds and nuts. And do that. And if your skin gets soft and velvety from that, then you can do it on seeds alone. I could not do it on seeds alone. So if you can’t do it on seeds alone, then augment with the oil whatever you get from the seeds and nuts. But you have to do all of this with a certain amount of diligence and foresight. You can’t just like, “Oh, well, I’m just going to eat a bunch of seeds and nuts. Oh, well, I’m just going to eat any oil I can. Oh, I’m just going to eat all this bad stuff.” You have to be deliberate. We live in a time where we have so many bad choices available that we need to make our choices about how we want to live deliberately.

Dr. Weitz:            Yeah. And I’d like to point out that argument that you just made. You can use that same argument basically against any sort of paleo or we should eat the way ancient man ate, because there’s no reason to necessarily think that the way ancient human beings ate was optimal for them. It’s just what helped them to survive.

Udo:                      Yeah. Yeah. And I think for a large part of human existence, we have been subsistence survivors.

Dr. Weitz:            The goal was to live long enough to procreate. It wasn’t to worry about avoiding heart disease and cancer when you hit 70.

Udo:                      Yeah, exactly. Exactly. But now we’re in a place where the idea that we can cheat nature a little by surviving over 40, right? Then we have to maybe do some things that… There’s a downside to that as well, obviously, right? Because you would say overpopulation. If everybody, according to nature on subsistence should die at 40, and then you got a third of the population is in between 40 and 90, right? That’s a load on the natural system.

Dr. Weitz:            Right. So you recommend consuming your oil and to put it on food or just take it a certain number of tablespoons of it a day.

Udo:                      No, I have never, ever recommended that people should take oil off a spoon. And sometimes people do, and they talk to me and say, “I don’t like the way your oil tastes.” So I say, “Well, how’d you take it?” “Well, I took it off a spoon.” “Well, when’s the last time you took a cooking oil off the spoon?” “Oh, I never do that.” “Well, why are you doing it with mine?” Right? Right? Oils taste like oil. Oil will never taste like ice cream.

Dr. Weitz:            Right.

Udo:                      You got to get used to it. So I always say mix it in food and spread your intake out over the course of the day.

Dr. Weitz:            Right.

Udo:                      Always. So I’ve never recommend it to do it that way, and I will never recommend to do it that way. But it goes well on hot foods, on cold foods, on warm foods, and it’s compatible with any food. It enhances flavors, and it improves the absorption of the oil soluble nutrients in the foods.

Dr. Weitz:            What do you think about the potential health of olive oil?

Udo:                      Olive oil, if it’s really olive oil, because they’re messing with olive oil quite a lot now, if it’s really extra virgin olive oil, it has been made by a process that does not damage the oil, that’s the good part of it. That’s one of the reasons it has a good reputation. But no omegas-3s.

Dr. Weitz:            Right.

Udo:                      And only 10% omega-6, 80% omega-9-

Dr. Weitz:            Right.

Udo:                      … which the body can make out of sugar and starch. And the other last 10%, saturated, body can make out of sugar and starch. So it’s good that it’s not damaged. But in terms of the two, only two things you need from oils, not that impressive.

Dr. Weitz:            But there is a fair amount of data that it helps to modulate your cardiovascular risk profile in a proper direction.

Udo:                      Yeah. Because the damage to the cardiovascular system can come from omega-6 and 3 deficiency, but mostly comes from omega-6 damage and omega-9 damage. And you will not get the damage to the molecules that then do damage in your body from an oil that hasn’t been damaged. And traditionally, olive oil was used cooked in water, this is the traditional use, cooked in water, dumped the water, put the oil on for flavor enhancement and absorption of nutrients. Now, everybody say, “Oh yeah, olive oil’s really good.” then they fry the olive oil. And all the damage that they didn’t do when the oil was made, you do in the frying pan. And then it’s like, no, then olive oil is a bad oil. If you fry it, it’s bad. It’s just that simple. Fried is-

Dr. Weitz:            No matter what temperature you fry it at?

Udo:                      Yeah. Well, because if you do it in water, you won’t burn the food, unless it sticks to the bottom of the pan, which can happen, right? But if you using oil for frying, even if it turns yellow, you’ve changing molecules. So when you say low temperature, if you use oil at the low temperature that doesn’t wreck it’s completely useless because it won’t fry your food, right?

Dr. Weitz:            Okay.

Udo:                      So even when the food just turns yellow, before it turns brown, before it turns black, even at that point, you’ve already made changes to the molecules. And those changes are always from natural to unnatural, and unnatural is what is toxic and ends up in your body in some place interfering with what needs to be going on in that space. That’s why the fresh whole, raw, organic. So when you do frying at low temperature, well, that’s better than frying at high temperature, and that’s better than turning oil into smoke, and then inhaling it. But it’s not as good as cooking in water, which is not as good as eating raw if it’s not contaminated.

Dr. Weitz:            Right.

Udo:                      So fundamentally, I always tell people, start where you are, but head in the direction knowing that the goal, the standard nature standard for health, fresh, whole, raw, organic, and probably for people, mostly plant-based. And then begin to take steps in that direction. If you fry every day, well, maybe take a weekend off. One day, you don’t fry. That’s a step ahead. Oh, then make it two days. Then eventually, you don’t fry at all anymore. [inaudible 00:53:22] that direction, if you want to be healthy.

Dr. Weitz:            What about eating seafood as a source of omega-3?

Udo:                      Well, seafood, unfortunately, is now the dirtiest meat on the planet because we have been using the oceans as a sewer for so long that the oceans are super polluted. It’s dirtier than chicken meat, which is dirtier than even the cows sitting in their feces and urine, which is worse than if you’re getting something that is actually grass fed and free to move, right?

Dr. Weitz:            Right.

Udo:                      Yeah. You have to understand, it’s my job to not take prisoners because-

Dr. Weitz:            Oh no, I know.

Udo:                      I need to say it honestly, so that you understand something and you can make choices that work for you.

Dr. Weitz:            Right.

Udo:                      But if I was a dietician, I’d say, “Oh yeah, frying is not bad for you, but you got to have some fun, so you might as well do it.” No, you’re not never going to hear me say that, right?

Dr. Weitz:            Yeah, no, I know that. I’ve heard you in other interviews.

Udo:                      Yeah. Yeah. I love health. Health is such an incredible gift, being pain free. I’m 80. I’ll be 81 in May. I have not any pain in any of my joints.

Dr. Weitz:            That’s great.

Udo:                      And you know the joints that get fat, you know how the joints swell and all of that?

Dr. Weitz:            Yeah.

Udo:                      I got nothing of that. None of my fingers are bent and can’t straighten, all the stuff that happens with arthritis and stuff.

Dr. Weitz:            Right.

Udo:                      But when I was 38, I had the beginnings of arthritis in my knees. So if I just bent my knees standing and put a little pressure on my joints, they hurt. So I had the beginnings of arthritis. All of my siblings have arthritis. I got nothing. Why is that? Fresh, whole, raw, organic, mostly plant-based. Right. And I don’t use the cooked oils, and I don’t buy that stuff in the… I could get a salad in the restaurant that doesn’t have fried oil in it, so I get the salad.

Dr. Weitz:            Right.

Udo:                      And at home I have very little bread or pasta. No pasta in the house, no bread in the house, no flour stuff.

Dr. Weitz:            What does your diet look like?

Udo:                      Okay, so one of the things I do, I like tahini. Tahini is sesame.

Dr. Weitz:            Right.

Udo:                      It’s like peanut butter, only made from sesame.

Dr. Weitz:            Right.

Udo:                      Has good antioxidants. So I get this by the case. 500, it’s about a pound in a glass jar. The glass has oil floating on top.

Dr. Weitz:            Okay.

Udo:                      Sesame oil. Sesame oil is about 45% omega-3, 40% omega-9, no omega-3. So I dumped the oil off of the tahini and I put my oil on it, the better oil, right?

Dr. Weitz:            Okay.

Udo:                      But not only that, I put on cayenne, and I put in ginger, and I put in turmeric or curry, and I put in black seed, and I put in cloves, and I put in ashwagandha and amla and bacopa. The strongest herbs, the most powerful herbs are unbelievably be good, anti-inflammatory, anti-oxidant, anti-cholesterol, anti-cardio, anti-diabetes, anti-cancer, anti-lupus. They have so many. And spices are the richest source of those. So what I’m getting is I’m getting my sesame, there’s my protein. I’m getting my oil, both omega-3 and omega-6 made with health in mind. I get all of these other spices that have antioxidants and anti-inflammatories in them, and then I dip my raw broccoli in it, or my carrots, or my cabbage, or my kale, or whatever it is I’m eating.  I don’t use potatoes because white potatoes are actually associated with strokes. And my mother actually had a stroke. She loved potatoes, but she also fried butter, so she did some other things that were probably not cool. So that’s what I eat. And then I take my supplements. I take 8,500 units of vitamin D a day. I have not had a cold for three years.

Dr. Weitz:            So you just have tahini, that’s all you have? Or do you put the tahini on something? Oh, you said you dip your vegetables.

Udo:                      I dip your veggies in them. Yeah. So I’m getting my salad with my tahini.

Dr. Weitz:            Right.

Udo:                      And then I also eat seeds and nuts. I eat seeds and nuts. And I have some fruit, fruit in moderation. Greens are better than fruit because there’s enough sugar in fruit that to be a concern when people have either infections that love sugar, bacterial infections that love sugar, or immune issues, because sugar inhibits immune function. And cancer cells love sugar, so why feed them?

Dr. Weitz:            Right.

Udo:                      Why feed them? They’re not nice to you. Why be nice to them? Right? And so how do you do that? Well, you change what you eat? You don’t… You starve them, basically. If you don’t have any sugar in your diet, you’re doing something to starve your cancer cells.

Dr. Weitz:            Do you have any animal products on a regular basis?

Udo:                      No, I’m pretty much off of dairy. I used to eat salmon, but I don’t eat it anymore, because like I said, fish is the dirtiest meat on the planet now.

Dr. Weitz:            Yeah.

Udo:                      Well, we’ve done that to ourselves, right? It’s funny, but it’s not funny.

Dr. Weitz:            Right.

Udo:                      And I don’t eat eggs. But I’m not a fanatic either. If I go to a restaurant, they make me an avocado sandwich and they put a little sprinkle of feta cheese on it, I don’t jump up and down and start tearing the place down. So I eat a little bit of it on occasion. But instead of milk, I use almond milk, and sometimes oat milk. And when I was a kid, we had lots of dairy. It was all raw. We go into the farmer and got the milk. We used the milk the cows. We made yogurt out of it.

Dr. Weitz:            Okay.

Udo:                      But when you get milk here and you try to open it up and let it turn into yogurt, it actually rots. That was a big eye-opener for me when I first moved to the city. So that milk is not what the cow gives. It’s very different. You don’t know what else they put in it. And then it’s in wax cartons. You don’t know how much wax ends up in the dairy. There’s the dairy fat. So there’s a lot of issues there. And yeah, a little yogurt occasionally might be okay, but you can get coconut yogurt. That’s just as good for probiotics.

Dr. Weitz:            Yeah.

Udo:                      But I’m not fanatic about it. But I do think… And the more I get older, the more I like raw foods. And I wasn’t always like that. And I’m not doing it because I got this head trip, like this religion in my head about plants. It’s just I’m following what makes my body feel best.

Dr. Weitz:            Do you consume teas? Coffee?

Udo:                      Yeah. Yeah. I have a drink in the morning that’s matcha and turmeric in almond milk.

Dr. Weitz:            Okay.

Udo:                      But I also make green tea, and occasionally I have some herbal teas. And I drink lots of water, and I eat food that has water in it. So I pay attention to that as well. The best water is the water that’s in foods, but I also have a machine that electrolytes my water so I can make the water more alkaline. And so I pay attention to that as well.

Dr. Weitz:            Right. Cool. Okay. So I think those are the things that I wanted to discuss with you. Anything else you want to bring up?

Udo:                      Yeah. No, we’re good. I also do a stillness practice every day. Because when you get really still, you discover the beauty of your own existence, and it also reverses aging.

Dr. Weitz:            Okay. And essentially, you’re talking about meditation?

Udo:                      Something like that, meditation, self-knowledge, mindfulness, but focused on being present in the space that the body occupies.

Dr. Weitz:            Right.

Udo:                      Yeah, so I do that every day. It’s kind of like, we say work hard, play hard.

Dr. Weitz:            Right.

Udo:                      We’re missing one. Work hard, play hard, do nothing hard.

Dr. Weitz:            Right.

Udo:                      Right? Because that’s your balance.

Dr. Weitz:            Right.

Udo:                      Because you can burn out playing too.

Dr. Weitz:            Right?

Udo:                      Burn out working, burn out playing. Where’s the rest time? And you get more rest when you do a stillness practice than you do when you’re sleeping.

Dr. Weitz:            Do you use sauna or cold plunge?

Udo:                      I’m not as big on the cold plunge. I do cool showers. I wouldn’t say they’re ice cold. I do that sometimes, more in summer than in winter.

Dr. Weitz:            Right.

Udo:                      And I haven’t done a sauna for a while, but I’ve be been most of the time pretty consistent on sauna. Sweating is good for you. You can’t argue with sweating. The best way to detox is through your skin. If you drive all that through your kidneys or your liver, you might hurt those organs. The worst thing that’ll happen to your skin if you sweat out toxins, you might get a rash.

Dr. Weitz:            Right.

Udo:                      But you’re getting rid of stuff and you’re getting rid of it in really the simplest way, and your body’s made for activity anyway. Because if you, there’s nothing to do. You don’t need a body, right? And you could just be a little disembodied spirit floating around somewhere, right? So sweating is a sign of activity. And activity is important for the body. And I have a medicine ball, and I have a little mini trampoline, and I have a shinning bar in one of my door jams.

Dr. Weitz:            Oh, okay.

Udo:                      And so I do stuff. And sometimes I’ll just dance. I don’t need music to dance. I just like the movement. I don’t do it for show. I just do it for what it feels like, and stretching and all of that. So I do all of that. But nothing… I’m not trying to be a bodybuilder. I’m not trying to get really big. I’m just trying to keep body and soul together.

Dr. Weitz:            Yeah.

Udo:                      That requires some activity. I walk. I also do quite a bit of walking, and I do gardening. So I’m active in that way.

Dr. Weitz:            Yeah, that’s good. Yeah, I go to the gym. For me, that’s a form of meditation too.

Udo:                      Yeah. some people do. Yeah. I grew up on a farm, so my deal was always you exert effort to get things done, pitch the hay or move the rocks or whatever. And the idea of going into a gym and then huffing weights and not getting anything done is strange to me. I get why-

Dr. Weitz:            Well, it’s like pushing the plow. You’re just pushing the bench press or the plows.

Udo:                      Well, I understand. I understand. There’s nothing wrong with it. And in the city where you don’t have that kind of activity going on, it’s important, nut I still have a problem with doing that. So I find ways to do gardening or schlep stuff, help somebody move and stuff like that.

Dr. Weitz:            There you go.

Udo:                      Yeah.

Dr. Weitz:            Okay, excellent. Well, thank you so much.

Udo:                      All right.

Dr. Weitz:            I’ll send you links after we post it.

Udo:                      Yep. Yep. Yeah. And we’ll promote you and you’ll promote us. Thank you.  



Dr. Weitz:            Thank you. Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review. That way more people will discover the Rational Wellness Podcast. And I wanted to let everybody know that I do have some openings for a new patients, so I can see you for a functional medicine consultation, for specific health issues like gut problems, autoimmune diseases, cardiometabolic conditions, or for an executive health screen, and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way.  And that usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective. So if you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111, and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.



Parkinson’s Disease with Dr. Karin Duncan: Rational Wellness Podcast 301

Dr. Karin Duncan discusses How to use a Functional Medicine Approach for patients with Parkinson’s disease at the Functional Medicine Discussion Group meeting on March 23, 2023 with moderator 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

6:17  What is Parkinson’s disease?  Some define it as the degeneration of the substantia nigra in the brain and the loss of the production of dopamine.  There are four symptoms that are usually seen in Parkinson’s and those are the bradykinesia, the stooped posture, the masked facies, and the pill-rolling tremor.  The research shows that it can actually start 10-20 years prior to the motor symptom presentation.  This degeneration of the dopaminergic neurons in the brain is a long term process and by the time the motor symptoms show up, the substantia nigra is already 70-80% depleted of its ability to produce dopamine.  The early symptoms that show up years earlier are the loss of a sense of smell (anosmia), constipation, and REM sleep disorder.  The question is if we identify these patients early and help them with these conditions and reduce the underlying inflammation, will we prevent Parkinson’s?  We don’t know the answer to that, but it makes sense to try.

10:25  Constipation indicates some gut imbalance or dysbiosis and for patients who end up getting Parkinson’s, it usually is extreme.  When the intestines are inflamed, they release a protein into the blood stream called alpha synuclein and patients with Parkinson’s have misfolded alpha synuclein protein aggregated in the substantia nigra.  If we want to help patients with Parkinson’s disease with their brain function, we need to help them with their gut. If they are taking oral medication and they have a dysfunctional gut, they will likely not be absorbing it as well and when we improve their gut health, we see a drop in the need for Sinemet or Carbidopa/Levodopa by up to 30-50%.

15:19  Cholesterol.  Lower levels of cholesterol and taking statins increases the risk of Parkinson’s disease.  Research indicates that total cholesterol should not go lower than 150-175.

18:48  Environmental toxins.  Trichloroethylene (TCE) is a dry cleaning chemical that was also used as a solvent including at Naval shipyards and military bases that is linked with a drastically increased risk of Parkinson’s disease. [Solvent exposures and Parkinson’s disease risk in twins.]  Pesticides and glyphosate can be triggers for Parkinson’s disease.  Mycotoxins from mold may also play a role.  Dr. Duncan likes using Great Plains lab to test for environmental toxins and mycotoxins.  If a patient is 80% deplete in dopamine, they are likely 40-60% deplete in glutathione.  When cells die, like the dopaminergic neurons, they go through apoptosis and they release their toxins, which causes oxidative stress on neighboring cells that leads to progression of the disease. This is one reason why supplementing with glutathione can be helpful. 

23:42  Reactivation of Viral Infections.  Viral infections like Epstein-Barr virus (EBV) or Herpes Simplex virus (HSV) can be triggers for Parkinson’s disease. So can Lyme disease.  If you test for EBV you need to make sure to test for EBNA, Epstein-Barrr nuclear antigen, which is more indicative of reactivation than IgG antibodies.

28:57  Lab testing.  Dr. Duncan has a standard lab panel that she runs for most patients with Parkinson’s disease that includes a CBC, a metabolic panel, glucose, insulin, Hemoglobin A1C, fructosamine, an iron panel plus ferritin, an extended thyroid panel, folate, vitamins B6 and B12, vitamin D, DHEAS, HsCRP, uric acid, F2-isoprostanes, and a fatty acid profile/omega check.  Higher levels of iron tend to make Parkinson’s disease patients worse.  Higher levels of uric acid are actually protective of Parkinson’s disease. Dairy inhibits uric acid, which is one of the reasons Parkinson’s patients should avoid dairy.  Inosine is a supplement that’s commonly used with Parkinson’s that can boost uric acid levels and alleviate some symptoms.

31:58  Pharmaceutical approaches.  The most familiar drug is Sinemet or carbidopa and levodopa. When Dr. Duncan has patients who don’t want to take any drugs and just want to use natural supplements, while there is Macuna Pruriens that increases dopamine levels, the dosages cannot be standardized even from pill to pill within the same bottle. It makes sense to take synthetic carbidopa and levodopa, which can slow down Parkinson’s disease and allow patients to perform normal functions like preparing food and eating and exercise.  There’s also an extended release form, called Rytary.  You slowly increase the dose till you reach the max and it tends to stop working as well after about 10 years, though when you use a Functional Medicine approach, you often get an extended benefit from synthetic dopamine.  When we take care of vitamin B12 deficiency, help with restoring gut motility, make sure that you are producing enough hydrochloric acid, that you are taking it with protein, that you are not taking magnesium at the same time, that you are taking CDP choline, and that you are taking vitamin C with it. Another medication that can be helpful is Rasagiline or Azilect, which is a novel MAO B type inhibitor.  This is the only drug that has shown some slowing of disease progression.  By the way, turmeric is a natural MAO B inhibitor.  There is also Imbrija, which is an inhaled form of levodopa, that allows you to bypass the gut, that can be used as a rescue medicine. 

33:07  Previous head trauma has a relationship with most neurological issues, including Parkinson’s disease.  Patients with Parkinson’s who have a history of traumatic brain injury or CTE tend to have a fast progression of their condition and tend to be medication resistant.  Dr. Duncacn may recommend Deep Brain Stimulation for such patients.

34:43  Neurological testing.  You want to look for cogwheel rigidity. You also want to check the gait and have them turn around as fast as they can and have them walk heel to toe.  Parkinson’s patients often have a lack of arm swing on one side and may have a head tilt to the side that’s affected.  You should also learn the tests that are included in the UPDRS. You should have them stomp and move their feet as fast as they can. The finger to nose test will test intention tremor and coordination. You should have patients sign their name on a piece of paper, and just look if they’re having that agraphia to see if their handwriting has gotten smaller.


Dr. Karin Duncan is a board certified Naturopathic physician with a focus on integrative neurology.  Dr. Duncan is a specialist in treating patients with Parkinson’s disease with an Integrative Approach.  Dr. Duncan works at Coeur d’Alene Healing Arts in Idaho and the website is cdahealingarts.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. To learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.

                                Welcome, everybody. I’m Dr. Ben Weitz. Welcome to the Functional Medicine Discussion Group meeting tonight. I’m very excited that we have Dr. Karin Duncan, joining us for what should be a fascinating discussion about a functional medicine approach to Parkinson’s disease. We have all probably heard quite a bit about a functional medicine approach to Alzheimer’s disease with Dr. Dale Bredesen, Dr. Kharrazian, Dr. Perlmutter speaking and writing about this, but I feel that Parkinson’s disease is a forgotten neurodegenerative condition. This is why I’m so excited to take a deep dive into how we can help patients with Parkinson’s disease with the natural approach.  I want this meeting to be interactive, so please participate by typing your questions into the chat box, and then I’ll either call on you or ask Dr. Duncan your question when it’s appropriate. I hope that you’ll consider joining some of our future meetings. April 27th, Fiona McCulloch is going to join us from Canada for a discussion on menopause and hormone replacement. May 25th, Dr. Mark Pimentel will join us. He apologizes for missing last month’s meeting. He’ll be joining us for a discussion on SIBO and IBS. We haven’t figured out June, but July 27th, Dr. Bredesen will be joining us for a discussion on Alzheimer’s disease.

                                If you’re not aware, we have a closed Facebook page, the Functional Medicine Discussion Group of Santa Monica, that you should join. If you’re listening out there, this page, it’s just for practitioners, so we can continue this conversation when this evening is over. I’m recording this event. I’ll include it in my weekly Rational Wellness podcast, which you can subscribe to on Apple Podcasts, Spotify, or YouTube. If you enjoy listening to the Rational Wellness Podcast, please give me a five-star ratings and review.

Now, I want to thank our sponsor for this evening, Integrative Therapeutics.  Steve Snyder, who normally comes and tells us about a few of their products, is unable to join us, because he got tickets to go watch UCLA in Las Vegas. I’m jealous, but I want to tell you about a few Integrative Therapeutic products. They have a great brain formula called Neurologix, which is a non-stimulant neurotropic supplement for enhanced cognitive performance. It contains neumentix, spearmint extract, which contains phenolic compounds for sustained mental focus and to support working memory. It contains cognizin citicoline to support brain energy and metabolism, enhanced frontal low bioenergetics, and increase ATP levels in the brain, and saffron extract, which supports positive mood.

                                They also have a great highly absorbable curcumin product, Theracurmin, which is a water-soluble form. There’s actually been a lot of research done using this particular product. One of the advantages is you get a therapeutic dosage with only two capsules a day, and there’s studies showing that it reduces dementia, and promotes brain health. Our speaker for this evening, Dr. Karin Duncan, is a board-certified naturopathic physician with a focus on integrative neurology. She’s a specialist in treating patients with Parkinson’s disease using an integrative functional medicine approach. Dr. Duncan practices at Coeur d’Alene Healing Arts in Coeur d’Alene, Idaho. Dr. Duncan, thank you so much for joining us.

Dr. Duncan:        Thank you for having me, Ben. Thanks for being here, everyone.

Dr. Weitz:           Absolutely. So, how did you first become interested in treating patients with Parkinson’s disease?

Dr. Duncan:        Well, my mom used to tell me as a kid, “18 words or less,” because I was a chatterer. So if I get going here too, just throw something at me. Long story short, I actually became a caregiver at the age of 14 for my dad who had a neurologic condition, and for 25 years, advocated for him in the conventional realm, and worked with physicians, and had this really deep passion for neurology. Then, when I went to school, I knew I wanted to focus on it, and I met Laurie Mischley. She is really the one out there spearheading the research. She’s funded by the Michael J. Fox Foundation, NIH. She presents at the World’s Parkinson’s Congress every year.  So at the beginning of every talk, I always want to say I don’t have any conflict of interest. I just have this incredible relationship with this woman who’s really spearheading the integrative approach for Parkinson’s. She invited me to be a part of the Parkinson’s disease summer school through Bastyr University, my alma mater, and Kenmore. On day one, I said, “Hey, Laurie, I don’t know how you do what you do. All you see is people with Parkinson’s. Don’t you get bored?” She was just like, “Give it a week.” At the end of that first week, I went up to her with tears in my eyes. I’m like, “This is what I want to do.”  It was such a profound experience for me to witness these people come in, share their stories, recognize that no two people were the same with Parkinson’s disease. There’s so much promise in the therapeutics that we’re doing, so it was exciting to join the team. Then the longer I do it, the more I enjoy it. Neurology has been in my blood since I was young, and here I am.

Dr. Weitz:            That’s great. So, what is Parkinson’s disease? How is it defined? How do we diagnose it?

Dr. Duncan:         Oh, well, really, I’d love to take this opportunity to open up to the crowd. If anybody wants to tell me what they think Parkinson’s disease is, I’d love to hear somebody else’s definition.

Dr. Wasserman:   I guess the simple degeneration or lack of dopamine, the substantia nigra, and any disease or entity can affect that. That’s my very light definition.

Dr. Duncan:        I like that one. What you’ll hear in most conventional terminology, or if you Google Parkinson’s disease, it’s your four symptoms, the bradykinesia, the stooped posture, the masked facies, and the pill-rolling tremor. When I talk to my patients or when I talk on these lectures, I always like to say when Parkinson’s disease is diagnosed dependent on motor symptom presentation, because we’re diagnosing it based on motor symptom presentation, but the research is showing that Parkinson’s disease can start as early into 10 to 20 years prior in the human body.   So, it is in short the degeneration or the death of dopaminergic neurons, but the symptom presentation that we’re looking at and how we’re defining it by autopsies is really far off. I think Ben and I have talked before. Until we redefine what that looks like for people so we can recognize it earlier, we’re going to be stuck in this hamster wheel of being too late to the diagnosis.

Dr. Weitz:            I think the most common symptom people think about is the tremor. That’s actually not something that always occurs, and sometimes occurs quite late, right?

Dr. Duncan:        Absolutely. I mean, what we’re recognizing is that by the time of diagnosis, depending on motor symptom onset, the substantia nigra is 70% to 80% depleting dopamine already. So by the time the motor symptoms show up, we’re so late to the game.

Dr. Weitz:            Right. Now, what are some of the common symptoms that happen early? Patients often have constipation. I understand that’s a big thing. I was thinking about the fact that one of the other early, early symptoms is a loss of taste. Now, we’ve got all these patients out there who’ve had COVID, and they have a loss of sense of smell and taste.

Dr. Duncan:        That one bit me in the ass, Ben, because I was lecturing and raising awareness about… Actually, the loss of sense of smell is what we recognize in people with Parkinson’s, not so much-

Dr. Weitz:            Oh, the sense of smell, I’m sorry.

Dr. Duncan:        Some anosmia early on. When COVID happened, I’m out there lecturing saying, “If you have this triad of non-motor symptoms, constipation, anosmia, and REM sleep disorder, we need to treat you as if we would treat somebody who is at risk for heart attack. You’re sedentary. You’re a smoker. You’re heavy overweight.” So, when I started lecturing about that, and then COVID happened, you should have seen the messages, “Oh my God, I lost my sense of smell. Am I going to get Parkinson’s disease?” But yes, when we look at that, those are the triad of symptoms that we’re really trying to stand on the rooftop and say, “If we are all aware that this triad of non-motor symptoms predates the diagnosis by up to 10 to 20 years, and we do something about it, could we actually cure Parkinson’s disease?”  I mean, that’s the big question, right? If we can slow those inflammatory processes down, and treat those, would it continue to degenerate?  Of course, we don’t know the answer yet, because we’re not doing it. It’s a huge passion of mine. I have, I would say, five to seven patients in my practice right now that I’ve identified, and actually had that conversation with, and said, “Hey, you’re meeting these risk factors.” Most of them have somebody in their family who’s had Parkinson’s or a neurologic condition. We’re seeing vitamin D deficiencies.  So, as things are piling up in the investigative work, I’m sitting them down and saying, “I want to be really upfront with you, because I’m passionate about this. I’m not saying you’re going to get it. I don’t have my crystal ball, but here’s what I know, and I’d be doing a disservice if we didn’t address this.”

Dr. Weitz:            One of the really interesting ones is the constipation, which indicates that there’s some gut imbalance, gut dysbiosis. What have you found is something that might make sense as an intervention? Do you find some of these patients have methane SIBO, or what would be the intervention that might make a difference?

Dr. Duncan:        Can I just say yes? Yes, any, and all. I mean, we’re finding so many GI dysfunction and inflammatory conditions in people with Parkinson’s, and they’re extreme. They’re really severe. I have a patient who he can’t sit down and watch a movie with his family just because of his gut inflammation and pain. So, to roll back, because as I understand it, Ben, these are all medical professionals here on this call, correct?

Dr. Weitz:            Yes. Yep.

Dr. Duncan:        Yeah, so I’m going to get a little nerdy here for a second.

Dr. Weitz:            Great.

Dr. Duncan:        The inflammation in the intestines, when the intestines are inflamed at ages studied as young as five years old, we’re seeing when the intestines are inflamed, they release a protein into the bloodstream. The name of that protein is alpha synuclein. If you’re familiar at all with the pathology of Parkinson’s disease, and autopsies of the people with Parkinson’s, we’re finding this misfolded alpha-synuclein aggregated in the substantia nigra. So, all of these pharmaceutical targets are how do we get rid of alpha-synuclein? How do we get rid of this? But really, the question is why is it there to begin with?

                                It’s an intentional compensatory response mechanism from the intestines saying, “SOS, we’re pissed. We’re going to send out alpha-synuclein.” Then anybody who wants to yell out to mute, what’s the nerve that connects the gut in the brain? We know the vagus nerve is doing that. There’s a huge hypothesis being accepted in the conventional world that that protein can travel up, and then the vagus nerve originates near the substantia nigra, and deposit there. So, when we’re looking at gut health and PD… We could take the rest of the hour talking about it, and I’ll try not to. So, throw something at me if I just keep going.

Dr. Weitz:            I would definitely. That’s a rabbit hole I would like to travel down as well.

Dr. Duncan:        Well, it is. I pump the brakes, and so many people will come into me, and say, “Hey, I want to work on my Parkinson’s disease. What meds should I take? What do I do for my brain?” I say… I think I told you this before, Ben. Excuse me. I consider it borderline malpractice to prescribe somebody an oral medication that they cannot absorb. If their gut is that inflamed, and they’re resistant to the use of oral medications, then I pump the brakes. As frustrating as it may be for patients to hear, “Wait, I’m not seeing an improvement in my symptoms yet,” I will say, “Hey, stand by.” What I’m noticing in my patient population is once we treat the gut, whether it be SIBO or IBS, Crohn’s, I mean, IBD, Crohn’s, things like that are just your run in the mill low gastric motility, because of autonomic dysfunction.

                                We are actually seeing a drop in the need for Sinemet or Carbidopa Levodopa by up to 30% to 50%. So, operating well, lower symptom presentation with a lower dose of the medicine that their neurologists are pretty much maxing them out on and saying, “You’re done. This is the end of the efficacy.” So, that gut health, it has to be first, because that’s where we’re getting all of the effect of our medicine and our nutrients.

Dr. Weitz:            I got to get my mega phone. Researchers on Parkinson’s, before we spend the next 20 years spending billions and billions of dollars developing drugs, blocking the formation of this Alpha-synuclein protein, take a look at the research on Alzheimer’s. Even though they have drugs that clear out the amyloid plaque, it doesn’t cure Alzheimer’s, and a lot of the patients get worse. So before we make the same mistake with Parkinson’s, and spend billions and billions of dollars trying to block this one protein…

Dr. Duncan:        Understand why the body’s making it.

Dr. Weitz:           Exactly.

Dr. Duncan:        I mean, in the beauty of the human body, when you really sit there and think about, it’s this gorgeous process that the body’s saying, “We’re putting out our distress signal. Why aren’t you listening?” We’re like, “Let’s kill your distress signal.”

Dr. Weitz:           Somebody asked about Alpha-synuclein, the protein I just mentioned. Dr. Duncan just mentioned that some of the drugs for Parkinson’s are designed to clear out this alpha-synuclein protein. It sounds very much like the Alzheimer’s story in that sense.

Dr. Duncan:        They’re already billions in, Ben, honestly.

Dr. Weitz:           Oh, I’m sure. Now, it’s interesting. You mentioned that we should be treating this like heart disease in terms of prevention. I was digging through some of the research on Parkinson’s today in between patients, and I saw several articles showing that lower levels of cholesterol are actually related to increased risk of Parkinson’s, and taking statins seems to increase the risk of Parkinson’s. So, maybe we don’t want to treat it the way we treat heart disease.

Dr. Duncan:        No, I don’t want to take a similar approach. You could pick anybody off the side-

Dr. Weitz:            No. No, I know. I know what you’re saying.

Dr. Duncan:        [inaudible 00:16:04].

Dr. Weitz:            I just wanted to point that out that that’s really interesting that cholesterol, which I think most of us in the functional medicine world know is super important for brain health. Yet, the conventional cardiology world would tell us that cholesterol is… that lowering cholesterol through taking statins has no effect on brain health at all. I recently heard a very popular podcast host who talks a lot about cardiovascular disease saying the goal should be to get ApoB or LDLC down to 30 or 40. Just drive it as low as possible using whatever pharmaceuticals are necessary, and claiming that there’s no problem with brain health, because the brain produces its own cholesterol.

Dr. Duncan:        You can get even more detailed than that, but the cholesterol levels are really important. I’m a huge proponent of collegiality. I’ve reached out to cardiologists time and again, and I’ve only gotten pushback once, to be honest. So, I really want to be a sounding board, just saying, “Bridge the gap. Have the conversations. Alleviate patient advocacy. Pick up the phone and call the team.” It’s such a great way to connect with that patient’s team. I’m a huge proponent of patient advocacy, but when I talk to this cardiologist, I’m saying, “Hey, here’s what the research is showing here. I respect what you’re doing. I understand what you’re doing. Can we set a goal?”   In the labs research that we’re finding, the cholesterol goal of 150 to 175 is really as low as we want to go. So, when you set that goal out there… Like I said, I’ve only had pushback once, and it’s, “Hey, let’s set this goal. Let’s lower the risk for statin. What are you doing over there?” We’re doing diet and lifestyle, and we have red rice on board, or we have some other botanicals and, “Hey, can we recheck in six months, and then collaborate and see if you feel comfortable with the plan?” It’s a really effective conversation. Like I said, I just don’t get pushback.

                                They’re most of the time… I’m not taking anything away from they prescribe it, and then they refill it, and then there’s not really that follow through. So when you bring their attention to it, “Hey, patient A’s cholesterol is at 110, and they’re really declining here.” We need to reduce that. Then when you talk about cholesterol in the brain, and fat and everything like that, that’s really what we want to be supporting and supplementing with if we need to.

Dr. Weitz:            We know that there’s lots of environmental triggers that can trigger the onset, or make Parkinson’s worse. What are some of the most important environmental triggers?

Dr. Duncan:        The ones that are proven as a dry cleaning agent, and then there’s a toxin. I think I stumbled on this last time you asked me. You think I’d be more prepared, but the toxin in the Navy that was used in navy yards and on navy ships, that has been a known causative now. It’s not even correlative for Parkinson’s disease. Other factors, pesticides, glyphosate is out there. There are some theories on mycotoxins. There’s a lot of theories on mycotoxins. I just… Anybody want to send me a link for a lab that true blue and accurate and hasn’t changed their reference ranges in the last two years, I’d love to see it, because those are tough ones to test. Then you repeat testing in the lab, change their reference range or what is normal.  So with that, there’s… But there’s a ton of-

Dr. Weitz:           What lab do you like for toxins and mycotoxins?

Dr. Duncan:        I’ve most consistently used Great Plains.

Dr. Weitz:           Okay.

Dr. Duncan:        That’s usually the one that I’ll use for that one. Environmental, or, sorry, elemental toxins, or when I’m looking at the essential toxins or toxic minerals, I’ll use the Doctor’s Data.

Dr. Weitz:           We’ve been using Vibrant. They have a total tox burden that includes 20 heavy metals, a bunch of environmental toxins and mycotoxins all through urine.

Dr. Duncan:        Great. No, I’d love to learn more about it. Testing is… There’s so many out there. Just trying to know what’s best, but that’s what we’re looking at there. An interesting thing on the toxin thing, Ben, I think I told you this too, but back in school, you take this environmental medicine class, and everybody leaves like, “I’m not touching anything. I’m not going to breathe the air. I’m not going to go out of my… I’m going to be bubble boy.” I was a little older. I went through med school. I had been in the military, and I was like, “Well, I’m screwed. I got every toxin out there that I-

Dr. Weitz:            Toxic think burn pits.

Dr. Duncan:        So when I’m looking at it, I’m saying, “What can we do to enhance the terrain of the body to eliminate toxins?” A really interesting fact is, like I said, by the time of diagnosis, because of motor symptom onset, if we’re 80% deplete in dopamine, we also have evidence that shows we’re 40% to 60% deplete in glutathione. Glutathione is the primary antioxidant of the central nervous system. So, in layman’s terms, what I tell my patients is, “If you have this degenerative disease because of the death of dopaminergic neurons, and we know that when cells die and go through apoptosis, they release their toxins into the environment or the debris, which causes oxidative stress on neighboring cells, that creates a domino effect or a faster progression of the disease.”   Now, we don’t have the dump truck. We don’t have the thing that’s going to come clean it up, so it’s perpetuating that pathophysiology there, if you will. So, when we talk about toxic burden, it is really important to recognize what each patient has, one for diagnosis confirmation, because there’s been a handful of people that I’ve undiagnosed with IPD to Parkinsonism based on heavy metal toxicity or toxic burden, but also for treatment. Many of the people with Parkinson’s that walk into my practice aren’t vital or resilient enough to even go through the detox process if they are burdened. So, it’s nice to know, but it’s also, in my opinion, more important to boost up that vitality and the resilience of the patient and their physiology.   Say, “What’s your glutathione levels? How can we help your liver support?” Of course, that brings us back to the GI, right? “Are you pooping? If you’re not getting rid of your toxic waste products, then we need to work on those emunctories first.”

Dr. Weitz:            Those are part of most functional medicine detox programs anyway.

Dr. Duncan:        Right. Exactly, but I’ve seen… I’ve had patients come in who’ve been through detox protocols, and they just weren’t ready for it yet, and they get really sick, and it can aggravate Parkinson’s. It’s inflammatory, so we have to be really cautious with this population, how hard we go into any treatment. I mean, even something as relatively benign as SIBO can really put that dent in the Parkinson’s symptoms, and when it’s degenerative, we want to avoid that risk very carefully.

Dr. Weitz:            I think the strategies that are going to tend to really make patients worse are when we’re using these oral chelating agents or IV chelating agents. I think the more modern approaches use liposomal glutathione and maybe some binders and liver support and things to support bile production,

Dr. Duncan:        Broccoli and selenium, Ben.

Dr. Weitz:           There you go.

Dr. Duncan:        I mean, don’t underestimate those types of things too, that can really help with that removal of those toxins.

Dr. Weitz:           Now, I’ve also seen some data that viral infections like Epstein-Barr can be triggers for Parkinson’s. Interesting, now coming back to that, we’ve been through this pandemic, and we’re finding that reactivation of dormant viral infections like Epstein-Bar are very common for patients as part of the long COVID process.

Dr. Duncan:        I mean, in my opinion… I won’t dive into the long COVID thing, because that’s a whole another podcast. But in my opinion, what I am seeing is that’s what we’re missing, in the biggest sphere of medicine in general, is we’re missing what else? Once we get to a diagnosis… I do this lecture to my patients so many times in online forums is, “Once you get this diagnosis of Parkinson’s, we’ll stick to that.” It’s really easy then for everybody to grab this big umbrella, and say, “Oh, you’re not pooping. That’s Parkinson’s. Oh, this is happening. That’s Parkinson’s.” Let’s just dump it all in this Parkinson’s bucket, because that’s a lot easier.   The same thing I think happened with the pandemic. When we start to say, “Oh, the body’s capable of having more than one disease or more than one dysfunction, and teasing that out,” what I tell people is, “If we diagnose you with hypothyroid, and some sort of food sensitivity, and B vitamin deficiency, now the diagnosis of Parkinson’s becomes a lot lighter and smaller, and we’re managing these other symptoms.” So, when we’re talking about EBV, just in general comorbidities, it’s really important to test for those, especially if we’re seeing the lab values show up that way.   We do have a history of seeing low lymphocyte values in people with Parkinson’s disease. If that continues to show up in monitoring, then that’s the next step I take is say, “What else is affecting your nervous system? EBV. Is it Lyme? Is it HSV?” There are so many potentials out there.

Dr. Weitz:            Absolutely.

Dr. Duncan:        With EBV, the last thing I want to say is knowing how to test is really important. I’m definitely not the end all be all, but I dove in really deep on this one, because so many people come and say, “I have EBV. I’m on all these supplements. I can’t afford.” It’s just it’s this long rigamarole, and I’ve never seen a reactivated EBV panel run. So, remember when you’re running EBV panels to do the thorough panel, and remember that if they’re IgG antibodies, and that’s not necessarily indicative of a reactivation unless you’re running that EBNA, and that one, if that’s showing up, is more indicative of reactivation, but not 100% specific there.

Dr. Weitz:            Can you tell everybody exactly what that test is you’re talking about, because I think a lot of us are relying on IgG?

Dr. Duncan:        Yep, they do. There’s the IgG, IgM for the viral capsule-

Dr. Weitz:            IgA.

Dr. Duncan:        There’s one more IgG, but then there’s a whole other brand, and it’s the Epstein-Bar nuclear antigen, the EBNA. That has also an IgG test, but if that’s elevated, that’s more indicative of a reactivation. The other ones are more indicative of a past infection. So, to determine whether or not you’ve had been exposed or not to whether or not it’s actually reactivated in your body, that fourth lab test is pretty important.

Dr. Weitz:            Right. Now, one of the things I’ve been seeing and some other practitioners have been talking about is a immune system dysfunction. We’ve been running some tests to look at immune system function like the… Cyrex has the lymphocyte map test, and then their cytokine test. That seems to be one strategy to helping patients with some of these reactivated viruses by trying to support the immune system in whatever way it’s imbalanced.

Dr. Duncan:        Right. There’s theories out there that Parkinson’s even originates as an autoimmune variant. What I tell, again, most of my patients, if they have the diagnosis, is that you’re technically under the classification of immune compromise by nature of your disease for whatever reason and however you reflect. It’s something to understand for themselves and their family that their immune systems are more vulnerable, and need to be protected.

Dr. Weitz:            Steve asked about have we seen an increase of Parkinson’s since COVID? I think in general, we’ve seen an increase in autoimmune diseases, haven’t we?

Dr. Duncan:        In general… I mean, in my clinic, I can speak to that for sure. I don’t know the epidemiology of Parkinson’s since COVID. I haven’t looked at that data, but Parkinson’s has spiked into being the leading disease in the population. I think that’s just by age as our boomers get into that generation, and the risk factors have increased in our society, I think.

Dr. Weitz:           Right. Dr. Vojdani has published a paper showing that COVID is the most autoimmune reactive virus that exists.

Dr. Duncan:        I haven’t been in practice long enough to know that, to be honest, because the flu’s really old but-

Dr. Weitz:           No. No, he’s actually done a study to show the number of different… What are some of the most important lab tests for us to do when we’re assessing potential patients with Parkinson’s?

Dr. Duncan:        I have a standard lab panel for most of my people at Parkinson’s. You’re going to do your blood count and your metabolic panel. I usually pair an A1C with insulin. Rarely do I run an A1C by itself anymore. I’ll always do A1C with insulin. Again, in the aging population, we tend to see numbers of your hemoglobin and red blood cells. There’s a lot of inflammatory anemia happening. So if you need to back up the blood sugar regulation with the fructosamine, that’s also something I add on. There is some theories out there, because it’s metabolic in nature that Parkinson’s being a type three, similar to what we’re saying about Alzheimer’s disease type three diabetes.  An iron panel plus ferritin, iron is hugely correlated with Parkinson’s disease, development of, progression of, so always running a full iron panel with ferritin. I do an extended thyroid panel.

Dr. Weitz:            By the way, iron generally increases risk, right?

Dr. Duncan:        Yes. An elevated iron increases risk. I have four now in my practice that I’ve diagnosed with hereditary hemochromatosis for the first time in their life. So, it’s a non-standard lab, and it’s just essential for not just neurologic health, cardiovascular health, and liver health for sure, but then we’re looking at expanded thyroid panel. I do an expanded thyroid panel, and everybody who comes in as a first patient, if it’s good to go, then we can cool it from there. I look at your B vitamins, B12 and B6, and your folate.  We know that the use of levodopa can deplete the body of folate and b12, so looking at those for sure, vitamin D.

Dr. Weitz:            Do you prefer-

Dr. Duncan:        I’m walking through my lab for vitamin D and then DHEA with a high sensitivity, CRP, uric acid, F2-isoprostanes, and an omega check. That’s my standard, and then of course, patient specific add or subtract.

Dr. Weitz:            Uric acid, we’ve learned from Dr. Perlmutter That even slightly elevated uric acid levels above 5.5 are associated with metabolic disease. But for Parkinson’s, elevated levels of uric acid are actually protective. Isn’t that right?

Dr. Duncan:        They are. Yeah, it’s really fascinating, and we see that when we avoid dairy. Dairy inhibits uric acid. We actually get an increase in uric acid levels, which are protective for Parkinson’s disease. We have to be a little bit careful, of course, patient specific, because they can be inflammatory. Inosine is a supplement that’s commonly used with Parkinson’s disease that can boost uric acid levels, and alleviate some symptoms.

Dr. Weitz:            Interesting. Is that one that you use?

Dr. Duncan:        On occasion. I don’t have a ton. Mostly, I joke most of my patients in the aging population have plenty of uric acid. I’m not seeing a big depletion here.

Dr. Weitz:            Let’s talk about some of the most common pharmaceutical approaches. Oh, somebody asked, can you repeat dairy inhibits? Did you say something about dairy?

Dr. Duncan:        Dairy will inhibit uric acid and with… There’s twofold there. Dairy is one of the major food groups that we do recommend avoiding for people with Parkinson’s. When I first started in my practicing, you learn it, and you’re gaining ground here. I was like, “Let’s try to avoid dairy, and here’s what we know.” Now, my poor patients, I’m like, “Nope. Dairy done. Get it out.” We have so much evidence to show it’s a risk factor for development of and progression of Parkinson’s disease. Then everybody wants to ask about goat and sheep.

                                My answer there’s they’re never going to do a randomized control trial of cow’s milk dairy versus goat milk dairy. So, go plant-based if you can, and boot it out of the house. Those are pieces of information we’re not going to know. Again, we know uric acid is protective, so it’s a twofold reason to avoid dairy. We want to boost up those uric acid levels, and we have these independent clinical evidence to show the progression [inaudible 00:33:07].

Dr. Weitz:            Actually, let’s pause on the drugs. We got a few questions, I think, we should try to address. Bernie asked about the relationship between head trauma and Parkinson’s, and most neurological diseases, Alzheimer’s including.

Dr. Duncan:        Bernie, I appreciate that question. Yes, head trauma definitely has a relationship to Parkinson’s. It makes it very challenging to treat. A lot of my people with Parkinson’s who have a history of TBI or CTE are either medication resistant, or their progression is quite fast that it’s hard to catch up with. So in that realm, we get a huge team on board neuropsychiatry. We have a functional medicine doctor that’s working on neuroinflammation. We’re doing trials of different Parkinson’s medications. Then if it’s a motor symptom prominent presentation, then I’m usually recommending DBS for some of those folks, but it makes it really challenging when there’s confounding neurologic trauma happening there.

Dr. Weitz:            On the testing, Steve asked about do you run organic acid testing?

Dr. Duncan:        On occasion. Yep, so I will check for metabolite function or presence in the urine. If I do, I use great… Hold on. Do I use? Yes. No, I use Dutch. I use the Dutch test for that one. Great Plains at PD summer school. But yes, we will run OATs testing on occasion to see how some of those metabolites are functioning.

Dr. Weitz:            Sherry asked, “What are the best neurological tests to run?” Now, we’re talking about the neurological exam part, which is separate from the lab testing.

Dr. Duncan:        Oh, like for physical exam?

Dr. Weitz:            Yes. I assume that’s what you mean, Sherry, right? Okay. So, you’re seeing the twitching-

Dr. Duncan:        I’ll answer that one. Your neurologic test is going to be really important. I always look for Cogwheel rigidity. I think that’s one that’s missed a lot in the diagnosis. They can actually show up a little bit before motor symptoms. So, people are diagnosed, but they’re not really strong in the motor symptoms, the tremor. You’ll often see that Cogwell rigidity in their shoulder or elbow joints. Then the gait analysis is really huge. Gait analysis, people get diagnosed on their walk all day every day by neurologists.   So, having them turn around, walk your normal gait away from me, turn around as fast as you can at the end of the room, come back heel to toe. You can do the shin slide, but making a really thorough gait and posture analysis. I will check gait. I will-

Dr. Weitz:            What are some of the most common gait abnormalities you’ll see?

Dr. Duncan:        Shuffling a little bit later on, but that lack of arm swing on one side is really the most early sign there, and then a head tilt, believe it or not. Oftentimes, people will have that head tilt to the side that’s affected when they’re doing their gait analysis. DTRs are always going to be important, that repetitive rapid alternating movements. If you really want to dive in, you can go to the MDS website, and learn the UPDRS, or just a few tests from the UPDRS. You don’t have to be qualified to do the entire test. I nickname it the chicken dance, but it’s really this.  Can you stomp and move your feet as fast as you can, so you can check those movements? The finger to nose test will test that intention tremor and coordination. I mean, those are really the big ones. Oftentimes, they’ll have people sign their name on a piece of paper, and just look if they’re having that agraphia to see if their handwriting has gotten smaller.

Dr. Weitz:            Some of you guys-

Dr. Duncan:        I also use that for signs of improvement. Hey, I need you to do sign again. Let’s see if these things are helping and if we’ve gotten better control of your motor symptoms.

Dr. Weitz:            Now, is there a quantitative score patients can get on that neuro test, or any-

Dr. Duncan:        The UPDRS is very detailed. That’s what movement disorder specialists are using for diagnostic and prognostic testing. It’s a very useful test when not used in isolation. I think the frustration is they’ll go in, and they’ll do excellent at the test, and they’ll be feeling like shit. They’re like, “Hey, my neurologist said I’m doing great. I don’t need anything else, but I haven’t pooped in four days, and my anxiety’s through the roof. Here’s how I’m really feeling, but my UPDRS was great.” So, again, taking that all into consideration.

Dr. Weitz:            Right. Always treat the patient. Somebody asked about isoprostane labs. Is that… Did you mention it?

Dr. Duncan:        Yeah, F2-isoprostane is a urine lab. As my mentor told it, it tells us how rancid somebody is, and it truly will tell you if there’s rancidity in the body, and if it’s in that toxic state. That can lead me to say, “Okay, we need further testing maybe on the toxic levels, heavy metals or mycotoxins if there’s something else at play here.” I also correlate that with the omega check. Are we getting enough of the omega-3s? Are we getting these anti-inflammatories? What is the burden there?

Dr. Weitz:            When you look at the omega levels, what are you looking specifically? What do you focus on the most? Do you just look at the omega-3 index? Do you look at the Omega-6:3 ratio? Do you look at the arachidonic acid omega-3 ratio, the EPA, the DHA levels? What do you think is most significant to focus on?

Dr. Duncan:        Yes. No, really, the big one… All of those things, of course, and you’re looking at those levels to be in favor of the omega-3, the anti-inflammatory markers. The DHA is really what most highly studied in people with Parkinson’s. I always say for DHEA or, I’m sorry, DHA, it’s the four Ds, and we’re looking between two and four grams of DHA at a daily dose to help with these things. The four Ds we’re looking for with Parkinson’s disease is depression, dementia, dyskinesia, and death. Those are four big Ds that you really want to address.   So, I have three nutrients, natural medicines that most everybody in my practice will get prescribed at some point in time early on. That’s one of the biggest ones is because, again, the brain’s made out of fat. The DHA is the prominent fat in the brain, and we really want to promote those high levels there.

Dr. Weitz:            What lab do you use for the F2-isoprostane?

Dr. Duncan:        I run mine through LabCorp, and it’s a urine lab. That’s the big thing to remember is that’s urine. You’re not going to find it on a blood panel.

Dr. Weitz:            Okay. Steve, you’re asking about CoQ10. Hold that. We’re going to go into drugs, and then we’ll go into diet and then supplements, if that’s okay. Can you talk about pharmaceutical approaches to Parkinson’s?

Dr. Duncan:        Yeah. Give me one second here. My son’s nest just went off or hatched. If anybody knows what a hatch is, then you know. Pharmaceutical approach to Parkinson’s disease, it’s growing. There’s many, many out there that are available. The biggest one that you’re most familiar with is Sinemet or carbidopa levodopa. My approach to that, I always like to take a couple minutes, and talk about it. As a naturopathic doctor, as a functional med physician or practitioner, I’m sure you get most of your patients come and say, “I don’t want to take drugs. I don’t want to take meds. Give me anything.”

                                Then the conversation ensues of, “If you have somebody who has type one diabetes, and their pancreas cannot make insulin, the most natural thing, an effective thing that you can give to these patients is insulin. You have Parkinson’s disease, and your body cannot make dopamine. The most natural and effective medicine that I can prescribe to you right now is dopamine.” So, we have those conversations, and there are natural supplements for dopamine. We’re talking about Mucuna Pruriens. Unfortunately, with the supplement industry not being regulated, we are seeing that that dosages cannot be standardized sometimes even from pill to pill within the same bottle.

                                So when I’m starting somebody on a medicine, I really do promote the use of synthetic carbidopa levodopa, because, I mean, we’re trying to fill up a bucket blindfolded. We don’t know how empty it is, and when we’re repeating the body of dopamine, what I’m seeing the most is that it’s not so much the medicine taking care of the symptoms of Parkinson’s disease, but it’s aiding in their ability to do the things they need to do to slow down Parkinson’s disease, so again, the non-motor symptoms like apathy, lack of motivation to do what they can, pain, anxiety.   When we give these patients the dopamine that they need, then they can start to overcome some of those, and go do the exercise, and eat and prepare their food, not to mention the huge effect it has on motor symptom presentation. So, there’s a couple different varieties up there, your immediate release, your extended release, controlled release, Sinemet, Rytary, generic. That’s really the first one that we come to the table with. [inaudible 00:42:21].

Dr. Weitz:            Now, something you told me last time we spoke, which I thought was really fascinating is it’s common for patients to be told by their neurologist. Let’s hold off on starting to take dopamine or carbidopa levodopa, because it will stop working after a certain period of time. You have found that when you use a functional medicine approach, that doesn’t happen.

Dr. Duncan:        I’m not going to say it doesn’t happen.

Dr. Weitz:            Well, it doesn’t happen as often.

Dr. Duncan:        Yeah. I mean, the goal is… Like I said, when we are taking a whole person approach, the theory out there is that carbidopa levodopa has a 10-year shelf life in the body. You’re going to keep increasing the dose until you hit max dose, and then it’ll start to wear off, and not be useful anymore. So, what I talked to people about is, one, “You can get 10 good years out of this. Do you want to take it?” I would. Let’s give it 10 good years, and let the researchers go do their job to see what else they can come up with in the meantime. Two, the majority of the time, what I see is in that line of thinking or philosophy, let’s prescribe this, and let’s keep increasing the doses.

                                Symptoms worsen and worsen and worsen without thinking of, “Hey, are you taking magnesium? That interferes with levodopa? Hey, do you have a B12 deficiency? Do you have slow gut motility? Are you taking it with protein? Do you have CDP choline on board? Are you taking it with vitamin C? Do you have enough hydrochloric acid?” The list goes on and on and on how we can make this medicine more effective for our patients. When that’s left out, then we’d need more, and it runs out of efficacy. When it’s brought in, that’s what I was mentioning before. We see the need for that medicine decreased by up to 50% while still managing symptoms.

Dr. Weitz:            That’s awesome.

Dr. Duncan:        It is. It’s incredible. I mean, I said, I’ve taken people right off the ledge. I’m at max dose. They’ve got nothing else. They’re on four or five different anti Parkinson’s meds, and we… Let’s pull this back a little bit, and they’re managing really well.

Dr. Weitz:            Awesome.

Dr. Duncan:        The other medicine I really want to hit on that comes right out of the gate from naturopaths office, which often astounds people, is Rasagiline or Azilect. It’s an NMAO B type inhibitor. Why I prescribe that or promote that is it’s the only pharmaceutical on the market right now with some research to show that it slows disease progression. All of the pharmaceuticals at this point in time are there for symptom management. This is the only one that actually shows a slight improvement in disease progression. So, again, I look at every single patient.  Is it me? Is it my mom? What steps do I want to take to slow this disease down, and buy all of us idiots over here more time to do the research, and figure out what else we can do?

Dr. Weitz:            Great.

Dr. Duncan:        My least favorite pharmaceutical, I’ll just go right into that if you want me to keep rambling, are the agonists. The agonists are tough. They’re effective, but they have a laundry list of side effects that I would say most patients experience. So, impulse control, behavioral changes are really pronounced when we’re using those agonists. They’re most often prescribed for people who have restless leg syndrome or the REM sleep disorder symptoms. As you all know, I mean, we’ve got oodles and oodles of tools to use for those symptoms.

                                So, again, if we can take those out of the Parkinson’s bucket for a hot minute, and address those in a different way, then we don’t necessarily have to use those medicines as often. Some non-standard medicines that I really am loving using, especially when we have GI issues, are Inbrija. It’s an inhaled levodopa. I use that as a rescue medicine. Then you have your new ProPatch, which also bypasses the gut, and can be helpful for managing symptoms of Parkinson’s.

Dr. Weitz:            Steven asked if ARBs like Cozaar are neuroprotective.

Dr. Duncan:        That’s a good question. I honestly don’t know. I’m sorry. I can do some research on that if you ever want to email me, and I can get back to you, but I don’t know right offhand if that’s a direct correlation.

Dr. Weitz:            Can you just repeat that med that you said is your favorite?

Dr. Duncan:        Dopamine.

Dr. Weitz:            No.

Dr. Duncan:        Sinemet, but the one that shows disease progression growing is Rasagiline or Azilect.

Dr. Weitz:            Yes. Thank you.

Dr. Duncan:        Interestingly enough, as a MAOB type inhibitor, just fun fact, turmeric has properties of an MAOB inhibitor too. So, all the other lovely things that we all love turmeric for also shows properties of the MAOB. So, I usually want-

Dr. Weitz:            Awesome.

Dr. Duncan:        Some form of turmeric in there.

Dr. Weitz:            One of the most amazing nutraceuticals for sure. So, what about diet? What are the most important dietary considerations?

Dr. Duncan:        The most important dietary consideration, as I mentioned to you before, Ben, is a healthy relationship with food. I’m a huge proponent of screening for disordered eating habits, body image dysmorphia. I don’t know off the hand… Of course, I don’t have these, but I would say probably 50% of my male and female patients over the age of 65 have battled with some disordered eating, whether it’s back in their teenage years or in their 40s or… Men aren’t exempt from this. Body image for men tends to be this very deep shame issue, so don’t not ask. Ask first.  If they laugh at you, then great. Move on, but those conversations are really important, because when we’re talking about neurologic disorders, anxiety and vagal nerve dysfunction are hugely important in the healing process.

Dr. Weitz:            We need the restrictive diet specifically for Parkinson’s. We need to be able to tell patients, “Don’t eat broccoli and cauliflower.” No, I’m kidding.

Dr. Duncan:        No, eat… Those exist. Once you pass that gate of, “Can you eat these healthy, and it’s not going to create stress and anxiety for you?” Because my motto is if eating the food or not eating the food causes you more stress than the food itself, then eat the food. We can do things to detox the food, but that stress and vagal nerve dysfunction is important. But when we’re looking strictly at diet, most of the research is coming back to that Mediterranean mind diet that we’re really aware of that’s been published over and over again.  I have a colleague who’s a MDS over in Seattle who’s hugely promoting a vegan diet. I don’t necessarily see that to be true in all of my patients. So, we ease our way into it. If they’re really willing to go there, then absolutely, especially if there’s cardiovascular risk, but I really start talking about what to avoid and what to focus on. So, my patients will leave my office with, “Here’s your goal. I want seven to nine servings or fruits and veggies. I want you to eat mushrooms. I want you to focus on wild caught salmon.”   By the time they get through the list of what I want them to focus on, they’re full. So, it’s less about restricting, and it’s more about, “Let’s make your grocery list. Let’s make your meal plan with these foods that we really want to get in your system. That way, it doesn’t feel so restrictive,” but dairy is the big one. Pork, red meat definitely has been shown to increase the progression. The other thing that I like to talk about is smoothies. What we’re asking people to do with the nutrient density and low protein is, “Can we put it all in a smoothie?”  There’s a lot of people with Parkinson’s who have dysphagia, difficulty swallowing. So, can we get some of your medication and your supplements in your smoothie with you? How can we make this easier for you to get and assimilate your medicine, and promote healthy bowels and water? Let’s add some water to your smoothie. Now, we can really amp it up. Diet’s a huge, huge aspect of health for people. It’s just it’s really touchy and really important, so tread with caution.

Dr. Weitz:           There’s some interesting data on the benefits of exercise for Parkinson’s.

Dr. Duncan:        Yeah.

Dr. Weitz:           Aerobic exercise, there’s some data even for strength training.

Dr. Duncan:        The most important thing I think for exercise is it’s dose dependent. So when I tell my patients that… We always joke that if I had a pill bottle to give you that said exercise on it, you would take it, but going out and doing it is much more difficult. So, when I tell them, “This is dose dependent. It’s dose and frequency dependent is how much you do exercise, how much benefit you’re going to get from it.” It’s a huge motivator for folks. We are seeing the evidence that if you exercise less than three days a week, there is no benefit in the slowing of progression. So, it is a three plus days a week where you’re seeing an increased benefit in symptoms and disease progression.

                                The most studies exercise is for Parkinson’s disease is going to be things like boxing. There’s rock steady boxing programs all throughout the nation. It’s a phenomenal program. It’s utilizing both sides of your body. It’s a great community the instructors that are familiar with Parkinson’s disease, so they know how to challenge and work with people. Then as I always like to say, as a former amateur golden glove boxer, you get to hit the shit out of something, and get out all your frustration. So, it’s a really great exercise to go into.

                                Tai Chi is deeply studied. Cycling and dancing, those are the top ones that you’re going to see in the research, but what I tell people is find something you enjoy to do that challenges your brain, because it’s something new. Get that BDNF going and flowing, and do something new, and do it regularly.

Dr. Weitz:            Going back to diet, Bernie asked about what do you think about gluten?

Dr. Duncan:        Oh, gluten, it’s going to be… Again, it’s going to be patient dependent. I often try to tell people to avoid gluten. It’s going to be under my recommendation to take that out as best as they can. If we need to do deeper studies, I have diagnosed a few people with Parkinson’s with celiac disease, again, in their sixth and seventh decade. I know we all know the stories, but you’re talking GI inflammation, and that’s been going on for that long. So, we do try to eliminate or avoid gluten as best as we can. Then if something where you can’t do it, then I will often prescribe a digestive enzyme to help break that down.

Dr. Weitz:            Bernie also asked about Pilates as a form of exercise.

Dr. Duncan:        Yes. I mean, there’s not really anything I’m going to say no to as long as it’s safe and effective. But one of the… As practitioners, do you get somebody with Parkinson’s in? What I really do want to say is help them build their team. One of the very first referrals that anybody should get with the diagnosis is to a Parkinson’s specific physical therapist. Strengthening those intrinsic muscles, reducing the risk of fall, even if they’re not there yet, is going to be really, really important for everybody.  I think as we recognize that, we need to build this team for our patients. That’s one of the very first referral. “Hey, do you have a referral out for PT? Have you done it?” “Nope.” “Okay, let’s get you one. Let’s get going on this building of your team and resources.”

Dr. Weitz:            Let’s go into nutraceuticals. What particular nutritional products have you found to be helpful in slowing the progression, and modulating some of the different factors involved?

Dr. Duncan:        What I like to say is people walk into my office with Parkinson’s disease. They’re typically going to walk out with three natural prescriptions, and that’s glutathione, high potency DHA fish oil, and CoQ10. What we’re seeing with glutathione, the research states back to the ’80s. I already touched on the deficiency that we’re seeing by the time of diagnosis based on motor symptom onset, and as the primary antioxidant of the nervous system. We really need to be proactive in getting that repleted in the body, help with the detoxification system in supporting neuroinflammation.

                                I typically don’t rely on NAC as a precursor to glutathione. Most of the evidence is showing, “Just give them straight up glutathione.” IV glutathione has been researched, like I said, since the ’80s. It’s not accessible. It’s invasive. It’s painful, and the effects aren’t always long-lasting. My mentor, Laurie Mischley, did some studies on intranasal glutathione. We are seeing a larger increase in… I guess a larger decrease in symptom presentation patient reported when we use intranasal. The tough part about intranasal is that it’s also not as quite as accessible.

                                You have to do that through a compounding pharmacy. Then patients aren’t always compliant. It tends to burn a little bit. They have to lay on their back for a couple minutes, and they’ll report half of it goes down their throat anyway. We like intranasal. It’s a direct route to the brain. So when possible, it’s a really great tool to use. Otherwise, I’ll use a liposomal oral bucally-absorbed glutathione to get that process going for my patients. The hiding… Oh, go ahead.

Dr. Weitz:            How did they get the intranasal? You said use a compounding pharmacy, and then is it use one of those machines to put it in?

Dr. Duncan:        They do that. I send you the compounding pharmacy, and then they send him home with the inhaler and the spray bottle and everything like that.

Dr. Weitz:            Oh, okay, so they put it in an inhaler.

Dr. Duncan:        Yeah.

Dr. Weitz:            Then as far as-

Dr. Duncan:        Never in my-

Dr. Weitz:            Do you have a particular brand and dosage for the liposomal glutathione that you prefer?

Dr. Duncan:        Dosage is going to depend patient to patient. I tend to use designs for health. The pump, that’s the one that’s been most well absorbed for people, but I use consumer lab reports to run my natural medicines through. So, again, as a functional or naturopath or integrative provider, I think I mentioned to you this before, Ben, I never thought my epitaph was going to be safely prescribed natural medicines, but I cannot say it enough. We have to be the gatekeepers of these medicines. They are not always safe. They’re not always indicated, and they contraindicate with pharmaceuticals.  I mean, I don’t know how many of you knew that magnesium will inhibit the absorption of levodopa, and the very first thing we want to give somebody for constipation is mag oxide, right?

Dr. Weitz:            Right.

Dr. Duncan:        So, really knowing these interactions, and understanding your nutraceuticals is really important. The DHA fish oil, again, I tend to go liquid on that, because you can throw it in a smoothie. It’s really beneficial. I like Pharmax and Genestra. Those tend to be one to two teaspoons a day to get that high potency dose.

Dr. Weitz:            What’s the dosage you like?

Dr. Duncan:        Two to four grams. That’s really what we’re looking at.

Dr. Weitz:            Of DHA.

Dr. Duncan:        Of DHA. Yeah, DHA, so really understand it’s when you look at the front of the bottle, they don’t have to meet label potency, right? Again, this is my epitaph that I didn’t ask for, and, again, patient specific, right? Fish oil’s a blood thinner, so we have to be aware of all those of different contraindications there. Then CoQ10, we’re all recognizing the mitochondrial effect of Parkinson’s disease. How I like to frame it to my patient is you’re burning a lot more ATP than I am just sitting here, because you have a motor disease, a motor… What am I looking for? A motor disease.

                                You’re going to burn that fuel a lot faster. There’s a ton of other research about CoQ10 and mitochondrial health and Parkinson’s disease that when I’m talking to a patient, this is how I like to say it, “Let’s keep your gas tank full. If you’re going to use it, let’s give it to you.” It’s really hard to make that much, but then we also know that membrane stability and providing those resources for the mitochondrial. There’s been studies with CoQ10 ubiquinol. Up to 900, 1,000 milligrams a day, and the evidence to show symptom improvement isn’t there to match, and it’s really expensive. So, I typically stay between one and 300 milligrams, and I like-

Dr. Weitz:            Did you say ubiquinol versus ubiquinone?

Dr. Duncan:        I usually use a ubiquinone instead of the CoQ10 just for the bioavailability aspect.

Dr. Weitz:            You said 300 milligrams?

Dr. Duncan:        Between one and three.

Dr. Weitz:            Between one and three, okay. By the way, I think the design health glutathione is private labeled from Quicksilver for whatever that’s worth, but… What else?

Dr. Duncan:        Somebody asked me, my youngest patient 41, just wanted to answer that on the chat, but it was too late to write 41, so I didn’t know if they would know who that was the answer for.

Dr. Weitz:            Oh, okay. What about vitamin D?

Dr. Duncan:        Vitamin D, we like those ranges to be between 40 and 60. I don’t get super scared of high vitamin D. I’m always checking that calcium. You can double check at PTH, but really ubiquitously. You look at the Venn diagrams of neurodegenerative diseases, and vitamin D is implicated in all of them. It’s really come out as a shining star after the pandemic too for immune health. So, absolutely, vitamin D is something that we check and supplement with patient specific.

Dr. Weitz:            You mentioned B12. We all know that B12 is super important for brain health, but I personally have found that serum B12 levels are not particularly accurate, and tend to rely more on homocystine and methylmalonic acid.

Dr. Duncan:        Same. Those are… Sorry, and I didn’t even include those. Those are in my lab order, the very first ones. I do run an MMA, and I run a homocysteine. Absolutely. We know there’s B12 in the blood, but are we using it is the question. So, we want to check this homocysteine levels. We know homocysteine elevation. The interesting thing is I actually have a lecture up if you go to either my website or Northwest Parkinson’s Foundations, where I did a lecture just on lab values and reference ranges. We take these standard reference ranges that are made for white man age 40 to 50, and say, “It doesn’t apply,” maybe to you Ben, but doesn’t apply to most of us or most of our patients.

                                So, we narrowed in those reference ranges based on the clinical data that we have to say, “Here’s what our goal is.” In the literature, we know that homocystine above 11 can be neurotoxic. Yet, the reference range on most labs is 14, 14.9, so the goal for people with Parkinson’s is below 10.

Dr. Weitz:            I just had a patient yesterday with a homocysteine of 90.

Dr. Duncan:        Ooh.

Dr. Weitz:            I know.

Dr. Duncan:        You don’t even have to test MTHF on that guy, right? That’s-

Dr. Weitz:            Right.

Dr. Duncan:        You’ve got homozygous there. We’re definitely… Those B vitamins… Interestingly enough, like I talk about, we all know if you prescribed Metformin, you dose B12. These are things that aren’t happening. If you’re going to prescribe levodopa, you prescribe B12. We know that it depletes the body of B12. Other things that can elevate homocystine levels, not just B12 and folate, but B6 and betaine. There is a product out there that I really like called homocysteine factors. Super easy.

Dr. Weitz:            I use the designs for health product homocystine supreme, but there’s a lot of similar products out there.

Dr. Duncan:        It’s great, but be cautious with your B12. Again, neuropathy is a really common symptom of people with Parkinson’s and too much B6, because a lot of our patients come in on these… They’re self prescribed medicines can actually cause that as well. So, checking labs, making sure that you’re not putting everything in this one box. There could be a lot of different aspects at play. There’s a lot of clinical research out there about high doses of B1. I wanted to hit on that. I have had four patients who went into some trials with that. Only one saw benefit.  I’m not dogging it. I’m just… I don’t think it’s going to do a whole lot of harm, and people often will burn out from not seeing the effects, or maybe have a few side effects from it, but I’m really interested to see what else comes down the pipe about high dose thiamin supplementation.

Dr. Weitz:            Low dose lithium has some data.

Dr. Duncan:        Oh my gosh, lithium has so much data, either hair or urine test. I prefer a urine test for lithium, but that is definitely something to test. There was… What am I thinking? Not a protest, but a motion to actually lithinate water in the Pacific Northwest at one time like we do.

Dr. Weitz:            Oh really?

Dr. Duncan:        Yeah, because there’s so much deficiencies, and if you look through the literature, low lithium levels are correlated with a lot of neurologic diseases including schizophrenic and bipolar disease, so the list goes on. But yes, low lithium levels are often implicated with people with Parkinson’s, and lithium is an important co-factor for BDNF, the brain drive neurotropic factor. So, we like lithium. I prescribe lithium. You’ll often get a side eye from your conventional counterparts. How I usually phrase it to patients and put it in their notes, “This is a physiologic dose of lithium. This is not a pharmacologic dose of lithium.”   You can always check their blood levels or their urine levels again. It also has evidence to show that helps with dystonia or that muscle cramping and pain that can happen in off periods. I really like lithium. I would say after my top three, that’s probably my next most prescribed nutraceutical.

Dr. Weitz:            I looked up other nutraceuticals. There was some data on resveratrol and also lycopene.

Dr. Duncan:        I haven’t actually heard about the lycopene thing to be honest, but antioxidants, if you put a big umbrella there, the antioxidant use is going to be huge, those bioflavonoids. I really like resveratrol. You can prescribe that. You can really dive into food. Once they start meeting some of those food goals, they’re going to be getting some of those nutrients naturally, and spices. We really can’t pass up the importance of spices in our life, and how they affect our health. That’s where we can get a really good healthy dose of resveratrol. So, I like spices.

Dr. Weitz:            You’ve talked about inflammation. We know that’s a really important factor. We’ve been using the SPMs, the fish oil derivatives for inflammation. What do you think about those?

Dr. Duncan:        I haven’t used those before. It’s a good question, but I’d like to learn more. So if you can shoot me a message about that, probably, I’d love to learn more about that.

Dr. Weitz:            You got it. What about some of the supplements that are specifically for brain function? You did mention citicoline. Do you have a dosage you like for that?

Dr. Duncan:        Yeah, and it’s interesting. The Neurologix is a product that I use you mentioned by IT-

Dr. Weitz:            Oh, okay.

Dr. Duncan:        They also have a product called ProThrivers Wellness, and that has lion’s mane in it. I really like their ProThrivers Wellness Brain brand. Again, I have no conflict of interest here. I’m not sponsored, but the formula there, lion’s mane has a huge batch of research behind it for cognitive support and immune function. Then the CDP-coline that’s involved in that formula is at two caps twice a day, so you’re getting 250 milligrams. That’s a really great proponent to use. We’re using that for cognitive function anyway. A lot of people are supplementing with it.

                                What we are seeing with people with Parkinson’s specifically in this population is when we dose citicoline with carbidopa levodopa, we’re seeing enhanced efficacy of the medicine. So, again, another way that we can reduce dose or the need for dose, and expand that 10-year timeframe out, and with continued use of citicoline, we’re actually seeing an improvement of 30% to 50% efficacy in four to six weeks. So, it’s pretty great evidence there in support.

Dr. Weitz:            Wow. In what dosage?

Dr. Duncan:        250 milligrams.

Dr. Weitz:            Okay, twice a day.

Dr. Duncan:        I’m going to say twice daily.

Dr. Weitz:            Twice a day. What about some of the other specific brain formulas? There’s vinpocetine. There’s a whole bunch of them out there.

Dr. Duncan:        There’s a chance that we’re talking cognitive function and DLB, things like that that are starting. Now, you’re diving into a whole different approach, I would say, in that realm, so really diving into the mushrooms, into the nutrients. You can do some intermittent fasting, and those are… I take a way more aggressive approach with those folks for sure. I often will use a proteolytic enzyme for somebody who has DLB or any inflammatory aggregates if it’s safe, something like nattokinase. That’s going to help with some of those inflammatory markers.

                                But some of the other, what did you say, cognitive, I’m a big herbalist gal. I love my herbs. They work really well. So, the ginkgo, rosemary, and bacopa, gotu kola or Centella, those herbs are powerful. They’re robust, and they’re multifaceted. But when you’re talking neotropics, in my opinion, you can’t get much better than herbal medicine for some of those functions.

Dr. Weitz:            Just [inaudible 01:07:39].

Dr. Duncan:        Then we can customize formulas then, right? We can use those, and we can add in some cardiovascular tonics and some anxiolytics like kava or skullcap, and help with urinary frequency. So, it’s really fun to formulate on that level, and make sure that we’re getting those herbs in there. Then you get your adrenal support. When we’re talking cognitive function, now, you’re diving into that vagal nerve dysfunction. How’s your dysautonomia? How’s your blood pressure? How’s your stress response? Are you screening for ACEs? Have you talked to your patients about their adverse childhood events or traumatic history?

                                A huge portion of my people with Parkinson’s will come into my practice. I say, “Hey, when did this start?” “I got diagnosed five years ago.” “No, when did this start?” “Well, I got divorced 15 years ago, or I lost my mom 20 years ago,” or there’s this trauma in their life, and then they can start to see how their health declined. We can trace it back to something like that. So, when we’re practicing root cause medicine, even if we can’t change the root, it’s important to address it, and have that conversation.

Dr. Weitz:            You mentioned vagal nerve several times. In my office, we’ve been experimenting with using a laser to stimulate the vagal nerve. Somebody came by my office today, and demonstrated this electrical stimulation machine that’s been shown to work on the vagal nerve, and have therapeutic benefits. Have you experimented with anything like that?

Dr. Duncan:        I’ve prescribed a couple vagal nerve stimulators. I use the earlobe technique with the Stim machines, but really, I follow Dr. Stephen Porges in his polyvagal theory and tracing our breath work. We know that when we exhale, we stimulate the vagus nerve. Vagal nerve function is not passive. It’s intentional in the body. We could cut it and survive. So when I tell people that the intention to stimulate it, and put yourself in the parasympathetic nervous system is intentional, and our exhales are going to stimulate that vagus nerve. So, doing a four, seven, eight breath technique, humming, gurgling water, contrast hydrotherapy, contrast showers can stimulate the vagal nerve function.

                                There’s a lot patients can do in their lifestyle that doesn’t necessarily add to their plate of go do this, or put this buzzer on, or take a supplement or something like that. Then finding a biofeedback practitioner if it works, finding a counselor really addressing the mental emotional aspect of Parkinson’s. Again, I mean, you guys all know as well as I do in this field of medicine, people walk in and say, “Oh, my doc said it’s all in my head.” I said, “Cool, your head’s attached, right? Let’s work on that. Let’s do something about that.”  More often than not, you talk about this hypervigilance or amygdala overactivation. Once we start working on that too, we see gut motility improved. So, there’s so much that we can do as functional medicine or integrative medicine providers that supports a patient’s wellbeing and quality of life with Parkinson’s disease.

Dr. Weitz:            Wendy asks, “Are you accepting new patients out who don’t live in Idaho?”

Dr. Duncan:        Yes. I do telemedicine, and I accept patients from wherever they want to come from.

Dr. Weitz:            That’s great.

Dr. Duncan:        I’m going to put my website on there.

Dr. Weitz:            Those are pretty much the questions that I had prepared. Is there anything else you wanted to talk to us about?

Dr. Duncan:        Oh, we;;, that’s-

Dr. Weitz:            I think we pretty much covered it.

Dr. Duncan:        Are we going to be here till midnight for some of these folks then?

Dr. Weitz:            Okay, great.

Dr. Duncan:        No, I mean, really the biggest thing I want to say, Ben, is the biggest thing I say is I’m passionate the more people we have with information to treat Parkinson’s. I don’t want all the referrals. I want everybody to have the information. Laurie Mischley has an online training program that you can go on through-

Dr. Weitz:            How do you spell her name?

Dr. Duncan:        Mischley, M-I… I’ll put it in the chat box.

Dr. Weitz:            Okay.

Dr. Duncan:        I can type it better that I can spell it. Laurie Mischley. There’s a ton of resources out there. If it seems like too much to take on somebody with Parkinson’s, then find somebody who is familiar with it, because we are trying to create this whole group of people who understand the integrative approach and who want to do more research on it and more boots on the ground as Laurie likes to call it. So, if you’re seeing these people, and you have questions, I mean, reach out to me. I’m happy to share my email, my website.  I’m collegial. I’m nice. I like to think I’m charming on occasion, so reach out. Ask questions-

Dr. Weitz:            [inaudible 01:12:12] myself.

Dr. Duncan:        Present cases. That’s why I said when I make bad jokes, I need to see if people laugh or not. So, please reach out.

Dr. Weitz:            Awesome, thank you so much. This was a awesome presentation. You put your website, which is cdahealingarts.com, how people can contact you, right? That’s the best way.

Dr. Duncan:        It is. Ben, just really quick, I see that Bernard wrote a couple times here, “Summarize the causes of PD.” I can summarize it really quick. We do not know, unfortunately. The Parkinson’s diagnosis is IPD, idiopathic Parkinson’s disease, so there’s a lot of theories from autoimmune to metabolic, obviously genetic, environmental toxicity. What I’m seeing in my practice with the hundreds now of people that I’ve accumulated is a combination of all of it. So, as much as I wish I could say, “Here’s the causes,” if I did, I’d be a Nobel Peace Prize winner, and I wouldn’t be sitting here talking to you guys.

Dr. Weitz:            Thank you.

Dr. Duncan:        Of course. Thank you all for being here. Please reach out, ask questions, send emails. Thank you for the work you’re all doing.

Dr. Weitz:            Great. We’ll see everybody next month.

Dr. Duncan:        I’m excited for Dr. Bredesen.

Dr. Weitz:            Great. I’ll make sure to add your name to the mailing list.

Dr. Duncan:        Please do. You got some big names there. Man, I was sweating when we started. I was like, “What? You’re talking to Dale Bredesen. What am I doing here?” Man, this is-

Dr. Weitz:            This is awesome. Thank you.

Dr. Duncan:        Got home, took a shot of whiskey before I signed on.



Dr. Weitz:            Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcast or Spotify, and give us a five-star ratings and review. That way, more people will discover the Rational Wellness Podcast. I wanted to let everybody know that I do have some openings for new patients, so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardiometabolic conditions, or for an executive health screen, and to help you promote longevity, and take a deeper dive into some of those factors that can lead to chronic diseases along the way.  That usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing. We’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective. So, if you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111, and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.



Phytomelatonin with Deanna Minich: Rational Wellness Podcast 300

Deanna Minich discusses Phytomelatonin 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

1:50:  Eating the Rainbow.  It’s scientifically true that it’s good to eat fruits and vegetables. She has spent a large portion of her professional career researching plants with various companies and now with Symphony Natural Health and phytomelatonin, a plant melatonin.

2:28:  Deanna cowrote a review article on melatonin:  Is Melatonin the “Next Vitamin D”?: A Review of Emerging Science, Clinical Uses, Safety, and Dietary Supplements.  Melatonin is often thought of as a hormone, but it is actually an important nutrient and we need to have levels that are fortified throughout our lifespan to ensure better resilience and better mitochondrial function.  According to Deanna, “vitamin D and melatonin are like brother and sister. One is connected to light and one is connected to darkness, so we need them both.” 

4:15:  Many people today suffer from darkness deficiency.  We don’t let ourselves be bathed in enough darkness so that our retinas can change the signaling by the peal gland to produce melatonin.  This has a lot to do with all the exposure we get in the evening to artificial light and our phones and computer screens and tv screens.  And a lot of this artificial light is blue light, which inhibits melatonin production.  And as we get older, our bodies tend to produce less melatonin.  In the evenings we need red light, not blue light. And this is why we should consider quality melatonin concentration.

4:52:  While the melatonin produced in the pineal gland may be the most important, melatonin is produced in organs throughout the body, including in the gut mucosa.  And Melatonin is produced in the gut at 400 times the levels produced in the pineal gland, but only the melatonin produced in the pineal gland in the brain works systemically and it informs the body about the circadian rhythm.  The melatonin in the gut plays a role in gut motility as well as in digestive secretions.

8:23  Melatonin testing.  The website phytomelatonin.com has a lot of the research studies and the latest publications on melatonin and phytomelatonin. Deanna feels that testing for melatonin is not very accurate, whether you use urine, saliva, or blood.  If we were going to measure melatonin, peak melatonin levels tend to occur between 2 and 4 am.

10:56  Benefits of melatonin.  Melatonin promotes sleep and one of the ways it does this is by decreasing core body temperature and this could be especially problematic for perimenopausal women who get hot flashes at night. The primary way melatonin helps with sleep is by resetting our circadian rhythm.

17:46  Dosage.  Deanna feels that we should use the lowest dose for the shortage duration. Dr. Richard Wurtman has shown us that to take a physiological dosage for sleep, we should take .3 mg.  If we need help with sleep or we are jet-lagged and we need to reset our circadian rhythm, then 3 mg makes sense. 

19:20  We may want higher dosages of melatonin for the antioxidant effect. Melatonin is an antioxidant, it’s an anti-inflammatory, and it’s a mitochondrial regulator.  Dr. Paolo Lissoni has looked at the benefits of melatonin for cancer and to work synergistically with certain types of chemotherapy, but this should only be done under the supervision of a practitioner.

21:09  Brain benefits of melatonin.  Melatonin may aid the glymphatic process where the brain detoxifies itself.   This aids in degrading toxic amyloid beta and hyperphosphorylated tau proteins in the brain.




Deanna Minich has a masters in nutrition and a PhD in Medical Sciences and is a Certified Functional Medicine Practitioner.  She is the Chief Science Officer at Symphony Natural Health and she is the author of six books on various wellness topics, including An A-Z Guide to Food Additives, Chakra Foods for Optimum Health, The Complete Handbook of Quantum Healing, Quantum Supplements, Whole Detox, and The Rainbow Diet. Her website is DeannaMinich.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 website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.

                              Hello, Rational Wellness Podcasters. Today, our topic is melatonin and in fact, plant melatonin. Most people think of melatonin as a sleep aid, but it’s actually a very powerful antioxidant and has many other health promoting properties including for gut health, eye health, brain health, heart health, immune function, bone health. It reduces inflammation, has anti-cancer properties. Melatonin really has a lot of amazing health potential benefits when you start digging into the research. And we’ll be speaking with Deanna Minich who has a master’s in nutrition and a PhD in medical sciences, and she’s a certified functional medicine practitioner. She’s the chief science Officer at Symphony Natural Health, and she’s the author of six books on various wellness topics, the most recent of which is the Rainbow Diet, which is how I think of her as promoting eating a rainbow of fruits and vegetables. And in fact, I recall being at a lecture she did for Metagenics, must have been 20 years ago with that topic.

Deanna:               I’m still talking about it, Ben. I’m still talking the rainbow.

Dr. Weitz:            Absolutely. I talk about the rainbow too.

Deanna:               It’s tried and true, right? It’s scientifically shown that it’s important to eat fruits and vegetables, and I have a love of plants, which is what I did for a large part of my professional work, my research, working with a variety of different companies, and then now most recently with Symphony Natural Health, as you mentioned, with their plant melatonin. So that’s given me the opportunity to go a bit deeper into what we need to know about melatonin. And as you and I were talking about before we jumped on, there are a lot of melatonin myths out there. So hopefully we’ll set the record straight.

Dr. Weitz:            Sounds good. And I want to commend you for doing a great job with this Review article you wrote, which is, Is Melatonin the Next Vitamin D? Review of Emerging Science Clinical Uses Safety and Dietary Supplements in the journal, Nutrients published in September, 2022. I love the way you compare and contrast melatonin to vitamin D.

Deanna:               So with my background in nutrition science, as I started to get into the research on melatonin, I soon came to reflect on, well, what is melatonin really? Most people think of it as a hormone, but as I began to go through the literature and to understand it at a deeper level, it soon came to me that perhaps melatonin is actually a nutrient. Perhaps we need it. We need to have levels that are fortified throughout our lifespan to ensure better resilience, better mitochondrial function. And it looks very similar to what we’ve done with vitamin D. Vitamin D started out as a vitamin, hence the name, but then later became under this scrutiny of looking at it as a hormone. So I would say that melatonin might be somewhat similar in that it perhaps started as a hormone, but now we start to see all the many applications. And I would even say that vitamin D and melatonin are like brother and sister. One is connected to light and one is connected to darkness, so we need them both.

Dr. Weitz:            So vitamin D is Luke Skywalker and melatonin is Darth Vader.

Deanna:               Wow, that brings in a whole other overlay to light and darkness. I think some people, it’s interesting that you say that because one of the things that we talked about in the article is darkness deficiency. How many people are not getting enough darkness. It’s almost like we may fear the darkness. We don’t actually let ourselves be bathed in the dark so that our retinas can have that connection to the absence of light in order to change the signaling by the pineal gland to produce melatonin. So no darkness, no melatonin.

Dr. Weitz:            Right, right. And that’s because of the artificial light and our phones and our computer screens and everything else that are producing all this artificial light. And a lot of that is blue light, which has been talked about a lot, which inhibits melatonin production.

Deanna:               Yeah, it’s toxic light. We need blue light in the early morning hours, but we need red light in the evening hours. So that’s why we start to think about, well, now we are not even endogenously producing enough melatonin. And as we get older from the age of 40 on, our bodies produce less of it. Now we start to go down and then we are surrounded with artificial blue light. So we’re really between a rock and a hard place. And that’s where things like supplementation and really looking at conscious supplementation with quality melatonin products would be something to start looking at as we get older.

Dr. Weitz:            Yeah. One of the things you pointed out in the article, which I thought was really interesting is that even though we all know about melatonin being produced in that part of the brain called the pineal gland, you point out that melatonin is found throughout the body, and like other brain chemicals, is produced in the gut at much higher levels than it’s actually produced in a brain.

Deanna:               Yeah. 400 times the levels that are produced by the pineal gland, the gut produces a lot, but there is a difference. So the melatonin that the gut produces tends to be used locally in the gut mucosa. The pineal gland manufactured melatonin is used systemically and is keying into different receptors throughout different body tissues in order to inform the body as to the circadian rhythm. So for the gut, it’s much more of a connection to a postprandial response and a local utilization of melatonin and perhaps further signaling, whereas the pineal gland is more specific to circadian rhythm.

Dr. Weitz:            Yeah, it’s interesting. We know that serotonin has all these roles actually in the gut and is involved with gut motility, and I wonder if melatonin is another factor in that whole process.

Deanna:               It is. Actually, you’re spot on. There has been some research to suggest that melatonin has different roles within the gut. Number one, it may be changing up the digestive secretions. Number two, it may be changing up the muscular action of the gut lining because we know that the gut is not just a tube, it’s neurological, it’s endocrine, it’s muscular. So we know that there’s a motility action on behalf of melatonin. Indeed.

Dr. Weitz:            Yes, absolutely. Motility’s a big factor in irritable bowel syndrome and the SIBO that causes a lot of it. I guess one of the things that happens with age is the pineal gland sometimes calcifies, which is kind of interesting.

Deanna:               Yes, there has been discussion about that in the literature and looking at, how do we prevent that? It’s just that it’s not a test that most people are keyed into. It’s difficult enough just to get people to get their nutrient levels tested. So I think when it comes to melatonin, we need to look at just how we live, how we sleep, how we go about our day, and what symptoms we have. A personal history of medical history can tell us a lot about whether or not there might be a melatonin imbalance.

Dr. Weitz:            How do we know if we’re low on melatonin? Is there a good way to test for it?

Deanna:               We have a website. There is a website called phytomelatonin.com. It’s a site of all the research studies that have the latest publications, what’s in the news. And there is a page where we explored testing, looking at urine, looking at saliva, looking at blood. And in general, it’s pretty difficult to get a good estimation of one’s melatonin status because you have to take into account the timing, the time of day, what was eaten, how you process it through the urine. In my opinion, I don’t believe it’s a very reliable measure. I do think looking at consecutive measures over time might be one way to do it. But I do think looking symptomatically to see whether or not people are having blue light exposure at night, are they sleeping poorly?   And you know what else? Many times people have issues with other hormones and for example, cortisol and melatonin have a dynamic. Cortisol is high in the morning, melatonin is high at night. So there is this dynamic. So if we have some change in another hormone, it can potentially pull on the hormone web to change melatonin. So we need to be thinking about that, which is why it’s important during perimenopause, menopause, andropause, very essential to look at that hormone dynamic and how there can be tugging in all kinds of directions.

Dr. Weitz:            And I think maybe the best potential way to test it if there is some benefit would be with saliva, because that can be done at different times of the day. And I’ve seen some of these salivary cortisol tests also include melatonin.

Deanna:               That’s true. But keep in mind that we would need to know at night at the peak of melatonin and more along the lines of a person’s kinetics or metabolism. So melatonin peaks during the time of absolute darkness between 2:00 and 4:00 AM So not many people are up and awake to take a sample to get an accurate read. And even if they had a little bit of light exposure, they can be changing their endogenous melatonin. So it’s not to say it can’t be done, Ben. It can, but there are all kinds of variables and factors to consider to ensure that it’s accurate.

Dr. Weitz:            Absolutely. So let’s go into some of the many benefits of melatonin, and let’s start with sleep since everybody knows of melatonin being a promoter of sleep. And I thought it was really interesting in your paper, you go into some of the benefits of sleep, and you mentioned that melatonin has a hypothermic effect in decreasing core body temperature as part of how it helps with sleep, which is something new to me. I hadn’t heard that before.

Deanna:               Yes. In fact, because it’s connected to lower body temperature, have you ever had that sensation at night? Maybe it’s 9:00 PM or 10:00 PM and you start to get a little cold and I don’t know about you, but I get that sensation and I always know, “Okay, that’s my body telling me I need to go to bed,” right?

Dr. Weitz:            Right.

Deanna:               Because that’s almost like the subtle, it’s called dim light melatonin onset. So even before we’ve gone to sleep, we start to have higher levels of melatonin. They don’t peak until that point of darkness. But as we start to prepare for bed and it starts to get dark outside, and if we’re not exposing ourself to excessive artificial blue light, we already start to get that change in melatonin, which can change body temperature. I often think about perimenopausal women, which I am one myself in terms of night sweats, hot flashes at night, when do they typically occur? They typically occur at around that… For many people that I talk with, it’s around that 2:00 to 3:00 AM timeframe. And while there is no science to suggest that melatonin is implicated in that, we do know that melatonin is implicated in body temperature regulation and there could be some change because perimenopausal and menopausal women are having issues with body temperature and making that transition through their cycle. So there could be some connection there.

Dr. Weitz:            That’s interesting. Yeah, I’m very sensitive to temperature, so I use one of those chilling pads under my sheets to keep an even temperature all night while I sleep. I wonder if there could be benefits to using a timed release melatonin to maybe help with consistent core temperature?

Deanna:               That’s an interesting point. Well, with Herbatonin, which is the plant melatonin, one of the things that is really unique about it is that it’s the cell matrix of the plant. So it has a lot of the other components. It has chlorophyll, it has carotenoids, it has essential fatty acids, so it’s actually the plant not extracted, but in its whole parts. So it allows for that slower release we believe, as it relates to the bioavailability. So the uptake in the gut is a little bit slow, and for that reason, it might be important in the efficacy as well as perhaps what you’re saying, the body temperature. We haven’t actually looked at that, but that’s an interesting point to consider.

Dr. Weitz:            Now, part of how melatonin helps with sleep is that it helps to reset our circadian rhythm, especially when our awakened sleep cycles have been thrown off maybe by irregular sleep patterns or travel. You refer to it in your paper to melatonin as a chronobiotic.

Deanna:               Yes.

Dr. Weitz:            So when it’s being used for resetting our circadian rhythm, how should melatonin be time dosed? Should it be just taken at night? Is there a benefit to taking it during the day, et cetera?

Deanna:               Yeah, that’s a really good question.  So typically, administration of a melatonin supplement would be about an hour before bedtime. It has a half-life of about 40 to 60 minutes, and that can be variable depending on the individual.  So if you take that through the night and sync that up with the waking time, typically, it’s about an hour before bedtime.  Now for people who are night owls, and we know that there are morning larks, people that arise naturally in the morning and have a lot of energy, and then you have the night owls who get their energy at night, so they have difficulty going to sleep and they have that delayed circadian rhythm.  Melatonin may be helpful for those individuals, and they might take it earlier than that one hour before bedtime in order to reset their circadian rhythm to an earlier phase.  Now, people that do shift work like nurses and so many other people, like people that work in casinos especially, I often think of that where they’re in artificial light.

Dr. Weitz:            Let me just stop you one second.

Deanna:               Yeah.

Dr. Weitz:            So let’s say your goal is to go to bed at 10:00, but you end up not falling asleep till 12:00. So you would take the melatonin maybe at 9:00 to get yourself more likely to fall asleep at 10:00, is what you’re saying?

Deanna:               Well, and I would say that if you tend not to get sleepy until later like closer to midnight, to even take that melatonin earlier.  It might bring the circadian rhythm closer in, so then it makes you tired earlier. You get to bed earlier. And for some people, they just have inherently, their circadian rhythm is programmed a little bit differently.  But I would say, Ben, that the studies suggest that veering more towards morningness this rather than eveningness is a marker of better health outcomes overall.  Of course, there’s a lot of personalization to that, but if we can prime our bodies to go to bed between 9:00 to 10:00 PM and wake up between 5:00 and 6:00 AM, then that aligns to, for the most part, depending on the season, the natural rhythm.  So for most people that naturally get tired at that time, I would say that having melatonin an hour before bedtime. But if somebody has a delayed phase where they don’t get sleepy until 11:00 or 12:00 and they’re wired up, then even starting melatonin supplementation a little bit earlier, and they may have to change and just try out different hours that make sense for them, based on their own kinetics.  But I would try it a couple of hours before.

Dr. Weitz:            So for each of these benefits, I’d like to get a sense of what the dosage is. So when we’re using melatonin for sleep, what would be a good dosage?

Deanna:               Yeah. Well, what I believe based on the literature and the safety of melatonin supplementation, I would say the lowest dose for the shortest duration. And a lot of that work is based on Dr. Richard Wurtman at MIT over the years who did a lot of this groundbreaking research in the early 2000s with his research team. There was one pivotal study that we talk about in this review paper where they looked at 0.3 milligrams versus a higher dose of three milligrams, and they found that the lower dose conferred greater benefit for sleep. So I would veer more towards that physiologic dose as well and do the 0.3 milligrams as a physiologic dose. And if you look at how we produce melatonin just in our bodies through the lifespan, having 0.3 milligrams helps to replenish what we’ve lost.    Now, if we need additional help or we are jet-lagged where we need to reset circadian rhythm to sleep better, that’s a little bit different, then I would veer more towards a three milligram dose in order to really have that reset of the circadian rhythm. But if we’re in our everyday lives and we just want additional fortification, 0.3 milligrams.

Dr. Weitz:            What if we were also trying to get some of the antioxidant benefits as well, and we’ll go into some of these other potential benefits.

Deanna:               Yeah. And just to summarize them, so melatonin is anti-inflammatory, it is an antioxidant and as you mentioned, a chronobiotic and a mitochondrial regulator. And that’s what people are doing, is they’re trying to really access those other benefits of melatonin through supplementation. So there may be, depending on the individual, their age, their gender, their cytochrome P450, kinetics, their lifestyle, their artificial blue light exposure. And again, in the paper, we go through a number of those different personalized lifestyle factors that we might think about in functional medicine. But sure, there could be a case for perhaps short-term use of higher doses.  And you and I were speaking about some of those doses, which some practitioners have used supraphysiologic levels and have used that with different patient groups for various indications. There isn’t a lot of data on long-term… In fact, there’s no data that I’m aware of with long-term use with high doses in that regard. Often if you look at the work of Dr. Paolo Lissoni and his work looking at patients with cancer, often those were certain types of cancer, certain types of chemotherapy under certain very targeted durations. So I think it has to be like you. You’re a practitioner, it has to be under practitioner supervision if there were going to be higher doses and what that indication might be for exactly.

Dr. Weitz:            Yeah. So one of the benefits of melatonin and its antioxidant properties, it appears to be with brain health, and you write about how it may aid the glymphatic process. For everybody who’s not aware, the brain has a natural detox process that occurs during REM sleep, especially where the glymphatic immune part of the brain helps to clear out toxins and melatonin aids this glymphatic process to help degrade amyloid beta and thus may prevent or delay dementia or Alzheimer’s disease.

Deanna:               I think it’s exciting. This is very cutting edge and emerging research looking at the glymphatic fluid and how when we sleep is when our brain detoxifies, it gets rid of a lot of these toxic beta amyloid metabolites, Tau proteins that have been hyperphosphorylated. So what there seems to be an indication of in the literature, and again, this is very nascent, we still need more research, but what we can see perhaps from more preclinical work is that melatonin may actually play a role in the glymphatic fluid. So that might be by way of carrying out these different metabolites.

                              Now, one other thing that I didn’t mention in the paper with my colleagues is this whole idea of rejuvenation and repair at night. I’m sure that most of your listeners are aware that the greatest repair time for the body is typically nighttime. And I do think that melatonin plays a role in that. And there was a more recent study that just came out, which is why it’s not in the paper, which showed that at about that 2:00 AM time point is where you start to see not just melatonin peak, but you also see glutathione peak. You see other enzymes like superoxide dismutase catalyze. I think glutathione peroxidase was another one. So it seems as though melatonin is very important for nighttime repair processes together with a lot of those other antioxidant defense enzymes and compounds, which also seem to rise at night.   So there’s a reason why we need sleep. It’s not just to process and condense memories, there is a physiological physical basis for sleep that may be connected to what you and I, Ben, have been talking about through the years, which is even detoxification.

Dr. Weitz:            And I can see melatonin being maybe added to liver detox programs, added to Alzheimer’s prevention reversal programs.

Deanna:               Yes, absolutely. It’s interesting because in the world of metabolic detoxification, we often think of the liver, we think of the gut, we think of the kidneys, the skin, but the brain is also part of the detoxification web. I think it’s essential. And of course the gut-brain connection is key there. And just to back up to something that you said about the gut, there is some research looking at the role of melatonin supplementation for IBS and even looking at GERD, gastro esophageal reflux disease. So there may be some indication where having melatonin in the gut supplementally may be of benefit.

Dr. Weitz:            Interesting. I’ll be talking to Dr. Pimentel in a few weeks.

Deanna:               Okay.

Dr. Weitz:            So melatonin has benefits in preventing migraines.

Deanna:               Migraines is another one, tinnitus, any kind of neurological issues we want to be thinking about.

Dr. Weitz:            Tinnitus is a really tough one too.

Deanna:               It’s very tough.

Dr. Weitz:            There aren’t a lot of tools.

Deanna:               Yeah. And also let’s not forget about the eye as part of the nervous system. So since we’re covering off brain health, we’re talking about migraines, headaches, tinnitus, there’s also the eyes and so many more people, I don’t know if you’re seeing this with your patients, but so many more people are having eye disorders and diseases. And I don’t know if that’s because of all of the blue light exposure that we’re getting through our devices and technology, but our retina is the key starting place for the reception of light or darkness, which then can change the signal to the brain. So it’s really important to even be thinking about eye health. And what’s really neat with Herbatonin, which is the supplemental plant melatonin, is that it contains other actives for the eyes like lutein and Zeaxanthin, to embed into the retina to actually protect it from blue light. So there’s also a value add.

Dr. Weitz:            Which particular eye conditions has been studied with? Is it macular degeneration in particular, other eye conditions?

Deanna:               I think that there were more for inflammatory eye conditions and also looking even at potentially glaucoma. Separately, I believe that the one that’s on the rise is age related macular degeneration, which theoretically, we might think that there could be some benefit there. Of course, I do think, again, I’m speaking to the science and many times, science is 20 to 50 years ahead of what we see done in the clinic. But we’re already starting to see that there’s this inkling of, well, if it’s an anti-inflammatory and it helps with inflammatory response, anything potentially that may involve that mechanism may be beneficial as we start thinking about melatonin. That we might see a beneficial response with melatonin.

Dr. Weitz:            Cool. You have a chapter, a few paragraphs, a section on cardiovascular health and that melatonin has some potential benefits for heart health. In particular, you mentioned that it decreased nocturnal hypertension, which is a underdiagnosed, potentially dangerous form of hypertension.

Deanna:               Yeah. And there can also be some connection to cardiometabolic health, even through blood sugar regulation. That can depend on gene variants and receptors and things of that nature. More recently, there was some work on body composition, which makes sense to me because even if we’re changing sleep or if we’re changing inflammation in the body, we know how important that would be for things like body composition and making sure that people have adequate and healthy muscle to fat ratios.

Dr. Weitz:            Yeah. The article also mentioned that melatonin may improve endothelial function in patients with heart failure. And heart failure is one of those really sad conditions, and we could certainly use more tools to help with that.

Deanna:               That’s right. So again, a number of different things, blood pressure, and if we’re changing endothelial function, we are changing so many different aspects about vascular functions. So indeed.

Dr. Weitz:            That could be part of our long Covid protocol too.

Deanna:               Well, it’s funny you mentioned that because melatonin is beginning to be looked at as it relates to long Covid. And if you look back at some of the initial papers just recently over these past years looking at Covid, there is a connection with vitamin D, zinc, vitamin C, and melatonin was brought into a number of those protocols. So it was interesting to me, to see that right together with vitamins, minerals, and all of a sudden melatonin comes in, which makes me think, again, is it a nutrient? And what about the obvious, which is immune health. Because melatonin is playing a role in inflammatory response, antioxidant and free radical scavenging. It’s obvious to me that there could be some connection to immunity.

                              And in fact, I would say that even more than sleep, in some ways, the preponderance of data on melatonin is in that direction of its role in circadian rhythm and also immunity. So it makes good sense. And I even had conversations with other people in our space about autoimmune conditions. So I talk in the paper about multiple sclerosis, potentially. There’s more coming out on that. So it can cross a blood brain barrier, which is why I think it’s important for those kinds of neurological and immune conditions.

Dr. Weitz:            And MS has this seasonal relapse and correlate with the light dark cycle. And then we also have the connection with vitamin D and MS as well.

Deanna:               Lots of dots to connect on that one. Yeah, absolutely.

Dr. Weitz:            It looks like from some of the articles I saw, that the dosage for some of those purposes is more like 10 milligrams. And then I know for Covid, they were talking about, I think 20 to 50 milligrams was being used.

Deanna:               Yeah. And I think for short term use, having that as part of a protocol with other nutrients and again, under the supervision of a healthcare practitioner, makes sense.

Dr. Weitz:            Yeah. I talked to Bob Rakowski one time and he’s been taking 50 milligrams for years just as a longevity protocol.

Deanna:               Oh, my. Okay. Well, we know how vital Bob is.

Dr. Weitz:            So fertility and pregnancy. In the article, you mentioned you use melatonin as supplemental melatonin being both safe in pregnancy for both the mother and the fetus, which is interesting because conventional wisdom would be, no, no, you can’t use that during pregnancy because it’s a hormone, et cetera.

Deanna:               Well, I think what we talked about more was fertility, for melatonin supplementation to play a role in a woman getting pregnant. I would say that we’ve checked in with a number of different physicians who are expert in this fertility space, and a number of them, they don’t express concern about melatonin and supplementation at very modest doses during pregnancy, but we don’t have a lot of literature on that particular group. So I think about it more in the fertility and actually getting pregnant, and also dealing with a number of conditions that can result in infertility, looking at polycystical variant syndrome because of its role with the inflammatory response with blood glucose control. I think that even endometriosis, there’s some initial work being done on that.

Dr. Weitz:            Yeah.

Deanna:               Yeah.

Dr. Weitz:            You mentioned in the article, one study showed 95% decrease in menstrual irregularities in patients with PCOS who took melatonin for two months. The endometriosis study was 10 milligrams, and at least one study showed a reduction of endometriosis pain by 40% with 10 milligrams of melatonin over two months. So it looks like there are potentially lots of hormonal benefits.

Deanna:               There can be, and again, we don’t want to paint the picture of melatonin as a panacea for all conditions, but I do think that the literature is stacking up and quite promising for a number of conditions that we might not have already thought about for melatonin supplements.

Dr. Weitz:            Right. And I think on the pregnancy thing, I think the angle was that it may help with some of the blood pressure issues that sometimes occur with pregnancy.

Deanna:               And I believe there was some talk about preeclampsia as well, right?

Dr. Weitz:            Right.

Deanna:               Yeah. Just getting at the whole picture of cardiometabolic health.

Dr. Weitz:            Also bone health and perhaps melatonin may be part of a protocol for helping patients with osteopenia, osteoporosis.

Deanna:               And that makes sense because of, again, the osteoblast-osteoclast dynamic with osteoclastic activity being upregulated with inflammation. And perhaps I’m personally most excited about that connection, especially with perimenopause and the changes in bone, the changes in vasomotor symptoms, cardiovascular symptoms. It just makes sense to me that that could fit very nicely into one’s healthy aging protocol, is to be looking at melatonin as a way of filling the gap and helping with improved inflammatory response.

Dr. Weitz:            Also, vitamin K, super important. I recently had a discussion on vitamin K on the podcast with Cristiana Paul, and we went a deep dive into what form and how much of vitamin K, but I think vitamin K is being underutilized for osteoporosis.

Deanna:               And several years ago, I had a blog that was, is vitamin K, the next vitamin D? Because I was also connecting into the hormonal aspects of vitamin K and the pleiotropic effects. And then you have different forms of vitamin K, different food sources, even of the different kinds of vitamin K. It does a lot of different things, and it works hand in hand with vitamin D.

Dr. Weitz:            Absolutely. Yep.

Deanna:               So what would happen if we put melatonin, vitamin D, and vitamin K in a protocol, right?

Dr. Weitz:            There you go.

Deanna:               That might be interesting for bone overall.

Dr. Weitz:            Oh, absolutely. Add some strontium citrate and maybe a little boron and some calcium magnesium.

Deanna:               Oh, absolutely. Yeah.

Dr. Weitz:            So the big C, as we know, cancer is one of the major killers today, and it looks like there’s some really impressive research on melatonin for cancer. I was just reading an article this morning and they had this chart of all the different pathways by which melatonin may actually have a beneficial effect on cancer, and it was amazing. It kind of reminded me of the chart on curcumin I’ve seen on that. And it looks like melatonin, even though it’s an antioxidant, has been shown to enhance the effectiveness of chemo in certain cases. And I know the dosage for cancer is quite a bit higher. And we were speaking off-air, that I had spoken to Dr. Paul Anderson not too long ago, and he had said that the recommended dosage now for cancer patients is at least for some patients, in the 100 to 300 milligram range. Whereas for years, I had always heard for sleep, it should be three milligrams, for cancer, maybe 20 milligrams, and now we’re looking at a 100 to 300 milligrams and possibly seeing some really amazing benefits.

Deanna:               Yeah, I think it’s interesting, and again, Dr. Lissoni is one of the people that I lean on. He has been doing this work for three decades in people undergoing chemotherapy and doing a certain dosing protocol before the chemotherapy starts in order to help with the receptivity of the chemotherapy. So higher doses, double digits, usually. Not triple digits, as you mentioned. I believe in his studies, I recall seeing 20 to 50 milligrams on a daily basis, but now that’s some time ago. And so I’m assuming that people like Dr. Paul Anderson and others in that field of oncology, it’s of interest to try out different doses in different people. I think under that type of, again, supervision, that’s not something that would be advocated for the average consumer.

Dr. Weitz:            Obviously, yes.

Deanna:               But working with somebody’s healthcare practitioner to help navigate that space and to perhaps try out different levels based on kinetics, I think it makes sense.

Dr. Weitz:            Yeah. None of the recommendations here are to-

Deanna:               Definitely no.

Dr. Weitz:            To be used by consumers to help with healthcare problems. You should consult your doctor on the use of an melatonin or any other nutritional supplements.

Deanna:               Ben, I just want to say one more thing before we move off that topic.

Dr. Weitz:            Yes, yes.

Deanna:               When it relates to cancer prevention, so if we think of shift workers. What we see in the literature is that there is an association between shift work and increased risk of certain kinds of cancer like breast cancer. So I often wonder how much that circadian distortion does change our biology, our physiology, what’s happening and how that could be impacting it significantly within that realm. The other thing that Dr. Russell Reiter. Now, Dr. Reiter is I would say, and it’s R-E-I-T-E-R, he’s brilliant. And whenever I talk about melatonin, I can’t help but mention Dr. Wurtman and Dr. Reiter because they have really created much of this ground level research for understanding. And Dr. Reiter has talked about how even having melatonin may change the metabolism of cells as it relates to the Warburg Effect.

                              And so changing, being able to remove some of those metabolic blocks in cancer cells, or at least to bring the metabolic pathways back into better regulation, which is so interesting. And it makes sense because if we know that melatonin is highly concentrated in the mitochondria and that’s the hub of metabolism, then it makes sense that melatonin could have an impact there.   Really important.

Dr. Weitz:            For health, for longevity, as well as cancer prevention, for sure.

Deanna:               Yeah.

Dr. Weitz:            So let’s finish up by talking about plant melatonin, phyto-melatonin and how that’s different than other melatonin.

Deanna:               So most of the supplements of melatonin on the market, and this is just even looking at Amazon, most of them are synthetically derived, meaning that you’ve got big chemically oriented factories cranking out melatonin from different petroleum based substrates. So they’re chemically synthesized. And by way of that process, two things are happening. One is that you can get the formation of toxic metabolites, and there was one publication that we cited in the article with at least 13 different contaminants that can arise from that process. Secondly, it’s very polluting and not very good for the environment to have these big factories. It’s cheap to do that.  Back in the late 1950s, people had extracted melatonin from the pineal gland of animals, but then there were issues with prions and viruses and all kinds of different issues. So then there needed to be some other strategy to get melatonin, and it was through this chemical synthesis. And not to say that’s always a bad thing. There are certain nutrients that can be created without that kind of problem, but with melatonin, there can be a number of things that fall out of that. So people are buying a poor quality melatonin product, and it’s from a company where they’re not testing for these other contaminants that might be problematic.

                              So with Herbatonin, this is a brand of plant melatonin that is directly from rice, chlorella, and alfalfa. So it’s the same melatonin that’s in our bodies with the added benefit of the other plant constituents. So it’s vegan for those who are vegan, and it also has a bit more of a complex plant matrix. So the digestibility and the bioavailability, we presume, is different than just taking straight on melatonin. Some of the melatonin products that are on the market might have more than just melatonin in the product, which we don’t really know how everything interacts or are you actually dialing down the function of melatonin if you have other things in there.

                              So anyway, it’s just good to know what you’re getting to get the quality. So with Herbatonin, it’s been tested side by side against synthetic melatonin and found to be 646% better in terms of its anti-inflammatory response, up to 470% better in terms of free radical scavenging. And even in a skin cell model of looking at reactive oxygen species, having a 100% better effect relative to synthetic melatonin. Now, that was not in my paper, that was in a different paper published in Molecules 2021 by a different researcher, just doing head-to-head cell assay studies just to look at the comparison. So yes, you want melatonin, but you don’t want the toxic metabolites, and you want the amplified activity of all of these other benefits of whatever comes along for the ride in the plant.

Dr. Weitz:            Now, does this plant melatonin come in a range of strengths?

Deanna:               It does. It has a lower strength, the physiologic strength, and then it has the more increased strength, more for jet lag and other kinds of applications. So 0.3 milligrams, which is based on the research and three milligrams, which is the higher dose to be used in specific applications.

Dr. Weitz:            Okay, cool.

Deanna:               Yeah.

Dr. Weitz:            Great.

Deanna:               You need to try some, Ben. We need to have you try some Herbatonin.

Dr. Weitz:            Okay.

Deanna:               It’s become my mainstay, that’s for sure.

Dr. Weitz:            I’ll add it to my 30 or 40 other supplements I take twice a day. I’m on the longevity train, I’m doing it all.

Deanna:               Everybody else has that goal of 120 years. I think for me, I just want to live a good quality life. When I’m done what I needed to do, I’ll know.

Dr. Weitz:            I never plan to be done needing to do what I want to do.

Deanna:               Oh, well, that’s a good point. And there are so many concepts as it relates to healthy aging, right? There’s lifespan and then there’s healthspan, and you want those two lines to be going together. You don’t want to have a lifespan without the healthspan.

Dr. Weitz:            Of course. Yeah. You focus on biological aging, for sure.

Deanna:               Yeah, I like that for sure. Yeah.

Dr. Weitz:            Okay. So thank you Deanna, and any other final thoughts for our listeners and how can they find out about if they want to get more information about you, your website, and more about phyto-melatonin?

Deanna:               Well, I’m surprised you didn’t ask me about-

Dr. Weitz:            Is phyto-melatonin… Go ahead. I’m sorry.

Deanna:               Well, I just want to say one last thing before we segue into that. You didn’t ask me about blue light blocking glasses.

Dr. Weitz:            Oh, okay.

Deanna:               Do you wear those? Do you do that, personally?

Dr. Weitz:            I don’t.

Deanna:               You don’t? Well, there’s actually.

Dr. Weitz:            I never have any trouble falling asleep.

Deanna:               Yeah, I agree. But are you on a computer late at night? So blue light blocking glasses are going to defray. I just want to mention it as part of a lifestyle strategy for some people where they feel really boxed in like, “Oh, wow, she’s telling me I have to be in complete darkness when it starts to get dark or dark outside.” So two strategies which can work very well hand in hand if you can’t correct your lifestyle and reverse that, there can be all kinds of things. Dim the light on your computer. There is science on blue light blocking glasses. And so having those on to trick your retina into thinking that it’s red light instead of blue light, and then a quality melatonin supplement to help your body to naturally have the levels that you need to prime circadian rhythm and keep you healthy, especially as you get older when we don’t have those same curves in place.

Dr. Weitz:            Yeah. And there are blue light blocking filters you can use on your phone or on your computer as well.

Deanna:               Yeah, you can. I’m really sensitive to that lately. I mean, I just think we’re never going to have technology go away. We’re not going to work by candlelight. So it’s nice to think about all those things.

Dr. Weitz:            Yeah. I’m not going to go around the house and put red light bulbs in. I think somebody talked about doing that.

Deanna:               There’s that. Well, my husband actually, we have a light system in our house under Phillips, it’s called Hue, where through an app, we can change the light intensity and the light color. It’s kind of cool, actually. I like color, so for me, I like it for that reason.

Dr. Weitz:            Okay.

Deanna:               But anyway, all kinds of different biohacks out there, as we might like to call them. But long story short, yes. Hopefully, this has been informative, that people get a better sense of what melatonin can do. Things to look for in a supplement. I did mention Herbatonin. How do they find me? Through my website, deannaminich.com or even the symphonynaturalhealth.com website where they can find out more about Herbatonin, bring it up to their practitioner if they’re interested, or they just want to try it on their own. Yeah, I think that-

Dr. Weitz:            Is Herbatonin only sold through practitioners?

Deanna:               No, no. You can find it also on Amazon.

Dr. Weitz:            Okay.

Deanna:               But for practitioners, there’s a different way that it’s packaged. And yeah, we have a symphonynaturalhealthpro.com, which is for health professionals and has different types of information there, but most people can find the product online or through the symphonynaturalhealth.com site too.

Dr. Weitz:            Great. Thank you, Deanna.

Deanna:               Thank you, Ben. Good talking with you.

Dr. Weitz:            Same here, thank you.



Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review. That way, more people will discover the Rational Wellness Podcast.  And I wanted to let everybody know that I do have some openings for new patients, so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardiometabolic conditions, or for an executive health screen, and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way. And that usually means we’re going to do some more detailed lab work, stool testing, sometimes you’re in testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective.  So if you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111, and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.