Archive for category: Rational Wellness Podcast

Podcast: Play in new window | Download | Embed

Subscribe: RSS

Dr. Paul Anderson discusses An Integrative Approach to Cancer at the April 28, 2022 Functional Medicine Discussion Group Meeting 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

12:55   While in early cancer care, conventional care has a reasonably high rate of success and the protocols are fairly standardized, in stage four cancer care there’s just as much experimentation and unknown in standard of care oncology as there is in Integrative cancer care.

14:00   We need to share with patients that while we don’t know how their case will go, we know a lot more and have a lot more tools to help patients with cancer, but being realistic is a difficult balancing act. When patients ask if he can cure their cancer, Dr. Anderson will typically answer that curing cancer is above his pay grade, but that we can help to improve your quality of life and when that is done, we often see cancer markers improve as well as cancer outcomes.  For patients with stage 4 cancers who kind of know how things are playing out, they want to have as much energy and they want to be on as little medication as possible.  For patients with curable cancers, they may have other outcomes that are important for them.

19:03  The patients who did the best with an Integrative Oncology approach have addressed the three main foundational pillars, which are the following:

1.  Food.  Your diet should be low glycemic and it should be as clean as possible. We also know that doing at least a 13 hour intermittent fast daily is associated with longer life and better survival in cancer patients.  

2.  Muscle.  For all chronic diseases, but especially in cancer, that I think we all realize now that whether it’s cancer or not, but especially in cancer, the more muscle metabolism you work yourself through and the less fat metabolism you work yourself through, the better your survival and the better your quality of life. And so this doesn’t mean the person has to be a power lifter. It just means they need to move their body.  

3.  Brain.  How you think about cancer and how empowered you are as a cancer patient will affect your outcome.   

The cool, high speed, high expense therapies like IVs, hyperbaric and hyperthermia will work better in the setting of these foundational things being attended to.

 

35:22  While chemotherapy and radiation will decrease the size of tumors in many cases, we know that in the long run, they are associated with the more likely return of more aggressive cancer. That might be months later, it might be years later, but we know that happens.  We need to be supportive to those therapies but also supportive to their normal tissue so that we don’t get recruitment of cancer cells by emboldening the cancer stem cells with the chemo and the radiation.  While cancer patients are undergoing active treatment, we often focus on reducing side effects, like mucositis, and enabling the patient to tolerate the therapies. Whatever we can do to improve their quality of life will be helpful on the back end.  What is done from an integrative perspective, unless you’re doing something really strange, you’re actually not going to interfere with anybody’s chemotherapy or radiation for the most part.  For every 100 units of concern that a radiation oncologist has or a medical oncologist has with you interfering with their very powerful therapies, there’s probably two or three units of actual concern that need to be had. Now, that doesn’t mean they’re going to buy that, but you need to have that conversation with your patient.

38:54  Antioxidants. The concern that most radiation oncologists and medical oncologists have is usually around antioxidants, since one of the mechanisms by which radiation and chemo kill cancer cells is using free radicals, there is concern that antioxidants will uncouple these therapies.  Often patients are told not to take any nutritional supplements because of this concern, even those that are not antioxidants, like glutamine and fish oil.  You might be best off having a conversation with your patient early on that there is a difference in world view between the oncologist and you, the Integrative practitioner, and that while the oncologist is going to be sure of what they believe, but that this information about antioxidants has a low level of scientific validity. Unfortunately, all doctors are not on the same page.  Dr. Anderson will often tell the patient that it is they who have the cancer, not the oncologist.  Radiation oncologists tend to be particularly hostile to the use of any nutritional compounds. Medical oncologists are on a huge spectrum and some are so extreme that they don’t want you to eat salads or any foods that have antioxidants, which makes no sense at all, while others do not have a problem with nutritional supplements.

42:19  During chemotherapy, Dr. Anderson tends to focus on using supplements that help reduce some of the side effects, like mucositis with L-glutamine and probiotics, as long as they have a good white blood cell count and demulcent herbs. During radiation, Dr. Anderson tends to use nutrients that help to potentiate the radiation, like milk thistle, curcumin, and boswellia.  Most of these nutrients would be taken daily several times per day.  The dosage for milk thistle is 400-600 mg 2-3 times per day.  Milk thistle is a really good is a radiosensitizer and a healing agent and it also keeps the vitamin C glutathione cycle really humming along.  He also like to use IV vitamin C on the Mondays of the week when they get radiation at a starting dosage of 25 grams and going to 50-75 grams.  

44:32  Is Glutamine contraindicated in cancer?  Unless the person is on a high sugar diet, glutamine is a non-issue in cancer.  Glutamine only becomes a fuel for cancer if they are on a high sugar diet.  And the same for glutathione.  What we know is that tumors can pump out glutamine and glutathione into the extracellular space, but this has nothing to do with the glutamine and glutathione that we might supplement these patients with. We should use glutamine during treatment, esp. if the patients have mucositis, 3 or 4 grams 3 or 4 times per day, but once their treatment is done and they start to heal, we back off on that dosage and discontinue.  The concern that some doctors feel warrants not using supplemental glutamine is that research shows that glutamine can feed tumors is based on glutamine feeding tumors that is produced by the tumors and not from ingested glutamine.

49:12  Fasting before, during, and/or after chemo or radiation. Even major cancer centers are recommending some sort of fasting or intermittent fasting around active treatment to reduce the side effects of treatment and also to enhance the effectiveness of the treatment. But you have to ask people what they are able to do. Some people can fast easily and like it, while other people might say that all that they can do is a 13 hour fast daily, which is still very helpful.  A good tool is Dr. Valter Longo’s Fasting Mimicking Diet, called Prolon.  It feels like they’re eating but it’s more like a fast. As far as diet, Dr. Anderson recommends either keto or low carb or modified Mediterranean. Low glycemic. Moderate in protein, since protein can be converted into glucose.  Lots of low glycemic vegetables.  Lots of herbs. Small amounts of low glycemic starches or none. Very small amounts of colorful fruit.  At least a 13 hour fast daily from dinner till eating the next day, while drinking a lot of water. Doing a short term water fast for one to three days is very helpful, such as one day prior to treatment, the day of treatment, and one day after. Or just fasting one day prior to treatment is still good. Dr. Anderson has a bunch of free articles and also paid courses on many of these issues, such as about vitamin C and other antioxidants and chemo and radiation on his ConsultDrAnderson.com website.  He also has some articles and courses on IV vitamin C and on how to detox after chemo.

55:03  During recovery from cancer treatment is a good time to reverse some of those things that chemo and radiation do, which is to make the cancer stem cells more bold.  During chemo and radiation the cancer stem cells go and hide and wait and are largely unaffected.  You want to make your normal cells more cancer resistant to keep the cancer stem cells from coming back.  You want to focus on healing from the treatments.  Do they have radiation burns?  Do they have leftover mucositis?  Do they have mucositis induced diarrhea that won’t stop?  Is their microbiome all messed up?  By cleaning up and helping to fix the quality of life issues, you also are actually getting at healing the normal tissues.  And the more you do that, the more you make them resist cancer stem cells.  It’s also important to bring back mitochondrial function, which will help to restore their energy.  Dr. Anderson has developed a radiation recovery formula via IV that includes nutrients and glutathione he developed for radiation burn patients, but this is after they’re done with radiation.

1:02:54   Will natural treatments or supplements interfere with some of the newer targeted therapies being used for cancer patients?  Some of the targeted therapies are synergized by natural substances, such as curcumin and melatonin and it is unlikely that natural supplements will interfere with these therapies. For melatonin for cancer, Dr. Anderson usually recommends 20 to 60 mg up to 300 mg per day.  Dr. Shallenberger has a good presentation on high dose melatonin: High Dose Melatonin Therapy.  Melatonin is particularly effective with breast and prostate cancer. 

1:09:00  There are three main theories of oncogenesis: 1. Genomic Theory, 2. Metabolic Theory, and 3. Cancer Stem Cell/Trophoblastic theory.  Each of these theories have a place and there is not one theory that wins. 

 

 

---

---

Dr. Paul Anderson is a Naturopathic Doctor, Medical Director & Founder of Anderson Medical Specialty Associates (AMSA). He is a recognized authority in the field of integrative cancer research and the treatment of chronic diseases, genomic conditions, and auto-immune and infectious disorders.  Dr. Anderson has written three books, Outside the Box Cancer Therapies: Alternative Therapies That Treat and Prevent Cancer, which he wrote with Mark Stengler, Cancer, The Journey From Diagnosis to Empowerment, and the recently released Cancer, The Journey from Diagnosis to Empowerment. Dr. Anderson also offers 80 different courses on a wide variety of aspects of a Naturopathic practice, including on biofilms at ConsultDrAnderson.com.  Dr. Anderson also has a hub website, DrANow.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 everybody to the Functional Medicine discussion group meeting tonight on an integrative approach to cancer care. I’m Dr. Ben Weitz, and I’m very happy to be joined by Dr. Paul Anderson, naturopathic physician and expert on an integrative approach to patients with cancer. I’ll make some introductory remarks before introducing our sponsors for this evening, which are Integrative Therapeutics and Vibrant America. And then I’ll introduce our speaker. I encourage each of you to participate and ask questions by typing in your question in the chat box.  And then I’ll either call on you or simply ask Dr. Anderson your question when it’s appropriate. So thank you for joining the Functional Medicine discussion group meeting, and I hope you’ll consider attending some of our future events. On May 26th we’ll be speaking about functional maternity with Dr. Sarah Thompson. And June 23rd, we’re going to have Dr. Ali Rezaie, who’s one of Dr. Pimentel’s partners, and he’s going to give us an update on some of the new, exciting research on SIBO and IBS.

And he and Dr. Pimentel have just published a book. If you’re not aware, we have a closed Facebook page, The Functional Medicine Discussion Group of Santa Monica that you should join, so we can continue the conversation. 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. And if you listen to a Rational Wellness podcast, please give me a ratings and review on Apple podcasts. And so now I’d like to introduce Steve Snyder of Integrative Therapeutics, to tell us a little bit about some integrated products. Steve?

---

 

Steve Snyder:                    Hello everyone. Just real quick. We actually have … this is a good topic for us. We have a line of products that were developed by Dr. Lise Alschuler, who’s a naturopathic oncologist and also happens to be a cancer survivor. And her idea on this was, there’s more and more people that are actually surviving cancer treatment these days. And they come out of this treatment and they’re trying to find the best thing for them, and their primary care doctor typically doesn’t have any clue. So they end up going to Whole Foods Market and some high school kid tells them to take this multivitamin.  And so her idea was to scour the research, come up with formulations for common issues that face, what she calls Thrivers, and that were sort of dual purposed to address the issue that they’re facing, as well as to have some chemo protective properties. The product line is called ProThrivers’s Wellness. There’s four products. There’s a multivitamin, that’s unique in what it doesn’t contain. So no beta-carotene, no copper, no boron, things that maybe generally the research suggests are not good for cancer survivors to be taking.

There is a product called the flavonoid complex, that is CoQ10, glutathione, resveratrol, green tea, theracurmin, and the alpha-glycosyl isoquercitrin altogether, kind of in a synergistic combination of antioxidant, anti-inflammatory ingredients, that people are probably taking multiple tablets to get to. And then there’s a couple targeted products. There’s a ProThriver’s sleep that uses a high dose melatonin, that’s typically kind of an antioxidant dose for cancer patients, that’s designed to help with people that come out of cancer treatment with insomnia. And then there’s a ProThriver’s brain formula that deals with chemo brain. And that has the Lion’s Main Mushroom, acetyl-L-carnitine, some citicholine. It also has theracurmin.  So those are really interesting products. If you’re treating patients that are survivors, these are really something you want to look at. We don’t typically recommend them other than the multi for people that are in treatment, but once they’re out, these are great options. And then the other one that comes up all the time is theracurmin. And almost every talk we have, theracurmin comes up, because the research is ridiculous. But there’s research on theracurmin in prostate cancer, biliary cancer, esophageal cancer, liver cancer. So it’s a really, really important product for people that are dealing with this stuff. So anybody have any questions, you guys know how to find me, but that’s just wanted to make sure everybody knew about those.

 

---

 

Dr. Weitz:                            Okay, great. Thanks, Steve. And Integrative Therapeutics is one of the few brands that we carry at our office. Now we have Margo Haswell of Vibrant America. Margo, are you there?

Margo Haswell:                 I am. Yeah. Thank you Dr. Weitz.

Dr. Weitz:                            Thank you.

 

---

 

Margo Haswell:                 Thanks for everyone for joining. So my name’s Margo, I’m the rep in Los Angeles for Vibrant America. We’re a full service lab offering functional medicine tests. Pretty much everything under the sun, under one roof. We’re CLIA certified. So our focus initially was on early diagnosis of chronic disease like Celiac, Lyme. We had some other tests as well. We’ve published several studies, validating our tests with the Mayo Clinic, Hopkins and Columbia University.

Recently, we’ve shifted our focus towards longevity. So specifically around reducing inflammation and oxidative stress. So we offer tests that look at toxic burden. We just came out with a new nutrigenomics profile. We offer testing for chronic inflammation, things like that. We do offer a $400 coupon, so you can try it out. You could do a clinical consult if you want, to basically try the test out on yourself and see what you think. So if you’re interested, I’m going to go ahead and put my email and my phone number in the chat. And I’ll go ahead and put our website as well, so if you want to open an account, we just need an NPI number. All right. Thank you.

 

---

 

Dr. Weitz:                            Thank you, Margo. And I vouch for Vibrant. We use their testing all the time. Everybody’s talking about, how do you coordinate all these different tests into some platform. You just have to get all your tests from Vibrant and they pretty much have everything. You can get all the full panels that you would get looking at cardiometabolic factors. They’ve got a great micronutrient test, that’s better than the old Spectracell test was. They’ve got the full Lyme testing. They’ve got the toxin testing, the mycotoxins. They got this great trio of toxin test, the toxic burden test through urine and it tests heavy metals, mycotoxins and environmental toxins. It’s really a killer test.

So our speaker for this evening is Dr. Paul Anderson, who’s a naturopathic physician, medical director and founder of Anderson Medical Specialty Associates. He’s a recognized authority in the field of integrative cancer research and the treatment of chronic diseases, genomic conditions, and autoimmune and infectious disorders. Dr. Anderson offers a large number of courses on his website, Dr.Anderson.com. So there are many aspects of naturopathic, functional medicine practice, including integrative cancer care. He’s an author of a number of books, including Out of the Box Cancer Therapies and his latest book is Cancer, the Journey from Diagnosis to Empowerment. Dr. Anderson, you have the floor.

Dr. Anderson:                    All right, well thank you. Thank you everyone for joining this evening. I know how these evening things are. So what we’re going to do, I’m going to switch the screen over. I’ve got some slides just to kind of keep me on track, just so you know kind of the direction we’re going, and then we’ll have some Q and A time obviously too. I really thought, because you talk about integrative cancer care and you could spend days, and days, and days speaking about it and we don’t have that.  So one of the things that I’ve done, especially now in the third decade of working with people with cancer, is in addition to my work doing research, cancer research with National Institute of Health Funding, I started to look backwards at just generally my cancer patients and what were the characteristics of the people who were more likely to survive, over the characteristics of their treatment pathways, et cetera?  And then that sort of led to a, what I think of as a nice overlay, a rational way to look at people in the cancer journey when you’re interacting with them. And so I want to come at the topic from that point of view, because I think gives a nice framework. And it also sort of informs what are the basics? And a lot of times we get people, as you all I’m sure have had, who everything is expensive everywhere, right? Everything that has to do with cancer and integrative cancer care can be very expensive.  And so I also looked at well, what were the things that really don’t cost people any more time or money to incorporate into their life, that are a base that we can work our way out from? And so I just want to talk about that as we go through. And then look at, there’s really four phases of interacting with a cancer patient, and that also can kind of help narrow down your approach and get focus for your patients. So I am going to go to share screen here. Now, also, Dr. Weitz, and I talked beforehand. Certainly just put your questions into the chat. If he has something that he thinks really fits right in, he’ll interrupt me. Otherwise, we’ll have time at the end as well. And so I’m good anyway you want to do it. So let’s get this moved over. All right.

So we can move past there. So with cancer, there’s always a few elephants in the room, and these are not surprising to anybody, but I think it’s good. Maybe it’s not the happiest thing, but it’s good to start out when we’re thinking about anywhere in oncology, standard oncology, integrative oncology, et cetera, to just remember that we have a lot of wins. We have a lot of people who, as was mentioned earlier, are thrivers. They make it all the way through. But we also have people who do progress and they do pass away. And one of the hard things I know early in my career, was not that I didn’t realize that, but just kind of coming to grips with the fact that the more cancer patients you deal with, the more people in the different parts of the spectrum you’re going to be working with.

And so in the standard of care world, they’re very clear with their statistics normally, even though they may not always share them appropriately. But it’s also good, I think to know, and this is coming from someone who’s both worked alongside and right with, and also in distinction to the standard of care oncology world, that they’re really, especially when you get to stage four cancer patients, there’s just as much experimentation and unknown in standard of care oncology, as there is in what we do. It’s just, they usually don’t call it that when it happens. Now, I do also want to just say, that while I have had patients of all over the spectrum in cancer, and as time went on, I certainly gained a lot of broad spectrum cancer care because of a number of things, probably time and practice, being associated with research and just being a referral center, my patients tended to be later stage aggressive cancer patients.

So I did not tend to get the people who had the more simple type cases. Occasionally, but not much. So one of the things that, I think that we have to come face to face with, is the fact that we actually now, especially if I look now versus say 20 or 30 years ago, we have a lot more tools than we used to have, a lot better understanding of how to use the tools. And I think that it’s incumbent upon us to share that with the patients, and in a positive way to let them know that we don’t know how this is going to work for you individually. But collectively over time, we certainly know a lot more and are a lot better, we’re better informed about how to deal with people with cancer.

And so, one of the things that I have seen, is being realistic is a balancing act. Not so realistic that some of my colleagues will say, “Well, you just don’t have enough evidence for what you’re doing, so you shouldn’t be doing any of it. Or you’re just taking people’s money.” I’m sure we’ve all heard that. Actually the bottom one is a quote from a relatively famous oncologist. He said, “I’m morally opposed to your oncology practice.” So I’ve heard all of these things. So I think we shouldn’t be really on that end of the spectrum, but also we need to understand that there’s a lot of realism that comes in with people who have cancer.

And I think what most of us come to, if you’ve seen more than zero or one cancer patient, is really with anybody, any patient, but especially cancer patients. When you get past the question that many people have, which is, can you cure my cancer? And I would always tell people, “That’s above my pay grade. I’ve seen cancer cured, but I cannot do that personally.” When you get beyond that, really what they’re looking for is the best quality of life, like we all are. And I think if you’re going to have that as a heart-to-heart with a patient and say, “Look, we’re going to do everything we can.” And a lot of times in striving for quality of life, you actually improve a lot of other cancer markers and a lot of other cancer outcomes.

It helps the patient get on the same page with you. And these are just some things I’ve learned the hard way over years. Good upfront discussion, find out what their real outcomes are that they want. Because you have people, it’s like, they kind of know how things are playing out, but they want to have as much energy and they want to be on as little medicine, and all this stuff as possible. And you get other people, at other places along the spectrum and they may have a very “curable cancer,” and they have many other outcomes that they’re looking for.

Dr. Weitz:                          Hey Paul, could I just interrupt you for a second?

Dr. Anderson:                    Yeah.

Dr. Weitz:                          On this topic of discussion and being realistic with patients as to what their prognosis is. Do you find that a lot of times patients are not really being given the proper information about what their prognosis is? And so I just had a patient this week and has a stage four cancer, that’s not very treatable. And they gave him a round of chemo and he thinks that he’s … they told him, “We don’t see any sign of cancer.” So he’s thinking, “Hey, this is great.” And I think it’s important for patients to be optimistic, but unfortunately it seems like a lot of times they’re not being told exactly what the truth is about what their treatment is. They’re getting palliative care and they think they’re actually getting curative care.

Dr. Anderson:                    Yeah. I think that kind of goes along with that theme, there is … it’s extremely common that what you just described happens, and part of it is the oncologist not being completely clear. Part of it is denial on the side of the patient. And you can usually sort that out, if you have a discussion with them about the difference between, you got a stage four aggressive cancer and they’re doing chemotherapy, there is no curative intent there. And they may be missing that.  I’ve also seen a fair number of patients with, again, aggressive stage four cancers who were on second, third, fourth, fifth line therapies, which are experimental at that point. And they still believe that there’s some curative intent. So there’s a lot of clarifying that needs to go on. And I think one of the most powerful things is, in your first visit or two, really just having the space in your conversation to have that discussion. Yeah. Because people are confused and sometimes it’s, they’re hearing what they want to hear. But other times also, they’re not hearing a good message or a clear message.

Dr. Weitz:                          Right.

Dr. Anderson:                    Certainly. This next section is real short and you’ll get the point real soon. But I just wanted to keep this in this presentation, because this really speaks to the basic things that I have seen over, and over, and over, over the years. That if these basics are covered, and this is something common to all of us who do integrative therapies, we often forget how important the basics are. And these are things that are part of our life, whether we’re doing other things or not.  And my real take home point from this, and I’ll kind of go through these slides fairly quickly, because they’re going to be obvious to you. My real take home point is, when I look backwards over those three decades, and I look at the patients where the treatments that we did really kind of stuck and made a big impact, they were attending to these core areas of foundational areas. And they’re that important. When I teach this to medical students, I use the pneumonic food, muscle and brain. And literally, if people are attending to these things, they shore up their physical foundation, so that whatever other treatments you’re doing go in and stick. And if they’re not, well, it doesn’t work out so well.

So it’s kind of like we use the analogy of a house and it has to have a foundation. That’s exactly what this is. And the idea is, so food is of course what you’re eating and your fuel, but it’s also how clean is the food and the drink that you’re eating? Are you taking in more toxins than you need to? Obviously there’s no non-toxic way to eat, but there’s lower toxic ways certainly. It also has to do with the timing of eating. We know now that at least a 13 hour intermittent fast daily is associated with longer life and better survival in cancer patients.  And then also your relationship to food and the way it affects your metabolism. So what way your diet is structured, beyond just the fuel, et cetera. Muscle is the fact that I think we all realize now that whether it’s cancer or not, but especially in cancer, the more muscle metabolism you work yourself through and the less fat metabolism you work yourself through, the better your survival and the better your quality of life.  And that’s true with other diseases, but with cancer, it’s very apparent. And that’s largely, I think because muscle metabolism signals the rest of the body that you are in the cytokine mode and your chemokines are such that they’re more resistant to cancer growth. Fat metabolism, which is largely but not completely insulin dominated is associated with proinflammatory cytokines and things that would tend to enhance growth. And so this doesn’t mean the person has to be a power lifter. It just means they need to move their body. They need to combine their diet, that has a low glycemic index, with their skeletal muscle moving to the degree it can. Real sick people, that might be standing up a few more times every day. People who are in recovery, it might be actually working out, getting the skeletal muscle working.

And then brain is the topic of my recent book, which is the Mind-Body Connection, how you’re thinking about cancer and really how empowered you are as a cancer patient. And so what I really see here, is if you look then above at step two and step three, you’ve got kind of foundational cancer supplementation and that’ll work better if you’re working on the dietary, and the food, and the fuel part, and the cleanliness. You’re working on getting your muscles to move a little bit. And then you’re working on the mind body connection.

And then all the, what I call the cool, high speed, high expense therapies, a lot of the things, like our clinics were set up to do IV, and hyperbaric, and hyperthermia, and all these cool things. They really do work longer at better in the setting of the other things being prepared and attended to. So I think you kind of get the idea. This is not new to people who are doing integrative care. But I was personally a little surprised when I look back at about 20 to 25 years of practice, and I started to see this pattern where the people, you have stage four cancer patients all doing the same other therapies. But the people that really hung in there and had the quality and length of life, were people who were doing these basics on top of the other things.

Now, the bulk of what I want to present is, again, something I kind found retrospectively looking back. I think we all do this intuitively, but I think it’s good to kind of call out the fact that the cancer journey can be divided into four discrete steps or areas. And the reason that’s important, is that your clinical focus and priorities, and really the patients, probably are different in each of these phases, because some of them, you have real high stakes things going on and you really need to laser focus on particular things. Others, you have a lot of background things going on and you have a lot of options as what to do. But those phases basically are primary prevention, where they don’t know they have cancer yet, which is we’d love to get everybody here. And we all make cancer cells every day.  We’d like to keep those from doing anything. So, that’s primary prevention. Then you get diagnosed. So diagnosis through active therapy is phase two. And this is usually where people are suddenly hit in the face with the diagnosis of cancer. They’re often, for good or bad rushed into cancer therapies. And they’re real confused and they’re overwhelmed. Now there’s an arrow that leaves here, because some people die during diagnosis and active therapy. We obviously don’t get everybody through all four phases.

Then there’s a very important part for long-term survival, which is recovery from active therapy. So this is when you get to the place where they say, “We’ve given you all the treatment we can. We did surgery, chemo, radiation, whatever, we’ve done all we can. So go and live a good life.” Well, this is a place where, every phase you can interact with people, but this is a place where we can really shine, because we can help people not only physically and mentally recover, but also strengthen their system to oppose cancer return or cancer aggression.

Post cancer return or cancer aggression. And, of course, there’s an arrow leaving there because some people don’t make it through that. And then there’s what was spoken of earlier as the thriver state. And we call that secondary prevention. That’s when you get to the point where you’re in either no evidence of disease or remission or stable disease, something where you’re not really having new therapies, you’ve recovered from the old therapies. And what you want to do is stay as healthy and anti-cancer as possible. So this is, like I said, just a way to think about your cancer journey and say, my patients coming in, where are they in this spectrum? And then that leads you to what things do I need to focus on, because I get this question all the time at conferences when I’m speaking and people say…

We might be talking about active cancer therapy where we’re doing some high level interventions and maybe they’re getting chemo and we’re trying to support the chemo and not have die from it and all that. And people say, “Well, why don’t you do these other things?” All of which are good. Well, the reason is that we only have so much time and resource to put into somebody in that phase. Whereas in the next phase, we have different goals, different objectives. And I’ll share these slides. You guys can have them and read them. They’re fairly straightforward.

Now, there are exceptions to this model, and those are usually when we get a patient who has a super aggressive stage four cancer, and we may only have one crack at doing something with them. In that case, we may throw a lot more at them. We may get very aggressive very quickly. And that’s fine too. It’s just that’s a unique circumstance. So primary prevention essentially is trying to keep your epigenome from turning your genome against you. And so primary prevention is doing everything you can to be anti-cancer before your cancer goes anywhere. So that is at the beginning on the left side of that scale there. And obviously prevention’s the best medicine. And your goal is to try and keep all your epigenetic signals in the mode of turning on your resistive genes and turning off your suppressive genes. More on that later.

This is something my staff named after me, because I kept preaching it to them for years. And so these are eight areas that we look at in primary and then secondary prevention just to try and clean the system up as much as possible. And I will not spend tons of time on them, because they’re fairly self-evident, although they’re labeled in an overly simple way. Self function means everything from your organelles working to the pH, to the input of good and output of toxins. And all that stuff includes your nutrigenomics and all of that.

Toxins, whether chemical or mold or metal, etc, always a problem, but certainly more of a problem as an epigenetic trigger when we have chronic illness in cancer. Biofilm and resistance factors, which include certainly biofilms as name, but also immune suppressive drugs, which a lot of our patients are on during their cancer journey and other things of that nature. The patient’s immunology becomes very important in primary and secondary prevention because what you’re concerned about there is, number one, you’re not engendering auto immunity, but also you have enough immune reserve so that when the immune system is called upon to fight with cancer, it can do that.

And so the big hindrances there beyond biofilm and resistance factors are chronic infections that are undiagnosed, auto immunity that is undiagnosed and those things that get in the way. The endocrine system is universally important through the whole process. The psychosocial obviously is huge. And then the whole digestive GI tract, which usually gets wrecked through treatment and it is going to need constant care. But because you have not only your GI neurology that goes on, but also your microbiome in your GI immune system, those are so critically important when it comes to cancer outcomes that the repair and maintenance of the GI tract becomes a constant project. And then physical and structural things.

So these are some explanatory slides about all that. But in primary prevention, I think it’s important obviously to think about your family history. Obviously you can be the first person in your family to have cancer. Not all cancers are certainly related, but if you have a family history of a lot of cancer, that does change. There’s something there in your epigenome that maybe is a little too friendly with cancer. And that means maybe we need to be a little bit more aggressive with cleaning the system up, etc. Looking at your determinants of health via those eight areas and really everything matters. But in primary prevention diet and GI tract health are easy to come first, because you can access the diet and there’s no cancer treatments or anything going on here.

Movement or exercise, and as we talked about the mental emotional space, people with chronic stress, people with certain types of neuro emotional disorders, etc, do have more cancer. And so getting after that and helping people find their way to empowerment becomes very, very important. Toxins, chronic infections and endocrine, these are all things in primary prevention you can clean up. You got time. So these are all great things to look at.

Then you move to initial diagnosis and therapy. And this is where you have usually… The sky’s the limit, but usually you’re trying to really focus what you are doing on the integrative side of things. So this is once the cancer is known and the patient’s going to do something about it. Now, that might be total standard of care and you’re going to do something to help out. They may, as Dr. Weitz was mentioning earlier, and one thing we see a lot is I will counsel people, especially if they have a stage four cancer, and I know that the standard of care is not very efficacious. If they haven’t already, I will ask them, ask your oncologist, number one, what the five year survival with the standard treatment is. And number two, if they personally would do this for themselves or a family member.

And in modern times, meaning not 20 years ago, but recently, I’ve seen more and more oncologists being a little bit more honest, not all of them, but more. And often they’ll say, “You know what? There’s less than 5% chance of a five year survival, and I’ve got 100% chance of giving you side effects. So I wouldn’t take those odds as an oncologist, you need to do whatever you want to,” because they don’t want to be put in the position of talking down on their care and limiting people with care. But if you’ve got cancers like that, it’s really good to know that because if you have somebody with an early prostate and early breast cancer and the survival at five years with treatment is 80 to 95%, you take those odds and we can do a zillion things to keep you healthy and help you in secondary prevention.

If you got aggressive cancer, that’s got under 50%, but certainly like under 20% survival rate with standard of care, as a patient, you have to decide, is it worth the side effects I’m going to get? And we have a lot of people who decide I’m not going to take a 5% positive risk. So that’s the idea there. We do need to remember during this phase that people are freaked out. They’re overwhelmed. Nobody wants to get a cancer diagnosis that I’ve ever met. And these people are overwhelmed in that situation. So we do have to walk them into their care carefully, add things as you go, like I said, unless you have a really aggressive cancer where you may only have one shot at it.

And one of the things that Mark and I wrote about in the first book outside the box cancer therapies, and to my knowledge, we’re the first book about cancer to put this into a book as opposed to being in scattered research. And that is that we are now pretty much 100% certain that while chemotherapy and radiation will decrease the size of tumors in many cases, we know that in the long run, they are associated with more return of more aggressive cancer. That might be months later, it might be years later, but we know that happens. And that’s for reasons I’m going to talk about later. But since we know that, what we have to do, if our patient, let’s say is getting radiation or chemotherapy surgery or some combination there, we have to be supportive in a way that is not only supportive to those therapies, but also supportive to their normal tissue so that we don’t get recruitment of cancer cells by emboldening the cancer stem cells with the chemo and the radiation.

So big thing is just being realistic with the patient what time do they have available? How much time do you and they have to work during this very intense time? They might be doing five days of radiation a week or a bunch of chemo or some combination there. They might need surgery and you may have little windows where you can interact with them. So you have to be strategic. How much energy do they have available? How healthy are they to put into doing things? You really have to prioritize here. Are there financial constraints? Everybody has them. It’s the rare person where money is no object, but it’s just something that needs to come up in my opinion, early. How are they tolerating the therapies? Should that be a big focus?  So a lot of times, during active therapy, especially if they’re getting a chemotherapy, especially old line chemotherapy regimens, we’re focusing on mucositis and the standard side effects of that, because that’s a giant quality of life thing. Well, it turns out that whatever you do, as I said for quality of life is also helpful on the back end. And it’s good to remind people of that. They might think, well, all I’ve got time, money and energy for is for you to try and lower my side effects. Well, that’s still a pretty tall order. That’s a pretty good thing to do.

Now, interactions between what you’re doing on the integrated front and surgery radiation and chemotherapy, for the most part, unless you’re doing something really strange, you’re actually not going to interfere with anybody’s chemotherapy or radiation for the most part, etc. For every 100 units of concern, for instance, that a radiation oncologist has or a medical oncologist has with you interfering with their very powerful therapies, there’s probably two or three units of actual concern that need to be had. Now, that doesn’t mean they’re going to buy that, but you need to have that conversation with your patient.

Dr. Weitz:                          That discussion in my experience is always around antioxidants.  Antioxidants are going to uncouple radiation, they’re going to uncouple chemo. And I’ve had oncologists say anything you give them, they shouldn’t take because it’s an antioxidant.  I just recommended glutamine for a patient and the oncologist said, “No, that’s an antioxidant, you can’t take that.”

Dr. Anderson:                    And I think what this really comes down to, there are times where you have to be judicious, of course.  But what I have found more important is if you have the chance and you can have eyeball-eyeball conversation with your patient and explain this difference in worldview and explain to them how and why the oncologist is going to be so sure of whatever they believe, and also how much of a low level of scientific validity that has.  It’s just a belief system for the most part.  And what I always tell patients is, look, it’s not the oncologist that has cancer, it’s you, it’s your body, you get to decide what you want to do with it.  I happen to be the expert with this end of oncology care.  And they happen to be the expert with that end.  And if you’re comfortable with it, why don’t we let them?  I don’t tell them how to dose chemo, I don’t give them the schedule to do radiation therapy, and they really don’t have a lot of business in my end of the world.  Most patients, if you explain it like that will come to some place where they understand what’s going on.  And I always just tell them, look, you’re never going to convince a radiation oncologist that anything is safe.  Medical oncologists are on a huge spectrum.  And most of them don’t even want you to eat salad. They don’t want any antioxidants in your food. They would like you to have a dead diet actually.  It makes no sense. There’s really no science behind it.  So if you’ll let me do my thing, I’ll keep you out of trouble here. We will let them dose what they’re doing.  And I find it’s a lot of… It’s like front end communication, because my experience has been, if you don’t tell them that, and then they come back and they think that you’ve been lying to them because the oncologist freaked out and said, you can’t take any of that stuff, you lose a lot of credibility.  So you got to really do it on the front end.  And they won’t understand because I think we aren’t all doctors on the same page. You just have to tell them no.  And there’s a lot of reasons.

Dr. Weitz:                          Can you clarify since there is a lot of controversy about this?  What is your position on patients taking antioxidant supplements while undergoing radiation or chemo?

Dr. Anderson:                    Well, the first thing is you can call probably 80% of the supplements that people take antioxidants in one way or another. And a lot of times they are. So that’s one of the things that bothers the oncology community.  During chemotherapy, I focus on basic nutrients.  I focus on opposing mucositis with things like glutamine like you did.  And as long as they have a good white cell count probiotics and demulcent herbs and things like that, if they’re just on chemotherapy, it depends on the chemotherapy.  Like if your basic nutrients they’re going to have some antioxidants in them, that is not going to block anybody’s chemotherapy.  Also, we do vitamin C IVs and other stuff like that.  That’s not blocking any chemotherapy either.  I don’t have people on oral mega doses of a lot of other things, because again, there’s only so much they can get in during chemo.  During radiation, it’s a little bit different.  I tend to do radio potentiating, things like milk thistle is very good, curcumin can be good, boswellia can be good, a lot of botanicals are very good in that setting.  If they can do (IV) vitamin C the beginning of every radiation week, they have far less trouble later on. And I’m going to give you some resources for that.

Dr. Weitz:                          Some of those things you just mentioned, would they take them on the same day as they get their radiation, before the radiation, afterwards? Does it matter?

Dr. Anderson:                    If they’re doing radiation, let’s say we’re doing milk thistle and their basic nutrients and whatever, they would do the oral things every day.  Yeah.  And if it’s no radiation, but there’s chemo, if that’s an appropriate strategy, a lot of times we use curcumin and boswellia right along with chemo, there’s just data on that.  And glutamine, even though you had that experience with the oncologist, that’s an everyday thing, because we’re just trying to keep their blood levels trucking along so that they can have the protection and the support together.

Dr. Weitz:                          Somebody just did ask a question about what about glutamine being contraindicated in cancer?

Dr. Anderson:                    Yeah. You can go on my website. If you look up glutamine, I think one of the first two or three hits will be glutamine and cancer. This is a rather long discussion. And I actually have a CE webinar about controversies in oncology, which goes into glutathione, glutamine, all these other things that we’re talking about. And it’s a pretty deep well. But the upshot of it is unless a person is on a high sugar diet, glutamine is actually a non-issue in cancer. It is thought to be contraindicated, but there’s no data for that. There’s no human data. It’s theoretical.  Now, if they’re on a high sugar diet, glutamine would become a fuel. And they shouldn’t be on a high sugar diet anyway, but here’s where the problems with glutathione and glutamine come in with cancer is probably well-meaning. And a lot of them are in the integrative medicine world. People don’t understand the tumor biology behind why glutamine and glutathione in the research appear to be associated with resistance. And that is that the tumor cells can make glutathione and they can pump out glutamine into the extra cellular space. That has nothing to do with the glutamine and glutathione that the patient is given if given rationally. And so they make the step that if the tumor cell does that for protection, then you giving those things must protect the cancer. And that’s actually not true. That’s not how it works.  A glutathione producing tumor or a glutamine influxing tumor will laugh at your glutathione or your glutamine. It’s not going to be enough to give it a big deal. Now, with glutamine, we do make sure that they’re on appropriate low glycemic diet at the very least. But the other thing is we use it during chemo and during mucositis, and then we back off on the dose. So if someone has mucositis, you might be giving them three, four grams three or four times a day, and once they start to heal you back off on that because they don’t need that much long term. So it’s a thought thing. And that is a very quick rendition of a real deep well there. Yeah.

Dr. Weitz:                            If you don’t mind, there’s one more minute. I spoke to one of the leading proponents of the metabolic theory of cancer. And he advocates a ketogenic diet. And he also recommends… His concept is that cancer can basically get its energy either from sugar or from glutamine. So he recommends a ketogenic high fat, low sugar diet. And then recommends taking a drug that blocks glutamine and pulsing it.

Dr. Anderson:                    Yeah. And there are times where that is like the blockade of glutathione or blockade of glutamine is appropriate. Most of the time, again, that’s a misappropriation of the tumor biology because the glutamine that is feeding the tumor is coming from those tumor cells is not coming from elsewhere. And so what they’re really talking about there with the blockade is if you’re going to do a metabolic therapy, you need to have them on a keto or a low carb diet to starve the tumor in that direction. And then what we do is we put them on things that force the tumor out of anoxic metabolism so that the glutaminolysis and the forcing of the glutamine out doesn’t happen. So that’s what he is talking about blocking the glutamine and all that, but really you’re doing that through their diet primarily.

And then things like we talked about earlier, the fermented wheat germ extract help in that area. There’s other metabolic shifting things that are very useful in that area as well. But also if you’re using glutamine therapeutically, it’s fine. You just use it appropriately, like I said, high dose when you need it, and then you take it away when they don’t eat it. So it’s not that cut and dried.

Dr. Weitz:                          Have you ever recommended fasting around radiation and-

Dr. Anderson:                    We’re getting to that. Yeah.

Dr. Weitz:                          Okay. Good.

Dr. Anderson:                    As a matter of fact here. So now I usually tell people I don’t put these University of California, San Francisco, Osher Center slides in because I think they’re so wonderful. I think they’re great people. But these are all things I’ve been telling people to do for a long time. And now we have a major cancer center telling people these are okay to do. And so I just find it’s nice to back up what we’ve been saying for a long time with the credibility of someone who’s on the inside, I suppose.  So I’ll share these slides. You can read it. This is a little short thing they do about fasting, but here’s the thing. And fasting is like diet change. You have to ask people what they can do. Some people can fast really easily and like it, other people they might say, I can do daily 13 hour fast, which is still very helpful, but I can’t probably do much more than that. Or they can do a 24 hour fast right before their chemo or their radiation and then fluids on the day of treatment and then go back to eating. Still helpful. Okay. And they go through here looking at different studies and saying, well, you could do up to a five day fast. Well, there’s less people to do a five day fast.

One of the things, and I’ve not used it a ton with people, but I think it’s a great tool is the fasting mimicking diets, and you can make your own up too, but Prolon is the famous one that Valter Longo helped develop. So you got people eating almost nothing, but it feels like they’re still eating and yet they’re actually fasting. If you can get people to fast, be right up to the time of treatment, and then the day of these don’t feel that great anyway and then go back to eating, not only does it lower side effects, but it tends to make things work better and more tolerated.

And so the red is eating whatever you want and the blue is fasting. And essentially these are side effects of this. In this case, this was chemo, but you could say similar for radiation. And so you can just see graphically that the blue is a lot lower than the red if the person is doing some fasting around treatment. Now, these are again from the UCSF folks. Pretty close to things that I tell people on the base. Anti-inflammatory diet. I would say colorful fruit in tiny amounts because you don’t really want a whole lot of fructose in a cancer patient, vegetables, you can get a low glycemic vegetables and other stuff, that’s fine, lots of herbs. Low to moderate carbon intake with low glycemic starches or none. We do a lot of keto, low carb and modified Mediterranean. All of them are in that direction. They’re very low glycemic. Protein, they make a good point. If you’re doing these things, you have to be careful with protein because one of the things that are going to happen with protein is when you cut the carbohydrates down, which you should, you can get glucogenic amines out of your protein. And if you have too much protein, you wind up with your blood sugar going back up. And this is a case where you really, in my opinion, if you’re really doing therapeutic diets beyond the good basics, you really want either you or somebody working with a patient like a coach so that they can eat this, not that, all of that.

Again, they reinforce the 13 hour fast every day. And basically I just tell patients when you’re done eating dinner, you can drink water all you want, but you don’t eat until 13 hours later the next day. Drink tons of water. I’ve done this for a long time, almost all of the side effects of 13 hour fasts are dehydration. So if they just keep drinking water, they’re fine. And then here they have short term water fast one to three days, very useful. And then prior to treatment, even one day prior to treatment is still good.

Oops, sorry. Wrong way. Now, as far as these are some free writeups that I’ve done about interfering with standard of care. So the first one is all about vitamin C and chemo and radiation. Next one’s about antioxidants and next one’s about leukemia specifically. And then the final one really gets to one of our next topics, which is detoxing after treatment. And so this is a area that some people also get kind of mixed up.

These are some very deep, if you do like vitamin C therapies, especially IV, there’s some kind of deep classes. So all the stuff here are writeups, these are free. Classes cost a little bit. And then you can just search the website there. So there’s that controversy oncology class. There’s off purpose or off label drugs. And then there’s one that’s on advanced cancer. Now recovery here, this is a time, I’ll just kind of tell the story and we get right past it here, but recovery from active therapy is actually a golden time for you to reverse those things I was saying that chemo and radiation do, which is make the cancer stem cells more bold. So really to simplify the way we want to think about this, and there’s a whole chapter in outside the box about this, or at least we talk about it in there.

You have the daughter cells, the cancer that we see, it’s usually bigger. Then you have the cancer stem cells. They are biologically opposite. So when you’re treating the cancer with chemotherapy or radiation, or you could say surgery too, but especially chemo, radiation, the daughter cells are heavily attacked by the chemo radiation. That’s why they shrink. The stem cells go and hide and they wait. They are unaffected by chemotherapy and radiation for the most part. And there is paper after paper after paper published that says this and everybody at the end of their paper says, “Well, this is true, but we don’t want to make a big deal out of this with the public because then they’re going to be afraid of chemotherapy and radiation.” And they’re hoping some day to come up with some magic fix for this. Well, the magic fix is actually taking care of the patient with the stuff we do.

The cancer stem cells retreat during therapy. When you’re in active recovery and in secondary prevention, you want to start to take care of the normal cells in a way where they become more cancer resistant. Because if you don’t, and you do what most people do, like you were saying, Ben, about your patient who they think, “Oh, the cancer got smaller and they’re really doing palliative therapy.” You can have the cancer get smaller and a patient thinks, “Oh, I’m cancer free,” which of course they’re not. And then they go about their life and they don’t do anything to clean up the system, the cancer stem cells will come back with a vengeance. They take advantage of that. So when you’re recovering from active therapy, there may be specific things such as surgical recovery where we’re given a more regenerative nutrients and things to help them rebuild, et cetera. Or it might be what is most common recovery after chemotherapy and radiation. And maybe this is the first time you see the patient.

So what we have to do there is first focus on the quality of life things. Do they have radiation burns? Do they have leftover mucositis? Do they have mucositis induced diarrhea that won’t stop? Is there microbiome all messed up? By cleaning up and helping to fix the quality of life issues, you also are actually getting at healing and getting on the road to healing the normal tissues. And the more you do that, the more you make them resist these cancer stem cells. Because everybody’s got cancer cells every day.  We probably have some cancer stem cells and everyone who’s survived cancer still has their stem cells. What we want, because there’s no way to make them go away-

Dr. Weitz:                          Are there natural methods that help to target cancer stem cells?

Dr. Anderson:                    Yeah. So yeah, I will elaborate.  What you want is to keep them asleep, okay?  There is no way to kill cancer stem cells for all intents and purposes. You want them to be so happy that they have nothing to do and you want your normal tissue and whatever’s left of the person after treatment to be so healthy that there’s no impetus for the stem cells to recruit in the stroma and the tumor micro environment, your normal tissue back to being cancer.  So we’ll get into that a little bit here.  So just psychologically, you have to remember this is a time where people are pretty happy usually because they’re finally done with chemo or radiation or whatever they were doing.  And so we need to support that, but we also need to support the idea that they need to work on things to clean up the quality of life stuff, which will decrease cancer stem cell activity.  And then we want to do things to heal their normal tissue, which also decreases cancer stem cell activity as well. there may be specific things like surgical healing.  There may be global things like I’m just fatigued afterwards, et cetera. You treat what you see and then you work your way down towards the epigenome.  The other nice thing about recovery from active therapy is this is usually a time where the oncology team says “Go and live your life. We’re not going to do any more chemo,” or “You’re done with surgery or radiation.”  And that often, if you’ve had a contentious relationship with the oncologist, that sort of takes the handcuffs off during that time as well.  During this time, a lot of our goal beyond side effects, which is a huge goal, is getting their mitochondrial function back. That helps to get their energy back, their recovery, getting their membranes working again. Detoxing usually can get started here and then repairing whatever else got messed up. Just during radiation, like I said earlier, orally, I use a lot of milk thistle during radiation and sometimes curcumin, but more milk thistle because as a radio sensitizer and a cell protectant, it’s hard to beat.

Dr. Weitz:                          What’s a good dosage of milk thistle in this case?

Dr. Anderson:                    If you get a like, and I’m doing this from memory so my apologies to Integrative Therapeutics, but they have a really good milk thistle product and it doesn’t have to be just milk thistle, but I’m usually going during radiation for about four to 600 milligrams two to three times a day. And that kind of keeps the silibinin levels level in the body.  And so that’s a really good one because a lot of people don’t have access to IV vitamin C or something.  But if you are going to do it, what I like during radiation is actually high dose vitamin C, at least on the Monday when they start their radiation-

Dr. Weitz:                          And what is high dose?

Dr. Anderson:                    Well, if they have a normal G6PD level, we start them at 25 grams and usually go to 50, 75. Can go higher. But during radiation, usually 50 to 75 is plenty for the average person.  After radiation, there’s a radiation recovery formula which is nutrients and glutathione and all kinds of other stuff that we develop for radiation burn patients but this is after they’re done with radiation.  And so that one is useful in that setting.  So obviously in recovery, you’re focusing on healing, kind of get them back into their dietary changes, muscle, brain, all those things.  And like I say, you’re looking at calming the epigenome down so that you don’t get this recurrence with the cancer stem cells. Now-

Dr. Weitz:                          We’ve been talking about whether or not some natural treatments might interfere with traditional chemo or radiation. What do we know about potential interactions between natural therapies and some of the newer targeted therapies, the immunotherapies and some of the other targeted therapies?

Dr. Anderson:                    Yeah. And again, that’s a three hour discussion at least, but-

Dr. Weitz:                          Oh, I know, I know.

Dr. Anderson:                    The upshot of it is, because now that we have more of those therapies, I teach about this a fair amount. Most of them are synergized by some of the things we use commonly, such as curcumin and melatonin. Those have some data with some of the targeted therapies. Vitamin C is very safe with them. There’s very few things that actually are going to block or inhibited most of the targeted therapies. Now-

Dr. Weitz:                          You just mentioned melatonin. What dosage do you like for melatonin?

Dr. Anderson:                    It very much depends. It’s interesting is 25 years ago, we commonly gave people a hundred or more milligrams when they had cancer and then we sort of, for whatever reason, went to 20 to 60 and now we’re giving people one to 300 milligrams of melatonin.

Dr. Weitz:                          Oh, okay.

Dr. Anderson:                    So it’s during either active treatment or especially in recovery, I think the higher doses make sense as a, again, that’s another real long discussion, but it’s also totally appropriate to do the medium high doses of 20, 40, 60 milligrams, which are still pretty darn high because they’re having a very therapeutic effect at those doses. It’s very different from say a low dose. If you’re doing therapeutic melatonin, actually free you can get the presentation. If you just search Dr. Shallenberger’s name and melatonin, he’s got a PowerPoint online all about high dose melatonin. And to my viewing, that’s probably the best resource for high dose melatonin. But regularly it’s very common for most people nowadays to do 20 to 60, even if they’re not doing the super high doses. But most of the targeted therapies, what I will normally do is if it’s something I know that are mainstream, so like curcumin or vitamin C or some of the other stuff, fine.

If I’ve got an idea to use something real specific and we get this brand new PD-1 drug or something like that. What I will generally do is do a search and I’ll do the drug class like PD-1 or NITNF or whatever it is and then I’ll put in the name of say the herb or the mushroom or whatever or the vitamin and I’ll just put in those two search terms and see if anything comes up. Occasionally you’ll find there’s research where they’ve actually tested them together and they’re okay and that’s even better. Once in a while, you’ll run into a study where maybe it looks a little shaky, but most of those studies that natural products are having a problem with biologics are like in vitro studies that may or may not at all match humans.  So there’s that.

Dr. Weitz:                            Okay.

Dr. Anderson:                    Now these next slides, I’m just going to tell you why they’re in here and then you guys can read them if you want to. There’s two concepts that are of paramount importance to keep you in remission or to do secondary prevention. One is keeping the tumor microenvironment calm. Like I say, you want your healthy cells to be as healthy as possible. You want the tumor cells that have died to stay dead. And then the other is the cancer stem cell milieu, which is right next door, and you want the stem cells to stay quiet and asleep. That’s what keeps you in remission. Now you’re fighting uphill because chemotherapy and radiation have made the stem cells stronger and more spunky. But what you can do, especially in this recovery or secondary prevention stage is the more things you do to clean up their environment of their body, so you’re starting to look at things like detoxification, look at their nutrigenomics and optimize those, get their gut healed up and working again, get their microbiome working again, not forgetting in your toxicity assessments. We think of metals, but chemicals and microtoxins are huge immune side liners.

And then kind of the opposite of the concerns early in cancer care, you really do want people to have really good antioxidant potential, which means that they have all of the compartments covered. You got vitamin E and omegas and phosphatidylcholine for the fatty areas. You got glutathione for cytosol and the plasma. You got vitamin C in the water soluble areas. They all back each other up. And of course, vitamin C is the weak link because we don’t make any in our body, but they all need some help. And then from there you can build other things on top.

One of the reasons I keep bringing up milk thistle is because we don’t talk about it as much as like curcumin, but milk thistle beyond being a radiosensitizer and a healing agent, it also keeps the vitamin C glutathione cycle really humming along, which is what you want. So these are theories of oncogenesis. They all actually have a place. So there’s not one theory that wins, they all have a place. But the bottom line is what they have in common between them, whether it’s metabolic or the stem cell theory, which we used to call the trophoblast theory, they’re the same thing, or the genomic theory, which is a small number of cancers, but they’re real. The crossover in keeping those things from coming back is your epigenome. And all that is is working on cleaning yourself up. Your hormones are balanced.

You don’t have any residual infections or other immune junk going on. You’re detoxing. You get rid of the junk from your system that’s all nasty proepigenetic triggering stuff. As I said, you’re healing the gut. You are doing all of those things with the whole body. This book is a lot about the how, like the targets and treatments during cancer, stuff like that. This book, as Dr. Weitz mentioned, this is a new one. This is more about the mental part and how to, you know, almost agnostic of how you’re treating your cancer. Your mind body connection is so important to healing up. So you can read through these. These are basically about tumor microenvironment and cancer stem cells. And these are some of the metabolic and biochemical reasons that the microenvironment gets either pro-cancer or anti-cancer return.

Dr. Weitz:                          Can I ask a question about that?

Dr. Anderson:                    Yeah.

Dr. Weitz:                          In terms of the metabolic theory of cancer, which is that cancer stem cells are primarily glycolytic and therefore a low carb diet’s going to be best, do you think that there’s certain kinds of cancer that are different? Like for example, prostate cancer seems to work somewhat differently and respond to different dietary factors like choline seems to be potentially a problem for prostate cancer whereas it’s not for other forms of cancer.

Dr. Anderson:                    Yes. Short answer is yes. Like I said, all of our therapeutic diets, we have an array of therapeutic diets. And the only thing that they have in common is that they all have a very low glycemic impact on the body. So there is no type of cancer that benefits from sugar. There are some types of cancer that are less impressed by low sugar diets, but you still remember sugar drives insulin metabolism and insulin metabolism is pro-inflammatory, it switches all of your eicosanoid fat metabolism towards inflammation. So even if the sugar is not really the part of it, keeping your insulin from bouncing around is a huge thing. And like you say, especially advanced prostate cancer, sort of its own little animal. And that’s because it has a lot of connection to toxicity and infections that other cancers do, but not as like prostate cancer literally concentrates those problems like we’ve been talking about.  So yeah, and it’s why many of the people I know who used to only recommend say ketogenic diets now really look more at the person’s metabolic flexibility. So like I say, none of the diets that we offer are high glycemic. None of them trigger a lot of insulin release. But there’s different ways to get into that depending on the person’s metabolic flexibility. And because that’s individual, we usually have people, if they really want to track what their diet is doing to their metabolism, we have them have a ketone and glucose meter and they check periodically through the day and they enter it into a chronometer program online and we track it. Because number one, most people who think they’re doing ketogenic diets aren’t. Really they aren’t because no one’s checking. And so people say, “Well, keto didn’t work” and they actually never were keto.

But then there are a lot of people where they can’t do a traditional ketogenic diet anyway. So yeah, diets are, you have to have the big picture, kind of your north star which is not a lot of insulin stimulation, a lot of good flavonoids, a lot of clean stuff in it. And then from there you build the macros to whatever. This is an odd representation of a human, but you have your cancer there in the middle, you have the tumor stroma which is the communication area between the cancer and the stem cells and normal tissue. And then they have most of your patient, which is actually non-cancerous tissue. The more quiet you can keep that middle ground by returning, you heal them up. As I said, everything you do for quality of life is in favor of anti-cancer.  So even if that’s all you do, it’s huge. Their diet, their movement, all that stuff is in favor of anti-cancer. And then you’ve got to get the rest of their cells and their tissues to have good antioxidant balance, to have low amounts of insulin going into trigger. And then that keeps your normal tissue from being pulled to the dark side and recruited by the cancer stem cells.

And there’s stuff in here you can read about all that, but that’s kind of the bottom line. I just put this in because it turns out that vitamin C, even at fairly low doses, pushes your epigenetics all in the direction that are anti-cancer. So beyond being helpful as an antioxidant or in high dose being a prooxidant, it has a lot of epigenetic strengthening that it does to your system. And so, especially in the healing and secondary prevention stages, vitamin C is cheap, it’s water soluble and we don’t have people on tons of it, but they’re taking one or two grams a day just to kind of keep the tank filled and that can be incredibly beneficial to their epigenome and also just their normal cells.

Dr. Weitz:                          Can I ask you about the alkaline acid?  Are you going to mention that concept?

Dr. Anderson:                    I don’t bring that up in here because mostly if you’re doing… Well, two things. One is if you’re doing a dietary intervention that doesn’t have a lot of insulin signaling, your movable pH balance is going to be fairly stable, which is what you want. Now, and there’s no slides on this, although many people talk about it, there’s actually a lot of decent research now that shows that especially with aggressive cancers, if you add in alkalinizing supplements. So there’s some clinics that have people take extra sodium bicarbonate orally, but what we find is if you use like the alkalizing minerals, there are those mineral products that are the-

Dr. Weitz:                          Potassium citrate.

Dr. Anderson:                    … yeah, the alkaline salts of potassium and mag and that. That way, they’re going to need the minerals anyway. And it turns out that that actually orally can, again, kind of keep the pH. And people always say, “Well, your pH is so tightly controlled. Does it make that much difference?” What we’re seeing now is, like I say, this is a moveable thing through the day, and you’re not looking at giant changes because you’d be dead. You’re looking at small changes and keeping the cell pH as alkaline as possible through the day over time. And that’s actually in kind of standard research now.

Dr. Weitz:                            I asked one of the other leading integrative cancer experts about this and she said that there’s really no benefit, that what’s observed is that cancer cells give off an acid, and so this idea that cancer thrives in an acidic environment is not really true.

Dr. Anderson:                    Yeah. I think it’s an oversimplification to say that, but if the folks listening want to look at a really well-informed person who lectures on this, and I think some of his presentations you can get online free. There’s a doctor in Portland, Oregon, named David Allderdice, A-L-L-D-E-R-D-I-C-E, Dave Allderdice, and he’s done presentations on acid/alkaline in cancer that are very much based in the current science. So what the person you’re talking about there was saying is this oversimplification of well, there’s acid and cancer thrives there. That actually does work. It just doesn’t work the way that people have talked about it for a long time.  So again, it’s a little hard of a concept to explain really quickly, but it’s not exactly that simple, but there is benefit in having alkaline forms, especially in minerals, going into your patient on a regular basis, kind of like vitamin C. It’s a base thing. Yeah. So you can read through that stuff. But I just want to end really quickly, secondary prevention, as was said at the beginning, we’re getting more people who survive and they’re in no evidence of disease or remission, or they have stable disease and their oncologists tell them, “Okay, go live a good life. Don’t get cancer again,” or something.

And now they’ll come to us and they’ll say, “Well, what do I do for secondary prevention?” And nobody likes the answer until you explain it to them and that’s that you have to investigate all of those areas, so all of those eight areas, whether it’s cell function, infectious and autoimmune and resistance factors, GI toxins, on and on and on, and people say, “Why is it so important in secondary prevention?”  Well, there’s a couple things. One is you could go into cancer treatment with no endocrine problems and come out with a ton of endocrine problems. If you don’t fix as many of those as you can fix, the person will not maintain their health. You can come out of cancer treatment very toxic. Most people go in very toxic and they don’t know it, but you can be super toxic when you come out. If you do not open up the bodies [inaudible 01:20:58] and get the toxins moving out, you will never keep that person in remission.

I have never tested a cancer survivor who didn’t have at least one, if not five infections, stealth infections, that they didn’t have any symptoms of. And the reason for that is either the cancer and/or the cancer treatment squelches their immune system so much that they’re growing all of these infections and they don’t know it. So you have to look at all. And like I said, the GI tract is this constant project you’re working on. So you’re always trying to repair that.

And then you got physical and structural and psycho-emotional, et cetera. So [inaudible 01:21:44] prevention literally is looking at everything and you don’t have to do it all at once, but you pick what’s the worst things you find. Do we want to work on endocrine first? Then do we want to go to toxic stuff? And then do we want to work on the leftover infectious things or should we really tackle the infectious things first and work our way down? Somehow you got to look at that as a constitutional holistic approach to the patient.

And that’s really these areas. Now, people say, well, which ones are usually messed up in people after cancer? The answer is they all can be. I’ve found all of them in people, but the most common are toxins, endocrine stuff, infections and gut problems. And obviously there’s going to be physical and structural as part and parcel. There’s going to be psychological issues that come up, there’s going to be other stuff. But those are the big areas that I find with people trying not to have cancer come back.

Dr. Weitz:                          Do you ask your patients to get a stool test at some point during the process?

Dr. Anderson:                    And a lot of this depends on if you’ve had them from the beginning, when they first got diagnosed and you’ve really been working on their gut, maybe you’ve really done a lot of work there, but a lot of times we get people later in the stage. And I really think that because the gut is so important and cancer treatment ruins the gut so much, some kind of a test to look at the gut integrity, the leftover infections. I like the ones where you’ve got a number of different laboratory type views in.  So that would be maybe some PCR and some culture and some microscopy of say the stool testing, also though there’s usually the membrane. The GI membrane is pretty inflamed. So you’re trying to heal that up. And obviously if they have sensitivities or allergies, that feeds into that, so I see definitely-

Dr. Weitz:                          Which stool testing you like best?

Dr. Anderson:                    Well, I’ve used a number, but not everybody. Okay. So the two I’ve used the most, and I forget their specific names from each company, but Doctors Data has one that has that combo of some PCR and culture and microscopy. And then also Genova has a similar one, but there’s others too. You just want something that kind of gives you as broad of a look into what’s going on with the microbiome as you can. Yeah. So this is kind of the, like I said, the focus is they need to know, look, you don’t have to jump on this all at once. This is a long term thing. We want to keep you alive for a long time. So let’s work on cleaning your body.  Most people can wrap their head around cleaning their body up.  And so if you check them and there’s not a lot of infectious stuff, move on. Usually you get to toxins and there’s a fair amount of toxic stuff.  And so you get them doing the basics, like saunaing and some glutathione.  And then if there’s metals, you use specific things there.  If there’s chemicals and mycotoxins, you do more binders.  And then the endocrine things, they can be pretty bad, depending on the type of cancer somebody’s had.

You give a lot of really slow thyroid and adrenal function [support] usually, just because they’re so worn out from the cancering process. And in almost everybody, you don’t want to overdo these things with the hormones, but you can bring the adrenals and the thyroid back up to good levels and that’s not going to hurt anybody’s cancer. In fact, it’s going to make them a little more resistant. If they have a hormonal type breast cancer or prostate, and it’s very hormonally active, then you have to be a little careful with the reproductive hormones.  That depends a lot on what they’ve got going on, but there are a number of things like as you clean up their system, a lot of their side effects from hormonal therapies, et cetera will just improve anyway.

And this is something I try and share with patients. And that is that the white crescents here are actually how much intervention the standard system has. And the gray is how much potentially we can do for them. So in primary prevention, there’s almost nothing in the standard system for primary prevention. There’s a few things.  Diagnosis and active treatment, yeah there’s little bit more because maybe they’re getting surgery or chemo radiation, something like that, but there’s still a lot. They’re not doing a ton with a person’s diet and their gut, not doing a ton with side effects, not doing a ton with even enhancing the other therapies. Recovery, again, not much that they’re going to do, and secondary prevention there’s almost nothing from the standard point of view.

All right. So whether we have time or not, I’m open for questions.   I’ll send you these slides.

Dr. Weitz:                            That’d be great. Yeah. You mentioned using glutamine for some of the side effects for the mucositis. Maybe a couple of other clinical pearls for helping with some of the side effects from chemo and/or radiation.

Dr. Anderson:                    Yeah. I think that certainly glutamine is one of the things we think about a lot. Also let’s say maybe you just don’t feel comfortable using glutamine. There are other things that I use in place of glutamine for the mucositis, et cetera, one which you can get from a number of supplement companies is called zinc carnosine. And so it looks like a zinc supplement, but it’s actually the carnosine that does the gut healing and it’s actually a bit anti-cancer, et cetera. So that’s a good replacement for glutamine. The other though are some of the gut repair powders that you might use that may have a little glutamine, but they’ll have like some demulcent herbs in them like slippery elm and marshmallow, things of that nature. Those aren’t going to do anything to the cancer and they’re going to be very healing to the gut.

As long as the person’s white cell count is not suppressed, so they’ve got at least 2,000 total white cells, I also give them human microflora type probiotics. During chemotherapy, I don’t use non-human strains. So I don’t use spore based and I don’t use other non-human strains. I might use them elsewhere, but during chemotherapy, I only want their gut to see what would normally be in a human. So the HMF types, human microflora strains. So as long as they have some white blood cell count, I have them do it, eat it in a little bit of yogurt or some applesauce or something. So a demulcent like let’s say slippery elm or marshmallow, or one of those powders that’s got it all in one thing and then throw the human microflora things in there.

The other thing that’s very helpful, if you can get the person earlier on, is like I said, probably in 98 out of 100 cases, you can have go-tos such as curcumin and milk thistle, and they will generally be very supportive to the chemo, but also supportive to keeping your normal tissue as healthy as possible through the process. Now, like I said, if you’ve got one of these new targeted therapies or something like that, what I do still to this day is I’ll look the targeted therapy up, the category like PD1 inhibitor or something. And then I’ll look up, I’ll say any data on curcumin and that, or the other. And usually you don’t find anything bad and then I’ll feel good going forward.  If you can get people early on and you’re doing melatonin, whether it’s a moderate dose or the 20 to 60, or even the super high dose, that pretty much doesn’t have anything it crosses over negatively with and so it’s easy go-to.

Dr. Weitz:                            And do you have them take all the melatonin in the evening or do you split it up?

Dr. Anderson:                    It depends a bit. I usually have them ramp their doses up to if they’re doing high dose because it can disrupt their sleep. And there are some people who are not sensitive in that way, so they could take their melatonin at dinner and after dinner and at bedtime and they’re not falling asleep on the couch. Other people are very sensitive and they have to take it closer to bedtime. I have them start and I usually give them a 10 milligram [inaudible 01:31:46] for a week, take this within an hour bedtime. Let’s see how you sleep. Let’s see how you do. If that goes well, we go right to 20 and then 40, and then 60. If they’re doing the super high doses, like an aggressive cancer, then we may split it up more.

Dr. Weitz:                          Dawn, do you have a question? Do you want to unmute yourself?

Dr. DeSylvia:                     Hi, thank you.

Dr. Anderson:                    Hi.

Dr. DeSylvia:                      Hi. So I have two quick questions. What’s your experience with SOT therapy? Do you use it and have you found it helpful in patients?

Dr. Anderson:                     I have to answer this carefully so I don’t get sued.

Dr. DeSylvia:                      Okay. Yeah. It’s maybe similar to my experience.

Dr. Anderson:                     SOT, so this is not sacred occipital technique. This is specific oligonucleotide therapy. So I’m not talking about occipital. So that therapy, if you look at it from the top down and the science around it, it has a big upside in future, I believe. The problem is at least what we have available right now in North America, it’s been only available through one company that I have personally and in groups I’m in with people who do a lot of this, not had good success with, but also not had good, reliable resulting from. And so because of that, I’ve not seen it really show out in a lot of people’s cases. [inaudible 01:33:40] people who do, but yeah, I don’t.

Dr. DeSylvia:                      Yeah, I appreciate that. And that’s been my experience, but again, it sounds so good on paper. So hopefully someone here-

Dr. Anderson:                    Patients really want it, and what I was telling them is it’s like it’s not ready for prime time and I wish it was. As soon as you start seeing more, if this happens, because the theory and the science behind it is actually fairly solid, as soon as you start seeing more people enter the SOT world from the laboratory point of view, I think that’s when I would maybe return back and look at it again. And I’ve experienced, so I consult for some hospitals outside of this country, and we have associations with real live big universities and their immunology departments and everything.  And we’re working on cancer vaccines and dendritic cell treatments and all this stuff. And what I know from working with the actual immunologists is all these things have a huge potential upside in the future, but anyone doing them now is doing them at like 10% of what they really could do, because we just don’t understand the tech. The technology is actually quite complex in these things. Yeah.

Dr. DeSylvia:                     Yeah. And thank you. And along those lines then, I have a lot of patients that ask for my advice of where to go. And I know you’re not seeing patients, but do you see a difference in Hope For Cancer or Integrative Cancer Centers of America? Or someplace else? Is there some center that you feel stands above the other ones or somebody who’s doing something that …

Dr. Anderson:                    I know some of those places and not others. I’ve had patients have good results with Hope For Cancer. There is a much lesser known smaller integrative center in Baja. And if you look them up, they would be under Nube Health, N-U-B-E. I believe it’s a Spanish word.

Dr. DeSylvia:                     Oh, great.

Dr. Anderson:                    Nube Health. And they do a lot of really interesting … They have a lot of doctors who consult and they do a lot of very interesting integrative treatments, including photodynamic therapies and IV and all kinds of stuff. I think of them, they’re a lot smaller than a lot of these other big places that you know the names of, but I’ve shared and consulted with them on patients that were in quite bad shape and they’ve kept them alive, which is usually, I mean, if anyone can do that, that’s a pretty good thing.

Dr. DeSylvia:                      Yeah. Yeah.

Dr. Anderson:                     So Nube Health, they’re also known as Baja Medgate, M-E-D-G-A-T-E. They’re worth looking at, and what I often tell patients is, I mean, if they’ve got time, I’ll say, look, give me the list of who you’re considering. I’ll tell you my top three or whatever. Visit two of them and see who you resonate with because they all do good stuff, but some do some stuff better than others. And quite frankly, some of them are way more expensive than others and that may take them out of the running too. Yeah.

Dr. DeSylvia:                       Thank you. That’s helpful.

Dr. Weitz:                            If I may, I’d like to ask you one more question. There’s a lot of medicinal mushrooms and it seems like for a while this mushroom was the most popular, it was AHCC, it was maitake D fraction. What do you think is the most powerful mushroom supplement for cancer patients?

Dr. Anderson:                    Yeah, I was going to bring that up earlier. Thank you. Well, the way I look at mushroom supplementation is it kind of depends where they’re at in the process. So I was not involved with it as much when we were doing the NIH research, but another part of our group was doing a lot of work with Cory Ellis, with turkey tail, which we hear a lot about. And there were a lot of tough cancers that they were actually having some good results with. And then they used it a lot in breast cancer and your common breast, colon, prostate, et cetera. So a lot of times what I would do with people would be during the active treatment phase, I would do specific mushroom things, such as turkey tail specific intervention or AHCC is another one you brought up. I use that a lot.

And then if we got past the active cancer and we were more in the prevention stage, often what I would do, and this is more based on looking at it from more of a botanical medicine point of view, I would often transition them off of the specific, where there was AHCC or turkey tail, something like that, or even maitake. I didn’t use that as much, but that would be one. And I would go to more of a blend, a mixture. And this is certainly not the only company, but it’s the one that comes to the top of my brain. Fungi Perfecti has one called my community, which is one we would transition people to when they were more stable.  And it’s just a mixture of medicinal mushrooms, because each of them, the reason you might use AHCC or maitake D or turkey tail or whatever at higher doses early on is they’re having a pharmacologic effect driving metabolism in one direction, which is great, but you don’t need that forever. So if the person gets over the hump and they’re in prevention, I like to broaden the mushrooms out and mostly that works pretty well.

Dr. Weitz:                          Awesome. Thank you so much, Dr Anderson. This was great.

Dr. Anderson:                    Thank you all. I’ll email you these slides. So you guys have them. So Dr. Weitz, I’ll just send them to you and you can do what you need to do.

Dr. Weitz:                          Great. Okay.

Dr. Anderson:                    And yeah, so at the bottom of all of my slides is my website and there’s hundreds of things you can search on there. They’re free. There are some courses, but do your search on there. There’s a ton. I have all my monographs that I wrote for cancer treatment and interactions and stuff like that, that we did for the research project that are free on there too.

Dr. Weitz:                          Great. Thank you. And thank you everybody and see you next month.

Dr. Anderson:                    Bye guys.

 

---

 

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

 

 

Podcast: Play in new window | Download | Embed

Subscribe: RSS

Dr. Christopher Shade discusses How to Reverse Biological Aging 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

3:05  Dr. Shade said that his chronological age is 53, but his biological age is younger. This is now measured by looking at methylation patterns on CPG islands in your DNA. This is through epigenetic clocks, such as the Horvath clock, as found in the Tru-Age test from Tru-Diagnostics.  [Turning Back Time with Epigenetic Clocks.]  The clocks have been trained or correlated with IQ, grip strength, balance, facial aging, etc.  If you are aging at a rapid rate, if you have a faster loss of function, then your biological age might be 70 when you’re 53, or if the pace of your aging is slow, then your biological age might be 43.  Our goal is to reduce our biological age to extend our health span.

6:35  Dr. Shade and Quicksilver Scientific have conducted a study using their supplements for three months and measuring their biological clock using TruDiagnostic’s TruAge test and the preliminary results look very good.  They saw improvement in the Horvath clock and in the pace of aging.  They beat the results of a two month caloric restriction trial.  They also saw positive epigenetic changes in certain white blood cells–monocytes and natural killer cells. The first month was detox with support for Nrf2 and AMPK activity (70% Nrf2/30% AMPK).  Second month, they shifted to 70% AMPK, 30% Nrf2, and a lot NAD+ and membrane building and sirtuin activation.   So clear things out, detox, then build up metabolic strength. Then the last month, we kept going on that mitochondrial metabolic strength, and the results were very positive.  According to Chris, “you start with AMPK phosphorylation with this PGC1A promoter for mitochondrial biogenesis, but then you have to deacetylate it with sirtuins, which means you have to have enough NAD+ to do that, and then you get full activation mitochondrial biogenesis, which makes more mitochondria per cell.”

11:14  AMPK, Nrf2.  How to slow the aging process should start with AMPK activation and this often goes hand in hand with Nrf2. Nrf2 is a master switch for chemo protection and when it’s upregulated, it’s called a nuclear transcription factor which means that it’s outside the nucleus and something triggers it to go into the nucleus.  Nrf2 is part of the chemo protection family, which includes antioxidants, detoxification, protein regulation, getting rid of unfolded proteins, fixing damaged proteins, and this is all cleanup stuff.  For example, to get rid of heavy metals, you need to raise nrf2 to bring up the glutathione genes and get rid of toxins like heavy metals.  AMPK can be triggered by fasting, carb restriction, exercise, and various nutraceuticals and pharmaceuticals such as metformin, berberine, resveratrol, and quercetin.  Fasting and carb restriction triggers you to mobilize and efficiently use your own stored energy resources, like glycogen, old proteins, and stored fat.  You use old proteins through autophagy.  You can increase glucose transporters, and lower insulin resistance/increase insulin sensitivity.  You are also going to mobilize stored fat and turn it into ketones for energy.  You can burn the fat out of fatty liver, which is called lipophagy.  If you take old, damaged mitochondria, and recycle them, this is mitophagy.  If you use old golgi apparatus and old endoplasmic reticulum, this is endoreticulophagy.  It’s the inner detoxification for your broken inner parts. So Nrf2 is more taking away environmental toxins and AMPK is more clearing out your own accumulations of waste, and that also includes unfolded proteins.  When you are always building proteins, sometimes you don’t make them right all the time, and you store the ones made improperly in vacuoles.  Eventually, if you don’t get rid of them, then your cells fill up with garbage.  So Nrf2 is an environmental cleanup and AMPK is a biological cleanup, and this raises yourself up to a higher metabolic efficiency. 

16:30  This autophagy happens because the body senses there are not enough amino acids to make up the proteins the body needs. There is also a switch that is engaged with this, called mTOR, the mammalian target of rapamycin.  Rapamycin was the first cancer drug that might be good for you because it blocks mTOR.  mTOR has a forward direction that is pro-growth and anabolic and then it is blocked and it causes you to go inward and recycle your own amino acids and burn your fat. If you are in growth mode all the time, you’re prone to cardiovascular disease and cancer.  Insulin and branch chain amino acids drive the pro-growth signals, while keto and intermittent fasting and the nutrients in the AMPK Charge product that Quicksilver produces and metformin all drive AMPK.

20:02  Uric acid.  There is a primal switch when your ATP (cellular energy) gets low, you can either go down the AMPK route or the AMPD route.  AMPK goes in and mobilizes resources, cleans up, and gives you insulin sensitivity, while AMPD does the opposite. AMPD increases fat storage, it further breaks down ATP. You burn off the AMP into xanthene, and then xanthene oxidase turns into uric acid.  Uric acid comes back around and blocks AMPK and keeps you stuck on the AMPD pathway. This AMPD pathway generates more uric acid, which creates creating mitochondrial stress and free radical damage inside the mitochondria, and it’s heavily associated with cardiovascular disease and early onset dementia.  If you are eating high fat but not restricting carbs enough, then you might need more polyphenols, more vegetables, you might not be eating enough vegetables, you might be eating too much salt, having too much alcohol, or not drinking enough water. 

22:40  Does promoting AMPK reduce cancer risk or protect cancer cells?  The reality is that while promoting AMPK and the other longevity pathways can prevent cancer, if cancer is present, they can also protect cancer cells.  But this is no reason not to promote the longevity pathways.

25:21  AMPK.  The best ways to stimulate AMPK is through intermittent fasting and also by working out fasted.  Almost every plant chemical has AMPK activation activity, including adaptogens and spices. The really strong ones include Berberine, Resveratrol and Quercetin.  Quercetin is so multifaceted because it stimulates AMPK, Nrf2, and sirtuins and is also a senolytic.  Milk thistle is both a AMPK and a sirtuin activator of the liver.  Many of the products that have AMPK activity also stimulate the sirtuins.  Ben Greenfield says that HIT training is the best way to activate AMPK with alternating periods for 30 seconds of all out training alternated with periods of rest. Morning is naturally more AMPK than night is. You have already fasted over night and there tends to be more autophagy in the morning and more rebuilding at night while sleeping.

29:35  NAD+.  NAD+ is a signaling molecule that’s present in the body for energy production, cellular energy, and for DNA repair.  At it’s most basic level, it’s going back and forth between NAD+, the oxidized form, and NADH, the reduced form. NAD+ is taking the electrons from your carbs, becoming NADH and going into the electron transport chain and dropping the electrons into the high energy electron transport chain and leaving the proton there. That’s eventually going to be pumped across the membrane, form that proton gradient, and come back through ATP synthase, and drive ATP formation.  So it’s shuttling energy from the sun, which is what built your carbs and your lipids, and bringing it in to make ATP.  NAD+ is also a cofactor in sirtuins, which are deacetylases. Acetyl groups are turning on or off different proteins.  To turn on the good anti-aging things, you deacetylate them, and turn on the bad anti-aging things, you acetylate them. But why would you want to acetylate the bad anti-aging things?  It’s to stop cancer growth.  While substances like resveratrol and pterostilbene and quercetin are sirtuin activators, NAD is the initial activator and it fits right into this hole in the sirtuin and activates it. NAD is also essential for gene repair. As we age, we’re always having assaults on our genes from getting exposed to toxins and radiation, etc.  PARPs go in to fix the genes, but they use the energy of NAD in this repair.  There’s also CD38, which also known as cyclic ADP ribose hydrolase, which seals up tight junctions when you get leaky gut or leaky brain or leaky liver, and this sucks in NAD as well.  NAD is doing all these things in every organ and therefore NAD deficiencies can play a role in eye disease, in fatty liver disease, in heart disease, etc. The way to promote NAD is to take one of the precursors like nicotinamide riboside or NMN.  Ideally you might want to take both of these, but because different companies hold the license to each of these, it would be too expensive to put both into a product. 

NAD originally comes from niacin, vitamin B3.  This is the story of the B vitamins. And then there’s the decrepit, degenerate, benign folic acid that everybody hates.  And then there’s the glorious 5-methyltetrahydrofolic, and then some of these half losers in between like folinic acid.  So it’s the same game.  B3 works its way up to NR and then to NMN and finally to the glory of NAD.  If NAD runs everything in the body, what can you do if you are a hunter gatherer and you don’t eat any food with niacin in it?  You can make niacin from tryptophan.  If you can’t eat any tryptophan, then you can recycle some of your cells, spit out some tryptophan and make it that way. It just takes longer and it takes more energy.  The enzymes that facilitate the jump up to NMN can get knocked out by inflammation and by age, so taking NMN and NR are the best ways to boost your NAD.  But there is also a balance with methylation. After the high phosphate bonds in NAD are broken down, you are left with nicotinamide, which is the non-flushing niacin, which blocks your sirtuins. You need SAM-e to methylate nicotinamide. If you deplete your SAM-e, this creates SAH, which creates Homocysteine, which gives you cardiovascular disease, inflammation, and depression.  So if you want to support NAD production, you also need to take B2, B12 and TMG to stimulate methionine regeneration.

42:36  Sirtuins.  Resveratrol and pterostilbene are both good products to stimulate the sirtuins. Quercetin and fisetin can also stimulate sirtuins and fisetin is also a senolytic.  When David Sinclair originally tried to promote longevity just with resveratrol, it didn’t work because you also need NAD activation or you will get mitochondrial dysfunction and then you also need enough methylation factors as well.

48:33  Senolytics and senescent cells.  A senescent cell is one that has suffered a toxic insult or mitochondrial dysfunction that causes telomere attrition.  Then the mitochondria start releasing pro-inflammatory mediators that diffuse out through the cell and cause growth cycle arrest.  The cell stops reproducing and it just sits there, becoming a zombie cell and it releases pro-inflammatory mediators.  That’s one of the major causes of the propagation of all that inflammation that shrivels us up and makes us old and decrepit.  There are two ways to get rid of these cells. You can reverse them and put them back into growth again and have them repair their mitochondria by having good Nrf2 and AMPK activity that restores the milieu inside the cell and restores the redox potential.  The other way is to get rid of these cells with senolytics, such as with quercetin, fisetin, resveratrol, pterostilbene, or curcumin.  Measuring senolytic activity is a challenge because when you go in and start cutting up these cells, there is a burst of senolytic cytokines, so it looks like there are more senescent cells rather than less and it takes a while to show a decrease.  We can show that senolytics can reverse phenotypic aging, but we can’t measure a decrease in sensecent cells as of yet.

52:38  Spermidine.  This was first isolated from sperm, but now can be derived from wheat germ and other vegetable products. It has a lot of activity for autophagy and mitophagy and senolytic activity.

53:45  Dosages.  Quicksilver products are in a liposomal form, which increases absorption, but they often include much lower dosages of these longevity products than the studies show are effective. So how do we know that we will be getting the proper dosages in these products. Chris explained that their quercetin product has a 25 fold increase in absorption, so 20 gm is equivalent to 500 mg.  Because their BioAge Reversal study, which has yet to be published, showed that using their products for three months was able to reverse the biological aging process, so the dosages used must be effective.

 

 

---

---

Dr. Christopher Shade is the founder and CEO of Quicksilver Scientific, which has revolutionized the nutritional supplement industry with their innovative nanoparticles and liposomal delivery system, their heavy metal testing, and their detoxification protocols that have become the standard for many for reducing heavy metals and mycotoxins.  Quicksilver also offers a great suite of age optimization products, including metabolic activators, NAD+, and adaptogenic blends, as well as hormone support.

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. Very exciting today to be talking to one of my favorite guests, Dr. Christopher Shade. Today, we’ll be speaking about longevity. We will be speak about how to delay the aging process to reduce the likelihood of chronic diseases and how to live longer and better, how do we take that aging curve where we see that aging for many is this long slow decline in function and increasing onset of chronic diseases that starts in our 30s and 40s, and turn it into a big rectangle where we maintain a strong level of function for a long period of time, and then quickly drop off.

Today, we’ll be talking about some of the key metabolic pathways and processes that have been identified to play a big role in aging, including AMPK, Nrf2, sirtuins, NAD+, senolytics, as well as hormones and toxins. I recently heard David Sinclair, famed longevity researcher saying on his podcast that these longevity survival pathways are like the Pentagon, which is where the coordinated defense of our country is organized, and we’re trying to make a crank call to the Pentagon for them to send out the troops to defend the body even though there’s no immediate threat. That’s what we’re doing when we are taking nutraceuticals, using drugs off label like metformin, peptides, practice intermittent fasting, cryotherapy in order to stimulate these longevity pathways.

Dr. Christopher Shade is the founder and CEO of Quicksilver Scientific, which has revolutionized the nutritional supplemented in industry with their innovative nanoparticles and liposomal delivery system. They’re a heavy metal testing and they’re detoxification protocols that have become the standard for many for reducing heavy metals and mycotoxins. Quicksilver now offers a new longevity line. I also want to say that after listening to this podcast, you can get 15% off your next order of products from Quicksilver Scientific by using the affiliate code WEITZ15. Chris, thank you so much for joining me again today.

Dr. Shade:           Great to be here, Ben.

Dr. Weitz:            Good. So before we get into what we can do to live longer, what do you think is the … Let’s talk about what’s the difference between chronological age and biological age, and then what’s the best way to measure this.

Dr. Shade:           Yeah. So chronological age, we all know I am 53 right now, but what’s my biological age? There’s a lot of ways that they go about measuring it. For a while, they were looking at different blood markers, and then what’s grown to be the norm is looking at methylation patterns on something called CPG islands in your DNA. So these epigenetic clocks like the original Horvath clock have been used extensively, and it’s funny, they say that they train the clock with people at a certain age more or less function.  So they’re taking people and they’re relating IQ, grip strength, balance, facial aging, IQ all to biological age versus the chronological age. There’s also a new clock. So in fact, as we talk, we’ll talk about a 40-person study where we put them through the paces of one of our systems to detoxify, raise AMPK, raise mitochondrial strength, and we’re able to shift back the biological age in this cohort.

Also, there’s a new one called the DunedinPACE.  Who names these things? Dunedin, if you’re from New Zealand, you’d be like, “Well, yeah, that’s called Miami Beach.” Dunedin is this little beach town at the south of New Zealand. They don’t make Miami beaches there. They make Dunedins.  So they had calibrated this clock. It was between Duke and these guys at the University of Otago and one other place, maybe Oxford. What they did is they worked on the pace of aging. So it’s more of an instantaneous measurement of the pace of your aging, how fast these genes are shutting down over time. So time is this progressive loss of function, and if the loss of function happens faster than the chronological years, then you’re aging at a rapid rate. So your biological age may be 70 when you’re 53.  When the pace of aging is slow, then over the period of time of having a slow pace of aging, then you get to 53 and your biological age is 43 or one of my friends at one of my doctors who prescribes for me, she’s 54 and she registered a 30.

Dr. Weitz:            Really? Wow.

Dr. Shade:           She uses everything. Yeah. So there’s these measures, and what we’re trying to do is extend our health span. You brought it up, run as fast as you can and then quickly. Remember the Blues Brothers? It’s the Blues, and it just drives like mad, and it’s cruising down the highway and the cops are all crashing trying to catch it. It gets to the final courthouse where it’s supposed to stop. They closed the doors and it just falls into a pile of bolts and it’s all over. So that’s what I want it to be, and that’s what we try to have is to have a good health span.

Dr. Weitz:            Right. Exactly. Yeah. So have the results of that study that you did with the biological clock, the study’s been completed?

Dr. Shade:           Yeah. It’s been completed. We got the analysis back. We’re using TruDiagnostic, which is the go-to out there now.

Dr. Weitz:            Right. Yeah. I think I talked to Ryan Smith. He mentioned that you guys were doing a study.

Dr. Shade:           Yeah, yeah. So we finished that all up and the results were great. We got very significant changes in the Horvath clock. We had very significant changes in the pace of aging. We, actually, in three months there, we beat the results from the calorie trial, which was a two month caloric restriction trial. That’s the only thing shown to slow the pace of aging. They pulled back 25% on their calories for two years. They changed the rate of aging, but they didn’t change the absolute clock.  Then looking into subsets, we found really strong changes in immune, and when you’re looking at the genes that were differentially hypomethylated or hypermethylated, a number of these were related to immune cells. So there’s a significant change epigenetically in the monocytes, in the natural killer cells, and what was the other one?  I got it here on the screen behind me.  Coming on now. There it is. B cells. Yeah. Natural killer B cells were the most significant, and then monocytes after that.  So it was really exciting. It was a three-month program. The first month was a detox, but with AMPK activity to it, say 70% Nrf2, 30% AMPK. Second month, we shift to 70% AMPK, 30% Nrf2, and a lot NAD building and membrane buildings, sirtuin activation, getting the mitochondria really clear. So clear things out, detox, then build up metabolic strength. Then the last month, we kept going on that mitochondrial metabolic strength, and we got these great results. As we talk about this more, we’re going to see some of these things are hard to uncouple like Nrf2 and the AMPK. You think they’re separate, but they’re so coregulated.

Then AMPK and sirtuins.  Well, one is just a secondary level of the other.  A lot of this metabolic clarity, I like to call it cardiometabolic efficiency, begins at AMPK. Then if you have enough NAD, you encode that into sirtuins secondarily.  So like mitochondrial biogenesis, you start with AMPK phosphorylation with this PGC1A promoter for mitochondrial biogenesis, but then you have to deacetylate it with sirtuins, which means you have to have enough NAD to do that, and then you get full activation mitochondrial biogenesis, which makes more mitochondria per cell.  So there are almost like these interwoven progressive layers of encoding this higher level metabolism.

Dr. Weitz:            That’s interesting. You mentioned about the immune system function and that’s definitely one of the markers of aging is when we age, the immune system tends to have less and less function, which is why you see-

Dr. Shade:           Senescence.

Dr. Weitz:            Exactly. So I read the Fahy trial in which it was the first trial that they were able to reverse aging, and they also looked at something called thymus involution, which means shrinking of the thymus gland, and they were able to reverse that, and have it as an indicator that the immune system is actually getting stronger rather than weaker, and that’s super important. In fact, we just recently saw what happened during the pandemic to seniors who have a weaker immune system. They weren’t able to fight off the virus as well.

Dr. Shade:           Yup. Yeah. They were really wiped out and it was like, “I wish I could have done some of that thymus work.” I mean, they were imaging them and stuff. We weren’t really set for that, but I’d love to go in deeper and reproduce some of these things, get better blood markers. One of the things we tried to do is get some of the blood markers, but it’s so nascent right now.

Dr. Weitz:            You know what? You should talk to Vojdani about doing a lymphocyte map test because that’s the first test that actually maps out all the specific T cells.

Dr. Shade:           Oh, so Ari has that.

Dr. Weitz:            Yeah. Yes. He just came out with it.

Dr. Shade:           Oh, jeez! That would be great. I’m going to give him a call.

Dr. Weitz:            Yeah, yeah, yeah. So let’s get right to what do we need to do to slow the aging process and live longer. Why don’t we start maybe with AMPK?

Dr. Shade:           Yeah. Well, we have this conceptualization of it that we call the longevity wheel, and it looks like a Star of David. It’s a six point wheel, and it’s got pop, pop, pop, pop, pop, pop, and these are things that you can intervene in. The top spoke of the wheel is AMPK, Nrf2. That’s what we’re going to talk about. Just to fill in, then then the next spoke is NAD. Plus, the next is sirtuins. The next is telomeres. The next is senolytics or senescent cells, and then the neuroendocrine system.  Why is Nrf2 and AMPK at the top, and what are the two, and why do they go together? So Nrf2 we’ve talked about a lot. You and I have talked about it’s this master switch for chemo protection, which when it’s upregulated, well, first it’s called a nuclear transcription factor, and that means that it’s outside the nucleus, and something triggers it to go into the nucleus. Sometimes they just hit signalers on the wall of the nucleus that go in, but the signal gets in and it stimulates transcription or upregulation of genes that go with some family.  For Nrf2, that family is the chemo protection family. So it’s antioxidants, detoxification, protein regulation, getting rid of unfolded proteins, fixing damaged proteins. It’s all cleanup stuff, and that’s Nrf2. We always talked about that because that was always metal detox guy. So you got to raise Nrf2 to bring up all the glutathione genes and get rid of toxins like heavy metals.

Then we did a study or actually [inaudible 00:13:10] down in Houston. He’s a functional medicine doc, did study on our PushCatch liver detox system where he found 82% resolution of fatty liver in one to two months. Just really crazy. We’re like, “Wow! You move toxins out and it does that?”  “Well, no, not exactly. That’s part of moving toxins out, but even if you move all the toxins out at once, that wouldn’t totally happen.”

AMPK then is this trigger, the AMP-kinase, and it’s triggered by certain things like running out of energy, and that would be fasting, carb restriction, exercise, and it also can be triggered by a bunch of nutraceuticals and pharmaceuticals such as metformin, berberine, resveratrol, quercetin. So when you trigger this, now remember, fasting, carb restriction, it triggers you to mobilize and efficiently use your own stored energy resources. So you’re going to mobilize glycogen. You can increase actually glucose transporters, and you’re going to lower insulin resistance, increase insulin sensitivity, and become a clean burning machine.  Then you’re going to reach into your fat. You’re going to mobilize fat. You’re going to turn it into ketones. This is how you go into ketosis and you’re going to use all that for clean energy. It’s why these fasting and exercise get rid of the symptoms of metabolic disease, and insulin resistance, things like that.  So AMPK is part and parcel of that cleaning up, but you’re going to your inner resources. You’re using your inner glycogens or sugar and fat. How are you going to use proteins? You get them through autophagy. So this is super, super important to both detoxification and longevity because what’s autophagy but self-eating. You’re going, you’re taking whole cells, you’re taking deposits. In fact, the burning of the fat out of the fatty liver is called lipophagy, so eating the stored lipids.  If you’re taking a old mitochondria that’s damaged, you do mitophagy. You could be breaking out of golgi apparatus and part of an endoplasmic reticulum. That’s endoreticulophagy, and you’re going to break all that down into its raw materials and you’re going to reuse it, and that includes amino acids and fatty acids, nucleic acids even if you’re taking whole cells. So it’s a recycling system. It’s the inner detoxification for your broken inner parts. So Nrf2 is more taking away environmental toxins and AMPK is more clearing out your own accumulations of waste, and that also includes unfolded proteins.

When you’re making proteins all the time, you don’t make them right all the time. And you store the ones that aren’t properly made in these vacuoles, and eventually, if you don’t get rid of them, it’s like taking the trash out of your house. Your house fills up with garbage. So Nrf2 is this environmental cleanup. AMPK is this biological cleanup, and this raising yourself up to a higher metabolic efficiency.

Dr. Weitz:            This happens because the body senses there aren’t enough amino acids around to make up the proteins they need. So that’s why the body starts recycling these other pieces of the cells.

Dr. Shade:           Yeah, essentially. Now, there’s this switch that’s intimately engaged in this, and this is mTOR, the mammalian target of rapamycin. So rapamycin was the first cancer drug that was ever really good for you because it would block this thing called mTOR. So mTOR has a forward direction and a blocked. The forward direction is anabolic and it’s pro-growth and it builds mass and it puts on mass, but we know if we just put on mass all the time, we’re going to get sloppy and messy and dirty. I mean, even weight lifters put on mass and then they cut it back down. All right?  So if you’re growing all the time, you’re prone to cardiovascular stuff and cancer and stuff. So you need a block to that. So when you block it, then you go inward and you recycle your own amino acids, you use your fats, you burn all that. So what drives it forward and what blocks it? So the things that drive it forward are insulin and branched-chain amino acids. The branched-chain amino acids are what goes back to you, sensing that you don’t have enough amino acids around and you start recycling old parts.

So when we’re eating carbs and protein all the time, we’re gaining mass. This is part of why keto was so therapeutic, where paleo, some people it worked and some people didn’t because they took in so much protein they didn’t get as much of the mTOR blocking, but then we have things like intermittent fasting. If we overlay some of these chemical triggers for it, maybe you’re using off-label metformin or maybe you’re using something like our product AMPK Charge or Keto Before 6, and even of our Liver Sauce, that’s why the Liver Sauce gets rid of the fatty liver so well.  Yeah, it was moving toxins and the Nrf2 upregulator, but the quercetin, the luteolin, the milk thistle, those were all strong upregulators of AMPK. So we can take these AMPK activators while we’re intermittent fasting and get this flush of activity. In fact, we used to call the product Keto Before 6 because you could be keto by day and they need carbs at night and then do it again the next day. So you’re getting some of both worlds.

Dr. Weitz:            You think about this argument because I was just talking to somebody about diabetes this morning and she was advocating for not eating a lot of fat because some of the data indicates that saturated fat reduces insulin sensitivity.

Dr. Shade:           I think it’s going to come down to what your blend of macros are, how much saturated, and are we talking about Crisco or are we talking about these beef tallow? Those are both saturated fats, and some are very strongly pro-inflammatory and some aren’t, and then there’s some other-

Dr. Weitz:            There’s a group of folks who are advocating, some of them are advocating a vegan diet, but they’re countering the lower carb diet, often advocated now for diabetics saying, “No, no. If you eat a higher fat diet, it impedes insulin sensitivity.”

Dr. Shade:           I think it’s going to come down to a couple of factors that they may not be looking at. Now, one of the subjects that’s coming up really hot and heavy right now is uric acid, and you’ll see Perlmutter is talking about. Rick Johnson is one of the masters of that. We’re going to have them here lecturing at our Colorado Functional Forum in April. I’m actually roping then into helping me prove out some of the products that we’re making for uric acid blocking.  So then this is going to bring our AMPK discussion back to this switch. You’ll see in Perlmutter’s book, Drop Acid, he talks about is this primal switch. When your ATP goes low, you can go one or two ways. You can go the AMPK route or the AMPD route. AMPK goes in and mobilizes resources, cleans up, and gives you insulin sensitivity. It gets rid resistance. AMPD goes exactly the opposite path. It’s made to get you fat. AMPK is taking off fat. AMPD is gaining fat. It’s breaking ATP down instead of regenerating it as in the AMPK pathway. You’re burning more energy to regenerate your ATP here. Here, you burn off the AMP into xanthene, and then xanthene oxidase turns into uric acid.  Uric acid comes back around and blocks AMPK and keeps you stuck on the AMPD pathway. Now, the AMPD pathway generating all this uric acid, the uric acid is creating mitochondrial stress and creating free radical damage inside the mitochondria, and it’s heavily associated with cardiovascular disease, and more importantly, early onset dementia.

So if you’re eating fat and other things that you’re doing like maybe you’re eating high fat but not restricting carb enough or you are prone to uric acid, maybe you need more polyphenols in your diet, you need more vegetables to block that path or you’re eating too much salt, you’re drinking too much alcohol, the biggest culprit is just not having enough water keeps you always down that path.  So the fat then is going to become inflammatory fat instead of clean burning fat, which is over here. So I think one of the things that I think I’m going to be advocating is that you got your uric acid meter, your keto meter, and your sugar meter, and you’re tuning yourself in so that you’re going down the AMPK side.

Dr. Weitz:            Interesting. I was going down the AMPK rabbit hole this weekend and I found one article that said that AMPK appears to reduce cancer risk by switching off cellular growth pathways, but if there is already cancer, the AMPK might be able to protect the cancer cells against stresses, such as shortage of oxygen or oxidative stress.

Dr. Shade:           Yeah. So is it going to protect against apoptosis? So it can keep you from going into apoptosis and maybe help the survival mechanism, but realize that it’s the biggest freaking trap in the world. Cancer and fear of cancer is the biggest impediment to health because every single thing that makes you live long makes cancer live long.  Now, just shut the damn argument down for a second, then bring it back and say, “What has cancer done that is genius? Cancer has immortalized itself. How does it immortalize itself? It upregulates glutathione. It upregulates NAD production. It upregulates growth hormone production. It controls AMPK and all these different pathways towards its longevity.  Then everybody’s like, “Well, what if I already have cancer? Then any of these things that help my longevity are going to help the longevity of my cancer.” Well, your cancer is going to show itself at some point and then you’re going to go after it, and it’s a certain way that you go after it, but having a healthy AMPK is going to prevent you from ever getting it in the first place. Then being afraid of doing these things that promote longevity, in case there’s some tumor somewhere in you, I don’t know, go get a big scan or something because it just becomes such a trap. Don’t you think?

Dr. Weitz:            Yeah. I’m sure. It’s also, I’m sure, the balance and the double edged sword of things that-

Dr. Shade:           Oh, hyaluronic acid, that’s another thing that cancer has a lot of. So all of a sudden, everything that immortalized cells have a lot of becomes a death trap. Yet, that’s all the stuff that makes you live longer. So yeah, that may be tactically true, but I mean, nobody is saying that when you’re taking berberine and quercetin and EGCD, I mean, there’s people using those as therapeutics for cancer. So I don’t think you’re in any risk of all of a sudden you’re going to go off the deep end.

Dr. Weitz:            So what’s the best way to stimulate the AMPK? What are the best strategies here?

Dr. Shade:           Yeah. So I love intermittent fasting. I think it’s a great thing. Some women it’s a little bit hard, but get as much fasting as you can, then workout fasted. Add in the AMPK activators. Now, here, as a broad brush, almost every plant chemical has AMPK activation activity to it, and including the adaptogens and all those plants that we love a lot of, spices-

Dr. Weitz:            We want to take the ones that are going to be most efficient and take the right dosage.

Dr. Shade:           Yeah, so some of the really strong ones, berberine, resveratrol, quercetin. Quercetin’s such a multicomponent for us and Nrf2, AMPK, sirtuins. It’s a senolytic. That’s a really, really good one. Then things like milk thistle. Part of that is AMPK and sirtuin activation of the liver. A lot of these things that are AMPK activators are also sirtuin activators.  So there’s this whole grouping of things that are really good for your metabolism. So you take those when you’re fasted or at least don’t have a lot of carb in you and maybe get some exercise in.  Ben Greenfield says the strongest AMPK activation are HIITs. He says 30 seconds as hard as you possibly can, and then I think he said four minutes of rest and then 30 seconds as hard as you possibly can, and then 30 minutes of rest, but anyway that you stack some use and exercise, lack of carbs and this and the AMPK activators together, you’re going to get a lot out of that.

Morning is naturally more AMPK than night is. We’ve just gone through the fasting, we’ve already got the fasting primed. Like in the skin, it’s more breaking down. It’s doing autophagy in the morning, and at night, you’re sleeping and it’s rebuilding everything. So I like to stack the AMPK activity into the morning and build up at night. So my carbs, those come at night and I intermittent the fast in the morning. Lunch, hopefully it’s salad and some protein and still low carb, but that varies a little bit depending on where I am. There’ll be times where I’m really cleaning up and then times maybe I just had stem cells or exosomes and I’m a little more anabolic, and then you’ll go more in.  I think understanding those two poles of the day, AM and PM are naturally that way a little bit, and then the pendulum of your life, “I’m trying to build a little bit, I’m trying to cut down and clean a little bit,” and I definitely go into times where I’m like, “Uh-oh. This baby is building up a little bit,” and then I really start fasting hard, and it cleans up really quick.

Dr. Weitz:            You just mentioned exosomes and stem cells. Have you gotten into those?

Dr. Shade:           Oh, yeah, yeah. I’ve gone offshore down to Columbia and done cord blood cells twice. I do exosomes every couple of months.

Dr. Weitz:            Which exosomes do you do?

Dr. Shade:           Which? I use Kimera. I mean, there’s not a lot of them out there. Kimera just shifted to doing only cosmetic. That window is closing a little bit in the FDA. So my freezer is filling up with them until there’s something else. There’s a lot of movement in peptides, too. Those are real good regenerative.

Dr. Weitz:            Sinclair was talking about he had some friends apparently who have a machine where they can manufacture their own peptides at their home.

Dr. Shade:           What? That’s crazy.

Dr. Weitz:            I don’t know. Probably very wealthy friends, but-

Dr. Shade:           Yes. Yes, very, very wealthy, “I have my peptide generator machine here. I got it used for $500,000 from Oxford University.”

Dr. Weitz:            So let’s talk about NAD+, which is this signaling molecule that’s present in the body for energy production, cellular energy, DNA repair.

Dr. Shade:           Yeah. So NAD is awesome, and it’s just the multiple levels at which it works are just crazy. There’s so many levels that are even understandable, but at its most basic level, it’s going back and forth between NAD+, the oxidized form, and NADH, the reduced form. It’s doing that by oxidizing your inputs of energy. That would be carbs and lipids. It’s taking the electrons away from them as your carbs make their way off to CO2 and at each little part of the citric acid cycle, all these different breakdowns. It’s NAD+. It’s taking to electrons, becoming NADH, and then it’s going into the electron transport chain, and it’s dropping the electrons into the high energy electron transport chain and leaving the proton there. That’s eventually going to be pumped across the membrane, form that proton gradient, and come back through ATP synthase, and drive ATP formation.  So it’s shuttling energy from the sun, which is what built your carbs and your lipids and bringing it in to make ATP. All right? So if it just did that, it would be a great molecule, but it does so much else.

So then it’s also the co-factor in sirtuins. So sirtuins are deacetylases, and acetyl groups are turning on or off different protein, and there’s the good anti-aging things and to turn them on, you deacetylate them, and then the bad anti-aging things, and to turn them on, you acetylate them. So when the acetyl groups are on, the sirtuin or a lot of the anti-aging things like FOXOs are off and things like P53, which makes more senescence, and why would you even do this stuff? It’s to stop cancer growth.  So a lot of the slowing down and winding down of the body is to make sure that cancer doesn’t take off and get on a run. So the sirtuins are shifting you over this cleaner building through this deacetylase activity. So we think about things like resveratrol and pterostilbene and quercetin and sirtuin activators, but actually, NAD is the initial activator and it fits right into this hole in the sirtuin and activates it.

Then there’s another hole where the sirtuin activating compounds. You’ll see Sinclair call them STACs. They fit into another part in the molecule and hyperactivated, and get it super wound up. So NAD is essential for having these sirtuins go on, and then it’s also essential for gene repair. So as we get older, we’re having assaults on our genes all the time and, say I get exposed to some radiation and it damages a gene. There’s something called a PARP that’s going to go in and try to fix it, and it has to use the energy of NAD to fix.  So it’s sucking anything that damages your genes, sucks a ton of NAD in there. Now, what’s that going to do? It’s going to take the NAD away from the mitochondria so the mitochondria can’t complete the electron transport chain, and you’re lowering energy. It’s going to take things away from sirtuins, so then the sirtuins aren’t going to be deacetylating the good genes, and so it’s sucking all this repair over there.

There’s also CD38. One of the good things that they do is seal up tight junctions when you’re getting leaky gut or leaky blood-brain barrier or leaky liver. So that’s sucking NAD into that activity, too. So there’s this hole, and then there’s some other ones that I don’t to understand as much into how it’s deciding which genes are turned on and off, so this epigenetic regulation of the epigenome, what we can turn on and what we can turn off. It’s basically, do we have NAD despair?  We’re going to turn on the good. Do we not?  We’re going to just hold our own.  We’re going to hold the fort down and make sure we’re at just default functioning.  When we’re in default functioning too long, there’s a lot of theories of cancer emerging from in that default functioning, this explosion or this overgrowth.

So NAD is doing all these things throughout every organ, and you could relate NAD deficiencies to eye disease, liver disease. I mean, you waste out your NAD, fatty liver is the first thing that you get, heart disease, every different organ. So NAD is really, really a powerhouse for driving the whole body and then driving what are the expressions of your genome. Remember, this is the consciousness of the body is deciding. You have multiple pathways, multiple possibilities for your consciousness to choose from in your physiological outcomes. NAD is right in that decision tree of what’s possible and what’s not possible.

Dr. Weitz:            A way to promote NAD is to take one of the precursors like nicotinamide riboside or NMN, and there seems to be two camps and debates as to which one is more effective.

Dr. Shade:           Yeah. Well, that’s just basically because humans like to be on this camp or the other camp. You’re a freaking liberal or you’re a freaking conservative, and you’re demonized either way.  It’s just, “Oh, are you NR or NMN?”  Look, where did all this still come from?  It comes from Sinclair.  Then he’s loathed to hear this, but his advisor, Leonard Guarente and him had a little rift.  So Guarente is all about pterostilbene and NR and has MLM product doing that, and Sinclair is all about resveratrol and NMN and had some shit on that.  So they got this little war like, “Which one is better?”  They’re both good.  Really, you want both of them probably in a product, but you can never get a license to get both of them because there’s intellectual property around it.  So we have a liposome of NMN. I made a liposome for Crominex of NR. It was freaking great, but they didn’t want it. So I can’t do that, and so I just do the NMN, but in the liposome, it’s freaking great. So the camp thing is silly there, but let’s get back to how you build that NAD and where does NAD come from normally? So NAD, nicotinamide adenine dinucleotide.

Dr. Weitz:            Niacin.

Dr. Shade:           Right, right. So this is the high level of B3 and you look at it like the story of the B vitamins. There’s the decrepit, degenerate, benign folic acid. Everybody hates it. It does nothing but lay vape to the universe, and then there’s the glorious 5-methyltetrahydrofolic, and then some of these half losers in between like folinic acid. So it’s the same game. B3 works its way up to the glory of NAD, and right before that you’re NMN, and right before that you’re NR.  So that’s where all this sequences, but as we get all, it’s hard to take the degenerate vitamins and make them into the glory. You’re just not as good of it, but then you think, if NAD runs everything in your body, what are you going to do if you don’t have some food, you’re a hunter gatherer and there’s nothing with niacin in it?  Well, you can make it from the de novo pathway where you make it from tryptophan.  If you can’t eat any tryptophan, you just recycle some of your cells, spit out some tryptophan, and you take it through a bunch of pathways. It just takes longer.  It takes more energy.  The enzymes to get up that last jump, it’s actually the jump up to NMN is that one gets knocked out by inflammation, knocked out by being old.  Anything that makes you sick makes that doesn’t work.  So coming in with NMN and NR are the best ways to instantly get you up to that NAD.

Then what people always miss is the balance with methylation. So NAD, all right, great, it’s going to activate the sirtuin, killer. What’s formed from that? It breaks down and all those high phosphate bonds are broken, energy goes into the system, and you’re left with nicotinamide.  Remember, that’s the non-flushing niacin. Well, nicotinamide blocks sirtuins. So you can’t build up this pool and nicotinamide need to drive it back up into NAD, but if you’re having a hard time doing that, then you’re blocking all your sirtuins.  So you got this circle called the salvage pathway, and it’s going down here and getting stuck.  So what happens then?  You pee it out, but to pee it out, you have to make it into methylnicotinamide. Where do you get the methyl group?  SAM-e?  So SAM-e methylates nicotinamide, you pee it away. You come in with a fresh NMN or NR and you keep driving this cycle, but you’re bringing constant input out and leaving stuff out the back. In doing that, you’re depleting your SAM-e and creating SAH, which creates then homocysteine. So if you keep driving that, you’re going to build up homocysteine and deplete SAM-e. Then what does homocysteine do? That gives you cardiovascular disease and you have lower methylation, and then you’re depressed and you’re inflamed and all this shit. So then you got to stimulate both the methionine cycle, which is going to regenerate methionine from homocystine and that’s interlaced with the folate cycle.  So you want to stimulate MTHFR, which you do with B2, and you want to stimulate the methionine regeneration. So basically, your co-factors you need, you need B2, you need B12, and TMG, and the pauper’s pathway to get there is just lots of TMG.  So if you’re going to drive NR or NMN, you’ve got to support methylation so those two are balanced.

 

---

---

Dr. Weitz:  We’ve been having a fascinating discussion, but I’d like to take a minute to tell you about one of our sponsors for today’s podcast. Are you ready to up level your health? Check out the longevity products from Quicksilver Scientific. They’ve been making premium nanoparticle delivery supplements since 2006, and they have a great suite of age optimization products, including metabolic activators, NAD+, and adaptogenic blends, as well as hormone support to name a few. You don’t have to look any further for comprehensive age optimization supplements with amazing bioavailability and absorption capabilities. To get 15% off your next order of Quicksilver Scientific products, please use the affiliate code WEITZ15, that’s my last name, WEITZ15, at checkout. Now, let’s get back to the discussion.

 

---

---

 

Dr. Weitz:            It’s interesting that you were talking about acetylation, and there’s so much focus on epigenetics as being all about methylation. I wonder if we just haven’t gotten to the research on acetylation and some of these other pathways.

Dr. Shade:           That’s histone acetylation. So there’s methylation and histone acetylation. Those are the two main epigenetic factors, and that’s actually probably how NAD controls so much of the epigenome, but it’s the methylation over time is the thing that is constantly increasing, and that’s the thing that you can do the clock with. They don’t have a clock with histone acetylation, and so they just ignore it, and everything’s about methylation. We all can run to one side and some people are worried, “Oh, my God! If I take too much methylation supplements, I’m going to methylate all my genome.”  In Kara Fitzgerald’s work, she’s a little worried about that, but there’s all this balance, and that’s great. I’m glad that you pointed that out because why aren’t we talking about that side of the whole deal because you look up epigenetics, those are the two fundamental ways that you turn on and turn off different gene sets. It’s important sometimes to shut things off and sometimes to open them up, and you’ve got the balance and you’re allowing both sides and allowing the enzymes to control all that. Then everything’s going to be great.

Dr. Weitz:            So in terms of sirtuins, you just mentioned resveratrol, you mentioned pterostilbene, there’s something called fisetin. What do you think about some of those different ways of stimulating sirtuins?

Dr. Shade:           I think they’re all good as long as you’re feeding in enough NAD. So resveratrol versus pterostilbene, I think they’re fundamentally identical. Pterostilbene has better data going through the gut because it’s got better absorption, but at a cellular level, I don’t think it’s any better. We’re going with nanoemulsions. I don’t really think it matters. We have a product coming out with both of them in it. Till now, we’ve been using mostly resveratrol because pterostilbene was so overpriced, but now it got better so now we’re using both.  Quercetin, I guess fisetin does it, too, but fisetin is also a senolytic. So then we’re going to talk about senolytics as well, but there’s all these things raise sirtuin activity, but if you don’t have enough NAD, here’s where there’s some conflicting data about resveratrol. Resveratrol, they tried to make that into a drug and they ran into phase two trials where some people were getting screwed up by it. Now, they were taking massive doses and trying to drive everything with that. They weren’t even thinking about supporting NAD. So here’s what happens. So I said that-

Dr. Weitz:            By the way, is this where … I remember years ago Sinclair was this guy who his big thing was … We know that caloric restriction seems to have this longevity benefit, but who really wants to live like that, eating 30% or 40% of your calories less than you should, and then the worst tragedy would be live that way like Roy Walford did and suffer, and have this miserable life and then die of ALS in your 70s, anyway, but I remember-

Dr. Shade:           So we’re trying to get to … All right. So he’s like, “Well, then we’re just going to pump the resveratrol in,” because, yeah, like Valter Longo, he points to these people who lived to 105, 110 in the mountains and they’re 4’5″, they’ve never smoked a pack of cigarettes, they had sex once in their life for procreation, and they don’t drink, and they eat a thimble full of food every day. He’s like, “Well, that’s not how I want to live.” So yeah, this is the grail. How do we get all this, right?

Dr. Weitz:            Right.

Dr. Shade:           True to anybody out of academia, let’s do a one hit wonder and cut to the chase. It’s going to take a couple of things all in balance. So he tried to just run it on resveratrol in the beginning, and then they had some studies that were like, “Ah, I don’t think this is working.”  Here’s what happens. If you don’t have enough … Remember I said the sirtuin that get activated has a place for NAD, which is the primary space, it’s necessary, and then it has a secondary space for a sirtuin-activating compound. Well, it turns out if you just jam in tons of sirtuin-activating compounds, it almost sucks the NAD in like a magnet. What does it do? It takes it away from the mitochondria. So then the mitochondria start misfiring. So you have all these sirtuins activating and you have mitochondrial dysfunction.  You can’t drive it with one. If you want to drive the sirtuin-activating compounds, you need to supply enough substrate to have NAD balancing it. Then if you’re going to do that, you need enough methylation factors to balance that, but that’s not that complex of an equation, but if you try to just press one of the damn buttons, it doesn’t work so well.

Dr. Weitz:            Right. Yeah. I think to this day Sinclair takes a gram of resveratrol a day.

Dr. Shade:           Yeah. Yeah, he does, and he takes a gram of NMN, and he probably takes some maltenes. So he’s got it all held up there, but in the beginning, they tried to do it just with the resveratrol. Notice, that was where all his work started. The last couple of years, he’s been all NAD. So he must have been like, “Yeah. What am I missing here?” and then he got all into NAD.

Dr. Weitz:            Yeah. I remember there was a point at which he was the guy who was going to solve this longevity problem, and then there was a point at which it’s like, “Yeah. That’s it. That didn’t work. Forget it.”

Dr. Shade:           Yeah, but don’t throw the baby out with the bath water, just what did we have to balance with that. I had this great paper I found that was biochemical archeology. They were talking about the balance between NAD and methylation, and they were talking about these different societies that grew up and which ones thrived and how the balance of methylation and NAD gave them this power. They were describing if you’re low NAD to begin with, you’re not going to get anywhere, but if you’re high enough NAD to get somewhere, then later in life, if you’re imbalance one way or the other, you get Parkinson’s either way, but there are different Parkinson’s. So there’s the high NAD low methylation Parkinson’s and the high methylation low NAD Parkinson’s, and then there’s the balance. When you balance the two, you raise the whole human potential up. I mean, that’s beautiful.

Dr. Weitz:            That’s beautiful.

Dr. Shade:           The language, spreading fields of proteinopathies, which are uncoupling electron flow from proton flow and spreading fields of proteinopathies leading to the metabolic diseases and degenerative diseases of cancer and neurodegenerative problems. Yeah, exactly. Balance that thing, raise them both up, and just hit hard.

Dr. Weitz:            Let’s talk about senolytics and senescent cells, they’re called zombie cells because they don’t function the way they’re supposed to.

Dr. Shade:           Yeah. So the senescent cell, now, it’s a mitochondrial dysfunction or a toxic insult that causes telomere attrition, that then progresses to mitochondrial dysfunction, and then the mitochondria start releasing these pro-inflammatory mediators that diffuse out through the cell. The cell stops, it goes into growth cycle arrest, stops reproducing, and it just sits there, and it releases pro-inflammatory mediators, which are spreading decaying inflammatory fields throughout the body, but they’re also recruiting other cells into this decaying inflammatory field.  That’s one of the major causes of the propagation of all that inflammation that shrivels us up and makes us old and decrepit. So the idea is to get rid of these cells. So there’s two ways. You can reverse them and put them back into growth again and have them repair their mitochondria, and that’s if they haven’t gotten too deep in, and that’s by having good Nrf2 and AMPK activity that restores the milieu inside the cell, restores the redox potential down to highly reduced, and it can come back on and reboot.

The other is to kill it, and that senolytics, senescent cell. Lysis is cutter. So senolytics, quercetin was the archetypal senolytic. Fisetin or fisetin came on as a really good one as well, but even things like resveratrol and pterostilbene and curcumin have some of this senolytic activity.  Now, measuring this is really a bit of a challenge. This is because when you come in with this, well, first, you’re measuring some of the cytokines, the inflammatory molecules that are coming out of these cells, but if you go in and cut a bunch open and kill them, there’s a burst of senolytic cytokines that come into the system. So the senescent marker actually goes way up when you’re addressing the whole thing, and then how long does it to take to come down?  So in our three-month trial, it went up and we were using tons of senolytics. It was quercetin and everything that we gave them, but we got the good shift in the genes. We just have to come up with more markers around that, but some of the trials that have been used with really high end design senolytics have really been able to reverse phenotypic aging in a lot of animals and in humans. So that’s a really exciting thing.  There’s a really cool question in there. Why the hell would you ever do that? Why would your cell ever do that? Well, one thing is for cancer surveillance. “Oh, my God! I don’t want to grow like mad with cancer. I’m just going to shut down the cell.” All right? So P53s do that, but then they don’t know how to get it out of there.

So then there’s acute versus chronic. Acute senescence say, “Boom! Ow! I just hit the edge of that desk there. I just broke a bunch of tissue in there.” All right? So now, there’s a bunch of cells in there that are going to go into senescence, and they’re going to sing the song of senescence really loudly all in concert. So it’s not just whispers of senescence. It’s like … and the immune system is going to hear the signal. It’s going to come in. It’s going to eat them.  So you can grow new tissue there. So that’s a programmed senescence to rebuild damage tissue, but when they’re spread all over the place, it’s just whispers, and the sound of inflammation may be loud, but the immune system can’t pinpoint where it came from and so it’s not going to clean up the mess. So that’s just one of the side effects of aging. So now we know that we can go in and clean out some of those cells and stop that inflammaging signal.

Dr. Weitz:            I guess there’s another compound now called spermidine that’s getting some play.

Dr. Shade:           Yeah. Spermidine, isolated from sperm. Hence, the name spermidine. You’re like, “Well, they must have got it from sperm whales. No, they got it from sperm, semen, and there’s a lot of spermidine in semen, and it’s-

Dr. Weitz:            Apparently, they can get it from wheat germ and all these other vegetable products, too.

Dr. Shade:           Well, that’s where they first got it. I mean, they’re not like lining guys up and-

Dr. Weitz:            Right. That’s where the name came from. Yeah.

Dr. Shade:           That’s where the name came from. Dr. Ruth Westheimer, remember, the sexologist, she said, “Oh, there’s so much good for things for you in sperm,” little Austrian voice, but apparently, she had the goods on spermidine.

Dr. Weitz:            It’s not as good for marketing, though.

Dr. Shade:           No, no. Every time I’m about to put in a product I’m like, “God, I’m going to have to listen to all this shit about this,” and it costs some fortune, but spermidine is really good for working on autophagy and mitophagy and senolytic activity. So I’m sifting through all the exact uses of that, but that’s looking like that’s going to be a really promising one.

Dr. Weitz:            Now, what about dosage? You read these studies and they say you have to have 250 milligrams of resveratrol, and your products, because they’re liposomal, have a lower dosage of a lot of these products. How do we know that’s the right dosage?

Dr. Shade:           Yeah. Our quercetin has a 25-fold increase in absorption. “Oh, there’s 20 milligrams of quercetin.” I’m like, “Yeah, multiply that by 25. That’s a lot of question.” The beauty of it is it goes right into the blood, and the levels in the blood, even at the 20 milligram level, you’re going to beat out 500 milligrams because it all goes in at once. It gets the peak dose in there. You think of a senolytic, it’s almost like chemotherapeutic. You need to peak dose to activate that, Nrf2, AMPK. Peak doses activate that. So it’s a beautiful way to do it.  Now, exactly what the right dose is? Even though, “Oh, you need 250 milligrams. This study …” we’re still really working that out. I know that the dosage schedule that we laid out in our Bio-Age Reversal works because I was able to shift the whole genome plaque back. So I know that’s working, I know that I saw the markers of senolytic activity go up that I was breaking down these cells, but it’s going to be a few more years of really getting the right assays, working out, what we really want to see to know exactly what it is, but I have people go on these little campaigns, “We’re going to detox for a while and maybe we’re taking 40 milligrams a day, 50 milligrams a day, I’m stacking a couple of things together,” and there you’re actually getting maybe a few hundred milligrams a day in these nano forms.  I know that we’re triggering it. I know we shift fatty liver. I know we’re upregulating Nrf2. I know we’re shifting the genome. So I know that these dosages are working, but will we get to more specific dosages, more clarity to them? Yeah, we definitely will, but I also did do sirtuin upregulation tests on people using peripheral blood mononuclear cells. So the white blood cells are the only blood cells that are really cells. Red blood cells, they don’t have a nucleus, they don’t have mitochondria. They’re not cells. They’re just oxygen transport. So you do it in whites.

This is really nice. We saw on a single dose of it was basically our AMPK charge, but it was a little bit different. It’s a product we’re going to come out soon. Single dose, over about two, three hours, the sirtuins upregulated about three, fourfold and they lasted 24 hours. So it was really nice because I like people to do these things in spurts and then take a couple day off, go a couple days, take a few days off because you’re stimulating the system, let it come back down, stimulate it, let it come back down.  So the way that we’re using these and we’re dosing them, we see the signals, we see the changes. We know we’re working well on them, but I want to get to a point where I’m like, “This dose for that, that dose for that, that dose for that.”

Dr. Weitz:            I also have a request. Is there a way that you could put your products in a capsule form as well as an alternative to some of the liquids?

Dr. Shade:           Yeah, and we did start doing that. They’re called SED systems, self-emulsifying delivery systems. So our CDDPN is that way. Micromanager, which is more for controlling microbial growth, but we are doing one that’s a sirtuin activator in a capsule and there’s more that capsule activity to come. In fact, maybe as we work out some of the senescent stuff, maybe we’ll do a senolytic in there as well.

Dr. Weitz:            Yeah, that would be great because some people prefer the liquids. Other people, they don’t like to taste and you have to go to the fridge all the time. So they don’t travel as well and stuff.

Dr. Shade:           Yeah. Yeah. So we are doing that.

Dr. Weitz:            Cool. Excellent. So any final thoughts and-

Dr. Shade:           No, we did good. We covered a lot of stuff.

Dr. Weitz:            Yes, we did.

Dr. Shade:           The only other thing we didn’t really talk about is membrane health, and the membranes are … We’re talking about phosphatidylcholine bilayers that are housing the cell, ones that are making up the mitochondria, ones that are making up the endoplasmic reticulum. Everybody loves the mitochondria, but the endoplasmic reticulum is this big, huge folded over just layer and layer and layer and layer and layer of membrane that are creating what I call the membrane potential, which is a power potential across, it’s a charge potential across a membrane that actually drives the number of the reactions or the little motors like ATP synthase that are in the membranes.

Then the membranous organelles all communicate one to another, and the quarterback of that is the endoplasmic reticulum, and they actually exchange signals and discuss between the mitochondria, the golgi apparatus, the endoplasmic curriculum with signals coming from the extracellular environment through the cellular membrane, all that decision making going into the nucleus and signaling which genes to be manifest within the nucleus depending on the availability of inputs and the extracellular compartments and the health of the intracellular compartments.

So it’s a really beautiful communication structure and building membranes with phospholipids like phosphatidylcholine is one of the best ways to build the health of the membranes, and that was my one fun thing when I went on to a retreat with Joe Mercola, Ben Greenfield, Robert Slovak, Emily Givler, Bob Miller, and a couple other people. Joe brought his bioimpedance meter that was for measuring membrane health and he measured everybody there. Then I was the last one to get there, and Emily was like, “Chris is going to win.”  Joe’s like, “Why?”  She’s like, “Membranes. PC. He’s the PC guy.”  Of course, I beat everybody and I had these great numbers there because everything that I take has phosphatidylcholine, and you can buy it directly. You can buy our Pure PC or our Membrane Mend or various ways to get PC, but building the membrane is the one thing, and that was in Europe. That was the first mitochondrial therapy was lipid replacement therapy. There was those old injectables, Lipostabil and capsules of PC.  So the membrane is a big modulator of the power of the system. So we’ve been talking about cleaning up, burning cleanly, powering up the system, the NAD, the sirtuins, getting rid of the senescent cells, and just having a high powered system and the transducer of the power or the capacitor of the power being the membrane.

Dr. Weitz:            So the main ways to stimulate the membrane is with phosphatidylcholine, fish oil. What else?

Dr. Shade:           Yeah, those good fats there. Those are the core, but where else can you get PC? So you can get it from lecithin, but don’t get cheap soy lecithin, even cheap sunflower lecithin. Go for the professional grades. We have it down into a nano form in the Pure PC and the astaxanthin, and then these really good carotenoids for protecting the membranes, and that would be like astaxanthins, zeaxanthin, lycopene, tocotrienol. Those are super good, and then other natural source. When I first started into this and it was watching a lot of Dietrich Klinghardt, egg yolk, organic egg yolks. Six of those give you a massive PC dose.

Dr. Weitz:            Interesting. There’s some cardiovascular literature to say that choline can raise your TMAO levels and that can be problematic depending upon your microbiome.

Dr. Shade:           Yeah. It’s all backward. Your microbiome turns choline into TMAO, but the TMAO isn’t actually what’s causing the cardiovascular disease. What gives you the biggest spike of TMAO of any food in our biosphere? Do you know?

Dr. Weitz:            Salmon.

Dr. Shade:           Yeah, fish. Fish are all at the top, and those are the heart healthy ones. So the thing is the heavy meat eaters get a microbiome that makes TMAO, but they make a whole lot of other things. That firmicutes/bacteroidetes blend goes in the wrong direction when you’re not eating enough plant matter, and there’s all these other things that happen that move towards the inflammation of the cardiovascular disease. TMAO is just a side player in that. I don’t believe it’s driving it at all. In fact, after that paper came out, there was a bunch of Swedes, I think, wrote a big response to it called Something Fishy About TMAO.

Dr. Weitz:            Right. Yeah. It’s never made any sense to me, but it is out there supporting membranes, and then you also talk about the importance of the hypothalamic pituitary adrenal access.

Dr. Shade:           Yeah. That’s coordinating mitochondrial health. That’s coordinating all of your hormone health. Yeah, we can do hormone replacement, but adaptogens are probably the best way to just make sure that all of that is working really well, whether you’re taking exogenous hormones or not. One of the things that’s cool about ginseng is it raises the receptor density for androgens and estrogens. So as we get old, our androgens and estrogens are going down, but if our hormone density goes up or our hormone receptor density goes up, the activity, the androgenicity is a interaction between the hormone level and the receptor density.  So if you double your receptor density, you double the reactivity to a given level of hormones, and that’s one of the beauties of the adaptogens. In fact, the adaptogens, all the good ones, the astragalosides, the ginsenosides, withanolides, which are from ashwagandha, gypenosides from gynostemma, all of them have the same steroid backbone of your hormones. So they’re obviously meant to be interacting with your hormone system and affecting receptor sites, and that’s why they work so good on that.

Dr. Weitz:            Yeah. I wanted to mention the Astragalus situation because I know there’s that TA-65 supplement out there, which is this, I guess, specialized form of Astragalus, but can we get that from other forms of Astragalus?

Dr. Shade:           So there’s is cycloastragenol. Now, that’s what’s come out. There was a freedom of information act request to get the formula there, and it was cycloastragenol. Now, there may be some synergistic factor in there, but cycloastragenol is the core. So in our Longevity Elite, we have all these ginsenosides, and we have special astragalosides. We have cycloastragenol and astragaloside 4. Astragaloside 4 upregulates klotho, which is a regenerative molecule you make in kidneys and brain.  The cycloastragenol works for telomeres activation to lengthen telomeres, but one of the things … Dr. Raffaele has been working with TA-65 a lot, and he thinks that … See, cyclo is also a killer senolytic, and he thinks that a lot of the senolytic activity is responsible for the regenerative capacity of TA and the astragaloside. So now, they used to have the market cornered. Now, there’s other ways to find cycloastragenol and astragaloside 4, but whether it’s working at a telomere level, a senolytic level or both seems to be good. That seems to be good is freaking great.

Dr. Weitz:            It’s interesting how hormones started out to be one of the first places a lot of doctors and researchers went for longevity because they send signals to the body that things are good, that things are strong to build, to get stronger. We know people get older, they get weaker, they can’t function, and now it seems like all we’re hearing is that anything that tells the body that things are okay is not good for longevity and all these pathways that tell the body that we’re lacking, that we don’t have enough is where we need to go, but somehow, I think there’s got to be a balance.

Dr. Shade:           Yeah. It’s a balance of the two. There is no doubt at all that hormones are increasing your health span, if not, your total longevity. I mean, that’s just to say that they will wipe the slate clean. Most of these things that helping longevity are hermetic, and there are little stressors and you respond and clean it. You can overlay those on top of the hormone signals, and they’re not going to cancel each other out. Doing both is where you want to go.

Dr. Weitz:            Let’s consider that Fahy, which we mentioned, publishes the first study to improve biological aging, and he used DHEA and growth hormone in his-

Dr. Shade:           Oh, yeah. No, absolutely. Growth hormone is absolutely correlated with decay. There’s so many guys who do test in growth hormone and it’s like, “God! I feel freaking great,” and that is regenerative. So these other things are cleaning up. So you come in, you have a little Nrf2 activity, and you have some AMPK activity, some sirtuin. That’s taking out the trash, but the power is coming through the HP everything system.

Dr. Weitz:            Great. Another awesome discussion, Chris.

Dr. Shade:           Yeah. It’s been a great one.

Dr. Weitz:            Yeah. Yeah. I’ve really enjoyed this. I think we hit a lot of interesting science.

Dr. Shade:           Yep. All right.

Dr. Weitz:            Okay. Well, thank you, and I’ll talk to you soon.

Dr. Shade:           Thank you. Take care, Ben.

 

---

---

 

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

 

Podcast: Play in new window | Download | Embed

Subscribe: RSS

Dr. Mona Morstein discusses An Integrative Approach to Diabetes at the March 24, 2022 Functional Medicine Discussion Group Meeting 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

8:28  95% of cases of diabetes are Type II and it is related to obesity, among other things. There are about 8 billion people on earth and about 2 million are overweight.  In the US, statistics on obesity are staggering, and even 15% of children are obese.  Over 37 million people in the US have diabetes and another 100 million have prediabetes, so one out of every three Americans have diabetes or prediabetes.  Close to 50% of those over age 65 have diabetes in the US.

11:02  TYPES OF DIABETES:  

1. Type I Diabetes, which is our classic Pediatric Autoimmune disease.  It typically does not start below one and half years and fades out around age 25.  There is an ongoing trial called the TEDDY trial, which stands for the Environmental Determinants of Diabetes in the Young, and they are looking at figuring out what the triggers are, including diet, nutrient deficiencies, vaccinations, infections, stress, etc..

2. Latent Autoimmune Diabetes of the Adult, LADA.  This condition tends to start after age 35 and most are in their 40s and 50s and they are insulin dependent.  Many of them get misdiagnosed with type II diabetes, since many physicians are not knowledgeable about LADA. This type I can be very slow onset where they may not need insulin at first, or they may just need a small amount of insulin, sometimes for decades, or they need full blown insulin from the start.

3. Type II Diabetes. This is the most common form of diabetes and it is insulin resistance driven. Most patients with Type II Diabetes are poorly controlled and many of these will go on to eventually need insulin.  But insulin dependent Type II Diabetes is still Type II.

4.  Mature Onset Diabetes of Youth, MODY.  This is related to genetic mutations where people either are unable to secrete insulin or are unable to receive insulin.  Athena Diagnostics offers testing to measure 1, 2, 3, 4, 5, and 8 of the MODY genes. For this group, sulfonylureas, which are not really good drugs for most of us, work really well for this group.

18:34  Complications of Type II Diabetes:  1. Hypertension, 2. Chronic Kidney Disease, 3. Impaired vision, 4. Neuropathy, 5. Amputation, 6. Pregnancy complications, and 7. NAFLD.  The majority of our cells have an insulin receptor and this allows them to grab glucose and pull it into the cell and turn it to fat and store it or burn it. But there are four cells in the body that don’t have insulin receptors, which are the eyes, the kidneys, the nerves, and the endothelial lining of the blood vessels.  When glucose gets into these cells, there is no insulin to process it, so if your blood sugar level is 300, then the sugar in your eyeballs will be 300. The cells in these tissues therefore become damaged if your diabetes is uncontrolled. If your diabetes is uncontrolled, you have a 4-6 times increased risk of dying from cardiovascular disease. Diabetes is the number one reason people wind up with end stage kidney disease. It’s the number one reason adults go blind. It’s the second most common reason for amputations and there are 356 diabetes amputation every day in the US. Diabetes can lead to non-alcoholic fatty liver disease.

22:05  Laboratory Analysis of Diabetes.  Labs should include CMP, CBC, lipids, Ferritin, which can help to detect anemia and it is an early indication of fatty liver. If there is indication of fatty liver, you do an ultrasound. GGT, which is another liver detox enzyme.  If someone is injecting insulin, then measuring insulin is no longer accurate. C-peptide is a better indication than insulin.  To assess heart disease risk, a standard lipid panel is bogus, so you need an advanced lipid profile and you need to include Lp(a), APoB, Oxidized LDL, Homocysteine, Fibrinogen, HsCRP.  You should check random micro-albuminuria at least once a year, which can show early kidney damage. The diabetic antibodies to diagnose LADA include GD65, insulin antibodies, Islet cell antibodies, Tyrosine phosphatase, and Zinc transporter 8. If it’s type I, then you also want to look at Celiac and thyroid antibodies.  Hemoglobin A1C. There is a .5 variability with this test.  In general, the lower the A1C  the better.  An A1C over 5.5 is already beginning to cause damage in the body such as to the eyes. [Association of A1C and fasting plasma glucose levels with diabetic retinopathy prevalence in the U.S. population: Implications for diabetes diagnostic thresholds]  Over 6 it’s causing kidney damage. [Poor glycemic control in diabetes and the risk of incident chronic kidney disease even in the absence of albuminuria and retinopathy: Atherosclerosis Risk in Communities (ARIC) Study] 

30:00  A Hemoglobin A1C of 5 translated to an average blood glucose of 100, six is 126, seven is 152, etc. You can have two different patients both with a A1C of 6 but one patient can have good, steady control with only mild ups and downs and another patient could be at 50 for half a day and at 150 for the other half and that patient could also have a A1C of 6.

31:44  There are certain cases where the A1C is inaccurate, including with patients with genetic hemoglobinopathy, like sickle cell anemia, you can’t really use A1C, you’d have to use fructosamine, instead. The only problem with fructosamine is that it doesn’t translate to a glucose number.  If the patient has serious liver or kidney disease, the A1C will be inaccurate and will appear lower. It can be too low if they have serious bleeding or high if they have iron deficiency anemia.

32:36  There are a few studies, including the ACCORD trial where they had patients eat whatever they want and they lowered the A1C below 6.5 by using some very strong medications, including the sulfonylureas, which cause weight gain and water retention, the TZDs, which cause weight gain and water retention, and insulin, which causes weight gain and water retention, and they had more patients dying. They concluded that lowering the A1C below 6.5 is not a good idea because it will cause heart disease and this has led some doctors to recommend not trying to get the A1C below 6.5. But all the ACCORD trial showed is that lowering your A1C below 6.5 without dietary changes and only using very strong medications will increase your risk of heart disease.  If the patient is able to lower the A1C to 5.4 with diet, supplements, and Metformin, they are not going to have a high risk of cardiovascular disease.

34:25  The American Diabetes Association has set the following glucose goals for diabetic patients, but they should be more stringent:

1. A1C below 7

2. Fasting glucose 80-130 mg/dL

3. Post-prandial <180 mg/dL 

Dr. Morstein feels the following goals would be better guidelines:

1. A1C below 6.

2. Fasting glucose <110 mg/dL  Ideal <100 mg/dL

3. Post-prandial <120 mg/dL  Ideal <110 mg/dL 

 

34:50  Diabetic Medications:

1. Insulins:

       A. Basal:

             Long-Acting: Levimir/detemir, Lantus/Toujeo/Glargine/Basaglar, Tresiba/degludec 

             Intermediate-acting: NPH (Neutral Protamine Hagedorn)

      B. Bolus/Corrections:

             Short-acting: regular insulin 

             Rapid-acting: Novolog/aspart, Humalog/lispro, Apidra/Glulisine,

             Very-rapid: Fiasp/aspart

2. Oral Hypoglyemics: 

       A. Biguanides: Metformin HCL, and there is an extended release  

       B. Sulfonylureas, which are problematic drugs because they cause water retention and weight gain and there is a high risk of hypoglycemia:

             Glipizide

             Glyburide, which is the worst one for low blood sugar,

             Glimepiride, which is the best in this group

       C. Mitiglinides, which nobody uses 

       D. Thiazolinediones (TZDs)

             Rosiglirtaxzone (Avandia)

             Pioglitazone (Actos)

       E. Sodium Glucose Transporter 2 Inhibitors–these are not bad drugs, but the sugar can cause bladder infections or jock itch or vaginal infections

             Canagliflozin  (Invokana)

             Dapgliflozin (Farxiga) 

             Empagliflozin (Jardiance) 

             Ertugliflozin  (Steglatro)

       F. Dipeptidyl Peptidase 4 Inhibitors (DDP4 inhibitors)–these seem to be fairly safe, though they are fairly weak.  And at their highest dosage they have a lowering of the A1C of like 0.5, while just taking out grains from their diet will lower A1C by 3.3%.

             Januvia/sitagliptin 

             Tradjenta/linagliptin 

             Onglyza/saxagliptin 

             Nesina/alogliptin

       G. Glucagon Like Peptide-1 Agonist–These are really good drugs that are fairly effective, and they may help patients lose weight, they reduce their appetite, but they are quite expensive.  There may be some nausea as a side effect.

            Dulaglutide/Trulicity 

            Exenatide/Byetta 

            Exenatide ER/Bydureon 

            Livaglutide/Victoza 

            Lixisenatide/Adlyxin 

            Semiglutide/Ozembic/Rybelsus 

            Albiglutide/Tanzeum

38:30  With respect to Continuous Glucose Monitors, there is the Dexcom and the Freestyle Libre from Abbott and Dr. Morstein finds the Dexcom much more accurate than the Freestyle Libre.

39:50  Diet for Diabetes.  In 2013 or 2014 the American Diabetes Association acknowledged that low carb diets may have value for diabetics. If we look back 100 years ago, there were not that many type II diabetics and the type I diabetics were dying pretty awful deaths until we invented insulin. Then diabetic patients were able to live longer, but they all eventually died of cardiovascular disease, so it was thought that this meant that their fat was too high, so the whole country started preaching eating low fat. Everybody started eating more carbs and things went downhill from there.  Only in the last few years have the ADA turned around and endorsed a lower carb diet for type II diabetics.

41:42  For Prediabetes the PREDIMED study showed that the Mediterranean diet works well.  [Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet]  Compared to the low fat diet, the Mediterranean diet reduces diabetes by 52%, which was more beneficial than putting patients on Metformin.  However, the low carb diet performs better than the Mediterranean and leads to most lowering of the A1C.

42:48  There is an outlying diet known as the MA-PI2 Diet, which is the high carb, plant based diet for diabetes.

 

 

 

---

---

Dr. Mona Morstein is a Naturopathic Doctor who practices at Arizona Medical Solutions in Tempe, Arizona. Dr. Morstein: has a practice focus on treating patients with autoimmune diseases, hormonal conditions, diabetes, thyroid, and gastrointestinal disorders like SIBO and IBS.  She is the author of the best-selling book, Master Your Diabetes: A Comprehensive, Integrative Approach for Both Type I and Type II Diabetes and she lectures frequently at medical conferences.  Her website is azimsolutions.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 drweitz.com. Thanks for joining me and let’s jump into the podcast.

Welcome everyone to the functional medicine discussion group meeting tonight on integrative approach to diabetes care. We’re very happy to be joined by Dr. Mona Morstein. I’m Dr. Ben Weitz and I’d like to make some introductory remarks before making some remarks about our sponsor, and then I’ll introduce our speaker and we’ll get started. So I encourage each of you to participate and ask questions by typing in your questions in the chat box. Then I’ll either call on you or simply ask Dr. Morstein your question when it’s appropriate.

So I hope that you’ll consider attending some of our events in the future. April 28th, we have Dr. Paul Anderson speaking on an integrative approach to cancer. May 26th, Dr. Sarah Thompson will be speaking about a functional approach to maternity. Then the next meeting after that will be June 23rd and that’s yet to be determined. So if you are not aware, we have a closed Facebook page, the Functional Medicine Discussion Group of Santa Monica, that you should join so we can continue the conversation when this evening is over.  I’m recording this event and I will include it in my weekly Rational Wellness Podcast, which you can subscribe to on Apple Podcast, Spotify or YouTube. If you do already list into the Rational Wellness Podcast, I’d very much appreciate it if you could go to Apple Podcast and give me a positive ratings and review.

 

So now I’m very happy to tell you about this evening’s sponsor, which is Integrative Therapeutics. I’d like to take a few minutes to tell you about a few of their products. One of their most popular products is Cortisol Manager, which is an excellent combination of several adaptogenic herbs and phosphatidylserine, which helps to modulate cortisol levels, which can be helpful in modulating blood sugar levels since cortisol surges due to stress can cause blood glucose levels to rise, which I’m sure Dr. Morstein will mention.

Another excellent product in the Integrative line is Berberine, which has quite a bit of research to back up its benefits in helping to control blood sugar and to improve insulin sensitivity. In fact, some studies show that it is equally as effective as Metformin, and can also be used concurrently with Metformin and has been shown to improve Metformin’s efficacy. This Integrative Berberine product is Berberine HCL, which is not an extract of Berberine from Berberine containing herbs, which is in their Berberine complex which is better for use as an antimicrobial for gut health.  In other words, if you’re using Berberine for managing blood sugar or helping with lipids, then you want to use the Berberine HCL. I personally use Integrative’s Berberine product for my patients because of its quality, both for blood sugar management, for control of lipids, and also as a longevity agent since it’s an activator of AMPK. One of the reasons why he Integrative’s Berberine and their other products are such high quality is because the company uses a manufacturing facility that’s a drug GMP facility rather than a dietary supplements GMP, which means that they test every line. They do bio-validity testing, stability testing for up to two years past the manufacturing date, et cetera.

So Dr. Mona Morstein is a naturopathic doctor in Tempe, Arizona who’s a practicing functional medicine doctor at Arizona Integrative Medical Solutions, which has a focus and her practice has a focus on treating patients with autoimmune diseases, hormonal conditions, diabetes, thyroid and gastrointestinal disorders like SIBO and IBS. She’s the author of the bestselling book, Master Your Diabetes: A Comprehensive, Integrative Approach for Both Type 1 and Type 2 Diabetes. I got to tell you, this is one of the most impressive, comprehensive, useful books that you would ever want to have and everybody should have this on your shelf for help with managing patients with diabetes. Dr. Morstein, thank you so much for joining us. You have the floor.

Dr. Morstein:                     Thanks very much, Ben. I really appreciate the intro and I hope everybody can see the lecture, the slides okay. I wrote kind of as a joke an abbreviated diabetes lecture, because it still is like 70 slides. but I try to extract. I’ve taught a lot of diabetes webinars to physicians and it’s usually a kind of a weekend affair, all day Saturday and all day Sunday. So we’ll try to touch upon a lot of things right now today. I also know I’m speaking to physicians, so you’re already coming with a fairly high level of comprehensive knowledge of this condition.

Okay. He just mentioned me. This is me. I will say this, I don’t think we talked talk about this enough in medicine because it’s embarrassing, but I got into diabetes because literally way, way back when, I mean 30 years ago, I missed the I missed a diagnosis of a type 2 patient in kind of an acute crisis of diabetes. So that really shook me to the core. I was a new doc, just starting out in Montana, and it made me doubt if I was a safe, responsible physician.  So the end result was that I just decided to never miss another diabetic patient and I really immersed myself in this condition. So it was nice to take one of the most worst moments of my medical career and turn it into a real growth trajectory that makes me feel very comfortable treating all types of diabetes and kids and adults and so forth to this day. So anyway. Ben already showed the book. You can get it on Amazon. It’s pretty good book. I’m proud of it. Thanks.

Anyway, let’s dive in. There are some statistics just to know about. We’ll talk a little bit about type 1 and of course type 2, but most diabetes is type 2, 95% of diabetes is type 2, and it is related to many things which we’ll talk about, but obesity and being overweight and this abdominal, visceral fat is a big part of it. As we can see the U.S. statistics on obesity are staggering if we’re going to choose any appropriate adjective. Even kids, 15%, that’s so sad.

 Then in the world, right now, we got 8 million people on planet earth, about 2 billion are overweight. It’s not a good thing. With 650 million, about twice the population of the U.S. are obese. So this is not a good thing worldwide, and it’s certainly is feeding into diabetes statistics. So in the U.S. right now, when I did this lecture say when I started 60 years ago, it was only 29 million, so it’s now up to 37 and a little over million people actually have diabetes. Pretty much one out of every 10 people in the mall, or you are going to see has diabetes. Prediabetes is almost another 100 million.

So if we add that up, it is clearly one out of every three Americans have either prediabetes or diabetes at this point in time. With those senior populations, 50% of them have diabetes. You can’t even really wrap your mind around it. So it’s really not a good thing. It’s a huge burden for these people, for the health, for our healthcare system and for the economics of our country as well. In the world, we have right now over 500 million people in the world have diabetes. You can see the deaths and how many pre-diabetics there are. So if you add a pre and diabetes, really 1 billion out of eight people have either prediabetes or diabetes.

Now, the types of diabetes. There is type 1. This is our classic pediatric autoimmune disease. Doesn’t really tend to start below one and a half years. Then even though we call it kind of pediatric, really, the bell curve is going to fade out around age 25, so older than our 18 year old cutoff, but we still consider that’s all that initial pediatric type 1 type condition, right? It’s an autoimmune disease. In my next slide, we’ll talk about that TEDDY trial.

The other type of type 1 is called latent autoimmune diabetes of the adult, LADA. Generally, it’s kind of kicks in from age 35 on, but the vast majority tend to be in their 40s, about 40 to 60 is where we’re going to see that bell curve the most. Now, the big thing with this is that the vast majority of them are misdiagnosed as type 2. I’ve rediagnosed literally dozens and dozens of patients who came to me lean, always been lean, they have type 2, and it’s clearly type 1, right?

So just be aware of that. There are still many physicians that are not knowledge about LADA and are not aware of type 1 happening in adults. This type 1 can be very slow onset where they may not need insulin at first, or they may just need… I have one gal who’s just needed two units of a basal insulin for a decade. She hasn’t progressed. Or these people can come on just as rapidly as a pediatric type 1 and need full blown, full insulin from the get go. So you’ll just have to be able to figure that out with your own patient.

This is the TEDDY trial, stands for The Environmental Determinants of Diabetes in the Young, so TEDDY. So this is a trial that’s still ongoing where they’re following kids and the diets and their vaccines and et cetera, and they’re looking at all of these factors as triggers for what seems to really be an actual trigger that they can clock and start saying, “This is a determined trigger for type 1 diabetes.” So they are looking at a very broad based way of things from nutrient deficiencies to vaccinations and getting sick and psychological stress, all of these things.

So when they are able to quantify it and really put it together and put it out, they put out little bits here and there, but they haven’t yet put the whole thing together. I think that’ll be helpful to all of us to really be aware of what we need to watch in kids early on to help prevent them to not get type 1 diabetes.

Then of course the last type, right? Well, not the last, third of four, is type 2 diabetes, which is the number one diabetes. It’s insulin resistance driven. Gestational diabetes is an insulin resistance type diabetes. These are pretty well known etiological factors, and I’m going to talk about them more in the further slides to come, but all of these things can be factors with developing and also potentially having trouble controlling type 2 diabetes.

Dr. Weitz:                          By the way, doc, if a type 2 diabetic ends up being insulin dependent, has that type 2 now become a type 1 or is it-

Dr. Morstein:                     Yeah, that’s a good question. So, no. So type 1 is relegated to autoimmunity, and both you’re going to be able to pick up for the vast majority. There are always a very, very small percent of antibody negative type 1 patients. That just happens. But the vast majority will have a positive antibody or several positive antibodies. Type 2 diabetes is generally poorly controlled. These people will become insulin dependent type 2 diabetes. So they stay type 2.  There’s a lot of patients who need insulin with type 2 diabetes. For me, unless the patient is literally completely in denial and refuses to change anything about their diet or their lifestyle. There are some patients like that. But for a lot of them, they’re just given misguided information from the physicians they go to. Easily, the vast, vast, vast majority of type 2 diabetic patients never need to be insulin independent.

The last one is a relatively unknown one called MODY, mature-onset diabetes of youth. These are just genetic mutations. These you tend to see, well, grandpa had diabetes and dad had diabetes and Timmy at 16 gets diabetes. But it’s not that bad and they don’t really need insulin. This is mild elevations. Their blood sugars are around 140 or so. These are genetic defects. For example, they make insulin, but there’s a genetic defect in their ability to secrete it, or they can secrete it, but there’s a genetic defect on the receptor that it doesn’t acknowledge the insulin.  So these are generally can be dealt. Most of them have to do with secretion. So sulfonylureas, which are not good drugs that we don’t really like, for this group of people is a good drug, right? If they just take a sulfonylurea, they’ll be fine for pretty much the rest of their life. So there’s one lab, Athena Diagnostics, that does measure all of them, they measure 1, 2, 3, 4, 5, and 8 of the MODY genes, right? If you feel a child needs to be investigated that way.

Just to put it together, a little chart of MODY type 1 and type 2, non-insulin dependent or parents affected and so forth, Acanthosis Nigricans, et cetera, and racial groups, right? Certainly we know with type 2, obviously many Caucasians get it, but Pacific Islanders, Native, right? We’ve been studying the Pima Indians with type 2 diabetes since the ’50s. Definitely Hispanic populations, our African American, very high risk for type 2.

So diabetes, but controlled, nobody has any problems with diabetes when it’s controlled. But when diabetes is not controlled, right? Physiologically, the vast majority of our cells do have an insulin receptor. When this pancreas secretes insulin, it lands on the receptor, sets up this phosphorylation chemical, and then that initiates the glucose transporters, particularly 2, to reach out, grab glucose and pull it into the cell, turn it to fat and store it or burn it as well. But we know insulin is called the fat building hormone. Its idea is to store food for later.  So the problem is there are four cells in the body that don’t have insulin receptors and the glucose is just going to… Osmolarity just walk into those cells. So those cells are your eye cells, kidney cells, neuro cells, and the endothelial lining of the blood vessels, which is why those are the ones that get damaged with uncontrolled diabetes. Because if your blood sugar is 300, your eyeballs are 300. Meanwhile, your fat cells and muscle cells and liver cells, they’re like, “Forget it. I’m not taking you in. I’m going to be resistant.”

So they’re not getting the glucose in, but it is getting in these other cells that by the nature of survival never want to be without glucose so there’s nothing blocking glucose from entering those cells. But this is why the majority of people with diabetes have hypertension. When you have diabetes, considering if you’re just getting regular treatment and you’re not really well controlled, you have a four to six time increased risk of dying from cardiovascular disease, which is not a good thing because everybody dies of cardiovascular disease in America, so you are really at risk.

Chronic kidney disease. Diabetes is the number one reason people wind up with endstage renal disease. It’s the number one reason adults go blind. The first reason people get amputations is trauma. The second reason is diabetes. So pregnancy and fatty liver, most fatty liver, which in America is still called non-alcoholic fatty liver disease, in Europe and probably within a year or two in America, it is going to be called metabolic associated fatty liver disease, because that is a vast majority of fatty liver, right? So diabetes has outstandingly devastating complications.  This is like a daily diagnosis. We have 4,000 people a day diagnosed, 356 amputations a day due to diabetes. About 160 people wind up with endstage renal disease, et cetera. Literally, the amount of money we spend on diabetes in this country is very scary and could really become an economic burden for our country in the future.

Now labs. So this is like one page of labs to consider. Obviously, the basic CMP, CBC with different lipids obviously. I always draw Ferritin. I include Ferritin on every lab, a yearly lab that I do. Ferritin, one, it’s the first way to catch anemia. Before the CBC is affected, you’re going to see low Ferritin. So you can catch people before it gets very serious. But even more so, it’s the number one lab that shows, that indicates a person has fatty liver. When Ferritin is elevated, of course, you’ll do iron panel and look at trans saturation, and as long as it’s not over 50 or so, they don’t have hemochromatosis, and most people don’t have hemochromatosis, about 2% of the population, but when that’s negative, then you can do your ultrasound and see the echogenicity. So… your ultrasound and see the echogenicity. Ferritin is the number one blood lab. When it’s high, that indicates as, and that’s as a liver, acute phase inflammatory marker. The second one is elevated GGT.

Dr. Weitz:                          By the way, Doc, on ferritin, are you using the lab range over 400? What are you using as high?

Dr. Morstein:                     I am. Well, it depends on the lab. Some labs are over 250, some are over… Yes, I am using for high, I am using high. Yes, I am using high. If the lab range was 400 and they were at 380 and you wanted to test for fatty liver, because they have a adiposity as a body type. There’s nothing the matter with that. I’m saying, literally, you’re going to get a great deal of your overweight or obese pre-diabetic or diabetic patients will have elevated ferritin. You’ll do the ultrasound and they’ll have fatty liver.

Dr. Weitz:                          By the way, Doc, I don’t know if you’ve noticed, but recently, some of the lab ranges have gone up. I had a patient last week with ALT of 65 and I said, “Oh, your liver enzymes are up.” Then it said normal. It was an asterisk underneath. This was a UCLA lab. New reference range, it’s now up to 70 is normal.

Dr. Morstein:                     I don’t think anybody who’s a real… I Just did a webinar series with a hepatologist and things on liver conditions. They’re not going to agree with that.

Dr. Weitz:                          Well, this is the normal range is the average American as a result of two years of pandemic drinking.

Dr. Morstein:                     Yeah, of course. Totally. Absolutely. I once called Sonora Quest because they’re postprandial insulin range was from 29 to 89. Now, when you look at studies where they are measuring postprandial insulin, pretty much the cutoff was around 30 where they said that it should be not higher than 30. I called Sonora Quest to research, how did they get their range? Do you know? Sonora Quest said, “Oh, well we just took 50 of our healthy employees, measured their postprandial insulin and got the range.”  That’s literally how they set up the lab value. That’s measuring millions of people. The lab ranges, we do have a right to be a little question them at times. I agree with that. The other ones that you can see are fairly standard. Remember that as soon as someone injects insulin, you cannot measure insulin. You have to measure the C-peptide. Anyway, C-peptide is a better reader than insulin, I think, anyway.

You can’t measure insulin once if they’re a type one diabetes because, they’re going to probably have insulin antibodies. Or once you inject insulin, you’ll make insulin antibodies. We want to switch to C-peptide. The cardiac risk panels, because we know cholesterol is pretty bogus to judge cardiovascular disease risk. The other panels are, these are better. Random micro-albuminuria, you’ll want to check at least once a year, if it is elevated, showing early kidney damage, you can repeat it every three months. Those are the diabetic antibodies.  The classic one for LADA is GAD65, but I would just do the whole diabetic antibody panel. Because sometimes it’s not, GAD and it is a different antibody and you don’t want to miss it. Then of course, celiac, and Hashimoto’s, at least once a year with your type one diabetic patients, you’ll want to check Hashimoto’s if they’re literally gluten free, you can’t really measure for celiac. If for some reason they’re just going to eat gluten, then you’ll want to check that every year as well.

Dr. Weitz:                          What about the new kid on the block, uric acid?

Dr. Morstein:                     Oh, yes, uric. Well, so uric acid going back, yes, uric acid obviously, elevated uric acid, not just gout, but it is an indicator of also risk of kidney disease, even heart disease and patients with diabetes. I don’t do uric acid that much because I already know their risk. What’s their A1C, what’s their et cetera? I don’t do a lot of uric acid. I will do them, I’ll do the micro albuminuria. I’ll do other things. Yes, it is an indicated lab. If you just want to throw that in, for sure. Thanks Ben.

Now, just to say, this is the conventional A1C lab reference ranges, pre-diabetes and then diabetes 6.5% and higher. The problem is, is with A1C, one, it always has a 0.5 variability. If you get a six, it could be from 5.5 to 6.5. There’s always this little variability. Now, we do know the lower the A1C, these old studies are still referred to this day. The DCCT and the UKPDS done in the 90s, type one and type two, showing that literally lowering A1Cs from nine to seven, based on basic and then aggressive control, made huge differences in the occurrence of complications.  We still need A1Cs to be as low as we can. Unfortunately, even though they don’t count person being pre-diabetic until it’s at 5.7, studies will show that an A1C over 5.5 is already beginning to cause damage in the body, such as to the eyes. Or over six, it’s causing kidney damage. In the pre-diabetic range, people are already having damage. This is a problem, because people, “Oh, it’s five, seven, whatever. That’s not that bad.” Well, okay, it’s not that bad, but it is causing damage. We do want to get people under controlling and get them protected.

Dr. Weitz:                            I think there’s a misunderstanding of what hemoglobin A1C is. I think a lot of people don’t really think about it too much and they just say, “Oh, this is three months of average blood sugar.” Really, this means that proteins in your body are being damaged by sugar.

Dr. Morstein:                     Well, yeah, I mean the A1C is a protein on the red blood cell. What we’re measuring is what percentage is covered with glucose. An A1C of five is 5% of those proteins are covered with sugar and 6% is 6% of it. It doesn’t seem like much, but of course we can translate this to blood sugar numbers and they go striking each number decimal higher is about 26. Five is 100, six is 126, seven 152 and up. There’s a fairly exponential rise per percentage of this glucose bound to the A1C protein on the red blood cell. I do have this slide just showing, there’s different ways.  You can get an A1C of six. You can have steady, good control, or you can be up down, up and down all day with an average of six. If you are at 50 half the day and at 150 half the day, you could get an A1C of six. We have to be aware that you always want to monitor blood sugar, not just take an A1C, because we don’t know what the blood sugar is doing to get that A1C. Then here’s a very, very busy slide, just saying when the A1C can be inaccurate. There are different races have different A1Cs.

Of course, the genetic hemoglobinopathies, if you do have a patient with a genetic hemoglobinopathy, like a sickle cell, you can’t really use A1C, you’d have to use fructosamine, instead. The only problem with fructosamine is that it doesn’t translate to a glucose number. It’s just low, normal, or high, but we can’t translate it into glucose like we can in A1C. Then different, depending on how, if they have serious liver, then the A1C can lose efficacy as well. Liver, kidney, iron anemia, et cetera. Last, the problem with the A1C also was these studies.  These studies, particularly the Accord. The accord was a study where they had people eat whatever they want. Because why would we ever deal with the diet in measuring medicines? They had people eat whatever they wanted, their goal was to get them less than 6.5% of an A1C. As a result, they had to use a lot of strong medicines, which was sulfonylureas, which caused weight gain and the water retention. TCDs, which cause weight gain and water retention, and insulin, which causes weight gain and water retention. They had a high amount of people dying.  As a result of this study, I can’t tell you the amount of patients who come to me and say, “Oh, my doc doesn’t like that. My A1C is at 5.8 and literally wants me to eat more carbs to get it higher, so I don’t have cardiovascular disease because of the accord study.” The accord study, that’s all we, and then the advance, these studies use the worst drugs that we have. This accord study is what took the TCDs off the market.

Now, they’re back on, but very rarely used. Probably all of you have also heard patients say, “Oh, my endo doesn’t want me to get less than 6.5, because I’ll get heart disease.” This is ridiculous. It’s solely based on the accord. If I get a person on a diet and supplements and maybe Metformin down to 5.4, trust me, they are not going to have a high-risk of cardiovascular disease. Just to be aware. The ADA has these glucose goals. I think we all want it a lot more stringent.

Because we can get it with the way we’re doing it versus the way the ADA tends to do it. Getting everything down back to as much normal as possible is the goal. These are the diabetic medications, there are insulins, they’re basically split to basal, which is covering the fasting glucose, which is either long-acting or intermediate. NPH is the worst insulin we have. Certainly, by far, has the highest rate of hypoglycemia. Very hard to deal with. Some people need it twice a day. Some people need it three times a day. It can last for eight hours.  It can last for 15. It’s a difficult insulin, but it is super-cheap. That’s why we’re seeing a little resurgence of it now in patients who can’t afford insulin as it’s priced now. Although I order a lot of insulin from Canada, it’s much cheaper there. Or people I have patients just drive down twice a year to Mexico and get their pens from nothing, just walking into the pharmacy. Then there’s the bolus, which is meal or correction. We have short-acting, regulars by far are the best for meals, but isn’t used very much nowadays for a couple of reasons.  The rapid-acting, and then the very rapid-acting, which acts within five minutes. These are our insulins. We have the oral hypoglycemic. There’s nothing the matter with Metformin. You’ve got Metformin, and then you’ve got the ER, because some people who can’t handle Metformin in the gut, the ER, they will be able to handle the extended relief. The sulfonylureas are problematic drugs, they do cause water retention and weight gain. They have the high-risk of hypoglycemia.

Glyburide is the worst one for low blood sugar, so we’d want to stick with Glimepiride. The mitiglinides, nobody uses. Why would we use this? I could take a sulfonylurea maybe once a day for 24 hours. Why would I want to take a tiny sulfonylurea with every meal? Nobody uses them. The TCDs, I just saw a patient on one for the first time in nearly a decade. The sodium glucose transporter to inhibitors, not bad drugs, except the sugar can cause bladder infections or jock itch or vaginal infections, but most people don’t have this recurrently.

You can get a euglycemic DKA in type twos, which sucks. You have to be like, people be aware of that. Then you have the DPP4 inhibitors, which don’t seem to be a problem very much. It’s just that at the highest dose, they have a lowering of the A1C of like 0.4, 0.5. Frankly, just taking out their grains will lower them 3.3%. They’re fairly useless drugs. They don’t do very much. Then we have the Glucagon-like Peptide-1 agonist, these are good. These are great. Patients like them. Most of them can handle them, even with the nausea. Once a week shot, they can lose a little weight.

Their appetite is better. Their blood sugar is better. These are well, good drugs. They’re just spendy, and so people have to hope their insurances will cover them. Otherwise, people are using for insulin, vials and syringes or pens or pumps, and then the CGMs. Dexcom is pretty good. FreeStyle Libre for the type twos, is pretty inaccurate. People get it, but it is not the best CGM.

Dr. Weitz:                          Dexcom is more accurate than-

Dr. Morstein:                     Yeah, Dexcom is 100% more… I was trying to go backwards. There we go. Dexcom is 100% more accurate than a FreeStyle Libre, absolutely.

Dr. Weitz:                          I know Dexcom usually recommends wearing it on the abdomen. I’ve seen some people put it on in the back of their arm. Is that acceptable? Do you know?

Dr. Morstein:                     Yes. That is acceptable. Also, back here in the back, is also acceptable. it’s just subcu. For example, this is probably the most common area people wear their Omnipod pump, which is in the back here. People love wearing their Omnipod here, and it’s the exact same technology and depth. With the Omnipod here, you can have your Dexcom here.

With diets, so in 2013, ’14, the ADA did acknowledge that low-carb diets have value in working with diabetic patients.  Now, if we go back, what happened with the ADA is that, diabetic patients say that needed, type one diabetics 100 years ago before Banting and Best were inventing insulin in Toronto. We didn’t have many type twos and the type ones would die pretty awful deaths where they just ate themselves. We invented insulin and diabetic patients were able to live longer until they all died of cardiovascular disease. They’re doing autopsies on all these patients with diabetes and they had cholesterol in their arteries. If you go back to the 70s, that meant their fat was too high.  That was 1978 was when the country said, “Wow, we should all eat low-fat.” Everybody started eating all these carbs and things went downhill from there. The ADA said, “Yeah, we’re seeing all this fat in these autopsies, so we should have a huge amount of carbs in our patients with diabetes and not much fat.” This has been going on for decades until recently, just in the last years, they’re turning around, which is something for them to do. They started acknowledging low-carb diets is, a physician could do this in an acceptable way.  

For prediabetes, this PREDIMED diet is very well known where they did Mediterranean diet versus low-fat and even Metformin. The Mediterranean diet, which is really just a super-healthy, non-processed food, omnivore type diet. Here’s the study and, the Mediterranean diet with olive oil or nuts and no calorie restriction reduced diabetes incidents by 52%, which was higher than putting people on Metformin. In other words, just eating a healthy Whole Foods omnivore diet with good oils can prevent diabetes.  This is what pretty much everybody was eating until they invented fast foods and candy bars. This has been a diet for humanity for centuries, and it works to not get diabetes.

Now, this is an outlier, I think we need to discuss, which is the MAPI2 diet. This is the high-carb plant-based diet. There is a company there. Actually, I wrote a book, Master Your Diabetes, but the mastering diabetes folks are doing this diet. They’re doing this high-carb, plant-based diet.  There is actually good studies on this diet. They did a six-month study of this diet. Now, this was all men. This was all type-two diabetic men who had pretty high A1Cs, and this was the typical diet that they ate. Now, the mastering diabetes people aren’t doing macrobiotics. This diet was what we classify as macrobiotic. You can see just all kind of foods that we wouldn’t think people with diabetes should eat. The results were outstanding in every area. The A1C from 12 to 5.7, pretty amazing.  Things like HDL went up, LDL went down. C-peptide actually raised a little bit. This is their lipids, the onset. After months, from acceptable, there was only 31%. After the six months, almost 94% of the patients had acceptable triglycerides and pretty good stuff. They had weight loss, they lost hip circumference.  Their BMIs went down, their muscle mass gained. This is everything we want to see, eating this diet. Now, these guys were fed this diet. This is a hard diet for people to put together, but in the study, they were delivered their meals. They just got everything fed to them. Now, this is kind of, I copied and pasted. This is from the Mastering Diabetes Group, and you can see what they want you to eat a lot of, which is, grains and legumes, veggies and fruits.  Then what they want you to eat just a little bit of, which is, things like pastas, avocados, because they’re worried about too much fat, especially saturated fat. Nuts, which is too much fat. Then there are other things that they don’t want you to have at all, which is meat and poultry. Part of this is the idea that animal protein, I think interpreting this, I went to a lecture from Dr. Joe Pizzorno, who’s a naturopathic physician. Brilliant. He did one of the best lectures I’ve ever seen, which was on cellular acidity, right? Now, in reality, our blood doesn’t really change alkaline or acid because tiny changes are so devastatingly bad, but the cell, we’re looking at intracellular, there can be acidic changes. And animal protein and salt are two of the main, main, main foods that cause the acidosis and that is causing insulin resistance. So in this diet, removing all the animal products is really pulling out that whole thing. The problem is you can’t eat half this diet and half of the other and have it all merge. This diet will work 100% its way or low carb will work 100% its way, which is what we’re going to talk about right now. Right?

So low carb, for diabetes, we’re usually looking at 40 or less carbs a day. Okay? The studies on low carb, there are a lot of studies on low carb, but this one that I want to show you, if you look at the authors on this study, first of all, Richard Bernstein, Richard Feinman, huge low carb, there are some really well known low carb researchers, Westman, Eric Westman, big keto guy. And so they did this study showing being a dietary carbohydrate restriction, first approach in diabetic manage, and this is what happens when you are doing a low carb diet, pretty much everything we want to have happen for people with diabetes. So this was with type two diabetics.

Then managing type one diabetes with very low carb diet, this was published in pediatrics. This wasn’t a study so much as it was a survey. And they surveyed a group on Facebook called type one grit, which is a very, very passionately low carb group for type one diabetes. Notice Bernstein and Westman are in [inaudible 00:48:45] these same people. Dr. Richard Bernstein, by the way, was my mentor. He wrote the book, Dr. Bernstein’s Diabetes Solution. He was the one who brought low carb diet to diabetes. He also was the one who taught us how to use insulin better. For example, using insulin to cover carbs, to cover protein and to figure it out in a completely different way than conventional care. And that works a lot better. David Dikeman, he’s a big low carb guy.  So they did this survey of parents of type one. And here’s the exceptional glycemic control of type one diabetes without adverse effects was reported by these people and their kids on a low carb diet with type one, with the reported mean of A1C at 5.6, which is pretty outstanding. So low carb diet is what most of us work with and what most of us want to do. But if one of my patients really wanted to do mastering diabetes, 100%, I don’t mind. The studies are good. They’ve been replicated. But you’ve got to choose one extreme or the other. So it’s total carbs minus fiber. It’s not the amount of sugars on the label. It’s total carbs minus fiber, right? That’s what a label should be. And these are the low carb nos, pretty much, right? The big groupings of foods that we’re taking out of the low carb diet, right? Which you probably know about.

And then Bernstein set up the idea of six grams of carbs at breakfast, 12 at lunch and supper because of the Dawn phenomena at breakfast raising our blood sugar innately. And so having less carbs at breakfast, and then as we’re up and moving around lunch and supper, we can have a little more then. And fat is a free for all. And protein is also weighted a little bit as well. We don’t want to overdo protein. We do need people getting in calories though and having energy and so forth. So we do a little. The protein is one gram per kilogram versus 0.8 for adults in general. And then we allow fat to make up many calories too.

I mean, obviously you all know how beneficial exercise is to people with diabetes with metabolic syndrome, prediabetes, people who are overweight and et cetera. It does pretty much everything we need it to do to help reverse that in patients. And then we can put it obviously aerobic. Resistance does burn 19 times the glucose that aerobic does. Now, I’m not talking if you’re going to decide to do a 10 mile hike with 3000 foot elevation, then the aerobic is going to work pretty well. But if you’re a half hour on a treadmill versus a half hour of lifting weights, you’re going to burn more glucose with the weights, right?

Dr. Weitz:                          Hey, Doc. Can I just ask you question about the diet, just to go back for a second?

Dr. Morstein:                     Oh, yeah. I’m sorry. I didn’t need to. If I’m-

Dr. Weitz:                          No, that’s okay. Yeah. So the low carb program you’re outlining, less than 40 grams. That’s very, very low carbs. Can you get a reasonable benefit with, say 50 to 100 grams? A lower carb program reduces the high glycemic carbs, takes out the refined carbs, but say the person has maybe a slice of gluten-free toast in the morning with their eggs and they have a yam with their dinner, and maybe they have some beans with their salad at lunch.

Dr. Morstein:                     I mean, they’re going to see elevations in their blood sugar. It just depends on how much, right? But generally, no, if you’re following low carb, those are not on the diet for low carb. Now, why not have a piece of base culture bread. Or if you go to a dietdoctor.com, dietdoctor.com has amazing recipes. They have these rolls, which are six ingredients. You mix them together. You bake them. You get these super tasty rolls that are two grams of carbs per roll. So the idea is there’s low carb bread, there’s low carb tortillas. You can make your own low carb rolls. Birch Benders has low carb pancakes. You can get Shirataki noodles.

So the idea is when you’re working with patients this way, here’s the deal, for every 20 seconds you spend taking some food or food group out of a patient’s diet, you want to spend about five minutes adding in the alternatives, because otherwise their psychology starts getting narrower and narrower and narrower. And it’s not like they have to live. They could have base culture. A slice of base culture bread is four grams of carbs and four grams of fiber, which is going to even further reduce the carbs that they eat. So if they have a sandwich at lunch with base culture bread, that’s eight grams of carbs, eight grams of fiber-

Dr. Weitz:                          What kind of bread are you saying? It’s not something I’ve heard of.

Dr. Morstein:                     Oh, it’s called base culture. B-A-S-E culture bread.

Dr. Weitz:                          Okay.

Dr. Morstein:                     So I’m saying that there are breads that people can eat, that will work for them without it being Dave’s Killer bread, which you can’t have. No, you can’t have this, you can’t have Ezekiel bread, but try this bread or try this granola. I have a reference sheet that once I go through, I have a eight or 10-page diabetes handout for the diet. So we go over everything. Then I have a reference sheet with recipe books, 300 15-minute low carb recipes. Oh, you want maple syrup? Well, guess what? Nature’s Hollow has it, Birch Benders has it, Lakanto has no carb maple syrup made with monk fruit, right? So if you give people some of these alternatives, so the diet isn’t this whole change, they can still have some things they really like, but it’s low carb and it’s going to do what we want to have done, that’s how this is a successful protocol for them, right? That’s how they buy in. And that’s how they have success with it.

Dr. Weitz:                            So in your opinion, you want to have success with the type two diabetic, it’s got to be super low carb or you’re not going to be successful.

Dr. Morstein:                     Yeah. That’s how I work with patients. Yes, yes.

Dr. Weitz:                            Okay.

Dr. Morstein:                     Now, otherwise, the rest of the exercise, I’m sure you had plenty… The only thing with exercise is that if they’re insulin-dependent, I have a whole lecture on doing exercise with insulin-dependent diabetics, because depending on the intensity, the length, so forth, you are going to have to figure out how to deal with their insulin before, during, and after. So you can get pretty good at it. You just need a little data to make these decisions, but that’s the most difficult patient to work with initially, are the insulin-dependent who are starting to really dive into exercise.

Dr. Weitz:                            So Dr. Watson [inaudible 00:57:44], you showed some slides about the Mediterranean diet as being helpful in preventing diabetes. But now you saying no way.

Dr. Morstein:                     No, no, no, no. That’s if you don’t have diabetes.

Dr. Weitz:                            Oh, okay. That’s preventing it from happening.

Dr. Morstein:                     That is preventing it. Now, if you have it, that you’ve stepped over that line and now we got to yank you back a little more tighter. So yeah. Now, I just have some things with blood sugar and exercise. It doesn’t matter where the blood sugar is when they start in terms of how well they’ll be able to exercise. The golden is I don’t agree with this 65 to 180. I tell patients to mostly be around maybe 80 to 170, if they start exercising around there, they’re going to have better effect. And the same with where their insulin levels are, if they’re on insulin and how it’ll affect their performance. So I’m working right now with a 16-year-old teen, who’s a cross country skier and has desires to get into the Olympics and so forth. So we’ve been getting really good at figuring out his food and his insulin before and after his races. So you just need a little data a couple times and you can figure this out if you have some aptitude with insulin and work with patients who are also athletes.

Dr. Weitz:                            Do you recommend a insulin pump?

Dr. Morstein:                     I’ll let patients decide what they want to do. Some patients for sure, do not want something embedded in them, 24/7. They just don’t. Other patients love it, because they don’t have to inject themselves five times a day. And you can have good control or bad control with any system, right? And you can also have success with any system. Now, pumps do give us a better control of basal insulin because we can direct the basal all throughout the day, exactly how that patient needs it versus I just inject in the morning and I just inject in the evening and there you go, it’s set. So pumps are the best for basal. They’re not good for meals. You can’t use the pump to decide what meal your insulin you’re going to do because they’re just doing the typical conventional figuring out of glucose, which is not a good way to do it.

So you’re going to have to still figure out your insulin for the meal and then tell the pump what to inject. But it is good for basals. It’s just that you can’t demand a patient get a pump and not every patient wants them. So you’re going to have to work with the basals else-wise, right?

In terms of stress. So this was an interesting study. It was stress management. Everybody was a type two. They had treated, which was one and a half hour groups for eight weeks. And in the people that got stress training management, look at their drop in their A1C. I mean, this is ridiculous. That’s better than any medicine, any oral hypoglycemic, or even better than a GLP-1. The stress management is dropping better than any of those medications versus the control, which had really no statistically significant drop. And the thing with stress is that stress can worsen diabetes, but diabetes can worsen stress. So we have to be aware of the psychology of having diabetes. “What am I going to eat? I have to check my blood sugars. I thought I ate right and yet now I’m at 170, this sucks, blah, blah, blah. I’ve been exercising more. My A1C is still 6.6.” I mean, it’s an intense condition and it’s 24/7.

So we want to be there always for patients. We always want to be finding everything positive that we can, giving them support, acknowledging when they get burnt out and helping them work through it, right? But the arrow is both ways. With the microbiome, again, its own lecture, but we have seen that with type one diabetes, they have found elevated Zonulin and Occludin in patients who have positive type one antibodies, but have not yet had the clinical disease show up. Right? So, that’s interesting. So we also know that short chain fatty acid, right, so fiber fermented by the Firmicutes bacteria family turns to short chain fatty acid, which is really, it’s the food of the colon cells. But it does a lot of things systemically. One is help produce GLP-1 from the intestines, which will help us monitor our blood sugars better.

So are people eating enough fiber? In fact, even with a low carb diet, we do need to make sure they’re getting enough fiber in. They may need a fiber supplement because low carb diets have been shown to decrease the amount of the Firmicutes family, which are the fiber eaters and short chain fatty acid producers. So we do need to make sure that they’re getting good fiber in on the low carb diets.

Dr. Weitz:                            Yeah. There’s a company that’s now producing [inaudible 01:04:09] and they have it in a product that’s been shown in a study to help manage glucose.

Dr. Morstein:                     Yeah. All right. That’s good. Yeah.

Dr. Weitz:                            That’s one of the [inaudible 01:04:19] producers.

Dr. Morstein:                     I will admit I’m very wary of any one probiotic really working systemically if everything else isn’t coming together. You know what I’m saying?

Dr. Weitz:                            Sure.

Dr. Morstein:                     Now, the lipopolysaccharides, so these are associated with type two diabetes, insulin resistance and fatty liver. So having a healthy gut on many levels, fiber that makes short chain fatty acids, it’s not leaky. It isn’t overproducing the lipopolysaccharides. These are all gut oriented ways. We know that gut tumor necrosis factor alpha can get into this systemic system and go to our muscle cells and produce insulin resistance. So the gut is pretty, really important. Having a very healthy gut is… Here’s another study with endotoxins and diabetes. So type ones who had the macro-albuminuria had higher LPS. They had higher LPS in patients with diabetes and hypertension.

So it’s amazing how these gut problems can cause havoc so systemically. And then with environmental detoxification, even the World Health Organization wrote that lead and arsenic causes insulin resistance and an increased risk of diabetes. Mercury as well. Now the PCBs, the PCBs are very well studied for gaining weight and becoming diabetic. The phthalates, which I may have spelled wrong. I don’t know. It’s hard to spell the word phthalates. And then they study the Canadian Aboriginals with their high risk of diabetes, a much higher body mass of environmental chemicals. There is this organization, diabetesandenvironment.org, it’s a nonprofit created by a researcher woman whose son developed type one diabetes. And she collects all the research on environmental impacts on type one and type two diabetes. And she has a free newsletter that you can get, I think it’s every week or at least every month.  Sarah, somebody, I forget her last name. But I think one of the most important studies was this bottom one that I made red. So they had two groups of obese patients that were equaled out in age and smoking and drinking, all of that was the same. And then they had, one group had diabetes and one group didn’t though they had the same obesity. And what they found that was different in this group with diabetes was this significantly higher levels of persistent organic pollutants in their fat through fat biopsies. So you’ve got overweight people. Who’s going to turn into a diabetic? Likely the one that has more environmental chemicals in them, such as POPs, PCBs, et cetera.

So it’s pretty frightening given how much people use these at home and it’s on our food. And if you walk into a store, I mean, they’ve been spraying toxins for bugs and stuff. We can’t get around it. You see this fantastically horrific statistic that newborns have almost 300 chemicals now in their cord blood. It’s crazy. So we do want to detox patients, getting their house clean, no fragrances at all. Have all their supplies and body stuff being clean, using natural weed killers or pulling them. Here in Arizona, there’s an exterminating company that’s all organic. I used to use them now [inaudible 01:08:47]. Yeah, I had a big ants problem. The ants suck in Phoenix. But they would come and they’d spray peppermint oil, literally. Not in the house, they never sprayed in the house, but outside they would go and- They never sprayed in the house, but outside they would go and they would spray peppermint oil. But honestly now diatomaceous earth works fantastically. We got to retrain people to not have all these chemicals around in their own homes and then to detox.

Now sweating, there’s loads of studies with sweating. I have them, I didn’t put them on the slide, but sweating releases chemicals, heavy metals, even micro toxins like okra toxin has been found in sweat.  When I went to medical school, when we did dead lab, just working on cadavers, it was in an old RV that didn’t have any ventilation. It was disgusting. Of course all the formaldehyde. And so what we would do is, of course we wore onesies of plastic and whatever, but nonetheless, as soon as dead lab was over, we’d run to our gym, which had a sauna. So I’m in the sauna, maybe 20/25 minutes after class and I could taste the formaldehyde coming out of my skin. I could literally taste it, in the sweat. It’s crazy.  So people don’t sweat in America because it looks, oh my god, I have an arm thing. So we want to teach patients always sweat, wear enough clothing so that when you exercise, you sweat, get a sauna, sweat in it, go out and sweat, just sweat, it’s so detoxifying.

And then there’s many other things with detoxification that I’m already probably boring you in overtime, but I don’t have time to do it, but you guys already probably know how to detox mold or chemicals, heavy metals. All of these can be a problem for diabetes. But number one, if someone’s finances are limited, you definitely want to do chemical testing. That’s number one for sure.

Last, this is my last section, is supplementation. Supplements do everything from better mood to antioxidants. Now, diabetes causes damage through oxidative pathways. That’s what it’s doing. There’s the hexosamine pathway, there’s a browning pathway. There’s many pathways of pro oxidative damage going on in the body, that’s causing diabetic damage. You always have to put people with diabetes on antioxidants, aside from other ones, I will always put people on a multivitamin. I always put people on a fish oil, but the next thing is antioxidant protection so their blood sugars will not cause damage in that regard. And not only that, but you can reverse neuropathy, you can reverse kidney damage.

 I have an obese guy who went off the wagon over the last couple of months, on his diet. He had positive random microalbuminuria. And so I have him on some antioxidants and I have him on this great tincture, it’s from Heron Herbs, it’s called Two Treasures. It’s a such a great kidney protection formula. And so he’s on it. And so even though his A1C went up, his kidneys remarkably got better because of the antioxidants and the herbs, which was amazing and surprising, but beautiful to see. His kidneys really got a lot better. So our antioxidants and our supportive products really can make a difference in these patients.

Dr. Weitz:                            What would be your full program for a patient with kidney disease as far as supplements?

Dr. Morstein:                     Well, let’s go through some of them, and I’ll give you a [crosstalk 01:13:20]… I have a supplement summary [crosstalk 01:13:23]…

Dr. Weitz:                            Okay, good.

Dr. Morstein:                     Now for Type 1 prevention, fish oils reduce risk and so does vitamin D3. There’s no reason an infant can’t be on 1000 IUs a day. And if his breastfeeding mom can take fish oil, which mom should, because fish oils are really good at preventing postpartum depression, for her to take it during pregnancy and afterwards, or I would just do that through the breast milk for a breastfeeding newborn.

But as they get older putting them on fish oils and vitamin D, this is just a good thing. Especially if there’s, God forbid, any autoimmunity in their family. Now, if they develop a honeymoon, there are studies that showed these niacinamide alone or with vitamin E actually can help prolong the honeymoon. Now you might also want to throw in a pancreatic glanular, you might also want to throw in a Gymnema Sylvestre, an herb that has been shown to help revive the pancreas and even increase the C-peptide and it is not niacin, it’s niacinamide. But you can see it doesn’t prevent people from getting diabetes but if the kids enter a honeymoon period, this can help extend it. And honeymoon periods, they can go for years. I have worked with kids who had seven year honeymoon periods. It can also just last for weeks, so we don’t ever really know. But we want to try to extend that as long as we can, if the child initiates it to begin with. We never really see it in our Type 1 adults.

Now supplements. So if you’re adding supplements you’re not going to have to adjust the insulin, it’s not that extreme, so don’t worry about that, okay?

Benfotiamine, if that’s how you pronounce it, is a fat soluble fireman. Now this kind of twists us, because we usually think fat soluble is a little harder to absorb than water soluble, but not benfotiamine, it’s much more absorbable. And you can see the biochemistry where it’s becoming the cymene pyrophosphate, it increases transketolase activity and that blocks glucose damage. It prevents that browning glucosylation of sugar landing on protein, and so that’s what it’s blocking and this is amazing and it’s very good. The therapeutic dose is around 450 milligrams. And there’s studies in protecting neuropathy, retinopathy nephropathy. Well, that’s what we’re looking for, right? So it’s totally safe.

 I have a product, this is totally proprietary formula, but I made a product called Diamend and it has benfotiamine in it at therapeutic dose, but even if you’re just doing it by itself, it’s a really good product, mixing it with alpha-lipoic acid or just giving alpha-lipoic acid and particularly R alpha-lipoic acid, because the S alpha-lipoic acid is not active in the body, but the R is. So, this is also shown to normalize AG formation, advanced glycosylated end products, hexosamine is an oxidative pathway. So it’s really helping people.

Dr. Weitz:                            What dosage of lipoic or R lipoic acid…

Dr. Morstein:                        You’d want to do at least three to 600 milligrams a day of R. Now, if you’re doing just alpha-lipoic acid, which is half R and half S, then you’d want to be around 1200 so you get that 600 of the R and you could throw out in your body the 600 of the S.

Other supplements, vitamin C preventing the aldose reductase pathways in your eyes. So when you have a blood sugar of 200 and your eyeballs get 200, that’s too much stuff in your eyeballs, so it starts off shooting off a lot of antioxidants to keep the osmolarity from I guess, your eyes from blowing up. So, meanwhile then, that’s turning to sorbitol and the antioxidants are thrown out and we get fructose, and then we get cataracts, we get retinopathy and so forth.  Now, vitamin C and bioflavonoids inhibit that initial pathway. The problem is we have to watch vitamin C with people with diabetes no more than 1500 a day, because it looks like glucose, and it can raise glucose levels on some glucose meters. We know that when we give IV glucose, usually people need to have a snack, because that can kick out their insulin and lower it when we are giving vitamin C. So, a little C and bioflavonoids are fine. The alpha-lipoic acid, NAC, N-acetyl cysteine does a lot of stuff for people with diabetes. Of course, we always think of it producing glutathione and liver and lung protection, but it does decrease insulin resistance, and of course, a very good antioxidant in general. So [nic-taurine 01:19:43], good for the eyes, especially with retinopathy, it’s the number one amino acid in the heart. Of course, it does help make a bile salt in the gallbladder, but that doesn’t tend to be necessarily a big thing with diabetics. The fatty liver could make a gallstone however.

The acetyl-l-carnitine at 1500 to 3000 milligrams. Even Diabetes Care Journal, which is from the ADA journal has good studies showing how it reduces peripheral neuropathy. A very good safe one.

Magnesium tends to be the number one nutrient deficiency in patients with diabetes. So maybe checking their red blood cell magnesium as well.

The Gymnema Sylvestre, which is called Gurmar in India, sugar destroyer, decreases cravings, helps increase pancreatic functioning. Here’s a really great thing for your patients who have very little willpower, particularly around the holidays, is that if you have Gymnema Sylvestre in a tincture, I used to do this when I was at the medical school and saw students, we would eat a little organic raisin, so sweet, then put a couple of dropper fulls of Gymnema tincture in your mouth for about a minute and then swallow, and you can’t taste anything sweet for up to one and a half hours. So you put raisins in and they’re these disgusting things you can’t taste, you have to spit them out.  So for patients who cannot control their cookies at the holiday parties, put some Gymnema in their mouth and swallow it and they can’t taste it, they’ll have to spit it out. You can’t eat it, it’s really intense. Very helpful.

And then of course, curcumin just awesome, tumor necrosis factor alpha, as I said, is an insulin resistant factor. It’s an antioxidant, it’s an anti-inflammatory, we know it reduces Alzheimer’s in diabetic patients. Ben already did all the talk about berberine. I do have the method of action [crosstalk 01:21:58].

Dr. Weitz:                            By the way, do you have a favorite form of curcumin?

Dr. Morstein:                     Oh, curcumin for sure. I think the best is Designs for Health Curcum-evail; that stuff kicks butt, I think, so that’s the one I use, it’s Curcum-evail by Designs for Health. And then here’s the berberine method of action, it’s just like he said, the AMPK, everything it does. Green tea, blueberry. If I had to choose between Gymnema and bitter melon, I will always choose Gymnema myself. Of course, we have the old cinnamon studies, like the one, the two and the six grams a day, how it helps, it doesn’t hurt anybody to do cinnamon. They have done a lot of studies on it.

Dr. Weitz:                            Doc, what dose of Gymnema Sylvestre?

Dr. Morstein:                     Oh, with Gymnema, anywhere from three, in my product there’s a thousand, but anywhere from 400 to 2000 is a good safe dose, and you should see some effect. So, if you have patients who have proliferative diabetic retinopathy and you’re going to lower the blood sugar, you could cause them to have a bleed. And you cause them to have a bleed because when the blood sugar goes down, the insulin goes down, but then insulin like growth factor comes out and that causes angiogenesis. And that causes a bleed.  So I did cause a bleed in a patient with PDR early on, and that was horrifying because they needed laser, it was a fiasco. You feel terrible. But then I decided to not have that happen anymore with patients who had PDR. I know it looks like a lot. They only need to be on this for a month or two with the initial lowering of the blood sugar.

But, in two other patients with PDR, they never had any problems with their eyes. It was very stable. Now I put everybody on a multiple vitamin and fish oil. I will use my diabetic product, which means it contains alpha-lipoic acid, it contains bilberry and NAC and benfotiamine, so that product contains that stuff. So I would add in taurine and a little selenium, and you’re going to protect these eyes so they don’t bleed with the sudden drop of the blood sugar in their eyes.  But before you do a low carb diet, patients are like, I haven’t been to the eye doctor for a couple of years; you’re like, okay, you go and when you’re done, come back, because I’m not going to put you on a protocol until I know what’s going on with your eyes.

So this is basically a multiple vitamin, mineral, fish oils, comprehensive diabetic product, or breaking it down individually, probably some vitamin D3. I use vitamin D3 complete, from allergy research, that comes with vitamin A, because you need vitamin A, because the vitamin D receptor is bound to an RXR receptor, a retinoid X receptor. So if they don’t have enough vitamin A, their vitamin D receptor won’t work and the whole process doesn’t work. So you have to throw in a little vitamin A, K and so forth. So, that’s my lecture. I’m sorry if it went too long.

Dr. Weitz:                            No, no, it was awesome. Can you mention that herb that helps with kidneys?

Dr. Morstein:                     Yeah. I can write it. Should I write it in the chat?

Dr. Weitz:                            That’d be great.

Dr. Morstein:                     So it’s from Heron. So it’s Heron Herbs, which is owned by Eric Yarnell, who is a master herbalist. And his specialty is men’s health and kidney health. And so he made this product called Two Treasures and it’s a tincture. And so that’s what I use, I use that with patients who are on lithium, people who have kidney damage for whatever reason, it’s a really [crosstalk 01:26:45].

Dr. Weitz:                            Yeah. If you have a patient with chronic kidney disease, what would be your full program, what else would you put them on?

Dr. Morstein:                     Well it depends. If it’s a IGA nephropathy, I’ll do food sensitivity, testing of IGA, not IGG, but IGA. I use Alletess and they have an IGA option. They have IGG. So I would do that tidy up the diet. Fish oils are great for the kidneys, Ginko and salvia miltiorrhiza is great. This Two Treasures is great because it has a lot of the other herbs, the [Peristeria 01:27:28], the rhubarb, all of the other herbs that, we have science, I have a whole lecture, I think I might talk about it in my book, but I have a lecture on treating, more specifically, complications in patients with diabetes. And I go over the science and the herbs and so forth with them, but you’d want to do cordyceps. There’s a naturopathic physician, Jenna Peterson who had kidney disease and that’s her whole practice, is treating kidney disease. She wrote a [inaudible 01:28:03] article and said for sure cordyceps with kidneys as well.

Dr. Weitz:                            [inaudible 01:28:10] data on astragalus?

Dr. Morstein:                     Well, she specifically said cordyceps.

Dr. Weitz:                          Okay.

Dr. Morstein:                     But, when is astragalus going to hurt anything.

Dr. Weitz:                          And of course, we have modified citrus packed in.

Dr. Morstein:                     Yeah. I don’t use that for the kidney very much, mostly I use to prevent cancer metastases, but I haven’t used it… Oh, thanks. Thank you. So, I actually haven’t known to use that for the kidneys.

Dr. Weitz:                          Yeah. Apparently it prevents fibrosis, chronic kidney disease, there is some data on it.

Dr. Morstein:                     Luckily so does the alpha-lipoic acid and the benfotiamine.

Dr. Weitz:                          Okay.

Dr. Morstein:                     So for sure.

Dr. Weitz:                          Excellent. Okay. Well, that was awesome doc.

Dr. Morstein:                     Thank you. Thank you. Thank you everyone, I appreciate that. Thank you.

Dr. Weitz:                          Absolutely. And thank you everybody. See you next month. Thank you, Mona.

Dr. Morstein:                     Okay. Take care, Ben.

Dr. Weitz:                          Okay, bye.

---

---

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

 

 

Podcast: Play in new window | Download | Embed

Subscribe: RSS

Risa Roux discusses Food Frames 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

0:55  Risa Groux has written a book FoodFrame, which details her approach that recommends one of six different approaches to diet, including paleo, keto, autoimmune paleo, vegan, low FODMAP and low lectin. 

5:32  Detoxification.  Risa likes to start many of her clients with a two week detox program to help to clean out the liver and open up the detoxification pathways both phase one and two.  A lot of patients’ symptoms go away after the detox, including itching skin, headaches, insomnia, acne, stool regularity, bloating, gas, and indigestion.  The detox also helps to set up weight loss.  On her detox, patients consume two collagen shakes that include protein, fat, and fiber.  And they eat animal proteins, unlimited organic veggies, good fats, eggs, nuts, and seeds.  They can have some sweet potato.  No processed or inflammatory foods.

13:14  Weight loss is a function of being healthy.  Those who are overweight but claim to be healthy likely have underlying inflammation that can be seen on lab tests or on stool testing.  For inflammation, Risa will look at CRP and Homocysteine.

15:08  In order to help reverse her Hashimoto’s autoimmune condition, Risa started on the Autoimmune Paleo diet and now she follows the paleo approach.  She said that she is now only 10 points away from reversing her condition, as measured by her TPO antibodies and at one point she was in the 1400s.  When you work with a patient with autoimmune disease like Hashimoto’s, the first thing to do is to reduce systemic inflammation.

 

 

---

---

Risa Groux is a holistic and functional nutritionist based in Newport Beach, California. She believes in treating the root cause of health problems and she believes that if she promotes the health of her clients with a Functional Medicine approach, weight loss will be a side effect of wellness. Risa has written a book Food Frame.  Her website is RisaGrouxNutrition.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 have an interview with nutritionist, Risa Groux on the FoodFrame approach to health. Risa Groux is a holistic and functional nutritionist based in Newport Beach, California. She believes in treating a root cause of health problems, and she believes that clients that need to lose weight, if they promote their health with a functional nutrition approach, weight loss will be a side effect of wellness. Risa has written a book called FoodFrame, which details her approach that utilizes six different dietary approaches depending upon the person’s symptoms and health concerns. These include paleo, keto, autoimmune paleo, vegan, low FODMAP and low lectin. Risa, thank you so much for joining us.

Risa Groux:         Thank you for having me.

Dr. Weitz:            So, perhaps you can start by telling us a bit about your personal health journey and how you became so interested in nutrition and functional medicine.

Risa Groux:         I have always been interested in nutrition from the time I was a little kid. I just remember growing up in a house where my mother was always on a diet. My grandmother was on a diet. I remember my grandma would always go, she would call it the fat farm once a year, which I later found out was Canyon Ranch Spa that she would go to every year. And there was always these words in my house called fattening and, “Oh, I can’t have that. It’s too many calories.” And I was always wondering why are foods different and what makes us fat and how do we gain weight and how do we lose weight and why are people always on a diet? So, I was always interested in food from a very, very early age and then slowly but surely I ended up never had a weight problem as a kid, and then started to develop some symptoms of a low thyroid. Didn’t really know what they were, just thought they were kind of normal. And I was able to conceive my first child without any problems at all.  And then I could not conceive my second child. I was having a tough time conceiving, and then I would have several miscarriages and finally went to an infertility specialist where they tested me and said, “You have a thyroid problem? Take this pill.” And I said, “Oh, how long do I take the pill for?” And he said, “Every day.” And I said, “No, no, no. For how long do I take the pill for?” And he said, “Oh, for the rest of your life.” And I was just astounded at that. I thought how could I be taking a synthetic for something that my body was actually born to produce?  So, shouldn’t we back up and say, why is it not producing this hormone?  And what can we do to fix it instead of-

Dr. Weitz:            That’s not a question conventional medicine usually asks.

Risa Groux:         Exactly. But that’s where the birth of it came for me, the curiosity, I have an innate curiosity. I’m always wondering why? Why is it? Do I have a deficiency in Synthroid because I have these symptoms. And I realized, no, I don’t have a deficiency in medication. And then-

Dr. Weitz:            And you a deficiency in lisinopril and you have a deficiency in statins and NSAIDs.

Risa Groux:         Statins. Yep. And pressure medications and Zoloft and so on and so forth. So, I realized that these are just wonderful band aids that we have in Western medicine and great for a momentary relief, but they really shouldn’t be taking long term. I have a sheets and sheets of all these side effects of all the medications, not just the effects of the body, but the blocking of nutrients that take place when you’re having these medications day in and day out. So, I always say, we’re going to plug the hole at the top of the boat, right. And cover the water there.

Dr. Weitz:            So, how did you manage to get your thyroid fixed and get off of thyroid medication?

Risa Groux:         So, I did a deep dive and was on the Synthroid for a bit and researched. This is way back when, before a lot of internet, so I did a ton of research and then was later diagnosed. I did everything. I did herbals, I did acupuncture. I did just everything I could naturally. And then, was later diagnosed with Hashimoto’s. And at that time, when I was told I had Hashimoto’s, I did not have one direction. Nobody told me to take out gluten, soy, dairy. Nobody gave me any dietary guidance. I didn’t have any medication guidance. I really didn’t have any guidance period. So, I did a ton of research and I thought, why is it that I have this autoimmune disease attacking my thyroid gland? So, I couldn’t find at that time a checklist of everything that could be a root cause to autoimmune.  So, I put one together after years and years of researching, I eventually assembled a list of root causes and put it in my book, FoodFrame, because I think it’s really important for people to know how you get autoimmune disease and how you can treat it and perhaps reverse it.

Dr. Weitz:            Cool. So, I noticed you like to start some of your clients with a two week detox.

Risa Groux:         Correct.

Dr. Weitz:            Why do you do this? What is your detox program consist of?

Risa Groux:         So, there’s a couple reasons why I do it. The first reason is because it puts bumpers on the situation for people, right. So, they come in, whether they’re drinking tons of coffee with lots of chemicals in their coffee, whether they’re having wine or alcohol frequently, and they’re eating bread, sugar, dairy, alcohol, they’re eating out of the bounds, it kind of puts bumpers on it and says, “Okay, here’s what you can eat and here’s what you can’t.” And so, it gives you those boundaries, which I think is really good. Instead of doing it slowly, it’s just a very structured, this is what we’re going to do for 14 days.

The second reason I do it and the primary reason I do it is to clean out the liver. The liver is the key to the castle. So, it really help the liver perform more optimally and help us with everything, any excess estrogens that are stored in the liver, it helps to take those out. It really balances out the blood. It opens up the pathways one or two, so that we are effectively able to detoxify. If somebody has a high level of homocysteine, it helps with that. It just helps stabilize things. The other reason I do it is because a lot of symptoms that people walk in my door would go away- itching skin, headaches, inability to sleep. Acne is a big one, regularity, bloating, gas, indigestion. A lot of those things will fall by the wayside in two weeks.

And then of course, people love it because there is weight loss. Everybody does lose weight on my detox, but it isn’t a weight loss program. I say that all the time, it is not a weight loss program. And as you mentioned, weight loss is a side effect of wellness and we’re just focusing on wellness, but I’m always curious to know how much we can get done just with food and detoxifying, which usually tends to be a lot. And the last reason I do it is because it’s my data gathering time. So, I’m ordering blood tests, I’m ordering stool tests. And by the time they’re finished with the detox, I really have a good idea. I have a roadmap now. I can see what the issues are. I know what your health status is. So, at that point I can springboard from there.

Dr. Weitz:            And so what is your detox program consist of and what is it that you’re detoxing?

Risa Groux:         So, my detox is 14 days. There are two collagen shakes every single day. So, the protein is collagen, which is great, very little carbs, lots of good collagen, which is great. I call it grout for leaky gut. It’s really helpful for hair, skin and nails as well, joint pain, any inflammation. And it’s a gut healer. I’m all about protein, fat and fiber. So, you’re having protein, fat and fiber in that shake twice a day. And then you’re eating basically paleo foods. So, you’re having animal protein, unlimited vegetables anyway you want them except for deep fried. And then you’re having good fats. So, eggs, nuts, seeds. And then you can have some sweet potato [inaudible 00:08:33]. So you should not be hungry. It has nothing to do with starvation. I’m just trying to clear out the liver and the toxins.

The unfortunate statistic here is that the FDA has currently approved 86,000 chemicals for us to use, 86,000. That’s the current number and that’s a new number and it really doesn’t matter who’s in the White House about 2000 a year, get approved. And most of them, which is the sad fact are not even tested. So, we have to be really diligent because we have more chemicals than any other country on the planet. And so we have to be diligent about really reducing our toxic load. So, that’s another thing that the detox does is, it decreases your toxic load. We’re eating mostly organic and non processed foods. We take out the processed oils and take out a lot of the inflammatory foods.

Dr. Weitz:            But how does your detox program facilitate liver detox? What does it do?

Risa Groux:         In addition to the collagen, there are an antioxidants and amino acids that are designed to help open up pathways one and two for efficient detoxification. Your liver numbers improve, your inflammation numbers improve. I see it all the time.

Dr. Weitz:            And during the detox, are they eating or they’re just taking the shakes?

Risa Groux:         Yeah, no they’re eating. So, it’s today and one meal and if you’re hungry, then eat a snack. If you’re really hungry, eat two meals. I have some professional athletes. I work with those people having two shakes and two meals, but I always say, “Eat when you’re hungry. Not when you’re not.” And it really helps that lectin that’s that hormone that tells us that we’re full and ghrelin that tells us we’re hungry. Sometimes people come in and they’re so dysregulated that they are not even functioning. We don’t know if we’re hungry and we’re just always eating because it’s either that time to eat or just because it’s in front of us or we’re afraid we might get hungry. And I always say to people, “It’s okay. We will not die if we’re hungry for an hour or three. We really won’t. Three hours. You’re good.” So, I don’t know what it is, but when I was a kid, I remember it’s like, “Wait till dinner time.” Now it’s, “Let’s eat before dinner.” So, it will tide you over.

Dr. Weitz:            Well, things have kind of shifted as they frequently do in the nutrition world. So, I’ve been in this a long, long time. And so, when I first started, the thing we had to tell everybody, you have to eat breakfast, because everybody would skip breakfast and maybe eat a light lunch and a big dinner. And that’s why everybody was fat because they skipped breakfast. And then the key was you had to eat breakfast and you had to have a snack or meal every three hours to keep even blood sugar. And so, the big thing, if you want to lose weight, you have to eat more because that’s going to stimulate metabolism. You have to eat within an hour of waking up and then you have to have a snack in two hours and then you have to have a meal and you have to have another snack. And unless you do that, your blood sugars going to go crazy and you’re not going to lose weight.

Risa Groux:         Right.

Dr. Weitz:            And now we’re back to skipping breakfast is good for you.

Risa Groux:         Yeah. But that’s where my methodology comes in as it’s not one size fits all. So, if you have a blood sugar issue and you are low blood sugar, I am not going to recommend intermittent fasting for you for sure. Conversely, if you have diabetes, intermittent fasting would be a great thing for you to do. It would help with blood sugar regulation.

 

---

---

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

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

 

---

---

 

Dr. Weitz:            So, you say that weight loss is a function of wellness, but some people claim that they are fat, but healthy. What say you?

Risa Groux:         So, I appreciate that point of view, but I’m all about numbers. I’m very science rooted. So, I like to see facts. And the fact is that when we carry extra weight, it really is equivalent to having inflammation. So, those people, I don’t know how they define healthy, but for me there are foundational issues and they come in two categories. One is systemic inflammation, which we know is the driver of disease. And we know now with COVID that people are dying from third stage inflammation, which is usually blood sugar related, right? Then we look at gut health and gut health is incredibly important. So, those are the two foundational issues I look at. So, that person who says, “I might be fat or overweight and or obese, but I’m healthy.” I don’t know how they define healthy. So to me, I’m looking are your inflammation numbers low, because that to me, defines healthy. And is your gut healthy? Is it intact? Do you not have all these overgrowth of bacteria? Are you not dysbiotic? And things like that.

Dr. Weitz:            What are the most important inflammation factors you look at?

Risa Groux:         So, I look at the CRP, the C-reactive protein that is very related to cardiovascular. And so that usually is a good indication of systemic inflammation. And then the other one I look at is homocysteine and homocysteine has a lot to do with methylation, but it is a major driver of inflammation. And if it gets very high, I’m talking over 12, which I see from time to time, it could lead to dementia. It could lead to cardiovascular disease, macular degeneration, lots of health issues. So again, those are the root causes. Those are the driver of disease.

Dr. Weitz:            Right. So, of the six dietary approaches that we listed, which one do you personally follow most of the time?

Risa Groux:         So, because I have Hashimoto’s, I’m about 10 points away from reversing it, which I started in the thousands and now I’m like 10 points away, which is crazy.

Dr. Weitz:            So, when you say 10 points away, what are you talking about?

Risa Groux:         So, when officially Hashimoto’s are diagnosed with autoimmune for thyroid, you’re looking at thyroid peroxidase antibody, TPO and you’re looking at thyroglobulin antibody. So, I never register positive for thyroglobulin antibody. So, I have registered for thyroid peroxidase antibody. And when I was tested positive, originally diagnosed years ago, I was in the 1400s and the lab now says you should be less than 34. So, I’m at 44. So, I’ve got about 10 points to go to reverse it completely. I follow a paleo program, but when I was first diagnosed, I was on the autoimmune protocol. Or I shouldn’t say when I was first diagnosed, because it really wasn’t invented. But, I originally took out gluten dairy and soy because those are really the major offenders. They have what’s called molecular mimicry to antibodies that attack the thyroid. And when you are in a state of autoimmune, those antibodies basically are what’s called inflammation. You’re in a systemic inflammation. Your Th17 gets activated, you’re in a cytokine storm, your NF-kappa B is involved and you have just systemic inflammation. And in this case and in the case of Hashimoto’s, you’re attacking your thyroid gland.

So, the first thing you need to do with an autoimmune patient is you just decrease that systemic inflammation. So, I have my fab five or now it’s my essential six that are supplements to help quell that inflammation. So, I diligently take those supplements every day, day in and day out. I have removed gluten dairy and soy from my diet completely. And then I do have sheep’s milk or feta very rarely, but occasionally it’s a different type of casing, different type of protein that I can tolerate. And then I started the autoimmune protocol AIP, which is a very restrictive form of paleo. So, it’s paleo, but you’re taking out eggs, nuts-

Dr. Weitz:            Seeds [inaudible 00:17:29]

Risa Groux:         And so, I did that for about 90 days and then I now follow a paleo program myself.

Dr. Weitz:            Okay. So, I noticed of the dietary approaches that you list, there’s one popular one, in fact, including popular and functional medicine [inaudible 00:17:51] that you don’t list here and that’s a Mediterranean diet. Why is that?

Risa Groux:         Yeah. I thought about that when I was putting together the book and I realized I really don’t promote that diet in my office and I don’t really recommend it even though there’s tons of studies that show it’s very heart healthy. And I think the reason that it’s very heart healthy is it’s very focused on olive oil, which is really a great oil to have its great fat. And the reason I don’t really stick by that is because it adds a lot of grains and legumes and I’m a former vegetarian or vegan myself. And I noticed that when I was vegan, I ate a lot of beans and a lot of grains, quinoa, gluten free grains, not a ton of rice, but a little bit of quinoa and millet and occasionally amaranth. But I sustained myself on that because you need to get your protein from a source. So, it’s going to come in the form of nuts, beans or seeds and grains.

And so, I noticed every time I did my blood work, my blood sugars were escalating and I’m thinking, “How could this be? I’m not eating any sugar at all.” And I was eating gluten-free bread and my products were gluten free. I wasn’t having any dairy and I wasn’t eating any sugar. I really was eating very little berries, but I was having berries. And, when my hemoglobin A1C got to 5.6, which just for reference range 5.7 is pre-diabetic, I said, “That’s it. This is not working for me.” And I stopped that diet and I went completely paleo. And I took out all the legumes and grains that are carbohydrates at the end of the day. They’re filled with great properties of great fiber polyphenols. All those things are really, really great, but at the end of the day, they’re carbohydrates and that just doesn’t work. And in my opinion for everyone.  Some people can, if you’re an elite athlete, I’m going to say you probably need more carbohydrates, but most of us are not elite athletes. Me included, even though I work out all the time, I’m not an elite athlete, so I don’t need that many carbohydrates. And so, I do recommend it for some people some of the time, but I don’t think that there’s a major population that thrives on a Mediterranean diet.

Dr. Weitz:            Agree to disagree on that.

Risa Groux:         Your thoughts on that?

Dr. Weitz:            I do think that a low glycemic version of the Mediterranean diet can be really good. And I think something like autoimmune paleo is a really difficult diet to stay on for a long time. It’s very, very restrictive. And, it depends on a person like you’re talking about athletes, like somebody like myself, even though I’m 63 years old and you know, I’m working in an office still. I’m getting about 20,000 steps a day. And if I don’t consume 3,500 calories a day, I’m going to lose weight and I’m not trying to lose weight. So, it’s really hard for me if I don’t have some legumes or healthy grains in my diet and I avoid gluten like you do and dairy, but I do find that judicious use of properly cooked and prepared grains and legumes and sweet potatoes is necessary for me to get the calories I need to make my body [crosstalk 00:21:25]

Risa Groux:         And I fully agree. I fully agree the if you’re having 20,000 steps a day regularly, you need more carbohydrates for sure. Especially if you don’t want to have weight loss. And let me just clarify, I’m not against legumes, especially if they’re sprouted or they’re soaked-

Dr. Weitz:            Soaked overnight, yeah.

Risa Groux:         Exactly. And certain grains like quinoa, which actually isn’t a grain, it’s a seed, but millet, quinoa, amaranth. So, I’m totally good with that in small doses. I have people who just say, “No, please, don’t take my hummus away.” Well, fine. Have some hummus. You’re not having a container of hummus every day. If you want some hummus and vegetables, have it, just watch your portions and you should be fine, but there’s tons of benefits in those legumes, but not somebody with SIBO or with IBS, right. That person I’m not going to tell, “You have some legumes.”

Dr. Weitz:            Right. Because they’re high in FODMAPs and I notice you have the low lectin diet. So, why do you have the low lectin diet in there?

Risa Groux:         So, low lectin-

Dr. Weitz:            I guess we could call it the Dr. Gundry Diet, right?

Risa Groux:         Dr. Gundry diet. Yes. He really highlighted the dangers of lectins. And for your listeners who don’t know, lectins basically fall under the category of anti-nutrients. And they basically are what I call a hard candy shell around the bran or the seed or the germ of a plant, because we all have our way of protecting ourselves. Humans, if we’re in danger, we can flee, bite, kick, scream, yell and call 911. Plants don’t have that ability, right. So, they have this protective coding on them that says, “If you try to eat me or destroy me, I’m going to do my best to sustain myself and procreate because those are our two main goals as living organisms.” And so, they’re very hard to digest for people.

So, not everybody, those people who have SIBO and IBS and some people have autoimmune, they’re going to have a difficult time breaking down those lectins, especially if you’re not having any digestive enzymes, you’re not taking any digestive enzymes or you’re not producing digestive enzymes, you are going to have a horrible time. And those are the people who come in and saying, “I had three garbanzo beans and I was bloated all night or I had hummus and I just wanted to die. My belly was like a balloon that needed to be popped.” Those people cannot break it down. So, low lectin is great for, I think for it’s an anti-inflammatory diet, it’s another anti-inflammatory diet and it’s really good for people with autoimmune. So, it’s very similar to paleo or AIP, but they’re different. It’s really more centered around lectins. And some people do really well with a low lectin diet.

Dr. Weitz:            Yeah. It’s, it’s pretty restrictive because I mean, there are so many vegetables that contain lectins, including cucumbers and tomatoes and squash. It’s very, very restrictive.

Risa Groux:         It is very restrictive and again, that’s why not everybody does well with it. But some people do.

Dr. Weitz:            Now on a practical level, as a dietician, you put somebody on a low FODMAP map diet or autoimmune paleo diet, what kind of guidance do you give them? Do you simply say, “Here’s a list of foods not to eat. Here’s the food you can’t eat.” How do you make this work? Because I’ve noticed some patients need more handholding. And do you have some way of giving them more detailed guidance in your practice?

Risa Groux:         Sure. So, in my practice I test everybody because what I do basically like… I watch a movie on HBO and then it tells me all these other movies I might be interested in. I listen to a song on Spotify and it tells me all these other songs that I would be interested in, right. We don’t have anything to tell us what kind of food that we are customized to eat. So, I’ve created that because it’s crazy that in this day and age, we’re not customizing our food to our health status. So, the first thing we have to do is find out our health status. So, if I’m working with you in my office or we’re working through zoom, I’m going to find out because I’m ordering your blood test and your stool test. So, I’ll find out what your landscape looks like?

Dr. Weitz:            What sort of blood test or stool test you’re going to order?

Risa Groux:         So, I order a comprehensive bioscreen and that tells me all 10 markers of your thyroid, not just the two or the one that your doctor orders, but all 10. And it tells me all four markers of your blood sugar. So, I’m looking for insulin resistance, I’m looking for prediabetes. And then it tells me inflammation markers. And then it gives me a breakdown of your white blood cells. And it gives me a ton of information, iron which is a big factor and all your liver enzymes. It gives me a very full picture. And I look for viral patterns. I look for bacterial patterns and then I order a stool test. And that tells me about 84 pathogens, fungus, yeast, worms, parasites. It tells me how much digestive enzyme, pancreatic enzymes you are producing, tells me how you do with fat malabsorption if you have a fat malabsorption issue, tells me about your immunity because so much of our immunity is produced in our gut.

A lot of people come to me with a lot of sex hormone imbalance and that gives me a good indication of beta-glucuronidase. If that is high, then that will likely be the factor that is dysregulating hormone. And then I look for leaky gut and inflammation in your gut. So, I can really see what’s going on. I can find out if there’s SIBO, bacterias, all that stuff. And so then, I am educated. I’ve got my data. I can say, “This is what your landscape looks like. And this is the eating lifestyle that best suits what your health status is.”

If I’m not working with you in my office or via Zoom and you just go on my website, you’re going to take the FoodFrame quiz and it really is an expeditious way to pretty much figure out what eating type is best for you. And then you go from there. But, I also have a course coming out on thyroid health. So that people can learn how to read their thyroid labs and ask their doctor what to test for and find out if they do have a thyroid issue or if their thyroid medication isn’t working. So, we just need to educate people on how to do this for themselves.

Dr. Weitz:            Okay. But practically, let’s say you select the low FODMAP diet. How do you get them to follow it?

Risa Groux:         Right. So, I give them a handout and I give them all the foods to enjoy and I give them a list of foods to avoid. And then I usually work with these people. So, I give them a food log and they’re kind of judging how they’re doing in a low FODMAP case. I would say, “Give me evaluation of how your bloating is or your constipation, your chronic diarrhea.” So, I have some assessment way of assessing-

Dr. Weitz:            So, they write down what they’re eating and then they write down how they’re feeling.

Risa Groux:         Exactly. And we’re starting to relate that, “Oh, if I have a quarter of an avocado, I’m good. But if I have more than a quarter, if I have a half an avocado, I have bloating or I have diarrhea.” Whatever it is. And so, we start to make those correlations of what food is affecting them. And then I work with people. So I have that ability to say, “Okay.” And then usually a lot of those lifestyles that are on there, like low FODMAP and AIP, those are a temporary elimination diet. So, that’s 30 to 90 days. Once you’re done with that, then I say, “Okay, let’s look at the landscape and see where do you go from here?”  So in AIP, they would typically either go to AIP… I’m sorry, they would go to paleo. So, they’re opening up a few more things or reintroducing things, or they would go low lectin, but usually they go paleo. And then with somebody with SIBO or IBS, I would recheck their stool test to see if their inflammation is gone. We’ll know because their symptoms will have gone away. And then we treat that whatever is in there and we look at the root cause and address it.

 

---

---

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

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

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

---

---

 

Dr. Weitz:            So, once they’ve been on one of these specialized diets for a period of time, do you try to introduce all the foods or do you keep certain foods out permanently?

Risa Groux:         I always like to have diversity in the microbiome, right. So, we now are knowing about short chain fatty acids, which is really the food for the colon, the end of the line, right. And I have a product-

Dr. Weitz:            Butyrate and propionate.

Risa Groux:         Exactly, exactly. And I have what’s called post BioMax, which is a postbiotic. They’re now called postbiotics, not prebiotic, not a probiotic, but a post. And it is those Butyrates and all those things that creates the diversity of the microbiome. So, always want to do things through food. And if you don’t have to take a pill, I’m always saying, “Let’s do it through food.” But as if I were to say to you, “I want you to go into the market and go into the produce section and buy every single food in there that you have no idea what it is. You don’t know what country it gotten from. You’ve never had it before, put it all in your basket, bring it home, put it in the blender, whip it up and drink that.” That’s going to create that diversity of the microbiome.

Risa Groux:         But unfortunately, we all eat about the same 20, 40 foods day in and day out in different forms or shapes. And so, we don’t get that diversity of the microbiome. So, especially if you’re on a restricted diet, I always want to say, bring in some more colors for sure. And more things. So, it depends on what you are. So, if you’re autoimmune, I’m not going to say to you, “You should have some gluten.” That wouldn’t be good for you. But if I’ve tested you and I’ve looked at your anti-gliadin on my stool test, and I say, “You really don’t show up high for gluten.” Then I would say to you, “Once we take care of the autoimmune, you can start bringing in gluten in every now and then.” Or if you wanted to have gluten, if you’re going to Italy, I’m going to say, “Have fun. Here, take some GlutenFlam with you, so you can mitigate the effects of that gluten. And it’s not going to cause major habit for you.”

Risa Groux:         Now, if you’re celiac, I’m not going to say that to you. You’re not going to have gluten. But I try not to say ever, never forever, but some cases that is the case. And every now and then a cheese might be okay with you, but I’d have to know what your specific circumstances in your health status is.

Dr. Weitz:            They say that saturated fats are among the healthiest fats, but don’t saturated fats promote atherosclerosis and heart disease?

Risa Groux:         Certain ones do. Yes, absolutely. If they’re from the wrong sources, for sure. So, saturated fats and coconut oil or coconut products as we know, are good for you. We know that they’re antimicrobial, they’ve got lauric acid and caprylic acid, really good for gut. Really good for skin.

Dr. Weitz:            It is controversial, but…

Risa Groux:         Yes.

Dr. Weitz:            I think for a lot of people, they probably are.

Risa Groux:         Yes. Now, would I tell you to have the saturated fat and Twinkies? No, I wouldn’t. Those are the ones that are going to cause you some issues, right.

Dr. Weitz:            The Twinky fats.

Risa Groux:         Yeah. Twinky fats are probably not really recommended. at least I don’t recommend them. But, if you think about it logically, I mean, think about it. I say to every patient I work with, “I want you to imagine that your body is just like a sneaker factory. You’ve got all the equipment to make sneakers. I know if I give you some leathers, some rubbers, some canvas, we’re going to get a sneaker at the end, right. May change in shape or size or color, but it’s going to be a sneaker. And if I say let’s put some cell phone parts in your sneaker factory, what would you say? Hopefully you would say no, because if we did that, what would happen to our machinery? It would break.” So, I use that silly little example because it’s a great visual. If you think about the Nike factory, it’s not the same as the iPhone factory, right. Fully different equipment, fully different parts.

And so, I use that example for, because whoever created us, whenever that was, all of a sudden, there were these things crawling on the ground and spreading from the earth that we could eat. And again, sustain ourselves and procreate are two main goals of living organisms. So, I’m trying to take out the cell phone parts. Twinkies were not on the planet when we were created. Pop-Tarts, Big Mac, Doritos, you name it, anything that really has a label on it, is not really food from the farm. So, if we eat food from the farm mostly, then we’re in pretty good shape. So, if we think about it that way, all the fats that came from the farm, we’re in good shape with. Those were what we’re meant to eat. Not a lot. Our plate shouldn’t be this much animal protein and this much vegetables.

We should have 60 to 70% of our plate living foods, whether they’re cooked or not, it doesn’t matter. But foods from the ground and then some protein, because we all need protein. And then we have some sweet [inaudible 00:35:45] some carbohydrates, right. That are good for us. We can’t forget about the good fats because we need good fat.

Dr. Weitz:            Why is sugar so bad?

Risa Groux:         Why is sugar so… How much time do we have? So, sugar is the devil. We really don’t glean any nutrients from sugar, unfortunately. And we like sugar. Everybody’s addicted to sugar and it makes us feel good immediately, but it doesn’t do well for us. And I’ll just give you a few of my things on my list. Sugar makes us fat. Why does it make us fat? Because it makes the pancreas pump out some insulin and it converts it into glycogen. And then we send it to every cell in the body and we use that for energy, right. It gets into there. If your receptors are open and it goes into the mitochondria and that’s our energy factories, right. We’re making energy. But any excess we have, if we can’t fit into the cell, it just parks it in storage, right. We just keep putting it in the storage unit.

And if your receptors on your cells are closed, that’s insulin resistance. We’re going to park it into fat tissues and fat cells. So, that’s number one. And we know that fat creates inflammation, which is the driver of disease. Second thing is, it causes fatty liver. It will really congest our liver, our gallbladder. It doesn’t help us there. It feeds cancer cells, right. It’s the nutrition for cancer cells to replicate. So, anybody with cancer should not be having any kind of sugar at all.

Dr. Weitz:            Yeah. We had Dr. Thomas Seyfried on the podcast.

Risa Groux:         Awesome. We [inaudible 00:37:20] a lot about that, I bet. It eats up white blood cells. Our white blood cells are our immune powerhouse. They are our protectors. So, even one tablespoon of sugar, table sugar can affect our immune system by 50% within one hour. So, I don’t know about you, but I’m going out in this world, especially with COVID with all my army with me. I’m not putting anybody on vacation. Everybody’s with me. I need as many troops as I can possibly have. Another reason why we don’t like white sugar at all is it causes fatigue. We spike and then we drop, we spike and then we drop. So again, I want my A game. We can drink sugar, right. Alcohol wine especially is a great resource of drinking sugar and it ruins our sleep. So, if you’re waking up between 3:00 and 4:30 in the middle of the night, you’re most likely having sugar plummeting and you probably have some blood sugar issues.

 So, it provides brain fog and fatigue. And gosh, I can keep going, but it’s not good for our skin. We get acne from sugar. We don’t glean any nutrition from it. And I talk a lot about eating for survival and eating for support. And I just want to be very realistic. It’s best that we eat for survival, but there’s always going to be support eating. Even me. I have to have my gluten free pizza every now and then. I don’t have it frequently, but I like it. And I want chips and salsa. Now, there are Siete chips or cassava flour and now I’m making my own salsa and I’m making my own guacamole, but every now and then, I would like to have some of that. So, we do.

Dr. Weitz:            What’s your favorite meals?

Risa Groux:         I have a few favorite meals, but I’m a big, huge fan of salads. I love a really good salad with some good fats, good animal protein. I’ve been making recently. I’m a little obsessed with this because it’s like literally in 10 minutes you can just whip this up. I do sauteed veggies with mushrooms and onions and kale and Bok Choy or whatever green I have or broccoli and then I throw in some chicken or some fish and then I love miracle noodles, konjac noodles. They don’t have any carbohydrates in them. There’s really nothing in them except for just a hair of fiber. And then I put coconut aminos. I have a sesame ginger recipe on my website that I basically do with a coconut aminos, which is a soy sauce, substitute almond butter, fresh ginger and Sesame oil. And it is so good and I sprinkle black and white sesame seeds at the end. And it’s packed with protein, fat and fiber, and even my 20 year old son, he loves it. So, it’s good.

Dr. Weitz:            There you go.

Risa Groux:         I love that. I do a lot of cauliflower rice with coconut curry. I like that a lot too.

Dr. Weitz:            Right, cauliflower rice. Yeah.

Risa Groux:         Easy. Really easy.

Dr. Weitz:            Yep. You basically cook it like rice.

Risa Groux:         Exactly. Just heat it up and-

Dr. Weitz:            Make a stir fry. Yeah.

Risa Groux:         Exactly. Yeah. Protein, fat and fiber. And I’m all over that.

Dr. Weitz:            Good. So, any final thought you want to leave us with? Did you want to maybe give us a case history maybe of somebody that you worked with?

Risa Groux:         Sure. I have a great story that came in this morning. She was my first client this morning. I’ve worked with her for a few years and she’s very shy and private, but I said to her, “I wish I could showcase your family.” Because she’s married to a surgeon. And she came to me a few years ago and she was exhausted. She napped every day, she had this constant congestion and she went to the doctor and her husband’s friends and they were giving her steroids and she just wasn’t feeling good. Her stomach didn’t work. And I did the detox with her and then we found out she had Hashimoto’s and she had a very, very high levels of ferritin. So, she was storing a lot of iron and she didn’t have hemochromatosis, but it was an acute phase reaction to inflammation.

Dr. Weitz:            What her ferritin levels [inaudible 00:41:37]

Risa Groux:         They were 600 something.

Dr. Weitz:            Okay.

Risa Groux:         So, we like them about a hundred and women usually fall between 40 and 70. So, she was 565, something like that. 600, somewhere around there. And she was prediabetic. We just found out all these things that was going on and we took her off gluten, dairy, sugar. We detoxed her. I think I detoxed her for about a month. In just less than a year, she lost 72 pounds with me. Every single solitary symptom was gone. Her husband ended up coming in. And the great story about him is that he’s an MD. So, he didn’t realize any of this. He wasn’t aware of anything with food and he added a garden in his house and he started planting and he came in after working with me for 12 weeks. I ordered all his lab work for him because he couldn’t do it at his hospital. And he also had some prediabetes and his iron levels were really high too.

But, he came in after 12 weeks and he said, “I have to tell you something. “I said, “What is it?” And he said that, “He had been wearing a hearing aid for the last two years, which I was unaware of.” And he said he went to the audiologist in his hospital and the audiologist said to him, “I don’t know what you’ve been doing, but you do not need a hearing aid anymore.” So, I was stunned because I haven’t seen that. I’ve seen a lot of miracles in my office, but not that. And I said, “What do you think it is?” And I had my idea, but he said exactly what I thought that it was systemic inflammation because all of his inflammatory numbers were really high. And so, they brought in their two daughters who just suffered from severe fatigue, two teenage daughters, they’ve lot on their plate with school and activities and things. But it turned out, they both had a pretty high case of Epstein–Barr virus. We treated that and they have been thriving ever since.

So, the woman came into my office a few months ago back in, she’s been doing great and had a full body rash and went to the doctor and they wanted to put her on all these steroid creams and everything. And so, I said, “Well, let’s do a stool test.” And we did. And sure enough, she had a pretty good case of geotrichum, which is a type of fungus and we treated it and we did a food allergy test as well. Her eosinophils were elevated. So, we did a food allergy test. She’s been so diligent, she came in this morning. She goes, “Please tell me I can eat more food.” Because she’s really restrictive. So, it’s been more than 30 days, so we started just adding it back today. So, we’ll see how she’s doing. Rashes are hundred percent gone. Everything [crosstalk 00:44:06]

Dr. Weitz:            And how did you treat the fungus?

Risa Groux:         I have what I call natural antibiotics that I use and a [inaudible 00:44:16] oil and garlic oil and a myriad of all natural herbs that I treat. Unfortunately, it’s not a 10 day script. It’s a little bit longer, but it works and it’s clearly worked.

Dr. Weitz:            And which ones did you use for her? Did you use combination products or you use several individual products?

Risa Groux:         There is a packet that I use from Apex Energetics that I use to treat this pretty much with almost everybody I work with and it kills. It just kills bacterias and yeast and fungus and H-Pylori, things like that. So, I’m always looking at the underlying cause, we found it and she came in today and she said the rash is fully gone. She feels amazing. And now we’re going to open up the gate so she can eat all these other foods again.

Dr. Weitz:            And so you use this Apex Product, what’s it called?

Risa Groux:         It’s called GI Synergy.

Dr. Weitz:            Oh, okay. Yeah.

Risa Groux:         Yeah. And I tested her zonulin also and she had leaky gut. So, I’ve given her my gut reboot, which is really, really good. I give it to everybody with leaky gut, anybody with autoimmunity. I do it every day in my shake and it has L-glutamine and Slippery Elms, Marshmallow Root, Zinc-Carnosine, everything to heal the gut.

Dr. Weitz:            That like a GI revive type of product.

Risa Groux:         Exactly. Very similar. Yes.

Dr. Weitz:            Okay, cool. Very good. So, how can listeners and viewers get a hold of you? Find out more about you if they want to work with you?

Risa Groux:         Yeah. So my website is risagrouxnutrition, it’s R-I-S-A, my last name is G-R-O-U-X nutrition. And I work with people all over the world. Instagram, Pinterest and TikTok even. I have all those things at risagrouxnutrition and then look for my Achieving Optimal Thyroid Wellness is launching March 11th and only open for a short period of time, but it’s a deep, deep dive into thyroid and then FoodFrame, we actually sold out our first run, but it should be back up on Amazon and Barnes and Noble and our website as well any day. So, FoodFrame and it explains everything that we really talked about in great detail.

Dr. Weitz:            Cool. Thank you.

Risa Groux:         You’re very welcome. Thank you for having me and I hope everybody learns something.

Dr. Weitz:            I’m sure we did.

Risa Groux:         Okay.

 

---

 

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