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Heavy Metal Detox with Dr. Christopher Shade: Rational Wellness Podcast 054
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Dr. Christopher Shade discusses how to test for and remove heavy metals from the body with Dr. Ben Weitz.

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

 

Podcast Highlights

2:25  Dr. Shade talked about how he got interested in studying mercury and developed a way to separate different forms of mercury as part of getting his PhD. 

3:35  Dr. Shade explained that he tried heavy metal chelaters like DMSA and DMPS and these made him much sicker, which led him to design better supplements for detoxification.   

5:45  I asked Dr. Shade to explain why his tests for heavy metals are more accurate than other tests on the market?  I then asked how serum testing can be that accurate, since it only reflects recent exposure and not metals that have been stored in the tissues for months and years?  This is why we do oral chelation challenge and collect urine for six hours to detect metals that have been stored in the tissues and are now being released through the urine.  Dr. Shade challenged that view and explained that chelaters like DMSA do not go into the cells and cause metals to dump into the urine.  What they actually do is pull metals from the lymph and the red blood cells and bind it out into a form that’s easily filtered out through the kidneys.  And serum reflects the body burden. And urine also is somewhat reflective of body burden and urine has a baseline level of metals, in contradiction to the assumption that there is no baseline of metals until the chelation challenge. Also, after the serum levels rise due to a recent exposure, such as eating some fish, it takes 45 to 60 days for the serum levels to go back to the previous level in a healthy person and up to 300 days in an unhealthy person.   

10:51  Dr. Shade described how organic methylmercury from fish is represented very well in the blood, while inorganic mercury from dental amalgams doesn’t represent itself very well in the serum.  But inorganic mercury is seen much better in the urine, provided that the kidneys are functioning properly and the kidneys can become damaged by mercury.  Quicksilver Scientific offers the Mercury Tri-Test, which separates out the inorganic from the organic mercury and measures mercury in blood, hair, and urine.  Hair is only reflective of organic (from fish) mercury and you can have a mouth full of almagams and it will not show up in the hair.  Quicksilver also offers the blood metals panel.  Here is a link to Quicksilver’s website with more information on their testing, including why urine challenge testing with oral chelators is problematic: https://www.quicksilverscientific.com/testing/clinical-metals-testing 

20:19  I asked if Dr. Shade ever measures antibodies to metals and he said that he is interested in looking at that and thinks that it may show patients who become symptomatic with metal exposure. 

22:18  Dr. Shade said that undiagnosed Lyme Disease may become symptomatic when treating the metals because raising the glutathione levels reboots the immune system. If you then send them out for more Lyme Testing they may then test positive when they were negative before. So you need to focus on controlling the infection with antimicrobials before you can effectively complete your metal detox program. 

22:58  Dr. Shade explains his approach to removing toxic metals from the body.  You can use the same approach for mercury, cadmium and arsenic, while the approach for lead is a little different.  Mercury is detoxified well by glutathione, but you also need glutathione S-transferase and transmembrane transporters and also magnesium.  So if we want to build a system of detoxification, we need to build glutathione levels. We need to turn up the activity of the transferase, and we need to turn up and support the activity of the the transport proteins.  And when it gets down to the GI tract, we need to grab it before it gets reabsorbed.

25:40  Liposomal glutathione is better absorbed and someone with mold toxicity or Lyme disease are sick and will have a tough time making glutathione from NAC. Taking liposomal glutathione is better than taking NAC in a diseased person.  Dr. Shade mentioned a study showing that 600 mg liposomal glutathione produced a 30% increase in glutathione levels in six hours while 600 mg IV glutathione only produced a 15% increase in six hours. 

30:15  Dr. Shade explains what a liposomal formula is and how it works.  You are creating a fat soluble bubble with phosphatidylcholine and tucking the glutathione in it, so it gets absorbed like a fat would and it passively absorbs into the upper GI tract.  Dr. Shade also explained that by making his liposomal products small enough, some of them will pass through the oral mucosa and directly into the capillaries, so you should hold the liposomal products directly in your mouth for 30 seconds before swallowing. He explained that all of his products are between 20 and 80 nanometers since below 100 they get much better absorbed but you also don’t want them to be too small or you have problems with nano particles toxicity. 

33:15  Once you get glutathione into the cells, then you need to up-regulate the transferase and get those membrane transporters working by invoking NRF2 by using Lipoic acid and polyphenols. You can also use sulfurophanes from crucifers and garlic oil.  The best polyphenols to use are green tea extract, pine bark extract, red wine extract, grape seed extract and haritaki. 

34:55  Dr. Shade explains that to get the transporter proteins working well, you need to stimulate the liver-gall bladder system and promote the flow of bile. The transport of toxins into the bile tree is synonymous with and linked intimately with bile transport. The two transporters that move bile from the hepatocyte into the bile tree are the bile salt export pump and MRP2, the multidrug resistance pump number 2. The MRP2 is the is also the toxin transport and thus it moves both toxins and bile salts.  These transporter proteins get up-regulated and down-regulated together, so cholestasis is toxostasis.  Thus, if you move bile, you move toxins.  If you don’t move the toxins from the liver into the bile, they get dumped into the brain and you get inflammation in the brain, the kidneys, you get lower back pain, skin rashes.  He likes to use herbal bitters to get bile and toxins flowing and also phosphatidylcholine to help solubilize the bile to keep it flowing. Then, when the toxins are moving through the GI tract, you want to use binders like thiol-functionalized silica, charcoal, clay, zeolites, and chitosan, so these toxins don’t get reabsorbed.

39:28  Dr. Shade explains why modified citrus pectin is not a good binder for toxins like heavy metals, though it helps to remove toxins by reducing inflammation.

           

                             



Dr. Christopher Shade is a PhD researcher and a recognized expert on mercury and liposomal delivery systems. He has lectured and trained doctors in the U.S. and internationally on the subject of mercury, heavy metals, and the human detoxification system. He founded Quicksilver Scientific and Quicksilver is an industry leader in blood metals testing and the development and production of superior liposomal delivery systems. Quicksilver Scientific is the only company to offer advanced mercury speciation testing (the Mercury Tri-Test), which comprehensively assesses for the body burden of mercury. Here is more information about the metals testing: https://www.quicksilverscientific.com/testing/clinical-metals-testing  Quicksilver Scientific is dedicated to producing superior nutraceutical products tailored at supporting the human detoxification system for the optimization of health. https://www.quicksilverscientific.com/home

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


 

Podcast Transcripts

 

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

                          Our topic for today is heavy metal toxins. This is a very important topic. We recently had Dr. Joe Pizzorno on talking about toxins, and now we’re going to focus in on heavy metals, mercury, lead, all the other heavy metals. And these are incredible important, can have all kinds of effects for our health, can play a role in various chronic diseases. And I’m very excited that I’ll be speaking with Dr. Christopher Shade, who is a PHD researcher and the founder and CEO of Quicksilver Scientific, a heavy metal testing and nutritional supplement company. Quicksilver Scientific is known especially for its detoxification products and its unique supplement delivery systems, and it’s patented mercury speciation test. Christopher, thank you for joining me today.

Dr. Shade:         Thanks, Ben, it’s a pleasure to be here.

Dr. Weitz:          Good, good, good. So can you tell me a little bit about your background and how you became interested in mercury and heavy metal testing?

Dr. Shade:         Oh, sure thing. I’ve a very circuitous background to get here. Grew up a scientist in an academic family. Got a little disillusion with reductionist science, went out into the woods, I was an organic farmer for a long time, sort of a Thoreau summer starting farms and stuff. And then one thing or another led me back into getting a graduate degree around pollution in the environment. I was looking at agricultural pollution and I got a masters in that.

Dr. Shade:         Then when I went to do my PHD, I didn’t really find the research that was going on there that interesting, but I found this guy who was specializing in global cycling of mercury as a toxin in the environment. And I ended up working with him. And they needed new analytical developed, new systems for separating different forms of mercury, which is really crucial to understanding their movement through the environment and movement through the body. And so I developed that, patented that, and graduated and started a company around that testing, originally doing environmental testing and then switching over into health and wellness. Because I wanted to get back to this human focused look at toxins in the environment and health in the environment, and cycle it back into looking at personal health.

                         And I brought this testing in, showed it to people like Hal Huggins and Dietrich Klinghardt, original pioneers in mercury toxicity. And they really liked that, but you know you bring up a problem, you gotta bring up a solution. And at the time, everybody was working with chemical chelators for getting rid of mercury and other heavy metals. And I thought I would do testing in conjunction with people using chelators, and so I tried all those chelators on myself and I got myself really into a hole. I really blew out my adrenals, I blew out my neurological balance, my immune system.  And while I was in the middle of just being in this dark night of my biochemical soul, I was watching these functional medicine meeting lectures here in Boulder County.  I was watching Bob Roundtree and Nigel Plummer from Pharmax, and they were talking about GI health and the GI system calling the shots in so much stuff. And I realized that a lot of amalgam toxicity was having so many metals in the GI tract.  And I was trying to push things through the kidney, but I should clear out liver GI functioning first.

                          And that led me to make my first detox supplement, which was kind of a chelator for the GI tract. It was like taking a clay or an activated charcoal and making it specific for metals. And as I did that and cleared everything out of my GI tract, I just opened up all my problems, I just cleared everything away. And introduced that product, which is now known as IMD, or Intestinal Metals Detox.  I introduced that to Huggins and Klinghardt and it filled a big void in everybody’s tool chest and it led me to research why it worked, and that led me to understand all the processes of the glutathione system and how the body’s naturally supposed to get rid of these metals. And that metal toxicity is not a deficiency of chelators, it is a deficiency of your own chemo defense system. And then when we optimize that, we can get rid of all these metals and at the same time make us resilient or resistant to other toxic insults. And so my whole life work became developing systems for optimizing all of that in people.

Dr. Weitz:            Cool. So can you explain about your heavy metal testing and why it ends up being more accurate than so many other testing?  And I keep coming back to whenever I look at serum testing I always think, you know, that’s only going to give us current levels of metals and so that’s why we’ve tended to do the oral challenge and then collect urine for six hours afterwards, with the idea that we’re going to liberate some of these metals, mercury, that’s been stored in the body, sometimes for months, years, maybe decades at a time. So how can you get a sense from testing of stored metals as well as what’s circulating and has come into the body recently?

Dr. Shade:           Right. But this is all … What did you just say to me? You said, “Well I think that this is only what’s circulating.”  Why do you think that? Did you do the primary research? Did you figure out why you think that?  Or are you just parroting what the guys who did chelation testing told you? Answer the question.

Dr. Weitz:            I have always been told that certain testing is only-

Dr. Shade:           Exactly.  Always been told is the problem there.

Dr. Weitz:            Including by the way some of the companies that do certain testing will tell you that as well.

Dr. Shade:           This is just what became the dogma of what’s going on. And the reality is that 20, 30 years ago we didn’t have really good testing to look at baseline levels. Like in urine, if you extended your discussion you’d say, but in urine there’s no metals in urine so I challenge it. That’s not true at all. There’s always a baseline of metals that are going on in the urine. And they are a filtrate of what’s happening in the whole blood, which is the plasma and the red blood cell. And the plasma and the red blood cell are in a steady state with what’s in the tissues.

                           Now for that whole argument that you brought up to be correct, that would mean that the chelators would go into all the cells and take a representative amount out into the serum and then make it go into the urine. But if you look at DMPS and DMSA, all the data around that says that they don’t do that. All the data around it says that they never cross the blood brain barrier, they don’t go into the cells. What they do is take what’s in the lymph and the red blood cells and bind it out into a form that’s easily filtered out through the kidneys.

                           And in a very famous paper that was done in Sweden in the mid-’90s, they were trying to look at DMPS and if it really reflects long term body burden, or if it’s just amplifying what you can already find in the body.  And they took acutely exposed workers who work with mercury directly, they took dentists with a long term burden, and then they took people with amalgams and people without amalgams.  And they looked at inorganic mercury in the plasma, and inorganic mercury in the urine before and after taking DMPS, 300 milligrams IV.  And what they found was that the mercury in the urine is linearly correlated with mercury in the plasma, and mercury in the urine after the challenge was linearly correlated with mercury in the urine before the challenge, and with mercury in the plasma before the challenge.

                          You’ve got these compartments and there’s a back and forth between them all. It’s not that the mercury comes in and goes into the tissues and sticks there and then leaves the blood. What happens, like if we went out for dinner tonight and we eat swordfish, a high mercury meal, we’re going to absorb that mercury in there and it’s going to peak between 12 and 18 hours after we eat. And it’s going to be much higher than our baseline is. So from our baseline let’s call it, let’s just give it a number. Say I’m at 5. I’m going to eat this meal, my peak is going to go up through maybe even 10 or 15, and then over 2 to 3 days it’s going back to this next baseline. And let’s call that 6.  And from the time to get from 6 back to 5, the original baseline, how long is that? It’s 60 days, 45 to 60 days in a healthy individual. As many as 300 days in an unhealthy individual. It’s not 2 to 3 days. The 2 to 3 days story was about a bolus that goes in, it goes up and peaks and comes back to a new baseline, and then it comes back.  But where people were kind of throwing their hands up with what’s urine mean, what’s blood mean? What’s going on here?  Methylmercury represents itself very well in the blood and will give you high levels.  Inorganic mercury from dental amalgam doesn’t represent itself very well.  It works on a lower scale.

                       Now why is that? It’s because of the distribution between the blood and the tissues. There’s always more in the tissues, which the prevailing wisdom is right about. There’s more in the tissues than the blood. But there’s a ratio between the two. And maybe it’s 10 fold more in the tissues for methylmercury and 30 to 50 fold more for inorganic mercury. And so dental amalgams and blood levels didn’t seem to correlate very well. But fish and blood levels did correlate well. But dental amalgams correlated pretty well with urine, and fish didn’t so well. That’s because methylmercury you find a lot in the blood, inorganic mercury, small amount in the blood. In the urine it’s all inorganic mercury. And so it’s reflective of the inorganic mercury levels in the serum, if the kidneys are transporting correctly.  And this comes down when we talk about detox we’re going to talk about pathways in the liver, you have the same pathways in the kidney. And when they get damaged, and they’re easily damaged, then that urinary representation of the blood blows out and you have low urine, high blood. Alright, but if it is working, then urinary mercury’s an inorganic mercury exposure.  Hair, you have Naturopaths going through all these soups to explain what hair meant compared to blood or intake. Hair is only fish. You can have a mouth made out of dental amalgam, if you eat no fish you have no mercury in your hair.

                     So there was all this improper, imprecise understanding of the pools of mercury, the compartments, and the interactions between them all. And so we just said, we’ll take the chelator, boom, a bunch comes out through the urine and we can compare people that way. And you can, but it’s not a very sophisticated way to go. And humans always do this, in order to justify that, they create this whole story that the mercury’s never in the blood except for like the last two days, and it’s all in the cells and the challenge pulls it all out of the cells and gives you this long term mercury number. But I pulled five or six different papers out of the literature where they examine that, and none of it worked.

                    Get this, one paper on DMSA, they took a grouping of people who had worked in the Chlor-Alkali factory, you sit there with a pool of mercury and stir it, and it’s an electrolysis cell, to split sodium chloride into sodium and chlorine. It’s the highest exposure you can ever get. So they all worked there and then they stopped working there for either one year or three years, but that’s the highest level of burden you can take into your body there is.  And then they took the general population and they measured urine before and after DSMA chelation.  Before DMSA chelation the guys who worked with the pools of mercury before were higher than the mainstream. But after chelation, the differences leveled out totally. There was no statistical difference between the two and there’s a reason for that. Because DMSA is really no good on inorganic mercury, which is what you get for that vapor form. But it’s pretty good on methylmercury. So this is a measure of how much fish these two groups ate. And it’s the same, because they were just a cross section of the population for methylmercury exposure, but one of them had significant inorganic mercury exposure.  So there’s all these papers showing the failure of the challenges to show long term burden. The exception being EDTA challenge and bone lead versus blood.  EDTA challenge is better correlated with bone lead than blood is, but blood’s still not bad.  You just have to take these scales, you’re looking for these huge, big scales, you’ve focused them down, and key for us for mercury, you separate methyl and inorganic mercury.  Give them their own reference ranges in the blood. Then once you have that inorganic mercury separated away from the fish-based methylmercury, that’s supposed to correlate perfectly with urine. And when it doesn’t, then you see it building up in the blood and you know where the damage is. It’s to transporters in the proximal tubules. It’s not even related to glomerular filtration. And you know when you treat them you have to focus on that. So there’s the whole story.

Dr. Weitz:      Yeah, so to sort of highlight a couple of points that you’re making is number one, the oral chelators like DMSA, they’re not effective at removing mercury and heavy metals from the tissues like we think they are.

Dr. Shade:     No, they remove from the blood plasma, maybe a little bit of soft tissue, lymph, and then the metals redistribute from the cells into the blood. And that’s when it’s important to have things that up regulate the chemistry that dumps out of the cells into the blood. Like lipoic acid. If you go to the Cutler theory, Cutler thought that DMSA was clearing the body and lipoic acid was clearing the brain. And he would start with DMSA and then he would move to DMSA and lipoic acid. DMSA clears from the blood and then lipoic acid gets the cells that dump into the blood. And then the DMSA can take it.

Dr. Weitz:      Interesting. So the first point is the oral chelators are not effective at removing the metals from the tissues. And two, the serum testing is actually effective for measuring mercury that’s in the body for up to 300 days.

Dr. Shade:     Yeah. And as long as you have the right testing. If you go to Labcorp, they’re not measuring low levels, and they’re not separating the two forms of mercury. So once you separate the two forms and you can measure really, really low, then everything’s good.  For instance, if say we’re measuring you and you have a lot of dental amalgams, but you never eat fish. Your total mercury in the blood might be say 0.5 parts per billion. Now the limit of detection for Quest is 1 part per billion. And some labs it’s 0.5. And so you’ll like less than the detection limit, less than 1. And they’ll say you have no mercury. But all of it is inorganic mercury. If you look at our reference ranges once you separate methyl and inorganic mercury, 0.5 parts per billion if inorganic mercury is the 95th percentile. It’s a very, very high amount.  And if your urine to blood ratio is good and your kidneys are working well and if you measured your urine, your urine would actually be fairly high. And so it was just, oh, we’ll measure serum. It only shows a little bit of one story. We’re measuring urine, only shows a little bit of story. You gotta put all this stuff together with the right technology. And there’s a beautiful story about the disposition of the metals and your excretion ability all in that one test.

Dr. Weitz:            So your company offers this tri-metals test that measures mercury through serum, urine, and hair.

Dr. Shade:           Yeah, that’s called the Mercury Tri-Test. Those three, blood, hair, urine.

Dr. Weitz:            And then there’s another test that measures multiple metals, and that’s a serum test.

Dr. Shade:           Yeah, that’s our blood metals panel, where you’re looking at nutrient metals and toxic metals. So the nutrients, you’ve got classic calcium, magnesium, copper, zinc. Most are really important because they have to be in a certain ratio. When you have high copper and low zinc, you’re synergistically toxic with all your other metals and it’s a marker of a serious dysfunction. So is calcium:magnesium.  Then you’ve got co factor detoxification metals like selenium, molybdenum, which is crucial for sulfur cycling, and you’re taking a lot of sulfur compounds when you’re detoxing. And lithium, which is a big one for B vitamin cycling.  And then in your toxics you’ve got the major four, arsenic, cadmium, lead and you have mercury but just as total mercury. If you’re just looking at somebody who’s a big fish eater and you want to know is it high, is it low, it’s sort of a good first cut.  A lot of people think, well if it’s high there then I’ll go do the Tri-Test. But if you have a patient who has dental amalgams but doesn’t eat fish, you’re not going to see anything in the total mercury blood. You need to go to the test that separates the two and looks at inorganic separate from methyl. It’s like they’re two totally different metals.

Dr. Weitz:            So ideally, if you have somebody that you suspect has serious metal issues, you really need to do both tests.

Dr. Shade:           You do both and you have a map of everything then. Both functional excretion capacity, sourcing, and your whole metals map, nutrient and toxic all together.

Dr. Weitz:            You ever measure the antibodies to metals?

Dr. Shade:           No, but every time I hang out with-

Dr. Weitz:            Dr. Vojdani?

Dr. Shade:           Yeah.

Dr. Weitz:            He spoke at our meeting last month so I got to hang out with him, it was great.

Dr. Shade:           Yeah. And so hopefully I hired guys to be in charge of a clinical research program here, and we’re starting to really crank out a lot of stuff. And so that’s on our list is to reach out to Dr. Vojdani and get a bunch of patients. Because he had said to me, “Well I think when you see the levels are high you’re going to see antibody response.” My take is very different.  When you see an antibody response, that’s going to mean that a certain level of metals is infinitely worse than maybe a higher level with no antibodies. So the antibody and the levels together will correlate with symptomology. And we’ll see, because you’re going to find a lot of people who are super symptomatic at low levels, and it’s this diffused whole immune dysregulation and neurological dysregulation. And the amount of mercury is really hard to justify that that’s doing it alone. But if they’re allergic to that mercury, then that can give those symptoms.

Dr. Weitz:            Yeah, boy, those can be some of the toughest patients, some of these chronic patients, and you’ve been doing mercury protocols and years later they’re still sick. Those are the toughest patients.

Dr. Shade:           Yeah, they’re very difficult. It’s very multifactorial, why did the immune system turn on it. There’s usually layers and layers of stuff going on.

Dr. Weitz:            Yeah, in one of the discussions you were having with somebody else, you were talking about how when you’re trying to get rid of metals or mercury, at a certain point sometimes that will increase some of the infections and you’ll have to stop and fight that off, like SIBO will recur.

Dr. Shade:           One of the things that we see a lot is that with Lyme, undiagnosed Lyme, when we start treating the metals we bring the glutathione levels up, it reboots the immune system and it starts reacting to the Lyme and they feel horrible. And then you send them out for more lyme testing and then they show positive on their Western blots, and then they have to take a side road and get some antimicrobial therapy before they can come back and just do the metals. Although there’s still detoxification support for that. So in the complex cases I would say there’s a sort of pendulum between microbial focusing and toxin focusing.

Dr. Weitz:          So can you talk about your strategy for helping to remove metals, and how much does it change depending upon the metal?

Dr. Shade:         Oh, good, good question. And I’ve gone to a more broadly focused detoxification strategy, but let’s just look at mercury now. And mercury, cadmium and arsenic are playing by basically the same rules, and lead plays by a different set of rules. And then cadmium a little bit straddles the fence between the two. So mercury is the classic glutathione dependent detoxification. So if we’re in a cell, say there’s a cell here and we got a protein and there’s a mercury stuck to it, we gotta get the mercury off of the protein because mercury’s blocking the function of the protein. So you’re going to have glutathione floating around in the cell. But it doesn’t just go and grab the mercury on its own. You need glutathione S-transferase. Glutathione S-transferase is part of the phase two detoxification proteins called transferases, where they link something you make, like glutathione, onto something you want to get rid of, like mercury. And so that transferase would be me, and it changes the bond structure on the mercury so it can come off the protein and go with the mercury. 

Dr. Shade:         So then we got a mercury glutathione complex in the cell, we gotta get it out.  Now it doesn’t just passably diffuse out.  There is a series of transmembrane transporters that depend on magnesium and ATP, meaning you need to energy to turn them over and you need magnesium.  And they actively push that complex out of the cell.  Okay, so the cell’s free, but it’s out in the body. And it’s in the extracellular environment and then that’ll join in to the blood flow and then how do we get it out from there? In the liver you got another transmembrane transporter that’s feeling around for these things, grabs it, pulls it into the hepatocyte, and another one that’s another one in these family of transporters that dumps it into the bioflow. And then from the bioflow goes down to the GI tract and out to fecal excretion. That’s when everything’s working well.  So if we want to build a system of detoxification, we need to build glutathione levels. We need to turn up the activity of the transferase, and we need to turn up and support the activity of the the transport proteins. And when it gets down to the GI tract, we need to grab it before it gets reabsorbed.  So we like to bring in liposomal glutathione for building glutathione.

Dr. Weitz:        Now how much is glutathione actually absorbed? Those of us in a Functional Medicine world have it in our heads, we’ve been told glutathione’s not absorbed, you gotta take NAC, that’s the only way to do it. If you end up in the emergency room with acetominophen toxicity, they’re going to give you IV NAC, so NAC’s the way to go. But now that we have these better forms of glutathione, like liposomal, how much is actually absorbed?

Dr. Shade:       Right, and so in … These total amounts absorbed in kind of vary and we’re doing a lot of research to show how much goes in and how these different approaches compare. But first, why would we do … Let’s just assume we get the liposome in and then we’ll come back to how well liposomes are absorbed, and what’s required for a liposome to be absorbed, because all liposomes aren’t the same. It’s like all cars are not the same, all wines are not the same. There’s a vast range of quality.

                       But first just assume that it gets in there. Why would you use that instead of NAC?  Now in the cases of really compromised individuals who are very sick, people with lyme disease, mold toxicity, things where there’s actually blockages of the enzymes that are synthesizing glutathione.  For instance, there was a paper done using ready liposomal glutathione in cell cultures and they took immune cells from HIV patients, which are notoriously poor at making glutathione, and they’re getting all these infections because of the low glutathione. And that’s one thing that people miss about glutathione is it’s an essential factor for proper immune response, it’s not just about detoxification.  So they found in these cells, they were challenging them with the tuberculosis culture, they culture the white blood cells, the put tuberculosis in, and for the cells to be able to handle the tuberculosis, they needed to raise the reduced glutathione levels. And then the cells could deal with this. And they tried two ways to do it.  One was NAC, and the other one was liposomal glutathione into the cell cultures. And they needed 5,000 times more NAC to raise the glutathione levels up the way that the liposomal glutathione did. 5,000 times. Because those enzymes are epigenetically being blocked by disease states. So when you’re sick, just pouring NAC in, it’s hard to get the levels up. You’re healthy, that’s a good way to go. If you have snips for poor glutathione production, then you want to think about both as differing strategies.

                      Then liposomes, what gets in, what doesn’t. We’re actually in the middle of a study right now where we’re measuring all the different liposomes on the market and the factors that go in to getting these into absorption. And we just got a study back from our Japanese partners, we’ve got a bunch of Japanese doctors who use our stuff, they wanted data on glutathione, I didn’t have it yet, so they went and got Doctors’ Data, blood glutathione test. They took 10 people, measured baseline, gave 5 of them IV and 5 of them liposomes, 500 milligrams each. And then they measured them six hours later. To see not right away, if you do an IV you spike up, but often you spike right back down. So they said six hours later, what’s the effect on this system?  IV six hours later there was a 15% jump above baseline. Liposome, a 30% jump. Anything that gets you a 30% jump is awesome. But the fact that we just beat the IV, because the IV has no mechanism for really interacting with cells. Glutathione’s not really good at getting in the cells. But the liposome showed its ability to raise the levels for an extended period of time. It was a beautiful piece of work. But in all the other data that we’ve got on liposomes, the membranes have to be right and the size has to be right.

Dr. Weitz:       And by the way, liposomal basically means putting it in a fat soluble form, right? Essentially combining it with phosphatidylcholine.

Dr. Shade:      Well what you’re doing is using phosphorylcholine to make a little bubble that’s sort of watery on the outside, fatty on the inside. And you’re making like a little cell and you’re tucking the glutathione in there. And so it absorbs like a fat would. It passably diffuses across the upper GI. So that’s why they say it’s like it’s like fat soluble, because it absorbs like a fat.  But if you make them small enough, they pass right through the oral mucosa into the capillaries in the oral mucosa. In fact in the blood uptake studies that we did with vitamin B12, we had a very significant bump in the blood levels in two minutes after holding it in the mouth. That’s why with our liposomes you take them orally, you swish them around your mouth, you let them hold in there 30 to 60 seconds and you swallow. The uptake begins there. Even if … You get to the stomach acid and the bile salts, you’re starting to beat on those liposomes. So the faster you start that journey, the better.  And that journey only begins that far up in the GI tract when they’re really small. We call them nano liposomes because they’re below 100 nanometers. And all of our products are between 20 and 80 nanometers. This is not a threat, don’t worry about nano tech. Because when you’re absorbing fats in your diet, you make something called a chylomicron. It’s triglycerides surrounded by phosphatidylcholine with a couple of apolipoproteins that you use as delivery vehicles to bring the fatty acids to the cells to use them. And those range down to 70 nanometers in size. So those are lipidnanoparticles, and you have a whole enzyme system for dealing with phospholipid based nano particles to take them apart, use the phospholipids in your cells, in your membranes. You can use them as fatty acids for energy, you can make acetylcholine.  So this delivery system is really good but it only worked when we got it below 100 nanometers. And all this other stuff on the market is selling you the dream of the liposome but they’re 2, 3, 400 nanometers, and I just don’t see any evidence that they’re working. So we’re really spending a lot of money and a lot of time working out exactly what works and what doesn’t work. Alright, so that’s the glutathione story.

Dr. Weitz:     What about the idea of spraying some in your nose, because Dr. Vojdani was talking about how there’s a route of entry from the nose for bacteria directly into the brain.

Dr. Shade:     No, that’s a great idea but it’s not a dietary supplement, then it’s a compound pharmacy product. Because a dietary supplement has to go through the GI tract.  Don’t think I don’t have a couple of nasal applicators here in my office. I did that, but I can’t do it on the market. So there’s the story there.

So back to our detox story, we got glutathione in, and now we need to up-regulate the transferase and get all those transporters working. So now we want to invoke NRF2, which is the little switch, the protein inside the cytoplasm that when you activate it, it goes into the nucleus and turns on all the chemo protective genes. It’s like the light switch for all the protection genes. So you want an NRF2 up regulator. So the things that do that, lipoic acid is probably my favorite. There’s a number of compounds from crucifers, like sulforaphane is very well known but there’s some drawbacks with those. There’s things from garlic that work very well. And don’t get deodorized garlic because it’s actually the stink of the garlic that works, it’s garlic oil that does it.  Then polyphenols, I love polyphenols.

Dr. Weitz:     Resveratrol.

Dr. Shade:    Well resveratrol’s not a great NRF2. It’s more in the SIRT 1 activation, so mitochondrial up regulation. But it is a polyphenol. And then people say curcumin, and that’s not the best either. The good ones are green tea extract, pine bark extract, red wine extract, grape seed extract. The Ayrevedic polyphenols from haritaki is one I use a lot. So all of those are really good NRF2 up-regulators.

                     And with that comes glutathione S-transferase. There’s also a bump to glutathione synthesis in there. So that’s working, and there’s also a bump to the transport proteins. But to really get the transport system working well, I like to work from the GI–gallbladder–intestinal axis here. Why am I talking about that? Because the biggest transport system that’s happening here is from the hepatocyte into the bile ducts. And that transport of toxins into the bile tree is synonymous with and linked intimately with bile transport.  There are two transporters that move bile from the hepatocyte into the bile tree. And it’s the bile salt export pump and MRP2, the multidrug resistance pump number 2. The MRP2 is the toxin transport, it moves toxins and it moves bile salts, and obviously the bile salt pump moves bile salts. These guys get up-regulated and down-regulated in unison. So cholestasis is toxostasis. If you move bile, you can’t move -toxins.

                   So what happens to the toxins that are in the liver when you can’t move them into the bile? There’s another door out of the liver back into the blood. It’s a pressure release valve. When you wind up a bunch of toxins in the hepatocyte, and the hepatocyte can’t deal, it can’t move them out fast enough, it dumps them back into the blood.  Where do they go from there? Brain, neuroinflamation. Kidneys. Lower back pain. Skin, rashes and things coming out through the skin. These are all the classic detox reactions, and they’re all caused from a failure to continue to move bile. So we’re taking our cues here from the early 1900s and the prohibition time when bitters was the medicine for everybody because it was the only way to drink, but it also cured half of what ails you, because stuck liver was what was going on. And when you open up liver, bitters activate those transporters, and when you open that up and you dump bile, you dump toxins and you start feeling better. So we use a lot of bitters.  We use a lot of phosphatidylcholine just on its own, not even in liposomes, because PC is always being donated from the hepatocyte cell membranes into the bile flow because it helps fluidize the bile flow. People talk about thick bile, PC is what’s solubilizes it. And it actually forms little mixed micelles with the bile salts so that the bile salts, which are a detergent, don’t dissolve the bile tree.  And the reason you have pressure release valves from the hepatocyte is when bile salts build up in there, they dissolve the hepatocyte. And so you’re dumping those back into the blood and then bringing them up when you can use them. So when you’re always moving out, you’re always moving toxins out of the system.

                 But what else are you doing? You’re cleaning the upper GI tract. Everybody’s talking about SIBO and SIFO, like it’s a new infection. Do you really believe that you have an infection in the small intestine that has to be treated? Why do you have an infection? It’s not like a creature came in and is living there in a classical infection sense. It’s crawling it’s way … It’s just bacteria in your lower GI tract crawling their way into the upper GI tract. Because the upper GI tract is supposed to be washed by bile. The antimicrobial detergent that washes the upper GI tract and acutely brings glutathione along with PC into the upper GI tract as part of the metabolism in the upper GI.  Upper GI is doing mostly chemical reactions. Detoxing things in food, and pulling things out of blood and dumping them into that GI tract, and then the microbes start growing further on down. And in fact, in people with congenital intrahepatic cholestasis, meaning you’re not able to move bile salts from the hepatocyte into the bile tree, those people are statistically higher cases of SIBO, and when you treat them, it keeps coming back.

                 So this bile flow, this keeping things moving out, is a crucial part of keeping the transport chain open, keeping the liver open, and then coming in with binders to bind these toxins in the GI tract so you don’t absorb them. And that’s binders like our IMD, which is thiol-functionalized silica for metal, or charcoal. Clays and zeolites, Chitosan, those are all grabbing different parts of the toxin pool and we blend those all together-

Dr. Weitz:            What about pectins, like modified citrus pectin?

Dr. Shade:           Now modified citrus pectin, I don’t buy into that at all. So remember my … No, I buy into it’s use therapeutically, I don’t buy into the idea that it can bind toxins. Because remember my PHD is in mercury chemistry. I designed the whole analytical system we use to model out what molecules bound mercury as it moved from the sky to the rain to the bacteria to the plankton to the fish to the people. We know this stuff really, really well. And there ain’t nothing in modified citrus pectin that’s going to be a good toxin binder.  But remember this, inflammation blocks detoxification. When inflammation is down, detoxification gets blocked because detoxification’s part of the antioxidant system and inflammation is pro oxidant. So they just go like this. And modified citrus pectin is a very nice immune modulator, especially in the GI tract, and it turns down inflammation in the GI tract. When you turn down inflammation in the GI tract, you release a stuck immune system and allow it to detox more. And I believe that that’s why modified citrus pectin has a therapeutic value in detoxification. And it probably does bind a lot of other toxins that are made, maybe it binds an endotoxin, maybe it binds some of the other dysbiotic toxins, maybe it gets a little bit of mold toxin. It does have a therapeutic thing but arguing for it mechanistically as a mercury binder is not a good path for the argument.

Dr. Weitz:            It’s interesting because it’s in a lot of products that are designed for removing heavy metals.

Dr. Shade:           Yeah. And again, I think therapeutically it works but not in the way that they’re describing. And my whole goal, my whole path here has been one of shedding light on the path, and the light is on the light of the mechanism that things are working. I am big into empirical medicine and knowing what’s worked and what hasn’t. But until you reduce that to mechanism, you can’t take the next step of effectively bringing together the best players for a different problem, and designing a higher order of natural medicine.

Dr. Weitz:            Right. Just a word on the SIBO. You know part of the theory about one of the reasons for SIBO, apart from decreased bile secretion, is that you get decreased motility and you get a blockage of the migrating motor complex which causes these peristaltic waves to happen in between eating that helps to clear out the small intestine.

Dr. Shade:           Flush, clean, flush, clean, flush, clean. You’re right. And so it has two sides to it. How do they get blocked, are they poisoned, is it a microbe, is it a toxin? But somehow they get locked down.

Dr. Weitz:            Well there’s that whole cytolethal toxin theory of Dr. Pimentel’s, and they even have a blood test for it.

Dr. Shade:           And what are those called?

Dr. Weitz:            It’s a cytolethal-

Dr. Shade:           distending toxin?

Dr. Weitz:            It’s an endotoxin secreted by a campylobacter jejune or some form of food poisoning that secretes a toxin that then damages the nervous system of the small intestine.

Dr. Shade:           Yeah. And when you go into the body and you look at what really amplifies toxins-

Dr. Weitz:            It secretes a cytolethal distending toxin.

Dr. Shade:           Cytolethal distending toxin.

Dr. Weitz:            Yeah, Dr. Pimentel has a test for it, I think it’s called the IBS check test.

Dr. Shade:           Okay, cool, I’m going to look more into that. Because things like endotoxin amplifies all the toxicity through the body because it’s pro inflammatory. And there’s papers looking at the damage of mercury alone and mercury plus endotoxin and it’s synergistically higher. And I was talking about those transporters that are moving the bile salts and the toxins. Well what blocks them the best? Endotoxin. And it actually causes the transporters to be pulled out of their membrane and internalized into a little vesicle in the hepatocyte. And you really want to damp the inflammation, get those transporters back in there to drain everything out.  And it was great, we put a paper, Carrie Decker and I wrote a paper in Townsend Letter about all these pathways and nutraceuticals work on these things. And one of the interesting things about milk thistle is that it actually preserved the transporter’s ability to stay in the membrane during the stress of high toxicity.

                           But another thing that blocks that is excess estrogen. And something that opens it up is progesterone. So there’s estrogen progesterone balance, estrogen dominance actually locks up your gallbladder. And in the brain estrogen dominant winds up the glutamate system which gives you anxiety, it makes you sympathetic dominant. But the gallbladder’s also para sympathetically innervated, so it’s working against you on so many different levels. So stress, estrogen dominance, leaky gut and endotoxin, all this is blocking your ability to detoxify.

Dr. Weitz:            And Dr. Vojdani at Cyrex Labs has a test, it measures anticytolethal distending toxin and also vinculin. That’s the part of the small intestine that gets damaged and they have a test for that.

Dr. Shade:           See me writing all this down. Distending toxin, I like that. Alright.  See, this goes back to understanding mechanism. The more we understand mechanism, the more we can reach out to other people that are working in different fields and say let’s bring this together and really let’s lock this down. And it’s an amazing time in the whole history of natural medicine where you go into PubMed and you see that there’s research being done all over the world on all the different natural compounds and the genes they hit, the proteins the express, interactions between the two. We’re getting all of the mechanism of all these transporters all down. This is a brilliant time where we can design the most powerful natural medicine systems.

Dr. Weitz:            That’s great. This has been an awesome discussion, Dr. Shade. So for listeners and practitioners who are interested in getting some of this testing done, or getting a hold of your products, are the testing and products available to laypersons or should they just go through functional medicine practitioners like myself? How does it work?

Dr. Shade:           Yeah, so Quicksilver Scientific is dominantly a professional company. We’re offering the testing to the practitioners, they pass it through. You guys buy the supplemental through wholesale, you pass them through. You use our protocols or individual products. But there’s such a world of hyper informed self medicators out there, and they’re dying for this stuff and I gotta give it to them because that’s me, too. And so we do sell direct to consumer all but some. Like there’s some real pro-grade stuff, like the EDTA, that’s practitioner only. But most of the other stuff is available. Even the testing, but but that’s state by state, about half the states allow direct access testing where you can buy a kit from us, go to to a clinic, get the blood draw done and send it back.  But it’s always good to go through a practitioner, because they’re going to bring a wealth of experience of all the other things that they’ve seen. And they’re going to button up the whole protocol and they’re going to put the little extra things you need in there. There’s “Oh no, did you think about doing this and this?”  So both are available, but we’d like people to work with practitioners.

Dr. Weitz:            That’s great. And for those who want get more information, where should they go?  

Dr. Shade:           Quicksilverscientific.com. And we have a whole new website being launched in about two weeks. Right now Quicksilver Scientific, if you’re buying as an individual, it will move you over to Quicksilver Life, our second website, which is a retail website. But they’ll all be merged together as Quicksilver Scientific in about two to three weeks. And there’s different things, it’ll be one site with different things available to you depending upon your journey in there, there’ll be more stuff available to the practitioner.

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

Dr. Shade:           Great, thank you so much, it’s been great hanging out here with you, Ben.

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Healthy Skin with Dr. Trevor Cates: Rational Wellness Podcast 053
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Dr. Trevor Cates discusses how to create healthy, glowing skin with Dr. Ben Weitz.

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

 

Podcast Highlights

1:50  Dr. Cates talked about how the typical dermatology model of looking at skin is that it is something to be suppressed, which is why topical steroids and antibiotics are often prescribed. Skin is really a great indicator of what is going on inside the body and of our overall health. If you’re breaking out or have dry skin or rashes, these are all signs that something in your body is out of balance. You want to find out what the root causes are and these are usually the same root causes of most chronic diseases. 

5:48  Dr. Cates talks about how the skin is permeable and things that you put on your skin can make their way into your body.  That is one of the reasons why we use nicotine patches or topical hormone creams.  So can some of the products we put on our skin like parabens, which are preservatives used in many skin care products, have also shown up in breast tumor tissues.  Many of these chemicals found in skin care and other personal care products are endocrine disrupting chemicals that can disrupt our hormones. Dr. Cates pointed out that when women get older they tend to use more skin care products when they are also struggling with hormonal issues related to menopause and hormone disrupting chemicals will only worsen these problems. These endocrine disrupting substances can bind to hormone receptor sites and either mimic hormones or interfere with the way that they’re supposed to work. They cause a number of health issues including infertility, early puberty, hypothyroid, and even certain types of cancer like breast and prostate. 

10:42  I asked Dr. Cates to mention some of the other chemicals we should be looking to avoid in our personal care products. One type of chemical is the pthalates that are present any time you see “fragrance” on the label. Pthalates are endocrine disrupting chemicals.  Better to go with products labelled fragrance free or use essential oils. This is why Dr. Cates created her own skin care line, The Spa Doctor’s skin care line. We also talked about how some companies will take out a chemical that has been publicized as being bad, like BPA, but substitute something like BPS, which is probably equally as bad but isn’t on the list yet of harmful chemicals. 

13:48  Dr. Cates talked about formaldehyde releasers that are put in products labelled formaldehyde free. She lists many of the harmful ingredients to avoid in skin care products in her book Clean Skin From Within. She recommends the skin deep database at the Environmental Working Group, ewg.org. 

17:03  Dr. Cates explained that our skin does best with a mildly acidic pH of 4.5-5. This also helps with the skin microbiome. Water has a neutral pH and soap that has a high pH will disrupt the pH of the skin. You want mildly acidic skin care products, which Dr. Cate’s products are.

21:56  Acne may be related to hormonal changes, nutritional deficiencies like zinc, to food intolerances, and to blood sugar imbalances. Dr. Cates often find that high glycemic, high sugar foods are both frequent triggers for acne.  When the blood sugar spikes it increases insulin secretion and this triggers excess sebum production, the oils in our skin, as well as androgen activity, which can trigger acne breakouts. She also finds that dairy is a frequent trigger for acne.  Also eggs can be a trigger for acne. She also likes her patients to do an elimination diet and besides gluten, sugar, dairy, and eggs, she likes them to cut out caffeine, alcohol, corn and night shade vegetables. 

28:01  Dr. Cates talked about the importance of decreasing inflammation and she likes people to take omega 3 fish oil to help with this.  It is difficult to get omega 3s from vegetable sources like flax seeds since there is a poor conversion rate of ALA into EPA. You also want to get plenty of fiber and avoid sugar. Eating cruciferous vegetables, like broccoli and cauliflower, helps with estrogen excretion and hormone balance. Making sure to get enough zinc is also very important, along with a little copper. B vitamins are also helpful, esp. niacin.  Niacinamide can be used topically. 

34:00  Dr. Cates explained how to treat eczema.  

                                         



Dr. Trevor Cates is a nationally recognized Naturopathic Doctor, aka as The Spa Doctor, and you can learn more about her and her all natural skin care line by going to her website, theSpaDr.com  She specializes in a Functional Medicine approach to clean skin.  You can get a free copy of Dr. Cates’s book Clean Skin From Within  and you can take her free skin quiz by going here:  http://theskinquiz.com/

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


 

Podcast Transcripts

Dr. Weitz:            This is Dr. Ben Weitz with the Rational Wellness Podcast bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field.

                             Please subscribe to the Rational Wellness Podcast on iTunes and YouTube. And sign up for my free ebook on my website by going to drweitz.com.

                             Let’s get started on your road to better health.  Hey, Rational Wellness podcasters. Thank you again for joining us today. And today, we’re going to talk about the skin. And this is the first time we’ve talked about the skin and yet, it’s such an important topic, affects every system in our body. And essentially if you look at the skin as an organ, it’s the largest organ in the body.

                             And our interview today is with Dr. Trevor Cates. Dr. Cates is a naturopathic doctor and she also has a masters degree in spiritual psychology. Dr. Cates worked as a nutrition and wellness coordinator for the Waldorf Astoria in Park City, Utah. And she is now known as the spa doctor. And her focus has been on helping patients achieve glowing skin and vibrant health. She has a weekly very popular podcast known as the Spa Doctor. And she’s in private practice in Park City, Utah.

                            Dr. Cates, thank you for joining me today.

Dr. Cates:            Thank you. It’s great to be here.

Dr. Weitz:            Good, good. So I was reading one of your blog posts and you said that you have found holistic skin discoveries. Can you talk about what those are?

Dr. Cates:            Yeah absolutely. And I talk about all these in my book, Clean Skin From Within. But I think some of the most important ones are the way we look at skin. And a lot of times, the way people typically view skin because of the typical dermatology model is to look at skin as something that needs to be suppressed. And so, a lot of the typical convention approaches are topical steroids or antibiotics that are just designed to suppress the symptom at hand.

                            But the way I encourage people to look at skin is that your skin, as you mentioned, is our largest organ. It’s right on the surface of our bodies. It’s actually giving us information about our overall health. And it can be used as a tool to help us see that. Because it’s on the outside, we don’t need special imaging equipment to see it. We don’t need to do any specific lab tests to try and find out. It’s just right there and it’s giving us all this information.

                            If you’re breaking out, is your skin dry? Is it more dull? Do you have eczema or rashes or all these different things. Those are signs the body is giving that something is out of balance. And so, it’s really about getting to the root causes. What is behind the skin issue? Because here’s the thing. When you address the root causes, it’s not only going to help your skin but those root causes are usually the same root causes that are related to most chronic diseases, most disease processes.  So if skin is your only issue or maybe your skin is not optimal and you address those root causes, you can prevent a number of other health problems. And then, if you have other health issues, you can also when you’re addressing the root cause, you can help overcome those health challenges more quickly by using your skin as a tool.

                            And as a doctor, it’s something that I’ve been using in my practice. I’ve been in practice for 18 years. And I’ve always looked at my patient’s skin as giving great information. It’s part of the physical exam is what signs is it showing? And so, instead of just covering it up, let’s figure out what sign is it trying to give us? Let’s get to the root cause, address those, and then help heal the skin from the inside out.

Dr. Weitz:            Yeah, that’s great information. I think those of us in the functional medicine world sometimes have forgotten about doing physical examination. And we’re so quick to do all these lab tests and look at numbers and really looking at the person, looking at their skin, looking at their posture. Some of those things can give us so many cues about their health.

Dr. Cates:            Absolutely. And it gives you information about what is coming up and then also, for functional medicine practitioners as they’re treating a patient, how well is that going? And skin is one of those key indicators.

                            So one of the reasons why I’ve started focusing on skin is I was working at the Waldorf Astoria Spa in Park City. And I was doing a two week weight loss program for the people there. And it’s at the end of the two weeks, what they would say is I’ve lost weight. I have more energy. All these great things that we’re used to saying and hearing. And then, the thing that surprised people was their skin. And what they would say is I didn’t even know my skin could look this good. I just assume that eczema was that thing that I have. Or acne, I’m just going to have acne breakouts. Or I’m at this age so my skin’s going to look more dull.

                            But at the end of the two weeks, they realized I didn’t realize that my lifestyle impacted my skin this way. And so, I just keep encouraging the public, the patients, as well as practitioners to use this as a tool. It’s right there and it makes it so much easier for us.

Dr. Weitz:            In those holistic skin discoveries, you also talk about how products you put on your skin end up getting into your body and affect your internal health. And I’m not sure everybody’s aware of that and the importance of being careful about what you put on your skin.

Dr. Cates:            Yeah, absolutely. And I think a lot of times that’s one of the big misconceptions out there is people will think that whatever they put on their skin is just going to stay on the surface. Or not even really thinking about it because they’re not eating it, they’re not thinking about how it’s going to get in internally.  And of course, if we eat something, if we put something in our mouth, we do absorb it differently than if we put it on the skin. It’s a different absorption. But our skin is permeable. And it’s one of the reasons why we use nicotine patches or hormone cremes or topical medications because we know that it’s going to get absorbed to a certain extent.  And so the products that we’re using on a day to day basis also can get into our bloodstream. And the research is definitely showing this. Things like parabens which are a preservative used in a lot of skin care products. You see paraben at the end of the word. And where we’ve found is that parabens …

Dr. Weitz:            Things like methylparaben and …

Dr. Cates:            Propylparaben, butylparaben, all of those. That parabens have shown up in breast tumor tissues. And so, we know that gives us really great … And other studies have shown us it shows up in the urine and other places too. So we know that what we put on our skin. It’s getting absorbed in our body and can get taken up into tissue. And with this particular study, it’s really disturbing that it can actually be taken up into breast tumor tissue.

                                So we need to be careful because also many of these ingredients have hormone disrupting effects so they’re endocrine disrupting chemicals like parabens. Parabens are known to have estrogen mimicking effects. And that’s really the last thing we want to be doing. But as we … especially for women as we tend to get older, we tend to use more skin care products to try and reverse the signs of aging or slow down that process. But many of these have these hormone disrupting chemicals and can actually throw off hormones when we’re at a place where that’s the last thing we want to be doing.

                                And I know that manufacturers say that we only absorb a small amount. Only a small amount gets into circulation. But my concern is that we are exposed to these endocrine disrupting chemicals now more than we ever have been. And they are in our air, our water, our food, and our personal care products. And because of the endocrine disrupting chemicals that have been made in the past and that maybe they’re banned to be made anymore but they still exist in our environment.

Dr. Weitz:            Things like PCBs, yeah.

Dr. Cates:            Yeah. And then also in countries like maybe in China, something is still manufactured there. Those chemicals can actually travel in clouds from China and rain down into our own environment. So it’s still … These are continuing to exist and then, all of these new chemicals are being developed. And so we are now getting exposed to more than we ever have. And so, and I don’t want to say this to scare people but we want to make choices to reduce our overall exposure. And one of those places we have control is through the personal care products we use.

And on average, people use nine … This is according to Environmental Working Group, ewg.org. They say, on average, people use nine personal care products a day which exposes them to 126 unique ingredients. That’s a lot of different ingredients and some of that we have research and information on and some of that’s still unfolding.

                                And then, there are the concerns of how do all of these chemicals react with each other which is not being studied. So our bodies become this soup of toxins and these endocrine disrupting chemicals and so the endocrine disrupting chemicals what that means is that these will bind to hormone receptors and either mimic hormones or interfere with the way that they’re supposed to work.

                                So we’re now seeing that they can create a number of different health issues from infertility, from early puberty onset, to thyroid disease, to certain types of cancer like breast cancer, prostate cancer. There are a number of different things. Really if you think about endocrinology and what … all the different ways that hormones can be impacted, it really can impact us in so many different ways.

Dr. Weitz:            That’s great. Can you mention some of the other chemicals we should be looking for that might appear in our personal care products?

Dr. Cates:            Yeah, absolutely. And I think it is really important for us to be looking at these. We look at food labels as educated consumers and practitioners, we look at labels to make sure that our food is clean. We look at our supplements to make sure that they’re the right ingredients and the right combination and there are no fillers and binders and all those kinds of things. So we want to do the same thing with skin care products.

                                And so, unfortunately though, it can be a little confusing. It is one of the reasons why I decided to create my own skin care line because I wanted to be able to provide something for my patients, my followers, that is trusted that I know the source of these things and where they come from and that they’re not only clean but I formulate them in a way that actually help improve the health of the skin, the pH of the skin, the skin microbiome and all of that.

                                But with ingredients, one of the big ones that is in so many products and that people aren’t aware of the potential downside of it is fragrance. And fragrance is actually not an ingredient. It’s a whole group of ingredients. But with personal care products, all they have to do is put the word, the manufacturers just put the word fragrance on there. They don’t have to disclose all the different chemicals that are in there.

                                And so there are actually a lot of endocrine disrupting chemicals that can be hidden in there. One of the examples that you won’t see on the label but is in fragrance, most fragrance is diethyl phthalate. And diethyl phthalate, DP, is type of phthalate. And phthalates are known as plasticizing agents. And phthalates, including GEP are known hormone disrupting chemicals, EDCs. And so, it’s best to either go with a fragrance free product or find one that’s naturally scented with essential oils.

Dr. Weitz:            One of the things that I noticed is they tend to take out the chemical that everybody knows about like DPA and they stick it in BPS which isn’t on the list yet but probably will be in five years. And I’m seeing some of these personal care products where they take out the sodium lauryl sulfate and there’s some other chemical that sounds very much like it and I suspect it probably would have the same properties.

Dr. Cates:            Right. And that’s why it’s best to go with a natural skin care line that is really used to making natural and organic products. Not just one that … you know, a company that has a natural line but one that specializes. Then because they really know and they really care and they’re going to try and find … continue to use those natural ingredients instead of just saying well, we’ll take this one out because the public is aware of it. A lot of companies are now trying to go paraben free.

Dr. Weitz:            Great.

Dr. Cates:            Yeah, and so they’re taking those out. But they’re still loaded with a lot of other harmful ingredients that people might not be aware of. Things like formaldehyde releasers. And formaldehyde releasers are one of those … It’s a really confusing ingredient because they’ve got really long names and there’s a variety of names that they can come from. And it doesn’t say formaldehyde on the label. It doesn’t say formaldehyde releaser. It will say things like DMDM hydantoin which you would have no idea that you put these ingredients on your skin, when you rub them on your skin it releases formaldehyde into the air around you. And we know that formaldehyde is a carcinogen. We know it’s toxic when it’s inhaled. And the manufacturers say it’s just such a small amount. It’s not going to be an issue. And that’s why it hasn’t been banned as well by the FDA.

                            But again, when using all of these things on a regular basis, it’s the products that we’re using day to day that are the biggest concern. If you use a product once every now and then, your body probably can do okay getting it out of your system. But most of us have these habits and rituals of skin care/personal care practices whether you’re a man or a woman. You know, deodorants and shampoo, conditioner, lotions, sunscreens, all of those things that we use. We’re using them every day or every other day. And so, those are the ones you really want to be careful with.

Dr. Weitz:           Yeah. I just read this report about a woman who had a Brazilian blowout and she was using a formaldehyde free product except that it contained this chemical that as soon as you heated it, it turned into formaldehyde. She had this acute reaction, was hospitalized, had this horrible autoimmune reaction and her whole health was just completely destroyed.

Dr. Cates:           Yeah, it’s one of those things where sometimes it’s hard to know so just again, using a trusted source. Again, that’s one of the reasons why I created the Spa Doctor skin care line is because my patients were asking me who do I go to? How do I know? And even I, as I was trying to do research on different companies and trying to find out more, a lot of this stuff is hidden and so I wanted to create something that people could trust. People don’t have to worry … One less thing for people to worry about because that’s … Really, it’s just not something that we want to spend a lot of time doing.

                           But there are great resources for people. My book, Clean Skin From Within. I do talk about all the different ingredients to avoid, the top ones to avoid. I have a whole list in my book. And why and the research behind why and then alternatives. Like instead of fragrance, choosing essential oils and which ones and that sort of thing. Then, there are also websites like I mentioned Environmental Working Group, ewg.org. They have a skin deep database. My skin care products on there are on there as a verified skin care line. And that’s … EWG can be a great resource for people finding cleaner products.  Also there are even apps that you can get on your phone that you can scan the barcode on the product and it’ll rate the level of toxicity of the ingredients and why it’s rated that way.

Dr. Weitz:            Cool.

Dr. Cates:            Mm-hmm (affirmative)

Dr. Weitz:            You talked about the pH balance. What pH should our skin be? Should it slightly acidic? Should it be slightly alkaline?

Dr. Cates:            Yeah, no our skin does best with a mildly acidic environment. Our skin has this mild acidity that actually helps protect it because it is our outer surface. Our epidermis has that barrier function, that’s a big important part of the function of this organ of our skin. So that mild acidity actually helps protect the skin.  The thing that’s really interesting about this is that I think a lot of people don’t know this about the skin because when we talk about health and wellness, there’s a lot of talk about higher pH.

Dr. Weitz:            Yes, that’s all everybody talks about. Be as alkaline as possible.

Dr. Cates:            Right, but when we’re talking about the external, externally on your skin, it actually needs to be 4.5 to 5, in that pH range which is that mildly acidic range. And if it’s really a lot lower than that, if it’s really acidic, that’s also harmful for the skin.

                            So there is this interesting natural balance and it does vary a little bit from person to person and different areas of the skin. But this also helps with the skin microbiome. And I know there’s a lot of talk right now in the health and wellness community about the gut microbiome and the importance of that. And the skin also has it’s own balance of microorganisms that live on and protect it.

                            And so, our gut microbiome has a direct connection to our skin microbiome. And there’s a lot of great research coming out about the gut/skin connection, even the gut/brain/skin connection. And so, from the inside out there’s a lot we can do to help promote the skin microbiome. But also, what we’re putting on externally on the skin can impact the skin microbiome. So using those antibacterial soaps and things like that. That definitely disrupts the skin. And then, the pH of the products that we’re using can also disrupt it.

So for example, even water has a neutral pH of seven. And some people will say I’m going natural. I just rinsed my face with water and I’m going to use a little coconut oil. Well, just using water is not going to help support the skin with that natural pH. And then, using a bar of soap that lathers up, that actually has a high pH so it’s going to further disrupt.

                            Now if we’re in a really optimal state of health and we’re rinsing our face with water, our skin will probably just bounce right back and reestablish. But especially if people are struggling with their skin or they’re struggling with their health, that ability to bounce back is not going to be as good so it’s good to support the skin with naturally, the mildly acidic skin care products.

                            And that was one of the big keys with creating my skin care line because when I was looking into natural skin care products, people would … my patients before I created my line, people would ask me so why are these natural skin care products not working? I’m using clean products but the natural skin care products I’m using aren’t working. And what I realized is that a lot of these companies were missing out on that pH of the skin and that the support that we use with the pH of the products was one of the really key things that helps with the health of the skin.

Dr. Weitz:            You know, that point that you made about the pH, I think is really important. And a lot of people are not aware that this same thing goes with parts of the gut. Everybody assumes that they know that your stomach is supposed to be acidic but then they assume that the rest of the gut is supposed to be as alkaline as possible. But in order for optimal gut microbiome for acidophilus to flourish in your colon, you need more of a slightly acidic environment.

Dr. Cates:            Yeah, so it is important to put an environment there that supports the healthy microbiome. And I do think that a lot of times people are quick to be like what probiotic can I take? Or is there a probiotic I can put on my skin? But you can also look at what helps support your body in developing its own healthy balance of microorganisms. And I mean, really probiotics are also really beneficial but you want to do both. It’s not always just about a magic pill or a magic product. You know?

Dr. Weitz:            Yeah, you need your garden to be healthy. If you get these great seeds, they’re not going to grow if you’re trying to grow them in a lousy garden. And that’s what your body is, a garden that you’ve got to try and make it as healthy as possible to encourage the growth of all these healthy bacteria.

Dr. Cates:            Yeah.

Dr. Weitz:            So I saw one of your discussions where you talked about acne which is the most common skin condition. What is the cause of acne? What’s the root cause of acne?

Dr. Cates:            With acne, it does vary somewhat from person to person. But looking for the root cause is important. And when we look at why someone is developing acne you want to look at a number of different factors. Does it change … For a woman, for example, does it change at different times of the month? That’s a big one. A lot of times women will notice right before their periods, they will break out more. And then we’re looking at a hormonal connection there. So we want to look at the root cause about what kind of hormonal imbalances are occurring that are causing the person to break out more.

                            Also we know if we’re talking about a teenager and they’re going through puberty, obviously there’s a hormonal component here. And then, there are also nutritional things that can lead to more acne breakouts like zinc deficiencies for example are one of the things that can trigger. Also certain foods that people are eating. If people … it can be a sign of a food intolerance or food sensitivity, allergy, if they’re starting to break out more.

                            I often see people breaking out more around their mouth. That can be from the foods that they’re eating. And some of the big ones for acne in particular and food is sugar or foods that turn to sugar. So the glycemic role and the glucose role in acne breakouts because when we eat sugar or foods that turn to sugar, a high carbohydrate diet also would do this, is it will cause our blood sugar to rise and this increases insulin. And then with increased insulin, that triggers excess sebum production, the oils in our skin, as well as androgen activity. And we know that those are some of the big things that do trigger acne breakouts.

                            So certainly balancing your blood sugar, being careful about not eating a lot of sugary foods or foods that are going to spike your blood sugar. That’s really an important one. Also, I find that dairy is another big trigger for acne for some people. Not everybody but…

Dr. Weitz:            Now what’s the connection with dairy?

Dr. Cates:            Now with dairy, it seems to be more … A few reasons. It’s more of a pro-inflammatory food and so anything that … I call it skin-flamation. Anything that triggers inflammation internally can trigger skin inflammation, inflammatory conditions. Also, there are just the nature of dairy is that it comes from a lactating mammal which means that there’s going to be hormones in dairy products. And so, that could be playing a role as well. So that could be part of it.  And then, dairy products tend to be one of the top allergenic substances or foods that people are sensitive to. So they do tend to be one of the big trigger foods for that. So there are a number of different reasons.

                            And then, another food that is … I’ll have people say I’m cutting back on the sugar. I’m really not eating much sugar. And I’ve cut out dairy. And maybe they’ve even cut out gluten and a few other things, but they still can’t figure it out. And they know it’s something that they’re eating but they can’t figure it out. And that tends to be eggs. And I know that surprises a lot of people because we think of eggs as being this really healthy food, just like people a lot of times think of dairy as one of those foods that we thought was really healthy for us.  But eggs, for some people, are a big trigger for acne. So I would say it you struggle with acne and you’ve tried giving up these other things, try giving up … try cutting out eggs and see if that may be the missing piece.

Dr. Weitz:            You ever run food sensitivity panels?

Dr. Cates:            Yeah, I definitely do a lot of those. Because I have a book and I try and keep it really simple for people. In my book, I talk about the top 10 foods for people to eliminate and then reintroduce after two weeks to try and identify it themselves. But certainly if people work directly with me, then I do like to run food sensitivity tests. What I would say about that though is what I’ve found in my practice is it’s really important to first address any gut issues before doing a food sensitivity test because if you run food sensitivity tests on someone who has leaky gut or really a lot of microbiome imbalances, then you’re probably going to see that a ton of different things come back as reactant.

                            And the patient is just frustrated and they don’t know what to eat and it’s just frustrating for everybody. And so, when I see somebody that apparently has a lot of gut issues going on, definitely address those first. We want to at least get them on the healing journey with that first and get that inflammation under control in the leaky gut healed and then do the food sensitivity tests.

Dr. Weitz:            So if you do that 10 food elimination diet, could you just real quick go over those 10 foods. So besides dairy, what are the other nine foods?

Dr. Cates:            Yeah, I think some of the things might surprise people. I mentioned sugar and I mentioned gluten and dairy. Also, when I have people do this diet, I like them to cut out caffeine and alcohol. They just tend to be … especially, this is a time to help support the detoxification pathways so cutting out any of these kinds of things is good to do. And then, I mentioned eggs.  I also find that corn tends to be one of the trigger foods as well as the nightshade family so peppers and tomatoes and potatoes. Those are also big triggers.

Dr. Weitz:            Okay, cool. So what else can you do for acne besides changing your diet?

Dr. Cates:            Certainly we want to decrease inflammation because that’s one of root causes of what can you do with your diet not only avoiding the trigger foods but also eating foods that decrease inflammation. Things like getting omega-3 fatty acids that are antiinflammatory. Those types of things are really important. Making sure that you’re getting plenty of fiber in your diet to help with balancing blood sugar.

Dr. Weitz:            And by the way, on the omega-3s, it’s important to get it from fish, right?

Dr. Cates:            Yes. I do think that fish is the best source and I think that it’s hard to get the level of omega-3s through just eating with your diet. A lot of times, people need to take a high quality omega-3 fish supplement to get the benefits if they’re really trying to address that inflammation so I think that’s good.

                            Now I know that sometimes people for philosophical reasons, they don’t eat animal products.

Dr. Weitz:            They just want to have flax seed oil or something like that.

Dr. Cates:            It makes it a lot harder because the body then has to do that conversion and so, it’s not ideal. I do still have some patients that just for certain reasons they won’t. But I really do try and encourage people to even if they don’t like the taste of fish to try and take an omega-3 supplement.

Dr. Weitz:            Yeah, because you’re looking at between 1-10% conversion rate of alpha linoleic acid into EPA and DHA.

Dr. Cates:            Right. It’s just not going to be the same. So certainly it’s a lot easier to do it that way.

                            Yeah, so certainly anti-inflammatory diet because we’re reducing inflammation. Also what can we do to help balance the blood sugar because that’s one of the big root causes so eating more fiber, watching your sugar intake, making sure you’re eating balanced meals. And then, also if we’re looking at balancing the hormones, what can we do to support that? And it really depends upon if we’re talking about a man or woman, what stage of life they’re in and what kind of hormone imbalances we’re talking about. But doing things to help support that even if it’s lifestyle things like stress management. I mean, even that alone can … that plays a role. Our stress hormones play a role in our hormone balance.

                            The foods that we eat, eating for women in particularly, eating cruciferous vegetables helping with estrogen metabolism and hormone balance. All of those kind of things might be beneficial to do. And then, also getting in certain nutrients like zinc, I mentioned, as I mentioned before. Certainly eating things like nuts and seeds that are high in zinc, oysters. Not that we want to be eating those every day but that is something that’s high in zinc. Also maybe getting it in the form of a supplement and then … But if you’re doing that as a supplement, you want to make sure you’re not just taking zinc. You want to also get a little copper with that or part of a balanced multivitamin/mineral supplement.

Dr. Weitz:            Yeah. The zinc/copper ratio. Besides those are there other specific supplements. I saw some discussion of niacin as being beneficial.

Dr. Cates:            Yep, yep. Niacin, B vitamins in general can be particularly helpful. Niacin, and what’s interesting about niacin is that it can be used both internally and externally. So I will have my local compounding pharmacist make up a topical that includes niacinamide in that topical because of the soothing and antiinflammatory benefits that it tends to have for people with acne.

Dr. Weitz:            Yeah, I saw some products online with niacinamide they seem to have in it.

Dr. Cates:            Mm-hmm (affirmative). Yep.

Dr. Weitz:            Boy, huge difference in price. One product was $6. The other was $84.

Dr. Cates:            Right. Well, it probably depends on the amount of niacin. You really want to get at least 3-4% in there. And if it’s not, then it’s probably just marketing.

Dr. Weitz:            Okay, interesting. Let’s see. In that article where you were talking about or it was a podcast where you were talking about acne, you mentioned eating cruciferous vegetables for liver detox, but to be careful if somebody has a thyroid problem.

Dr. Cates:            Yeah. And I think it’s good to … If we’re talking about cruciferous vegetables just because of the goiterogenic component in those vegetables that people especially if you know you have a thyroid disease, thyroid imbalance, that you just want to lightly steam those vegetables first before eating them. And I generally just say that …

Dr. Weitz:            For people who are not familiar with that, there’s this concept that certain foods negatively affect the thyroid. And they’re referred to as goiterogenic. They inhibit thyroid function, right?

Dr. Cates:            The idea that they can actually help … I mean, that they can worsen the condition, yeah. So that’s why just to be safe, I think it’s good to just lightly steam. And it doesn’t … When I say lightly steam, it’s even just a couple of minutes just to put a little hot water in there for a couple of minutes and steam it lightly because if you overcook vegetables, then you lose a lot of the nutritional benefits so it’s a little balance there.

                            I grew up with family members who thought you had to cook things for hours. Vegetables had to cooked in lard and for hours and hours to have any flavor to be palatable.

Dr. Weitz:            Yeah, I did too.

Dr. Cates:            That’s rarely the case.

Dr. Weitz:            I grew up eating canned vegetables. So one of the other common skin conditions is eczema. How do you handle eczema? What specific things do you do for that?

Dr. Cates:            Yeah, that is another common skin condition. It’s actually what my … what led me on this journey is I had it as a child. And I had a lot of allergies and eczema, hives. Those were a lot of my skin issues. And I really struggled with it as a child and that is what finding natural medicine is what led me on the path to becoming a naturopathic physician. So I know that really well of how intense that can be to have the itching and the rashes and the eruptions and how intense it can be. But I also know that you can overcome it.

And so, part of that is that inflammation. Addressing the internal inflammation, looking for triggers that might be causing it. So definitely supporting the body internally. Gut issues tend to be a big trigger for that. Gut microbiome, addressing any imbalances with that. And leaky gut where you’ve got the gut lining is more permeable than it should be so then food particles actually slip through and the body actually creates this immune response which someone will flair up allergic. Or any kind of immune type reactions. Anybody that has eczema tends to have an overactive immune system anyway and so we want to do things to help calm that down.

                            And you know, I’m talking a lot about this internal stuff but you also want to do things externally like I mentioned before. And this is true for acne too. When we get acne or eczema, our skin microbiome gets out of balance. And part of restoring that is from the inside out. But part of it is also … And I think it’s probably 80% is from the inside out.

                            But then, there’s still this 20%. And this is one of the things that shifted for me in my practice when I started doing a lot of research on topicals and skin care products was that realizing that this was a piece that I was missing of what can I do externally to help support the skin.

                            Because it’s still, you get patients, and they get them to a certain point and they would be really improving but there’s still this imbalance in the skin on the outside and so, using products with the correct pH. That’s key to help support the skin. And then also, I use my compounding pharmacist a lot to help create topicals that have natural ingredients that help support the skin and help it get to that balance back.

Dr. Weitz:            Like what kind of topical products?

Dr. Cates:            I mean, for the acne, I mentioned niacinamide. So that can be a great one. That one can also be really helpful for people with rosacea. And so, there are things like that. There are certain herbs that can be antiinflammatory and supportive. Even something as simple as aloe can be soothing to the skin and helping restore it. There are tons of ingredients that we can use. It’s just a matter of what … I really individualize that part for the person but the thing that across the board that is helpful are things … There are certain ingredients like aloe and also the pH of the product that can be really supportive to the skin.

Dr. Weitz:            I saw where you said that sometimes for psoriasis, you’ll use apple cider vinegar topically.

Dr. Cates:            In combination with other products.

Dr. Weitz:            Okay.

Dr. Cates:            I wouldn’t use just apple cider vinegar. But yeah, it can be soothing. It also could be disrupt the pH of the skin if you’re just using it straight. So I would be careful with using that directly, yeah.

Dr. Weitz:            Okay, great.

Dr. Cates:            But you know, also things like …There are also really simple things for eczema. We were talking about for eczema is an oatmeal bath.

Dr. Weitz:            Okay.

Dr. Cates:            And you can put oats in a bath and just soak in that. And the oats on the skin can also be very soothing.

Dr. Weitz:            Cool.

Dr. Cates:            And I share a lot of that information in my book, Clean Skin From Within.

Dr. Weitz:            Okay, great.

Dr. Cates:            So I have a lot of that and I even have tables explaining here are all the different things you could add internally and externally to help support the root causes that are behind the various skin issues.

Dr. Weitz:            Great. And that book’s available from Amazon and Barnes and Noble?

Dr. Cates:            Yeah, it’s available, yeah, Amazon and Barnes and Noble. I have all of that on my website thespadoctor.com.

Dr. Weitz:            Okay, great. I’ll put that all in the show notes.

Dr. Cates:            Great.

Dr. Weitz:            So thank you Dr. Cates. This has been a very informative podcast. Thank you for sharing some information with us.

Dr. Cates:            Great. It’s been great to be here.

Dr. Weitz:            Okay. So I’ll talk to you soon.

Dr. Cates:            Okay.

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Toxins with Dr. Joe Pizzorno: Rational Wellness Podcast 052
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Dr. Joe Pizzorno speaks about how to remove toxins from your body and improve your health with Dr. Ben Weitz. 

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

 

Podcast Highlights

2:00  Dr. Pizzorno will be giving several talks on how toxins cause infertility and he said he is finishing a textbook with Walter Crinnion for doctors called Clinical Environmental Medicine that will be released in July.  He said that environmental toxins have become the primary drivers of chronic disease.  

3:22  I asked Dr. Pizzorno to explain how toxins damage our bodies?  He explained that we should consider how environmental toxins cause diabetes. Toxins like phtalates that are commonly found in our health and beauty products and Bisphenol A in our soups and plastic containers that we put our foods in attach to insulin receptor sites so the cells stop responding to insulin resulting in the pancreas having to produce more and more insulin. Dr. Pizzorno said that he is shocked how commonly people in the US are being exposed and damaged by arsenic. Arsenic is commonly found in the water, the chicken, and the rice, which is really good at concentrating arsenic if it is grown in water that has arsenic in it.

7:12  Dr. Pizzorno said he is a big believer in eating organically grown food, but then you have to ask what water is being used to grow these organically grown fruits and vegetables and does it have arsenic in it?

7:43  I asked how do we know if we have toxins? What about some of the testing methods?  Dr. Pizzorno explained that to determine current exposure, we can do serum and urine testing. The best test is to do a fat biopsy, but this is invasive, so tends to do a challenge test with a prescription chelating agent like DMSA or DMPS or EDTA, and then see how much that increases their secretion of metals into the urine. That actually is useful, but it’s also flawed.  In general, I prefer more tests like blood tests and tissue biopsies than I do things like urine tests. Because it tells you what’s in the body, not what the body’s getting rid of. I asked what he thinks of antibody testing of chemical and metals, such as developed by Dr. Aristo Vojdani and offered by Cyrex Labs?  He said that he finds these intriguing and he would consider using them but he would like to see more data on them before endorsing them.

15:04  I asked Dr. Pizzorno to talk about how to eliminate toxins from our bodies.  He said that there are a three steps to take: First, decrease exposure. Then number two is support the body’s own natural detox systems, and the third one is, okay, let’s do stuff to directly get things out of the body.  We talked about how to remove toxins from the water by having a whole house carbon filter that removes organic compounds. To support the body’s natural detox system you can increase fiber intake and take N-AcetylCysteine or NAC, which increases the body’s glutathione levels.

20:23  I brought up the thought that those of us like myself who treat a lot of patients with gut problems like IBS and SIBO may put patients on a low fiber diet to avoid feeding the bacteria we are trying to remove and we may actually inadvertently be increasing their toxin load as we try to improve our gut health.  Dr. Pizzorno responded that in his The Toxin Solution book he has patients spend two weeks cleaning up their gut and he likes them to increase their fiber intake. Then, to help patients remove toxins, he recommends that they take oral DMSA 250 milligrams every third night, along with extra fiber and NAC.  He said that it’s a slow process, but it’s extremely unlikely anybody will have a bad reaction. He also likes to use bile sequestrants like cholestyramine that bind to the chemical toxins in the gut. Dr. Pizzzorno said that in his book, The Toxin Solution, he spends two weeks avoiding toxins, two weeks improving gut function, two weeks improving liver function, and finally two weeks strengthening the kidneys. He said we now have an epidemic of kidney failure, which used to be rare.  Now we’ve got dialysis centers all over the place.  People’s kidneys are failing from all the chemicals they’re being exposed to including prescription and non-prescription drugs like nonsteroidal, anti-inflammatory drugs, like acetaminophen. For kidney detox, Dr. Pizzorno recommends an alkalinizing diet that reduces consumption of high sulfur amino acids and decreased salt consumption. 

29:04  Dr. Pizzorno said that after detox, he does nutritional medicine.  When we get people the nutrients they need so the body works properly.

29:47  Dr. Pizzorno explained his gut protocol to get it ready for detox.  He explained his four step program:  1. kill the bad bacteria, 2. absorb the toxins that have been released, 3. re-seed with healthy bacteria, and 4. then stimulate the healing of the gut.  Dr. Pizzorno developed this about 10 years before anybody ever heard about the 4R Program. That’s one of the reasons he’s one of the founders of the Functional Medicine movement. 

31:56  Dr. Pizzorno said that instead of doing stool testing, he does a urine test in his office known as the Obermeyer or Indican test.  It measures levels of indoles and skatoles in the urine, which indicate the breakdown of protein by the wrong bacteria in the gut that produces these chemical toxins.  He has them return once per week to repeat the test.  When their gut cleans up, the test improves.  The formula for making up the indoles to perform the test is in his Textbook of Natural Medicine.  

 

                                           



Dr. Joe Pizzorno is a Naturopathic Doctor who has written or co-authored more than 12 books including, The Encyclopedia of Natural Medicine, which has now sold over two million copies, and The Toxin Solution, his newest book.  Here’s the website to learn more about this book: http://www.thetoxinsolution.com/ Dr. Pizzorno is one of the most important Naturopathic Doctors, educators, researchers, and one of the founding members of the Functional Medicine movement. You can also learn more about Dr. Pizzorno from his website: http://drpizzorno.com/  You can preorder Dr. Pizzorno’s forthcoming textbook on Clinical Environmental Medicine from Barnes and Noble.

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


 

Podcast Transcripts

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

                                          Hey, Rational Wellness Podcasters. Thank you so much for joining me again today. For those of you who enjoy this podcast, please go to iTunes and give us a ratings and review, because that helps more people find out about the Rational Wellness Podcast.

                                          Our topic for today is toxic chemicals that we get exposed to on a daily basis in modern society. We’re going to talk about the role they play in chronic diseases, what we can do to avoid them, and how to detoxify them from our bodies once they become incorporated into us.

                                          Our special guest today is Dr. Joe Pizzorno who’ll be joining us today to talk about toxins. Dr. Pizzorno is one of the most important naturopathic doctors, educators, researchers, and one of the founding members of the Functional Medicine Movement.  Dr. Pizzorno has written or co-authored more than 12 books including, The Encyclopedia of Natural Medicine, which has now sold over two million copies, and The Toxin Solution, his newest book, which was released last year, and which I highly recommend.

                                          Dr. Pizzorno, thank you for joining us today.

Dr. Pizzorno:                     Well, thanks for the invitation. I’m delighted to be talking with you today.

Dr. Weitz:                          I’d like to start the interview by asking you what have you been up to lately? Because I’ve seen some of your recent talks, and I know you’re doing a lot of projects related to toxins.

Dr. Pizzorno:                      Two things have really taken all my attention right now. First off, I’ll be giving a lecture at the end of the month. Actually two lectures, one for consumers, one for doctors, on how environmental toxins cause infertility, because as you know, infertility is becoming a bigger and bigger problem. I’ve been looking at all the research around infertility.

                                           The second major area I’m working on right now is that I’m co-authoring with Dr. Walter Crinnion a new textbook for doctors called, Clinical Environmental Medicine. We’re now just doing the final proofs before it goes to publication. I would say not only is it one of my most important books, but it’s also one of my most depressing books.

                                           Because when we started looking at the data on toxins and disease, it is just stunning. We’re poisoning ourselves. I’m making the case, and I’m literally lecturing all of the world on this, that environmental toxins have become the primary drivers of chronic disease. Not that nutritional deficiencies and excesses have gone away as a cause of disease, we’ve simply added an even worse problem.

Dr. Weitz:                           Yeah, shocking, shocking.

Dr. Pizzorno:                      Very worrisome.

Dr. Weitz:                           Yes. Toxins seem to be involved in almost every chronic disease, and they’re found in our food, our water, in our environment, and the products we put on ourselves.

Dr. Pizzorno:                      Yup, everywhere.

Dr. Weitz:                           Can you talk about how toxins damage our bodies?

Dr. Pizzorno:                      There’s a number of ways in which it happens. Actually, I have three slides, each of which has three reasons. There’s nine key reasons why this happens. I won’t go through all of them.

Dr. Weitz:                           Sure.

Dr. Pizzorno:                      I’ll look at the high points.  The first one that got me most interested in this area probably because the most research is there, is how toxins cause diabetes. It looks like there are two mechanisms by which this happens. The one which appears to be most important is that many chemical toxins like, oh, how about the phthalates that are in our health and beauty products, or how about bisphenol A, that’s in our canned soup, for example, and all those plastic things that we have our food in.

                                           They actually bind to the insulin receptor sites on the cells, so that the cells don’t respond to insulin like they should. Our poor pancreas has to overproduce insulin in order to get sugar into the cells. Well, that’s a good example of how incredibly adaptive our bodies are to the challenges of living. Also, when you’ve overused an organ for 20 or 30 years like that, it burns out and now, you’ve got diabetes. Looking at just one condition like diabetes, which is 20 times more common now than when I was a student in naturopathy medical school half a century ago, this epidemic is primarily due to environmental toxins basically blocking insulin receptor sites.

                                           Not only that, things like bisphenol A and phthalates, but also arsenic. One of my biggest surprises in looking at the research is how commonly people are being damaged by arsenic. Of course, it might, excuse me at the obvious joke that people only think they have arsenic toxicity when their spouse is trying to poison them. While that may be happening, the reality is that 10% of the public water supplies in the U.S. have arsenic levels known to induce disease in humans, and only half the water supplies have even been tested for arsenic.

Dr. Weitz:                            Wow.

Dr. Pizzorno:                      Now, I suspect, I’m being a little pejorative here, sorry, but I suspect some of those public water supplies tested and found the arsenic and didn’t want to report it because of what they found. This air, water, food, health and beauty aids, household cleaning products, everywhere all these chemicals and metals are poisoning or bodies.

Dr. Weitz:                           I heard you talk about how arsenic is often contained in chicken.

Dr. Pizzorno:                      Yes. Up until recently, the USDA allowed farmers to put arsenic compounds into chickenfeed-

Dr. Weitz:                           Wow.

Dr. Pizzorno:                      … for two key reasons. Number one is that it helps address the parasites in chickens that they get when they live in close quarters, and second is it helps to plump them up, makes them fatter so then they can make more money. They finally stopped approving that. Now it doesn’t mean it’s not still happening, but hopefully, we’ll see the arsenic levels in chickens finally start to go down.

Dr. Weitz:                            Yeah, we’ll probably see it get re-approved.

Dr. Pizzorno:                      The problems the chickens have haven’t gone away, so now they’re using different compounds. I’m sure we’ll find them toxic as well.

Dr. Weitz:                            Apparently, there’s a lot of arsenic in rice as well.

Dr. Pizzorno:                      It turns out, and I don’t know why, but rice is very good at absorbing arsenic. If rice has been grown in one of those water supplies that have arsenic in it, and as [inaudible 00:06:33] will absorb it. It turns out rice is a significant source of arsenic for anybody who eats rice.

Dr. Weitz:                            Is there any way to get rice that doesn’t have arsenic?

Dr. Pizzorno:                      Well, of course, if the rice has been grown with water that does not have arsenic in it, it’s not going to have arsenic. I’ve been now asking the organic rice farmers, please tell us how much arsenic is in your rice, and none of them have answered me.

Dr. Weitz:                            Huh.

Dr. Pizzorno:                      Which I find a little worrisome.

Dr. Weitz:                            Yeah, that may be one more of the variables that’s so difficult to control. You go and you get organically grown fruits and vegetables, but what water are they using?

Dr. Pizzorno:                      Yup, yup. I’m a very, very strong believer. Everybody should only be eating organically grown foods, but now having said that, you have to make sure that those organically grown foods are grown properly and are not contaminated.

Dr. Weitz:                           Yeah, I think ultimately we have to accept that we’re all going to get exposed to a certain amount of toxins.

Dr. Pizzorno:                      Yeah, yeah. We can’t get around it, so what we have to do is decrease exposure as much as we can and then support the body’s own ability to get rid of toxins.

Dr. Weitz:                           Right. How do we know if we have toxins? What about some of the testing methods?

Dr. Pizzorno:                      Yeah, great question. I gave a lecture at NIHM last October entitled, How to Practice Environmental Medicine. When you think about toxicity realize that we don’t have, you might say, a monolithic population. I break the population down into three groups when we think about toxins.

                                           The first group is what I would call the yellow canaries. This is from an old practice of coal miners, where they’d bring yellow canary birds down into the coal mines. When they started to faint, they knew they were being exposed to carbon monoxide, and they would then rush out of the mines. The reason they would use the yellow canaries is because they’re much more sensitive to the toxins than are the humans. Yellow canaries are those humans that are most sensitive to toxins. They have their own set of issues.

                                           Then we have people who have an obvious exposure. An obvious exposure will be something like you have a mouth full of silver fillings. Because if you’ve got 10 silver fillings in your mouth, you’re leaking 10 micrograms of mercury into your body every day. And don’t believe the dentist when they say, “Ah, it doesn’t go into your body,” because there’s a direct correlation between the amount of mercury in your mouth and the amount of mercury in your brain, in your kidneys, and your tissues. There’s no question that there’s an exposure problem.

                                           But the third category is probably the biggest, of course, overlaps with the other, but that is anybody with chronic disease must consider the role of toxins in that chronic disease. I’m seeing more and more … I’ve looked at tons of research, and I would assert that at least half of chronic disease is due to environmental toxins. Which means that it’s preventable, and in many cases, even reversible.

Dr. Weitz:                           It’s so interesting. You can put somebody on what seems like an appropriate diet say for a condition like diabetes, but if part of their diabetes is being fueled by toxins, unless you also address the toxin factor, no amount of low carb eating is necessarily going to make those insulin receptor sites work properly.

Dr. Pizzorno:                      Right. That’s absolutely true. Let me go a little further than that, because you brought up a good point. It’s something I’m actually starting to talk more about. That is, how do you measure success in medicine?  Now what conventional medicine says, people have diabetes which means basically high blood sugar, and we are properly treating the diabetes if the drugs we use will decrease the blood sugar levels. Well, of course, that’s reasonable to do, because super-high blood levels of glucose cause all kinds of problems.

                                           But what if you had instead a measure which is, how well is the body itself controlling blood sugar? Because even though things like metformin and insulin will decrease the number of the side effects of high blood sugar, they still will have people progress to the sequelae of diabetes. Which means their arteries and their nerves start to degenerate. They get peripheral neuropathy. They start losing their kidneys, start losing their eyesight, increasing rate of dementia all those kinds of things. Okay.

                                           It’s slowed down by metformin and insulin, but that’s not a substitute for the body itself maintaining proper blood sugar control. Because when the body maintains blood sugar control, you don’t get the sequelae. You don’t get the loss of blood flow and neurological function, and things of this nature.

                                           In many ways, conventional medicine has justified its existence by using these lab tests that seem to show benefit, but in reality, it’s just covering up the fact that the body’s not working properly. If the body’s not working properly, doesn’t matter how much drugs you’re taking, the body’s going to break. You’re going to get disease, and your quality of life and longevity will be lower.

Dr. Weitz:                           Interesting. On the testing, what kind of tests do you recommend that people get that practitioners use? I know there’s serum testing. There’s urine testing. There’s provocative urine testing. But there seems to be a lot of question as to how accurate these tests are.

Dr. Pizzorno:                      Yes, a very good point. When we’re testing, we have to break it down to two categories. One is current exposure, because you want to make sure, is a person currently being exposed? Because if they are, I don’t care how much detox you do. If they’re currently being exposed, they’ll get worse, so acute exposure. What’s generally accepted is blood and urine for that purpose. That’s fine for most acute exposures.

                                           The problem is … What we’re more concerned about is, what’s in the cells? What’s in the brain? Now what are the deep body load of those toxins? That’s more difficult to get.  For example, if you want to know how bad your chemical toxin exposure is probably the best thing to do is to do a fat biopsy to see what’s in there. Okay, well, that’s fine. You can only pick up fat soluble chemical toxins, but the fat soluble chemical toxins tend to be the worst anyway.  In order to determine how much metal is in the body, many of us are using what’s called challenge testing. We give a person a drug, like DMSA or DMPS or EDTA, and then see how much that increases their secretion of metals. That actually is useful, but it’s also flawed. There’s no question that it’s not a perfect test.

                                            Because the only way to determine how much mercury a person has that’s causing trouble, for example, with the brain causing dementia is to do a needle biopsy of the brain. In general, patients don’t want you sticking needles into their brain. The bigger the needle that you need for tissue biopsy, the worse it is. We have to infer what’s going, and those methods aren’t very good. But they’re better than just blood and urine.  And mercury being a great example, because if blood and urine are so great for determining acute exposure, then you’d expect that blood and urine to correlate very well with each other in their levels of mercury. It turns out blood and urine and mercury don’t correlate with each other very well at all.  In general, I prefer more tests like blood tests and tissue biopsies than I do things like urine tests. Because it tells you what’s in the body, not what the body’s getting rid of.

Dr. Weitz:                           What do you think about the chemical antibody testing that’s available now?

Dr. Pizzorno:                      It’s intriguing, and I’m following it. I’m sure you’re aware of the work of another chiropractor, Dr Datis Kharrazian.

Dr. Weitz:                           Yeah, yeah. We just had a Functional Medicine Meeting, and Dr. Vojdani spoke at the meeting.

Dr. Pizzorno:                      Oh great, okay. You know the work of-

Dr. Weitz:                           He developed a lot these tests.

Dr. Pizzorno:                      Aristo and Datis are doing some, I think, really important work. What they’re doing that I find so interesting is they’re pointing out that these chemicals and metals are binding to normal body tissues. Normal body tissue, normal body proteins, which the immune system says are okay. Well, when you change some … adding a chemical or a metal, you’ve now made a new molecule that the body now thinks is an invader, and now you’re setting people up for auto-immune disease.  I think these tests are quite intriguing and may be quite valuable. I think we’re a little early in the process for me to be using them clinically, but they’re at the point now where I would consider using them. I’m not quite ready to say that this is the way to go.

Dr. Weitz:                           Yeah, cool. Can you talk about some of the ways that we can get rid of toxins from our bodies?

Dr. Pizzorno:                      There are three key methods. Number one is stop exposure. I’m going to be really aggressive about this, stop exposure. Because many of these toxins, we’re actually pretty good at getting rid of. Now, I mentioned arsenic for example. Half life of arsenic in the body is only two to four days. That tells me as we evolved as a species, we were exposed to arsenic, we figured out how to get rid of it.

                                           But if your water has arsenic in it, if you’re eating rice and chicken, you’re constantly being exposed to the arsenic which is why it’s the number one toxin right now. It’s a big, big issue. What do we do-

Dr. Weitz:                           What do we do about water? How do we get rid of toxins in our water?

Dr. Pizzorno:                      It depends upon the toxin. If it’s the chemical toxins, a carbon block filter would work just fine. In our house, we have a carbon block filter, a big one, on the water supply coming into the house, so the water in our showers has now been cleaned up. Because it turns out a lot of these organic compounds in the water are more efficiently absorbed by inhaling them than they are by eating them or drinking them.

Dr. Weitz:                           Like chlorine and stuff?

Dr. Pizzorno:                      Chlorine, yes, problematic, but I’m much more concerned about the chlorinated organic compounds. When we chlorinate the water supply to kill bacteria, and it does that by the chlorine binding to the organic molecules in the bacteria and kill them that way. Those chlorinated organic compounds are actually pretty toxic and many of them are carcinogenic.  Now, they’re not a big cause of cancer. I read a study where the public health people said, “Okay, we know that by chlorinating the water supply, we’ve basically dramatically improved human longevity.” If you look at human longevity, three quarters of it was from public health putting … doing things like putting chlorine into the water supply to get rid of invading organisms that are killing babies, so that works really well.  The researchers also know that about three people out of every 10,000 who are consuming this chlorinated water will get cancer from that chlorinated water because of these carcinogens. Now I’m sure these chlorinated compounds cause other trouble as well. It’s a small factor, and if that was the only factor, that’s okay. But the problem is it’s only one of many, many factors.

                                           There are over 100 chemicals and metals in our environment at high enough levels to damage human physiology and cause disease. You might say, “Well, that one only causes like 1% of disease. Why worry about it?” Well, because it’s one of 100. You have to get all hundred of them. You can’t just pretend that they don’t count. They all count. They add up.  It’s worse than that, and that is these things are synergistic. One plus one does not equal two. One plus one equals three. One plus one plus one does not equal three, one plus one plus one equals ten. As our body load of toxins increases, our ability to protect ourselves from the toxins becomes depleted, and you get more and more disease.

Dr. Weitz:                           Interesting. When it comes to doing detox, there are so many different detox programs out there. You see all these programs at the health food store just take this set of pills; just use this detox powder. There are so many different opinions on how to do detox. You get in a special sauna, stick your feet in this ionic bath …

Dr. Pizzorno:                      Let’s finish this question you asked me.

Dr. Weitz:                           Okay.

Dr. Pizzorno:                      First one, decrease exposure. Then number two is support the body’s own natural detox systems, and the third one is, okay, let’s do stuff to directly get things out of the body-

Dr. Weitz:                           Okay.

Dr. Pizzorno:                      … you might say, by chemistry.

                                           Second one is to support the body’s own innate systems. There are a lot of approaches we can take. The two simplest ones which are safe for virtually everybody is number one is increase your fiber. Because our body is constantly dumping garbage through the liver into the gut, and the body’s expecting there to be fiber there to bind to the toxins and get it out of the body. If you have all of those systems, we’re consuming 100 to 150 grams of fiber a day, unfortunately the average person now only consumes 15 to 20 grams of fiber a day. Excuse me. Spring has finally come.

Dr. Weitz:                           Bless you.

Dr. Pizzorno:                      Okay. One thing you can do then is to increase fiber, so that when the liver … Sorry.

Dr. Weitz:                           What type of fiber? You like the modified citrus pectin?

Dr. Pizzorno:                      I like pretty much every fiber except wheat bran fiber. Whether it’s pectin or oat bran or flax seed or whatever it may be, or eating fruits, I like, beans and such, just more fiber will help detoxify.

                                           Then the second one just one simple supplement, and that’s N-Acetyl Cysteine or NAC for short. That increases production of glutathione which plays a huge role in detoxification. There are a lot of other ways we can support detox.  In my new book, The Toxin Solution, … Well, actually, it’s new in terms of the paperback came out, the hardback came out last month, anyway, so I talked in there about ways to support the body’s own detox systems.

Dr. Weitz:                           One interesting point I’d like to make is since I treat a lot of patients with gut problems, one of the trends with patients with IBS and small intestinal bacterial overgrowth is putting the patients on a low-fiber diet, because a lot of times fiber makes your gut worse, because it feeds these bacteria. It’s interesting that we may actually inadvertently be increasing our toxin load as we try to improve our gut health.

Dr. Pizzorno:                      If you look at my book, the first two weeks, I show people how to avoid toxins. The second two weeks, I say, “Now how do we clean up the gut.” Because indeed, the wrong kind of bacteria in the gut will cause all kinds of trouble.  I’m one of these people who … I’m not a great believer in the whole SIBO diet and things like this. Not that they don’t help people in the short term, but in reality what I think they are is they’re just an indication that the gut’s not working properly, fix the gut. Because all those other foods they’re saying you have to avoid, they’re also natural, healthy foods. It’s not the food’s problem, it’s the gut’s at the problem.

                                    Now the third category then is to directly get toxins out. One way to do that, for example, is to be aware of what toxin the person has, and then look at what molecules we can give that person to get the toxin down more efficiently.  I’ve seen a lot of people with high levels of lead and/or mercury. A lot of that is because as people get older when they start losing bone the lead and mercury stored in the bones starts getting released into the system.  For those people, I recommend oral DMSA, and I recommend not very much, 250 milligrams every third night, along with extra fiber and NAC. It’s a slow process, but it’s extremely unlikely anybody will have a bad reaction, and over time-

Dr. Weitz:                           DMSA is by prescription now, right?

Dr. Pizzorno:                      [crosstalk 00:22:10]-

Dr. Weitz:                           Depending on the state, I guess?

Dr. Pizzorno:                      Yes. It used to be available in health food stores, now it’s only by prescription. Actually, when I’ve used it with my patients, I always use it by prescription, because I want to make sure about the quality and dosage and such. Whereas in health food stores, some if you’re with … If you buy from a good manufacturer, everything’s fine. Unfortunately, there are also bad manufacturers, so it’s hard to tell between them.

Dr. Weitz:                          You mentioned NAC. What do you think about taking glutathione orally or IV?

Dr. Pizzorno:                      Oral glutathione is broken down by the bacteria in the gut. While oral glutathione will increase glutathione levels, it does … Basically, it’s expensive cysteine. It’s much cheaper to give people N-Acetyl Cysteine than it is to give them oral glutathione. Now, having said that, you can give them topical glutathione, intranasal glutathione, IV glutathione, there are a lot of other ways to get glutathione into the body. But just oral glutathione doesn’t work real well.

Dr. Weitz:                           Right, they have all these new liposomal forms, and there are claims-

Dr. Pizzorno:                      Those are better.

Dr. Weitz:                           Yeah. M’kay. Go ahead with your detox protocols.

Dr. Pizzorno:                      Okay. Now for a person that has really high levels of chemical toxins, you can speed the process up by giving people, I hate to say it, but sometimes I do recommend drugs. That is, I give them bile sequestering drugs.  Things like costyramine, cholestyramine, things of that nature actually bind to the chemical toxins in the gut much more efficiently than even fiber does. This is a good way of getting toxins out if someone has a really high chemical load.

Dr. Weitz:                          What about using clay or charcoal as binders?

Dr. Pizzorno:                     Right. Clay and charcoal, those all should work. Unfortunately, there’s not much research on them. That’s not surprising, because nobody makes money with those things. I wish there was more research on them. There’s a very small amount of research on rice fiber. There’s a small amount of research on wheat fiber, but not near as much as we would like, but what’s there is very encouraging.

Dr. Weitz:                          Okay.

Dr. Pizzorno:                      Let’s talk about another method, and that is sweating, saunas, okay?

Dr. Weitz:                           Yeah.

Dr. Pizzorno:                      Heavy exercise. It turns out if you … Have you had Stephen Genuis on your show?

Dr. Weitz:                           No.

Dr. Pizzorno:                      If you get a chance, I recommend it. He’s an MD in Edmonton, Alberta.

Dr. Weitz:                           Okay.

Dr. Pizzorno:                      He spends half his time doing research on toxicity and half his time detoxifying patients.

Dr. Weitz:                           Oh, cool.

Dr. Pizzorno:                      Everybody knows, well, saunas are supposed to be detoxifying because of all the sweating. Everybody knows that, but who actually tested it? Stephen went and got a bunch a people, got some volunteers, had them sweat, took the sweat, looked in a laboratory to see what was in it, full of chemicals and metals particularly cadmium. Sweating is a very effective detox system, and I recommend people do a sauna at least once a week and preferably twice a week to get the toxins out.

Dr. Weitz:                           Do you like infrared sauna?

Dr. Pizzorno:                      The nearest we can tell, it doesn’t matter how you’re sweating, just as long as you’re sweating. Whether it’s infrared sauna or regular saunas or running or like me playing basketball, it doesn’t matter, just, you’ve got to sweat.

Dr. Weitz:                           Cool.

Dr. Pizzorno:                      I can keep on going for as long as you want.

Dr. Weitz:                           Let’s keep going on with the detox protocols. You mentioned mercury and lead, and it’s interesting … Myself and I know other Functional Medicine practitioners sometimes get these chronic patients with these elevated levels of mercury and some of these other toxins, and it seems like it’s very, very difficult to get rid of them.  What do you do with some of these patients?

Dr. Pizzorno:                      Yes. I want to state as strongly as I can, that a lot of people say, “Oh, I’m toxic, therefore I should do a detox system protocol.” Well, don’t do a detox protocol until you’re sure that your organs of elimination are working properly. Because if you stir things up and can’t get rid of them, you’ll make yourself worse. A lot of people get discouraged about detoxification because of not appreciating that this is a process that must be done properly.  In my book, The Toxin Solution, I spend two weeks, make people aware of where the toxins are coming from so you stop putting them into your body, two weeks to clean up the gut, two weeks getting the liver to function properly, and two weeks getting the kidneys functioning properly.   We now have an epidemic of kidney failure. This is something that used to be so rare, and now we’ve got dialysis centers all over the place. Because people’s kidneys are failing from all the chemicals they’re being exposed to including prescription and non-prescription drugs. The nonsteroidal, anti-inflammatory drugs, particularly acetaminophen, are very, very damaging to the kidneys.

                                           Okay. Now we have a cleanup, get everything cleaned up, and now we can start going on a detox program. The detox program that I recommend is having people do regular saunas, at least twice a week preferably three times a week. Increase their fiber. Go on a mild caloric restriction, I don’t want to do a lot of caloric restriction. Because for a person saturated with toxins, and they start losing weight, and their fat starts breaking down, it releases the toxins.  Just a little bit to help release, and then I put them on an alkalinizing diet. Reason for that is that many of the toxins in the body are more efficiently released when the body becomes more alkaline. I put them on an alkalinization diet, and what does that mean?  What that means is decreasing consumption of high sulfur containing amino acids, which means basically less meat, and it also means decreasing consumption of salt.    We consume so much salt that we impair the kidneys’ ability to get rid of other toxins such as excess acid but other toxins as well. By making the body more alkaline through decreasing sulfur and sulfur containing amino acids, and decreasing salt, we now have the body more able to get rid of the toxins, and we start detoxifying.

                                           Another point that’s important here is if you’re going to do detoxification not only must you do it properly, but you must also recognize it takes time. We’ve been trained to buy the modern chemistry to expect treatment from doctors to be really fast.

                                           You have pain, you go and take an anti-inflammatory drug, a nonsteroidal anti-inflammatory drug, your pain inflammation well, within a few hours, it’s dramatically better. Well, modern living through chemistry. It sounds good. Well, of course, most of those drugs work so quickly, because they simply poison the body’s enzyme systems that are producing the symptoms not actually dealing with why people are sick but anyway get quick results.

                                           Then we do nutritional medicine. It’s not as fast as drugs, but it is a little quicker than detoxification. When we get people the nutrients they need, it can be weeks, sometimes even months, to get enough nutrients into the body, so the body works properly. That’s fairly good.

How about for detoxification?   First, you have to stop the toxins coming in. Then you’ve got to get the toxins out of the body. Then all those enzyme systems that have been poisoned by those toxins, they’ve got to be replaced, and now your body can start healing. This takes months to even years to get the job done. But if you work at it properly, the health benefits you get are profound and long-lived.

Dr. Weitz:                           Cool. How do you support the gut to get it ready for detox?

Dr. Pizzorno:                      There’s a protocol I’ve been using on patients now for, oh God, 40 years. I developed it myself, and I noticed that other people have now developed derivatives of it, but it’s very straight forward.  First off, kill off the bad bacteria, and I use good old goldenseal to do that. Because goldenseal will kill the bad bacteria but leave the good bacteria alone.

Dr. Weitz:                           Goldenseal is basically a source of berberine?

Dr. Pizzorno:                      Right. The berberine and hydrastine in the goldenseal kill off things like Clostridium and other toxic bacteria.

                                           The second thing I do, and I’ve learned from my poor patients, is that when you kill off all that toxic bacteria, they release a lot of their toxic constituents. Remember there’s 10 times as many bacteria in your gut as there are cells in our body. When they die, they release everything that’s in the cells, bacterial cells, and lots of problems. You have to use a lot of fiber while you’re doing this to make sure you’re absorbing the toxins as they’re being released.

                                            Next thing we want to do, of course, is re-seed the gut with proper bacteria. I prefer broad-spectrum strength bacteria, not just one bacteria, but lots of good ones. Finally, we need to stimulate the healing of the damaged gut.

                                            So four steps: 1. kill the bad bacteria, 2. absorb the toxins that have been released, 3. re-seed with healthy bacteria, and 4. then stimulate the healing of the gut.

Dr. Weitz:                            Essentially, your version of the 4R Program.

Dr. Pizzorno:                      I did this about 10 years before anybody ever heard about the 4R Program. That’s one of the reasons why I’m one of the people who helped found Functional Medicine. Because I’ve been working on this for a long time.

Dr. Weitz:                           Right.

Dr. Pizzorno:                      It’s why I have literally hundreds of patient stories, people with this, that, and the other chronic disease where I did this foundational, age-old naturopathic program which is: clean up the gut. And clean up the gut, a lot of disease goes away.

Dr. Weitz:                           Right.

Dr. Pizzorno:                      Old time age old adage and that is, “Disease begins in the gut.” I was taught that when I was a third-year student almost half a century ago.

Dr. Weitz:                           That’s great, very profound. You ever do stool testing to see what’s in the gut first?

Dr. Pizzorno:                      Yes and no. The method that I use for determining how toxic the gut is, is relatively simple and inexpensive, because that allows me to do it more frequently. There’s something called the Obermeyer test, also known as the Indican test. I don’t know if you’ve run across this.

Dr. Weitz:                           Is it like a urine test?

Dr. Pizzorno:                      A urine test, right.

Dr. Weitz:                           Okay.

Dr. Pizzorno:                      The urine test measures something called indoles and skatoles in the urine. What these are, are the, you might say, the breakdown of protein by the wrong bacteria in the gut that produces these chemical toxins. I say to the patient, “I think you have a toxic gut, and you have a lot of indoles and skatoles,” and, of course, you get a blank face with your patient. Then I say, “Well, they have other names. They’re also called putrescine and cadaverine.” Okay?

Dr. Weitz:                           Right.

Dr. Pizzorno:                      When you say that, all of sudden the patient says, “Oh, that doesn’t sound good.” Anyway, I use this test, and it’s a real simple urine test. Actually, I used to … My undergraduate degree is in chemistry, so I actually-

Dr. Weitz:                           Is this part of an organic acids profile?

Dr. Pizzorno:                      No, it’s unfortunately not.

Dr. Weitz:                           Okay.

Dr. Pizzorno:                      I wish it was available, but it’s a test … There is a website on the internet that does sell it. It’s real inexpensive, and if you have any chemistry capability of your own, you can make up the test yourself.

                                           Well, you take some of the patient’s urine. You shake it up in this little vial, turns bright blue in proportion to the amount of indoles and skatoles or putrescine and cadaverine in the gut. As I put them on the protocol, I have them come back once a week to test the urine. It’s really inexpensive to test.

Dr. Weitz:                           You do the test in your office just like that?

Dr. Pizzorno:                      We do the test in my office, it’s real easy.

Dr. Weitz:                           Wow, very cool.

Dr. Pizzorno:                      Anyway, I just have them come back. I don’t have to see it myself. I have to make sure they’re progressing. We test them every week, and what we find is as we clean up the gut, the indoles and skatoles go away. It goes from blue to light blue to clear, and as their gut cleans up all their health improves as well. It’s a nice objective reinforcement for the patient to show that the subjective feeling their having of feeling better is also objectively demonstrated with the test.

Dr. Weitz:                           Wow, that’s great. That’s a real practical tool that we can use.

Dr. Pizzorno:                      Yes, very practical, very useful.

Dr. Weitz:                           Where do you get the reagent from?

Dr. Pizzorno:                      If you look at my book, the Textbook of Natural Medicine, I have the formula for making up the indoles … The Obermeyer test is in my-

Dr. Weitz:                           Okay, cool. It’s in the appendixes in the back?

Dr. Pizzorno:                      Right.

Dr. Weitz:                           Yeah, yeah. I just finished reading it, highly recommend that book very, very-

Dr. Pizzorno:                      Yeah. Now, that’s in the Textbook of Natural Medicine, not in my consumer book, The Toxin Solution.

Dr. Weitz:                           Oh, okay. Okay. Okay. Cool. Let’s see, so what is your liver detox protocol? How do we support the liver? Now, we’ve been talking about Phase 1 and Phase 2 of liver detox. Now people are talking about Phase 3. Somebody just mentioned Phase 0, so I guess it’s getting more and more complicated.

Dr. Pizzorno:                      You always have to be careful about losing the forest by looking too closely at the trees. I think these are all of interest, and indeed people have problems in every one of them.

                When I go back to the liver, I do really foundational things. That is first off, are the nutrients a person needs available for the liver to function properly? For example, look at those Phase 1, Phase 2, particularly, Phase 1 liver detox systems. They are all based on iron molecules, iron-containing molecules. If a person is low in iron, for example, most menstruating women, if they’re low in iron, they’re going to have trouble with their detox systems. Because they can’t make enough of the enzymes. I want to make sure they have enough iron. Also, those detox systems, enzymes both Phase 1 and Phase 2, are highly dependent upon magnesium and neuro-magnesium as well as the B vitamins. What I do with these people is, I make sure they’ve got the minerals they need like iron and magnesium, make sure the B vitamins are there so the detox functions properly.

                                           In addition, there are some herbal medicines we can use to do things like, I know it’s an age old thought that has been derided by conventional medicine, but liver detox. There are herbs you can use to help the liver get rid of the bile and other things that built up in the liver that are full of toxic material.  Things like artichoke, for example, Cynara, is good at detoxifying the liver. And milk thistle, for example, upregulates liver detox systems. Basically, make sure the nutrients are there, get the herbs in there to help stimulate things, and get the liver working quite well.

Dr. Weitz:                           Phase 2 is really crucial, right? Otherwise, you create too many toxic intermediates?

Dr. Pizzorno:                      Right. The way that many of the most difficult to detoxify chemicals are eliminated by the liver is they’re first activated by Phase 1 detoxification.

                                           Then and the [inaudible 00:36:46] molecules are actually way more toxic, and then they’re then bound to Phase 2 in something called conjugation, where these activated intermediates are more easily conjugated. Phase 2 conjugates them with things like, for example, glutathione.

                                           I mentioned glutathione before. Well, if you have a person who’s been consuming a lot of alcohol, for example, they’re depleting the glutathione stores. If they consume a lot of acetaminophen, they’re depleting their glutathione stores. What happens is that Phase 2 does not work as well, so they actually have more toxic compounds there.

                                           I then looked at Phase 2 and realized some compounds in Phase 2 can be easily depleted. We want to make sure there’s plenty of it there. That’s why N-Acetyl Cysteine is such a good molecule for detoxifications, because it increases glutathione production.

Dr. Weitz:                            Now, NAC, it’s interesting you brought that up. It’s my understanding that in order for Phase 2 of liver detox to work properly, you need sulfur containing amino acids like cysteine. But if you put the patients on a low sulfur diet in order to alkalinize them, you may be depleting Phase 2 liver detoxification.

Dr. Pizzorno:                      That’s a very good point. The NAC is a sulfur-containing amino acid and a small percentage of the population, I think maybe around 3%, I’m not sure but just looking at what experience has been treating people, have trouble metabolizing sulfur compounds. They typically are the deficient in molybdenum or the enzymes are genetically made so they don’t work very well, and people need extra molybdenum.

                                           Now when I’m giving people N-Acetyl Cysteine, particularly over a period of time or in particularly higher dosages, I also give them molybdenum to make sure they’re metabolizing it properly. With everything, it’s always a balance. Yes, N-Acetyl Cysteine is more acid-forming, but that’s easily taken care of by eating more fruits and vegetables. Real simple.

Dr. Weitz:                           Right. I think some of these detox powders have those specific amino acids as well. Do you ever utilize those as part of your protocol?

Dr. Pizzorno:                      I have used them, and I think they are useful. I notice that some patients like to be put on a program. They want to get a box with stuff in it that has everything they need. Days one to four, take this formula, then days five to seven, take this formula. Which is fine. There are good ways of doing this, and I support that.

Dr. Weitz:                           Can we order the Pizzorno detox box from you?

Dr. Pizzorno:                      Well, you can actually, if you go to Bioclinic Naturals. They have something called, the 7-Day Detox Kit, and that’s something that I helped design, and-

Dr. Weitz:                           Oh, okay. Cool.

Dr. Pizzorno:                      By the way, fair warning, I’ve had a lot of people tell me it was wonderful. But one out of four people, it detoxifies them too quickly. If you use that formula and aren’t feeling very good, it means your detoxing too quickly. You need to back off. But for everybody else, it works real well.

Dr. Weitz:                           Yeah, yeah. I find a lot of times, a 30-day detox is easier to do than a one week or two week or 10-day detox.

Dr. Pizzorno:                      Right. I want to reinforce what you just said. We have to realize, detox is not a fast process. If you think you’re doing a fast process more likely you’re going to run into trouble. It takes times.

Dr. Weitz:                           Especially if these toxins are stored in your body for long periods of time, in your bones, in your fat.

Dr. Weitz:                           Right. I think some of these detox powders have those specific amino acids as well. Do you ever utilize those as part of your protocol?

Dr. Pizzorno:                      I have used them, and I think they are useful. I notice that some patients like to be put on a program. They want to get a box with stuff in it that has everything they need. Days one to four, take this formula, then days five to seven, take this formula. Which is fine. There are good ways of doing this, and I support that.

Dr. Weitz:                           Can we order the Pizzorno detox box from you?

Dr. Pizzorno:                      Well, you can actually, if you go to Bioclinical Naturals. They have something called, the 7-Day Detox Kit, and that’s something that I helped design, and-

Dr. Weitz:                           Oh, okay. Cool.

Dr. Pizzorno:                      By the way, fair warning, I’ve had a lot of people tell me it was wonderful. But one out of four people, it detoxifies them too quickly. If you use that formula and aren’t feeling very good, it means your detoxing too quickly. You need to back off. But for everybody else, it works real well.

Dr. Weitz:                           Yeah, yeah. I find a lot of times, a 30-day detox is easier to do than a one week or two week or 10-day detox.

Dr. Pizzorno:                      Right. I want to reinforce what you just said. We have to realize, detox is not a fast process. If you think you’re doing a fast process more likely you’re going to run into trouble. It takes times.

Dr. Weitz:                           Especially if these toxins are stored in your body for long periods of time, in your bones, in your fat.

Dr. Pizzorno:                      A good example is people with high levels of mercury. Well, most people will say, “Well, let’s give you an IV,” DNPF, for example. Well, an IV DNPF will get the toxins out really quickly, but you’re much more likely to have adverse drug reactions. I use the oral protocol instead. It takes maybe three times longer, but you don’t get side effects. I’d rather it be a little slower and not cause unexpected damage.

 

Dr. Weitz:                           That’s great. Well, thank you Dr. Pizzorno. This has been a great interview. You’ve given us a lot of very interesting information about toxins, and how to avoid them, and how to get rid of them.

Dr. Pizzorno:                      Great, happy to help.

Dr. Weitz:                           For those listening to this, how can they get a hold of you?

Dr. Pizzorno:                      Well, you can go to my website drpizzorno.com. D-R-P-I-Z-Z-O-R-N-O dot com. I’m trying to set it up, so that it’ll be easier for people to connect with me. I’m still learning about all this social media stuff.

Dr. Weitz:                           Right.

Dr. Pizzorno:                      Also, I have a Twitter account Dr. Pizzorno D-R-P-I-Z-Z-O-R-N-O.

Dr. Weitz:                           Okay.

Dr. Pizzorno:                      Whenever I say something interesting, I’ll tweet it. Not whenever … When I have some time, and I say something interesting, I’ll tweet it. Because I say interesting things all the time. I don’t always have time to tweet it though.

Dr. Weitz:                           Right. And The Toxin Solution, they get a hold of that wherever bookstores … at all the bookstores, Barnes and Noble, Amazon. And when is your textbook for clinicians on environmental medicine going to be available?

Dr. Pizzorno:                      Clinical and Environmental Medicine  will come out July 7th, and Elsevier will be the medical textbook publisher. I’m really excited about it. Because, while, I have a good body of knowledge in this whole area of environmental medicine, Walter Crinnion my co-author also has a huge body of knowledge. What’s was surprising to us is there wasn’t actually a lot of overlap in our knowledge bases. By putting both of our work together in one textbook and really being rigorous and looking at a lot of science, I think we’ve created something that’s going to be fantastic. I’m so excited that’s going to be coming out.

Dr. Weitz:                           That’s great. I can’t wait. I’m very excited for that book to come out, so put me on the list.

Dr. Pizzorno:                      Okay.

Dr. Weitz:                           Thank you, Dr. Pizzorno. Hope to talk to you soon.

Dr. Pizzorno:                      Great chatting with you.

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Rational Wellness Podcast 051: Improving Posture with Dr. Steven Weiniger
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Learn how to improve your posture with Dr. Steven Weiniger who speaks with Dr. Ben Weitz. 

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

 

Podcast Highlights

1:41  Dr. Weiniger explained that he noticed that his chiropractic patients would often improve but then their symptoms would return. He then studied with Dr. Vladimir Janda in the Czech Republic and also blended yoga and the work of Patanjali, Pilates, Alexander, and Feldenkrais into some systematic clinical protocols.

5:06  Dr. Weiniger said that if you train your body to do stupid things, your body is going to get really good at doing stupid things, meaning that you will become adapted to postures that place structural stress and damage your body. Dr. Weiniger talked about becoming aware of your body and strengthening your posture. 

6:50  Holding your body in an asymmetrical way will lead to abnormal stresses and wear and tear on your muscles and ligaments and calcium deposits building up in your spine and other joints.

9:28  I asked about forwards head posture, one of the most common postural flaws, and what are the health consequences and what to do about it?  Dr. Weiniger explained that you need to look at the whole body from the bottom up and make sure that it is all balanced. He talked about how headaches result from forwards head posture due to the shortening of the suboccipital muscles and the connection between the suboccipital muscles and the dura mater that covers the brain. He also talked about how from sitting with forwards head posture you get a shortening of the suboccipital muscles and a weakening of muscles in the front of the neck. You’ve got tight muscles at the top of the chest and weak muscles in the upper back.  That makes it very difficult to just change your posture since they have trained their body to sit differently.

16:33  Dr. Weiniger highly recommends taking a posture picture so the person can visualize how distorted their posture has become and gain awareness.  Dr. Weiniger talked about the Strong Posture Protocols that he teaches in his book Stand Taller Live Longer.  “So, you want to be addressing the three elements of balanced alignment and motion in a posture strengthening program to connect somebody more accurately with the reality of how are they balancing? How are they aligning, and how are they moving?”

26:53  We discussed lumbo-pelvic alignment and what posture is optimal.  Dr. Weiniger talked about how to create postural balance and how to work toward a pain free range of motion and balanced strength.

38:10  I brought up scoliosis and Dr. Weiniger explained that the focus of his program is not currently on scoliosis and scoliosis is more of a neurological thing to him. But doing a 7 week strong posture program is a good way to start. 

41:09  Dr. Weiniger said that practitioners can go to posturepractice.com . If you are a lay person, please go to Posturezone.com  or to PostureMonth.org  And you can also download the free posture app, PostureZone app onto your iphone or ipad.  

 



Dr. Steven Weiniger is a Doctor of Chiropractic with a specialty in posture analysis and correction. Dr. Weiniger is an author, speaker, and internationally recognized posture expert  https://www.bodyzone.com/posture-expert/  Dr. Weiniger has written Stand Taller Live Longer: An Anti-Aging Strategy available through Barnes and Noble  https://www.barnesandnoble.com/w/stand-taller-live-longer-steven-weiniger/1009154991?ean=9780979713606  and Posture Principles-–5 Principles of Posture. 

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


 

Podcast Transcripts

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

                                            Hey, Rational Wellness podcasters. Thank you so much for joining me again today. We have a very interesting topic. Normally, we talk a lot about nutrition and functional medicine, and today, we’re going to talk about posture and it’s more of chiropractic oriented discussion but posture is just as important for your overall health and part of your anti-aging strategy as eating right, and exercise, and sleep, and everything else.

                                           Our guest today is Dr. Steven Weiniger. He is an internationally known posture expert. He’s trained thousands and thousands of patients and other doctors on improving their posture. His professional program is known as the Certified Posture Exercise Professional program. He is the creator of PostureZone, a free posture assessment app, and his latest book is Stand Taller Live Longer: An Anti-Aging Strategy. Steve, thank you so much for joining me today.

Dr. Weiniger:                     Ben, thank you for having me.

Dr. Weitz:                            How did you get so interested in posture? How did that become a focal point for you?

Dr. Weiniger:                     Well, I’ll tell you, as you said at the beginning that this is a chiropractic oriented, and you’re right that that’s where we started from but posture is very much health to everybody. The way that I started was as a chiropractor. People came to me with problems: neck pain, back pain, and we got it better but a lot of times their problem came back, and I worked on them again, and I got them better, and their problem came back. This is a common complaint of a lot of chiropractors.

                                           And I started getting into, kind of at the same time, both yoga personally because I had some significant flexibility issues and some issues with my posture and my body, as well as the work of Vladimir Janda, who was the originator of what’s been called the Prague school of rehab. And I spent time in the Czech Republic with Vladimir when he was alive and we observed that there are ways to train bodies to move differently. But if you don’t train the body to move differently, it’s going to start to move the way you’re training it to move, and that was one of the Janda’s big insights and the effect on that are more detailed scientific perspective with things like what’s called Upper-Crossed and Lower-Crossed Syndrome, which are a common posture observation within both the chiropractic and the therapy worlds.

                                          That there wasn’t a systematic way to address a patient and once we started working on melding the work of yoga, and Patanjali, and some other people in the posture world like Pilates, and Alexander, and Feldenkrais into something that was more systematic for a clinical protocol.  And it’s expanded. We started having a practice that we were seeing patients, and then doctors started to come because they were hearing what we’re doing and then we started teaching seminars to other professionals and they wanted the tools. So, we developed other tools and other things to help promote the idea that posture is important and you can do something about your posture, to strengthen your posture. 

Dr. Weitz:                          Yeah, I know, on a daily basis I get patients coming to my office with neck pain or back pain, and they say, “How did it start? I didn’t do anything. I didn’t strain myself. I didn’t lift anything.” And a lot of times, a common factor is they’ve been sitting with lousy posture for hours at a time, slumped, rounded shoulders, forwards head all these different postural flaws. Maybe they’re sitting twisted typing into a keyboard with a monitor off to the side. So, I’ve come to understand the importance of posture and trying to retrain my patients into using better posture and you’ve got a really detailed system for helping to do that.

Dr. Weiniger:                     Well, we do and then part of it is changing the perspective of what posture is because the word that you use kind of says it all. People have lousy posture. It’s putting it into a box where you almost are making pathology of it and it’s not a pathology. If you train your body to do stupid things, your body is going to get really good at doing stupid things. And when you’re focused on your phone or your keyboard, and you’re disconnecting from an awareness of your body, you become disconnected from it. So, changes happen that, “I don’t have to stop. I’m a little bit tight, I can keep on going,” and your body gets better and better at moving in those adaptive ways.

                                           I’m not saying that we should all get rid of our phones and go back to living a simple life because that means we are out in the fields toeing things and running around and chasing bikes in which is not the life that I see myself living but if you’re going to spend a big chunk of your time doing what we do, being more aware of your body so that you’re dealing with a less mechanically stressed posture and doing things to turn your body back the other way. It’s not a matter of just getting rid of the pain, it’s a matter of, “How can I strengthen my posture?” Because it’s not a good or bad.

                                           If I told you your posture was bad, you’d say, “Oh, yeah. I know that. That’s the way that I am,” and a lot of your patients, I’m sure have said that. But if you tell them, “Your posture’s weak, then that opens a little question in your mind of, “In that case, what we need to do? How do I strengthen it?” And that’s what we teach doctors to do with patients.

Dr. Weitz:                          Right. Well, really isn’t it about how efficiently we resist the forces of gravity because gravity, all day long, is pushing down on us and if we’re not properly balanced, then when I can efficiently resist gravity and there’s going to be abnormal stresses on our muscles, our ligaments, our joints.

Dr. Weiniger:                     Almost right. You said abnormal stresses, if you hold your body in an asymmetric position, it’s normal to have those mechanical stresses occurring in that asymmetry that’s going to normally result in asymmetric forces that’s going to make wear and tear. That’s going to make … Calcium deposits, that’s going to make stretching occur. That makes that the easier, mechanically speaking, posture to hold because all other things being equal, symmetry changes when you keep on molding it into an asymmetric position.

                                         So, if it’s somebody that has a marked forward head posture and kyphosis but if they’re laying on their back, their head is extended 30 degrees on a flat surface. You must stand with your head on top of your shoulders for that person’s architecture. That’s not their normal because they’ve worked hard, not intentionally, but they’ve worked hard to change their posture. One of the book that I wrote for the public, and that a lot of professionals use, a lot of CPEPs use to teach their patients and posture programs is based on five principles of posture, five concepts and the second posture principle is balance. Your posture is how you balance your body no matter how … If I’m standing all horribly posture bent forward but I’m standing, the question that we ask people is, “Is my posture balanced if I’m like this? Is it balanced?”

Dr. Weitz:                       No. It looks like you’re going to fall over to your left.

Dr. Weiniger:                  On an overall mechanical basis, is it balanced?

Dr. Weitz:                       Well, I guess you could say because you’re standing, it must be.

Dr. Weiniger:                  It’s not that you could say, but in objective reality, in looking at it from a rational empirical basis, if you are vertical, it is balanced.

Dr. Weitz:                       But you’re not necessarily loading joints on both sides equally.

Dr. Weiniger:                  That’s the point. It’s not symmetric. It’s not efficient. It’s not good long term but on an overruled by a mechanic’s basis, it is balanced. If it weren’t balanced, it would fall down. The principle is your posture is how you balance and that pattern of muscle asymmetry on multiple layers of functional compensation and structural adaptation it’s precisely what you want to be observing, looking at, and working with to address and to strengthen posture.  

Dr. Weitz:                       Why don’t we start by talking about one of the most common postural flaws, certainly, that I see in my practice, which is the forwards head posture and that’s the one where the person’s head is jutting forwards and that’s usually a result of sitting and looking at their laptop, or their iPad, or just using poor posture at their desk writing. What are some of the long-term consequences that can occur from forwards head posture, and then what are some of those strategies that we can utilize to reverse it?

Dr. Weiniger:                  I’ll answer that question but let me change the perspective just a little bit. If your posture is how you balance your whole body, and your head is going forward, even though you’re not thinking about it, something else is suddenly going backwards, or some things are going backwards, or there’s some other zigzag occurring. Your posture is a whole body phenomenon and I agree, the habit pattern of working on a computer, close-quarters texting where you’re looking down instead of up, strategies for addressing texting instead of wrapping your head down to your device, lifting your device up, looking more at it, then that’s part of being conscious of it. The challenge becomes if you only work on the top, then you’re making different compensations occur lower down the chain.

Dr. Weitz:                       Now, that’s while you’re standing, how about when you’re sitting?

Dr. Weiniger:                  When you’re sitting like you’re still balancing and the muscle patterns of asymmetry from standing to sitting, they’re not exactly the same. But if you don’t retrain one, the one that’s been longer standing is going to keep on being a bias towards the one you are trying to retrain. And since humans are made to move from a dynamic point of view, and it’s one of the things that Janda talked about with the Lower-Crossed being the most common postural syndromes, the force propagation is bottom to the top because you’re balancing on your feet.  And just like, if you had a stack of kiddie blocks, I don’t know if you have kids but when my kids were little-

Dr. Weitz:                       Yeah, I have older-

Dr. Weiniger:                  Again, how can you get the stack? And if it was wobbly at the top, you didn’t fix the one on top, you gotta go down to the bottom. Get up a stable base and work your way up. So, in terms of awareness about what a head posture, pulling your head back makes sense, the problem that many people going to have is because they’ve trained that forward head posture. Some muscles have gotten too long and some muscle have gotten too short, and that is symmetry in a front to back direction is what sets up a lot of the health consequences, probably the most. Excuse me.

Dr. Weitz:                       Yeah. You were going to talk about some of the health consequences of having forwards head posture. 

Dr. Weiniger:                  One of the most common everyday health consequences are headaches. And when your head goes forward, it’s going straight forward, your heads going to have to tilt down unless you lift it up again, and when you lift it up again the muscles at the very top of the spine, the suboccipital muscle between the occiput … Exactly, at that last little hinge you just did when your head jerked up the muscles you were using, the back part of your neck, just under the occiput. The occiput to C1 to C2, those muscles are going to have to become shorter and that chronic shortening of that group of muscles called the suboccipital muscles creates muscle tension.

                                        And a lot of people say, “Well, I’m just tense, that’s why I’ve got a headache.” If you’re holding your head in that position, especially if you get more fatigue, those muscles have to work harder. In ’97, they found out that one of those muscles, the rectus capitis posterior minor had fibers that went between the skull and the first part of the spine, and connecting onto the lining around the brain, the dura mater. The theoretic reason for this is, it pulls that lining backwards to allow for more open flow of the fluid around the brain and spinal cord called the cerebral spinal fluid.

                                        In addition, in 2012 at Logan College of Chiropractic in St. Louis University, they found that the other muscles in that area, rectus capitis posterior major, obliquus capitis superior and ligamentum nuchae, which were all part of the deep, deep tissue connecting the skull and upper cervical spine. They also have connections that travel into and between the vertebra, and that directly touch onto the lining of the dura, the meninges that contain the fluid that holds the brain and the spinal cord. So when you have that kind of tension, that can affect that fluid flow.

                                       This is probably the best explanation for why, when somebody has chronic headaches, they go to a chiropractor with a killer headache, they’re dying, and, “Oh, man. Doc, I feel wonderful. Thank you. It’s like you opened a valve,” because you literally took the pressure off the base of the brain, but that’s one of many, many things. Something else that Janda talked about is, it’s very rare to have forward head posture existing by itself–you almost always have an upper torso compensation occurring also where your shoulders are rolling in because the hands are rolling in.

                                          It’s kind of scissoring, it’s called a collapse of the kinetic box where your head should be level, and your torso should be level. When one goes forward and one goes back, you have muscles that are getting tighter and weaker at opposite sides of that box. So, basically, you’ve got tight muscles at the suboccipitals and weak muscles in the front of the neck. You’ve got tight muscles at the top of the chest and weak muscles in the upper back.  And once that kinetic box collapses, that becomes the position of needing less energy to keep it there because of that muscular imbalance.

                                          So at that point, it’s not merely a matter of, “Stand up like this, it takes less energy,” because that person has trained their body to be differently, they can’t do that, and just trying to go in that position, the response is always, “That doesn’t feel comfortable to me,” because in their perception, their body looks like this, but if you took a picture of it, that’s not reality. And this is one reason why we highly recommend posture pictures so that you have a benchmark of, “Hey, how’s my posture doing?” 

In terms of what you can do to begin awareness, take a picture, see what you look like and try to text somebody take a picture, if a selfie of yourself doesn’t work. Having someone do it, you can do it with the phone that you have. The free postures on app will let you do it but you need someone else to help you. And when they take the picture, try to stand tall with what you feel like is, “Yes, I’m standing tall,” which is probably better than your habit is and that’s fine because people will must always find when there’s a problem they’re blown away by when they thought they were standing tall, what the picture really says.

Dr. Weitz:                          So, after you take a picture, then what are some of the strategies that you do to try to help a client like that?

Dr. Weiniger:                     The protocols that we teach professionals and that we talked about in Stand Taller Live Longer, are called the strong posture protocols.  And the strong constant protocols work with the three elements of posture. We’ve talked about sitting posture versus standing posture. Posture is not just when you’re static, not moving. If you’re running, you’re going to have a running posture. Your running posture will have the patterns of your standing posture, your sitting posture, because your posture is not just when you’re standing statically, it’s when you’re moving dynamically as well. And the three elements of posture begin with, what I spoke about a moment ago, balance.  Your posture is how you balance your body.  It’s also how you’re aligning your body, and you align and you move your body in patterns of motion.

                                        So, you want to be addressing the three elements of balanced alignment and motion in a posture strengthening program to connect somebody more accurately with the reality of how are they balancing? How are they aligning, and how are they moving? So, in terms of posture picture, that’s a benchmark of how you’re aligning and beginning retraining your benchmark of your perception of, “Yes, I feel like I’m standing tall and straight, the camera says otherwise,” me just telling you to move differently, you’re going to keep on coming back, “Well, that doesn’t feel right to me,” because your body has what’s called a proprioceptive system.

                                       I know you know what I’m talking about with that and it’s not something that’s an intellectual and you can just change it because you want to decide to, it’s something that you need to have a program or some way to retrain it bit by bit, pushing it in a direction that is more accurate to reality. We use a very, very expensive high-tech tool to help connect somebody to reality, it’s called a wall, you may have one. Seriously, using the wall to focus your attention on one thing at a time, and because you can’t focus on more than one thing at a time because that’s what focus is, one thing at a time. You can’t focus on your head, your shoulders, and if you ever think of a golf lesson and had somebody try to-

Dr. Weitz:                         I golf every week. 

Dr. Weiniger:                    If you’re changing a sway, if somebody tells you three things to change, what happens?

Dr. Weitz:                         It’s really hard.

Dr. Weiniger:                    Okay, the best coaches pick the most effective thing to change. Focus on one thing and work on that. And we do the same thing with retraining posture. And this is what CPEPs do to retrain people’s posture, to help them find their weakest link in their chain.

Dr. Weitz:                         What part can chiropractic adjustments or other parts of a chiropractic treatment play in making sure you improve posture?

Dr. Weiniger:                    Huge, because when you have a collapse of the kinetic box, if there is a segment or the spine or a shoulder, and hip, especially lower extremity, a knee or an ankle that is not moving with symmetry, you’re going to have that adaptive motion pattern keep on recurring so the best results with retraining and strengthening posture include restoring motion to links in the kinetic chain that aren’t moving and parts we haven’t moved for a long time. So, you can then direct the exercise to that previously neglected, unused link and use strong posture exercises to strengthen it to move towards symmetry, beginning with the alignment of using the wall and focusing on one, what’s called the posture zone at a time. The first torso pelvis linkage, then head torso linkage, then lower extremity integration, and then upper extremity integration.

Dr. Weitz:                         What do you think about some of the chiropractic strategies that various chiropractic gurus have come up with to passively stretch the ligamentous structure back into a more efficient shape? Things like traction devices with a roll here, and a weight, and different types of things like that where you stay for a period of time, maybe with some weight or something like that to try to re-stretch the passive structures?

Dr. Weiniger:                    Not necessarily evil but if you’re only working on the passive structures and you’re not working to strengthen it, the moment you load it, if you’re adding more stretch, why is something that’s overly stretched already going to change? Your body is not just things that are as tight, it’s things that are tight paired with things that are lengthened. And if you’re not teaching it to actively move towards symmetry, you’re not going to be fixing it, moreover, in a kinetic chain because your body is a kinetic of chain.

                                       It’s not just your neck. I know a lot of chiros dial into forward head posture and that’s an important thing but if you’re not done with the whole body, you’re missing a big chunk of what should be addressed effectively strengthening in a kinetic chain. If there is a tight link and a loose link and you scratch the whole chain, which link moves first? Think about it for a second.

Dr. Weitz:                         Yeah, you’ve got to repeat that question for me. 

Dr. Weiniger:                    Okay. Before we talked about, in the spine, if a spinal joint isn’t moving, that means it’s tight, agreed?

Dr. Weitz:                         Yap, yap.

Dr. Weiniger:                    And so, within the entire chain, if one link is tight and one link is loose, and you stretch the entire chain, what does it stretch? Where it’s loose or tight?

Dr. Weitz:                         Yeah. I guess the problem is it’s liable to stretch the loose part because that’s already moving. So, that’s one of the reasons why chiropractic adjustments say, “Get in there and mobilize the-

Dr. Weiniger:                    Tangling.

Dr. Weitz:                         … junction,” it’s important.

Dr. Weiniger:                    And the thing about chiropractic, as we learned in school back in the day, is you need to find the restricted link of motion and then you need to take out the tissue slack. If you try to adjust somebody without taking it at the tissue slack, what happens is nothing because most is going to go up and down the chain and part of what in effect chiropractic adjustment is identifying a site and identifying the direction that it should be moving and tractioning it in that direction to take out the type of the slack in motion.

                                       If you teach someone how to move differently, you also need to be incorporating their personal awareness of how they’ve trained their muscular system to move, which means how they’ve trained then neurological system to move and to stabilize that muscular system to make the force move in a different pattern. The problem is, if the pattern that you’ve been moving in that feels normal to you and that’s what your posture truly is when you look at it from a global biomechanic perspective.

Dr. Weitz:                         And of course, the person who has forward head posture, they also usually have certain other postural issues, such as a collapsed thoracic spine, internally rotated shoulders, and you’ve got to address those concerns as well, right?

Dr. Weiniger:                    Right. In terms of looking at internally rotated shoulders is it because someone’s got a tight pec, or a weak serratus, or is the problem the rhomboid stabilizing that? But then how does that tie into the psoas, but in that case, we also have a problem with its glutes and piriformis is neglected and you can’t get what’s going on back on top with the upper extremity with coracobrachialis. And this is why, from our point of view, the approach of work on one muscle at a time becomes this, like, you’re keeping that very long chain.

                                       Whereas, working with global body awareness and motion to address how the global body is balancing, how it’s aligning, and how it’s moving and looking and focusing on one possible zone linkage at a time has incredible leverage from what patients and doctors, of course, do all the things to help them make a dramatic difference and how they feel how they move. Very often the sports performance as well if they’re athletes because we want to move the accurate to reality. And if you know you’re standing tall on screen, that’s the beginning point of all your motions. All motion begins with posture, all emotion ends with posture. So, that resting position is not just an arbitrary position, it’s your perception of where your body is in space and what you’re doing to keep it there.

Dr. Weitz:                       So, when you look down at the lumbar-pelvic region, what are some of the most common postural flaws? There’s a lot of discussion about the fact that you’re supposed to keep the proper amount of backwards lumbar curve. Some people train flattening neck curve. Other people work on making sure you have enough curve day. We have a Pilates program in our office and there’s always a big discussion of neutral, and what is neutral, and everybody defines neutral differently. Do you try to flatten the lumbar spine or recruit the deep abdominal muscles? Do you keep it slightly arched? How much arched? So, what do you see as some of the most important postural issues related to the lumbar-pelvic region?

Dr. Weiniger:                  You’re encapsulating the problem that we work to solve because one of the challenges is that different people playing these games, doing these things … Not playing games but doing work and therapeutic modalities like this have different personal histories and experiences, and when you step two steps back, it’s not about what the perfect lumbar curve is nor is it, to me, about the perfect cervical curve, it’s about strengthening the body that you have because … and you would despite the fact that your body might not be perfect. Moreover, if you’re like the rest of humanity, it probably never will be.

                                       We need to take care of back and treat you, or that we need to work out how to functionally strengthen the body that you have been given genetically and in the way that you’ve treated it and take those consequences of those actions and actions are consequences into effect, including things like injuries that have created patterns and strengthening how that unique system can function in daily life. So, to answer your question about lumbar curve, because the big question is that is, if it should be more, if it should be less, if it should be stabilized in this way, if it should be stabilized in that way.

                                       I said that the second principle of posture was balance. Your posture is how you balance your body. The first principle of posture, your body is designed to move. If you recall muscle anatomy, a muscle contracts, the quick motion. Muscles only contract. Muscles don’t push. Muscles are never ropes. So, if I’m pushing, it’s not my muscle pushing, it’s a combination of leverage of muscles being combined to create that but the muscle itself is only shorting. Within a muscle, the shorting happens because of shortening of a muscle fiber.

                                       A muscle fiber is an individual cell. A cell will shorten because a nerve impulse hits it and there is depolarization of the membrane, calcium ions rush in. You have two different fibers actin and myosin, and there’s a little head on one of the other. When the calcium rushes in it goes like this and it shortens. Anatomy 101, remember that from school? When an individual muscle fiber contracts, it contracts fully or it doesn’t contract. An individual muscle fiber cannot contract halfway.  Is that truth to you? Is that truth to everybody that knows anything about biomechanics?

Dr. Weitz:                       Yeah. I completely agree. However, there is certainly a lot of discussion about things that don’t quite fit into that paradigm, like somebody has a lot of tone in their muscles. They’re not necessarily … Their muscles are not stronger. They’re just more toned, or they’re harder, or they’re-

Dr. Weiniger:                  And that’s totally agreed. The resting muscle tonus will affect appearance, but in terms of gross anatomic function from Guyton’s Physiology on down, there’s no one that I’ve ever met that will say that the muscle fibers can contract fractionally, that a fiber can contract halfway. It’s fully contracted or not at all. 

Dr. Weitz:                       But when it comes to the lumbar spine, isn’t it the case that having the curve there, some amount of curve, gives the spine more resilience to be able to handle load? So, if you look at somebody-

Dr. Weiniger:                  The question about curve though I think is misplaced because the point that you’re making … The question is which is more stable? The argument is, this amount curve or that amount of curve, which opens the question of, “Which direction do you stabilize in towards neutral, which is where a lot of your Pilates that came from?” And if you have Pilates in the office, you might feel … and that’s where your orientation comes from and that’s why I went through that because we’ve had people from every different niche that look at posture-

Dr. Weitz:                       No. Actually, my orientation comes from weight training. I did the whole bodybuilder, power lifting, weight training thing and studied that for years and years and years, and even wrote a book called The Back Relief Book. So, I’ve really studied it from that. So, I kind of clash with the Pilates instructors a little bit.

Dr. Weiniger:                 And when you talk to them, one way despite the model that I’m still at right now, which is like hardcore science biology 101, maybe 102.  Data that you can’t possibly argue it. And my point is from in terms of principles of posture that pretty lights are also immutable, your body is designed to move. So, the best strategy is not to get really good at stabilizing in this angle, or this angle, or this angle, but teaching people how to move with fluid accurate control all the way through a functional range with that load and with stabilization in different directions. That’s why we use balls and a lot of tools to strengthen people. The whole motion track of these wrong posture exercises use balls but that’s only after we’ve started working with before that alignment and before that balance.  Because the way that you move is dependent upon how you align in order to balance-

Dr. Weitz:                      Let me ask you the same question.

Dr. Weiniger:                 I’ll come back to it. Working with full range comes first and then yes, a little bit of curve makes sense. How much curve? Depends what your body genetics are and that’s why feeling your body and working with that makes more sense than an arbitrary, “This is perfect and you should be like this.”

Dr. Weitz:                      Okay, let me add another layer or a different way of looking at the same sort of situation. When you’re working with a client with a specific type of injury or low back condition. So, let’s say in one case you have somebody who has a confirmed herniated disc in their lumbar spine versus somebody who say has bony stenosis, where the bones actually are narrowing the space where the nerves and the spinal cord comes out of and is leading to pain. Do you treat those two types of conditions in terms of the posture of the lumbar spine differently …? For example, if I have a patient with a herniated disc, we’re going to tend to use more of an extension strategy.

                                      Usually, I’ll test a person and you know if they feel more pain or they feel radiating pain when they lean forwards and leaning backwards doesn’t make them worse, I’ll tend to focus on having more of a curve in their lumbar spine or working on having them do more exercises that involve putting a curb there as opposed to the stenotic person where we’ll work on trying to flatten a lumbar spine. 

Dr. Weiniger:                 That’s not a bad direction. If you’re curious, sometime I might challenge you to try to work on that person a little bit differently and then observe if there’s any difference in your outcome. My anticipation is you’ll find that what you’re doing passively when you work with somebody, and passively is both chiropractic, traction, muscle therapy to unlock and to facilitate the possibility of motion in an arc is something that you do want to work with and with a plan and a direction. But once you unlock something, any additional exercise for a couple of times doing extension is going to be a good stretch to them and you want them to be able to have that kind of practice.

Dr. Weitz:                       Oh, sure. Yeah, we definitely do that.

Dr. Weiniger:                 But having them go in stretching directions that’s going towards their pain free range is the big idea, and using that pain as a diagnostic makes sense. But using the direction of that motion being with stronger posture to take out other compensations up and down the kinetic chain is one of the things that really makes a huge difference.  Because otherwise, if it’s a low back problem that was someone’s got a stenotic canal, the stenosis is likely not in just the lumbar spine.  Moreover, the symptoms did not just start with the onset of the problem.  The body has been compensating into that for a long time.

                                      So, there’s things don’t wind up and down the chain. So, when you look at the person that you’ve taken care of that’s got, for example, marked forward body lean as you were describing with stenosis and you look at their head, they’ve got that same kind of head forward posture with extension, and if you start to teach them how to incorporate that strong head torso position as well as doing the extension you’re doing, my anticipation is you’ll find the results are better.  Because you look at people doing it right now, most of them, if not all of them, are using some compensation in the top of their kinetic chain and below the kinetic chain.

                                         They do more knee bend and you’re saying something, “Well, you want to keep the knees more straight,” and one of the things that we do with the strong posture protocols is by tiering where you want to be focusing the effort, using what we call mass versus dry cueing, to focus some of the tension on this is the important thing right now to gain that control to the maximum of their biomechanic potential.  And then sequencing it in a direction, you can get a more profound change more systematically, because you’re making them focus on the things that they reflexively don’t want to move that are weak, because that’s where their reflexes are.

Dr. Weitz:                         Interesting. So, what about scoliosis or this curvature that some people have? Is that beneath the posture thing? Is that something you address as well?

Dr. Weiniger:                    I have addressed it. I’ve seen some cool things with it. Even though some CPEPs … CPEPs are Certified Posture Exercise Professionals the people that use the tools that we talked about and that teach … And they are chiropractors, largely, they’re also trainers and physical therapists, and Pilates teachers, and Feldenkrais teachers. And one of our CPEPs is Feldenkrais instructor of other Feldenkrais teachers, and yoga people, and anyone that looks at biomechanics like trainers. A lot of people, in their own practices, incorporate strong posture. I lost my train of thought, what were we talking about?

Dr. Weitz:                         Oh, scoliosis.

Dr. Weiniger:                    Oh, scoliosis. Scoliosis to me is more of a neurologic problem than a muscular problem and I know that there’s people that we trained in that direction using different kinds of braces that are potentially interesting, I know a lot of this stuff that’s been done historically is with surgeries and what not, and braces, and Harrington rods is … I’m less focused on that, some of the muscular as things going for scoliosis like Scott, and others in those directions, have reported decent results and we’ve looked at it but I’m not focused on scoliosis. I’m focused on overall body posture, because, if and when we come with a scoliosis program, there’s other things that I see that are not being effectively incorporated into it that should be and could be, and I think chiropractic should be a good part of it. 

I personally have had some wild, wild cool scoliosis cases but candidly, I’ve had some that haven’t responded as well. Incorporating things like kinesiotape, instrumented soft tissue mobilization are as some of the things that can be incorporated that makes sense. We have a lot of people that work in those realms and that’s good. I would say if someone haven’t grown scoliosis, beginning a seven-week strong posture program is an easy down and dirty way to begin and see what happens. Take a picture and see what happens, and that’s why taking the picture here is such a valuable way to benchmark rather than getting into how you feel and not what do you think, and it’s a lot easier than taking x-rays.

Dr. Weitz:                         Right, cool. Well, I think you’ve provided us with quite a bit of interesting information Dr. Weiniger. For patients, people who are viewing this or listening to this as well as practitioners, what’s the best way for them to get a hold of you?

Dr. Weiniger:                    Two different questions: if you’re a doctor or practitioner, go to posturepractice.com, that is information on CPEP, certified posture exercise Professionals program. It’s got the CPEP logo on it. If you are a member of the general public, I would suggest going to posturezone for overall information, and for both, I wouldn’t suggest going to posturemonth.org. May is posture month and we are the instigators, and they call me the chief posture evangelist of posturemonth.org. Posture is important and having a good awareness of posture begins with being aware, taking a picture.

                                          In fact, the campaign for 2018, for this month’s posturemonth.org a program is ACE your posture. A, stands for awareness, C for control and E for environment. Be posture aware, take a picture. As I said I like the PostureZone app and the app is … It’s not ready, it’s my camera. Basically, use the app to take a picture of somebody, not my office, but to take a picture of somebody and to measure where the body is in space, to measure … Can I share it with you? It’ll be good if I share.

Dr. Weitz:                          Yeah, sure, yep.

Dr. Weiniger:                     So, this allows somebody to assess somebody else’s posture, and can you draw lines on it as well? Okay, so let’s go back. I’m uploading up a picture-

Dr. Weitz:                          And this is a free app that we can download and put on our phone or our iPad.

Dr. Weiniger:                     It’s a free app. PostureZone is a free app for iPad, iPhone, and Android.

Dr. Weitz:                          Okay.

Dr. Weiniger:                     I don’t know if it’s going to work. If you can see this from there.

Dr. Weitz:                          Okay, yap.

Dr. Weiniger:                     Okay. I took this picture before … When you take the picture, there’s a line on the top on the bottom that you want to rotate it to make it level and that’s aside view, so it’s taking a side view. And I don’t even see the bracket, you can move around to bracket, the head, the torso, the pelvis over the feet, and you can double tap to make it a bit more precise in the pro version. To get a picture of where someone … Basically, your posture is how you balance your body. So, benchmarking when you’re trying to stand tall. It’s like as where’s your head or your torso, it’s where’s your head torso and pelvis over your feet because it’s about the whole body and then assessing the picture to benchmark the degrees of deviation of the head over the feet, the torso over, the feet and the pelvis over the feet when you believe you’re standing straight.

                                         And then you can save that in a folder and this is my messing around folder and compare today’s picture to prior pictures and see what kind of changes occur. If you’re a professional, the free version … If you’re a professional. It’s a one-time purchase, there’s no monthly things. I think it’s 29 bucks, and you can chuck the rate reports on and PDFs, and email amount and communicate to patients and people what their posture looks like and that’s what we do. If you’re a member of the public and you’ve got a question about your posture, if you look in the PostureZone app when you get it, there’s a button that says, “Find a posture professional.”

                                         And all hands on, there’s a CPEP near you that does strong posture work and that may be even be doing free posture pictures for the month of May, and if you would like to have a free posture picture, go to your CPEP and let him or her take your posture picture so you know what you will look like when you’re trying to stand tall.

Dr. Weitz:                        Cool. That app looks like something that would be really useful. I’m going to go download it as soon as I get off this call.

Dr. Weiniger:                   Fantastic. If I can give you a hand with it, let me know, doc.

Dr. Weitz:                        Thanks, doc. I really appreciate your time and we’ll talk to you soon. I’ll put your information in the show notes on my website.

Dr. Weiniger:                   And I forgot, buy Stand Taller Live Longer, its a prejudice but it’s a great beginning to understand more about posture.

Dr. Weitz:                        That’s great. Buy Dr. Weiniger’s book, Stand Taller Live Longer, and until then, we’ll see you next time.

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Lyme Disease with Dr. Darin Ingels: Rational Wellness Podcast 050
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Dr. Darin Ingels talks about how to manage patients with Lyme Disease with Dr. Ben Weitz. 

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

 

Podcast Highlights

3:15  Dr. Ingels explains that he got interested in Lyme Disease because he suffered with it and found that antibiotics were not the long term solution. He realized that taking herbs and changing his lifestyle were better long term strategies for treating Lyme Disease than taking antibiotics. 

5:25  We discussed the symptoms that might alert you to the fact that a patient has chronic Lyme Disease. Dr. Ingels pointed out that it can be confusing to diagnose Lyme, which is why it’s known as the great imitator. Patients may complain of brain fog, memory problems, dizziness, and balance problems.  There can be migrating joint point, numbness and tingling, and a sensation that there are ants crawling under their skin, or a burning sensation in the skin.  There can also be chronic swollen glands, fevers, and chills.

7:30  Dr. Ingels points out that Lyme is often associated with chronic rheumatological conditions like rheumatoid arthritis and lupus. Lyme can also be a trigger or catalyst for things like Multiple Sclerosis, Parkinson’s, and Alzheimers. Dr. Ingels explained that if you treat the Lyme their MS may get better or go away. He explained how when the immune system attacks an infection like Lyme Disease, through molecular mimicry it may then attack our own tissues and this can result in triggering an autoimmune diseases like MS.

10:40  I asked what is the best way to test for Lyme Disease?  Dr. Ingels said that the conventional testing is not very sensitive–say 40%–and the diagnosis a lot of times is based on clinical symptoms.  The testing is less accurate the further away you are from the initial infection.  He said that the testing offered by Quest and Lab Corp is not very accurate but testing offered by specialty labs like IGenx are somewhat better. 

15:32  Dr. Ingels recommended also testing for common Lyme Coinfections, like Bartonella, Babesia, Anaplasma, Ehrlichia, Tularemia, and a new virus called the Powassan virus, which has been responsible for a few recent deaths.  These are infections that are also spread by ticks.

18:03  Dr. Ingels described his 5 step plan for treating Lyme Disease: 1. Treat the gut, 2. Alkaline diet, 3. Herbal protocols, including the Zhang protocol and the Cowden protocol,  4. Clean up the toxins from your environment, like mold, 5. Lifestyle factors like sleep and exercise. 

28:34  I asked Dr. Ingels about using Ozone therapy, a commonly used modality among Lyme practitioners I know, and he said that the benefits of oxidative therapies like ozone and hyperbaric oxygen are short term and they are also expensive, esp. since you have to do quite a bit of it.  Dr. Ingels likes to use Low Dose Immunotherapy (LDI), which he finds very effective.

34:05  Dr. Ingels explains how you repeat his 5 step protocol again for patients who are still symptomatic.

 

 



Dr. Darin Ingels is a Doctor of Naturopathic Medicine practicing in both Southern California and also in Connecticut, who has a specialty in treating patients with chronic Lyme Disease and he has recently written The Lyme Solution: A 5-part Plan to Fight the Inflammatory Auto-immune Response and Beat Lyme Disease, which can be found on Barnes and Noble, https://www.barnesandnoble.com/w/the-lyme-solution-darin-ingels/1126791520   Dr. Ingels can be reached at https://dariningelsnd.com/ or you can call his office in Irvine at 203-254-9957.

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


 

Podcast Transcripts

Dr. Weitz:            This is Dr. Ben Weitz with the Rational Wellness podcast, bringing you the cutting edge information on health and nutrition from the latest scientific research, and by interviewing the top experts in the field. Please subscribe to the Rational Wellness podcast on iTunes and YouTube, and sign up for my free e-book on my website, by going to drweitz.com.

                            Let’s get started on your road to better health. Hey, Rational Wellness podcasters thank you so much for joining me again today. For those of you who enjoy this podcast, please give us a review on iTunes, it helps more people find out about the Rational Wellness podcast.

                           Our topic for today is Lyme disease, and we’re here with Dr. Darin Ingels. Let me tell you a little bit about Lyme disease first. So, Lyme disease is actually a very complicated and confusing disease that starts originally with an acute infection that can become chronic, and that goes on for years. Unfortunately a lot of people are not even aware that they have the initial acute infection, and this Lyme disease actually starts with a tic bite. Of course the tics can be so tiny that they’re very hard to see. And this results in an infection, with a corkscrew like bacteria, known as Borrelia Burgdorferi, although now we know that there are a number of different strains, including Borrelia, Miyamotoi, which is found more commonly on the West Coast, and a bunch of other strains found in other parts of the country and in other parts of the world.  After the initial infection, Lyme may create a chronic condition that’s very difficult to detect and treat. Such patients may not have any knowledge about having been bitten by a deer tic, and exposure could’ve been years ago. The Centers for Disease Control estimates that there are approximately 300,000 new cases of Lyme disease per year in the US, and this number seems to be increasing.

I’m happy that we have Dr. Darin Ingels joining us today to explain how to deal with Lyme disease. Dr Ingels is a licensed naturopathic doctor in both the states of California and Connecticut. His practice focuses on environmental medicine, with an emphasis on Lyme disease, pediatric acute onset neuropsychiatric syndrome, known as PANDA’s, and chronic immune disfunction, including allergies and chronic infections. Dr Ingels has published a number of books, including the Natural Pharmacist, Lowering Cholesterol, Natural Treatments for High Cholesterol, and his book, The Lyme Solution, a five part plan to fight the inflammatory auto-immune response, and beat Lyme disease, which will have been just released by the time this podcast airs. 

                           Thank you Dr. Ingels for joining us today.

Dr. Ingels:            Good morning Ben, thank you for having me.

Dr. Weitz:            So, Darin, can you tell us how you became so interested in Lyme disease?

Dr. Ingels:            Sure, I became interested in it because I got it. There’s nothing like some personal experience to give you a very quick education on how to deal with it. So I actually contracted Lyme disease about 15 years ago, 3 weeks before I was set to open my own practice. I had classic Lyme disease with headache, joint pain, 105 fever, and a big bullseye rash on the back of my leg.  And I underwent conventional treatment with doxycycline, and after four days of treatment I actually felt quite well. But in retrospect, when I opened my practice, as you know I was the doctor, the receptionist, the bookkeeper, and I was doing everything. So it was 10, 12 hours days, and after about eight months of keeping up that schedule, I started to relapse and get symptoms again.  So I went back on treatment, and it wasn’t working, it changed treatments, it didn’t work.

Dr. Weitz:            So your initial treatments were antibiotics, right?

Dr. Ingels:            Yeah, my initial treatments were doxycycline, which is the recommended treatment for acute Lyme disease. And I did take it for 21 days, even though I felt better after about four. But after eight or nine months of keeping up with that schedule, and I started getting symptoms again, when I went back on the doxycycline or the antibiotics, it really didn’t do anything.

Dr. Ingels:            So I changed antibiotics and it still didn’t do anything, and over the course of really eight or nine months I kept changing antibiotic protocols, but it wasn’t helping, in fact I was getting a lot worse. So I had actually had a couple of patients that had seen a doctor in New York City, a Dr. Zhang, who’s a Chinese medical doctor, and licensed acupuncturist, and he had been treating people with Chinese herbs.

Dr. Ingels:            So I saw him, he treated me, and it really got me 85% better in the course of about three to four weeks after starting his therapy. So I realized that I had kind of set the stage with my own lifestyle, that by not really taking care of my self it had allowed this organism to persist and eventually start to creep up and cause problems again.

Dr. Weitz:            Interesting. So what are the symptoms that would make you first suspect that a patient may have chronic Lyme disease? Because, you know, the acute disease with the bullseye rash, that’s relatively easy to know what’s going on, but the chronic patients, which is really the bulk of the patients that we might see for Lyme disease, and which is really the biggest problem, how do you identify that?

Dr. Ingels:            You know it can be challenging. We call Lyme the great imitator or the great mimic. It looks like a lot of different things, in fact there are upwards of 100 different symptoms that are associated with Lyme disease. So my feeling is when you have a chronic illness, if you’ve ruled out everything else and you can’t figure it out, that might be worth investigating.  But one of the things that we typically see in the chronic Lyme is this sort of myriad of different neurological symptoms, and people will complain of brain fog, short term memory problems, dizziness, balance problems. We can still see a lot of the symptoms you might see in acute Lyme disease, so people will complain of migrating joint point where it kind of wanders from joint to joint. One day it’s your left knee, one day it’s your right elbow, next day it’s your right ankle. You can see what’s called neuropathy, numbness and tingling, typically in your hands and feet, but really can occur anywhere on your skin.

                           People also describe what we call a sensory distortion where they’ll feel like there’s ants crawling under their skin, or a burning sensation in the skin. And you look at the skin and it looks completely normal, that tends to be associated with Lyme. You can also get chronic swollen glands, some people will still get fevers, chills.  So when you feel sick, and if it hasn’t been explained, and it’s been going on for not just a handful of days or even weeks, but when it starts to go on for months, that’s usually evidence that there’s some sort of persistent infection. And there really aren’t too many bugs that do that. So Lyme and some of these other co-infections that you can get through a tic bite tend to be associated with these long term effects.

                           So those chronic rheumatological symptoms, even things rheumatoid arthritis, lupus. A lot of autoimmune diseases have been associated with Lyme disease. And so it’s possible that Lyme really is the trigger or the catalyst for things like Multiple Sclerosis, Parkinsons, and Alzheimers.  If you go to your doctor and you ask him “Well, gosh, I’ve been diagnosed with MS. Okay, well why?” They’re not going to have a clue, and I think there’s some pretty good evidence in the literature that Lyme at least can be one of these organisms that triggers that kind of problem.

Dr. Weitz:            So, if Lyme is a trigger for some of those problems, if you go back and address the Lyme, will that help that condition, like MS or some of the other conditions you mentioned?

Dr. Ingels:            Absolutely, and I’ve treated several patients who were diagnosed with multiple sclerosis, that we also found out they had Lyme disease, and in treating their Lyme, their MS improves and sometimes even goes away. All the symptoms, and I’ve even had a couple of patients where they’ve had a repeat MRI, that’s part of how you diagnose MS, and there’s typically specific lesions you see on the brain, and we’ll see those lesions go away.  So was it MS?  Was it Lyme disease?  It gets to be a bit complicated, and I think the neurologists out there might have a different opinion on this, but a lot of these conditions are really descriptions, and they don’t specifically tell you why you have that condition. But again, I think there’s been some pretty compelling evidence that Lyme disease can become a trigger for autoimmunity. And whether it’s affecting your joints, or affecting your brain, that seems to vary from person to person who gets Lyme, but again, a lot of the issues that come up with chronic Lyme disease, there’s really this capacity for it to trigger autoimmune problems.

Dr. Weitz:            Is that because essentially when we’re dealing with Lyme disease, your chronic Lyme disease, we’re really not so much dealing with an infection, but with a condition of immune dysregulation?

Dr. Ingels:            Yeah, you know I think the infection is the initial problem, that’s why people feel acutely ill when they get affected. But the longer it stays in your body, there’s a concept in immunology called molecular mimicry, and what that means is that there’s a molecule on the organism that’s similar to a molecule that’s in your own body. So the immune system tries to fight the infection, it accidentally starts fighting your own tissue.  And so whether it’s in your joints, your intestinal tract, your skin, it really can affect any tissue. But again, there’s been some good evidence and studies that Lyme has this capacity to trigger that autoimmune event. And I think in most cases the brain and the neurological tissue just happens to be more affected perhaps than others.  So any of these autoimmune conditions, whether it’s Lyme, and there’ve been a lot of other organisms that have been identified as trigger autoimmunity, I think it’s important that people start investigating that microbe trigger. And fortunately we have a lot of different ways we can evaluate them.

Dr. Weitz:            Well when you suspect Lyme disease, what’s the best way to confirm that, or test for it?

Dr. Ingels:            The testing is a bit controversial, the CDC recommends what’s called a two tiered testing, where the first test is a Lyme screen, it’s a blood test, it’s an antibody test. And if that test is positive, it then flexes over to a more detailed test called a western blot.  The general rule is if your Lyme screen is negative, they don’t even do the second test. I was a microbiologist before I was a doctor, I used to work in a lab and do these tests, and in the laboratory world, a test to be a good test has to be both what we call sensitive and specific. So what are the likelihood it’ll pick up the disease if you have the disease? And if the test is positive, what is the likelihood that that’s an accurate result and not a false positive?

Dr. Ingels:            And a good test should be at least 95% sensitive and specific. Well, what we find with the Lyme testing is that it’s about 40% sensitive, which means it doesn’t even pick up half the people that have Lyme disease. In our world that’s a terrible test, so I find it ironic that in 40 years of doing Lyme testing, we’ve really never changed that criteria. And we’ve learnt so much about Lyme disease that it just seems odd that nothing has really changed in how we’re looking at Lyme.  So if you go to the CDC’s website and read, Lyme disease is really what we call a clinical diagnosis. It’s based on your symptoms, particularly if you live in an area that’s endemic for Lyme. Plus you have to rule out all these other things like autoimmune disease. And when you’ve done that, that sort of starts narrowing it down. If your Lyme test comes back positive, false positives with Lyme tests are actually quite rare, but false negatives are extremely common.  So the bottom line is that a negative test through the conventional testing methods doesn’t necessarily exclude the possibility of Lyme. Now, the good news is we do have other labs out there that do more sensitive testing, they use different test kits. They also report it in a slightly different way, that increases your likelihood of picking up Lyme.

                            So, if someone’s really interested in getting tested, I recommend going to one of these labs that does better Lyme testing, and probably forgoing the standard Quest, Lab Corp test, just because of the small likelihood of picking it up, particularly the further you get away from being infected. Because we’re measuring antibody levels, your antibody levels should be highest closest to the time you get infected. The further you get away from that, immunity naturally wanes. So the likelihood of picking it up two years, four years, ten years after you’ve had exposure goes way down.  So, I think if you use some of the other labs out there, you increase your likelihood of picking it up.

Dr. Weitz:            Have you used Dr. Vojdani’s Immunoscience lab?

Dr. Ingels:            I have used his occasionally. There’s a lot of good labs out there, Immuno science I think does a good test. IGeneX, are probably the one that most people in the Lyme community use. They’ve been around a long time and they do very good testing. I also use a lab called Medical Diagnostics Laboratory in New Jersey. I like them, I think their testing is equivalent to IGeneX, plus they bill insurance. So for a lot of our patients who’ve already paid so much out of pocket, it’s nice that you can actually bill something to your insurance plan.

                           And then there’s a new lab that just came out, in fact I’m actually on their scientific advisory board, called Global Lyme Diagnostic. And the doctor that developed their test is actually a vaccinologist, and he was tasked to find a vaccine for dogs, for Lyme disease. But to create a vaccine you have to find something that’s very common to all these different strains of Borrelia. We know that in the United States there’s about 100 different strains of Borrelia, and there’s about 300 strains worldwide. We don’t even know how many of them are clinically relevant, our guess is it’s probably somewhere from 10 to 12.  So he had to find a sequence of part of the organism that’s common to all Borrelia, and so instead of making a vaccine, he actually turned it into a laboratory test. And because Borrelia Burgdorferi is the dominant strain, there are these other strains like Borrelia Miyamotoi, and many others. So this test actually looks at all the different strains of Borrelia.

Dr. Ingels:            The testing, I did mention it earlier, but the testing that’s available through what the CDC recommends, only really looks at Borrelia Burgdorferi. So if you happen to have another strain of Borrelia, either your test might be negative, or it might look kind of gray where maybe you get one or two antibodies, but not the full complement that you might expect.      So this is where we come back that a negative test doesn’t necessarily exclude the possibility of Lyme, because maybe you have a different strain of Lyme that’s not Borrelia Burgdorferi.  So the good news is we’re getting better in our testing, we have a lot more available to us, but again, at the end of the day, that piece of paper is really only confirming what we really already suspect, and you really have to go based on patients symptoms.

Dr. Weitz:            And is it valuable as well to test for some of the common Lyme co-infections like Bartonella, Babesia, et cetera?

Dr. Ingels:            Absolutely. So whenever we’re working anybody up for Lyme disease, you want to test for all these other co-infections. We know that in New England, where I spent part of my time, about a third of the tics that have Lyme disease also carry some other infection. I go to these Lyme conferences every year, and it seems like that list of things that tics spread gets more and more every year.  I don’t even know how practical it is to test for everything, now that we know that there’s a lot of bacteria, other viruses that can be transmitted through these tics. So we tend to go for at least the big ones, and then depending on what we find sometimes we have to start looking at the more obscure things that you can get through tic bites.

But things like Bartonella, which is a bacteria that we typically associate with cat scratch fever. So even if you never have a cat, you can get this bug through a tic bite. Babesia, which is a cousin of malaria, it’s a blood parasite so it causes a lot of malaria like symptoms where you can get cyclical fevers. And there’s a thing called air hunger where you just feel like you can’t get a deep breath. Anaplasma is actually quite common in the North East, which is another bacteria. There’s Ehrlichia, there’s Tularemia, there’s a lot of other things.  And I think the one that’s come out in the last year, especially in New England, is there’s a virus called Powassan virus. And viruses, because they behave differently than bacteria and they’re able to penetrate your cells a little more easily, can potentially cause a lot more problems. So Powassan was scary this year because there were actually several deaths associated with Powassan.

Dr. Weitz:            How do you spell that?

Dr. Ingels:            It’s P-O-W-A-S-S-A-N.  So for someone that’s got a really high fever, very acutely ill, particularly if you know that there’s a tic bite, there are a couple of labs now that are testing for Powassan virus.  But antibiotics don’t do anything for viruses, so I think what happened in those few cases is that they were probably treated with antibiotics, but it’s not the appropriate treatment, and unfortunately it was lethal in those cases.  Again, it’s an emerging virus, we haven’t had a lot of cases, but the few cases we had have been very severe.  So, it’s just one of those things that depending on how people are presenting, you have to rule out the possibility of having more than just Lyme, and look at the breadth of all these different infections you can get through a tic bite.

Dr. Weitz:            Can you talk about your five step plan for overcoming Lyme disease?

Dr. Ingels:            Sure. So, you know, I laugh when I say it out loud, a five step plan, it makes it sound so easy. Lyme disease is actually very complicated, but I was trying to condense it into a way that could really help people focus on some of these things that I see as really being obstacles for people getting better when they have Lyme disease. So, I don’t mean to simplify Lyme in any way, but this an easy way for people to think of it.

                             So the first step is really about treating the gut. And the reason is that your gut accounts for about 80% of your immune function. So if your gut’s not functioning well, your immune system’s not going to function well. And so many people I see with Lyme have chronic constipation, chronic diarrhea, poor digestion, gas, bloating, the whole gamut of things.  So, it tells me a little bit that your body’s ability to digest your food, absorb your food, might be compromised. And since you need all that nutrition to drive the rest of your engine, we want to make sure that all that’s working properly. So it’s important that people take stock of how their elimination is, their digestion, and you should be having at least one to two bowel movements a day.    I’ve had doctors tell patients that they poop once a week “Oh no, that’s fine. That’s normal.” That’s really horribly constipated, that is not normal. So it’s a good idea to take stock of how you’re eliminating, and then again I talk about in the book, there’s a lot of things we can do nutritionally to help support better bowel habits.  So things like glutamine can be very nutritive to the gut, to help heal the large intestine. Of course probiotics can be beneficial to help repopulate the gut, particularly if you’ve already been on antibiotics for Lyme disease. Antibiotics of course do set the stage for having an imbalance in your gut floor, or creating an overgrowth of yeast. So I use a lot of probiotics. And then we can use things like fish oil, and curcumin as natural anti inflammatories to help quell any kind of inflammation of the gut.

            So the first step is really let’s get the gut in good working order. The second step is really about diet, and I’ve tried a lot of different diets with people. There’s the paleo diet, the anti candida diet, of course the keto diet is very popular now. And having tried a lot of different things, the diet I’ve found for myself and for my patients that seems to work best is what we call an alkaline diet.

Dr. Ingels:            And what that means is that you’re eating foods that help promote better alkaline PH in your body. So for people who don’t know, PH tells us about how acidic or how basic your body is. It talks about your body chemistry. And virtually all your cells, with exception of your stomach, your bladder, and for women the vaginal area which is very acidic to help protect against outside invaders, the rest of your body is actually very alkaline.  So, by eating certain foods we can help keep that PH more balanced. And we get exposed to so many things in our world that make our body very acidic, whether it’s chemicals, medication, acid rain of course affects the PH of the foods that we eat. So that tends to make us acidic. And it’s a lot of details to simplify it for our purposes here, it’s basically eating a mostly vegetarian plant based diet.  We try to limit animal intake, so that’s meat, fish, shell fish, eggs, we try to keep that down to about 20% of your total dietary intake for the week. And then we eliminate all junk foods, all dairy, coffee, I know, I love coffee, but I found for myself even a few sips of coffee would trigger inflammation in my body. So if you’re a coffee drinker, it’s a good idea to start working on weaning that off.

                          And it’s not really about the PH of the food, it’s about what the food does in your body. So for example lemons and limes are very acidic, if you squeeze them on a PH strip they’ll turn very acid. But in your body they break down in a way that actually makes your body very alkaline. So starting your morning with a glass of lemon water or lime water is actually a great well to help start moving your body in a more alkaline state.  And this is one of these things where people can buy PH strips and they can do urine testing before they eat in the morning and later in the day. And they can monitor their progress, and kind of show how their body’s moving, whether it’s more acidic or more alkaline.  And it takes a little time and a little practice, but once people start to shift their diet we’ll see that they’re able to maintain that body PH a little bit better.

                         So that’s the second step. The third step is really about going after the active infection. So I talk about a lot of herbal protocols that I’ve used on myself, and I’ve used on my patients, to help treat the infection. I think when a lot of people get Lyme they feel like antibiotics are the only option, and in acute Lyme I’m a big proponent of antibiotics. I think for a lot of people it helps get rid of the infection before it ever gets to be a problem. But once you’ve gotten into the chronic stage there’s actually not very good evidence that antibiotics are terribly effective.       And I’ve heard people, and I’ve seen people who have gone on antibiotics and did okay, but I’ve seen a lot more people that went on antibiotics and got worse, or it did nothing at all. Or they had a temporary benefit, and as soon as they came off the antibiotics they started to relapse again.

                       So I talk about some of the herbal protocols I’ve used, if you go online and read about herbs there’s probably eight or nine different protocols out there. The top two that I tend to use, again, Dr. Zhang has a Chinese herbal protocol, that’s what I used to pull myself out of the weeds. And in Chinese medicine they always use formulas, they never really use single herbs.  So I like his protocol because it really addresses the gamut of everything Lyme does to your body. So not only does it go after eradicating the organism, it helps improve circulation, it helps boost your immune system, it’s anti inflammatory, it’s analgesic. So it does all these over things that Lyme can do to the body. So I think it’s really one of the more comprehensive herbal protocols out there.

                       And I’ve also used a variation of Dr. Cowden’s protocol. So Lee Cowden was a cardiologist in Dallas, I think he’s retired now, but he created a series of tinctures that come from the Amazon. And I like them because they’re liquid, so they’re great for kids who have Lyme disease that can’t swallow capsules. And his protocol’s actually been studied by a research at the University of New haven, here names Dr. Eva Sapi. And she’s actually found that those herbs worked better than antibiotics. So if people are concerned “Oh Gosh, herbs aren’t very effective,” well she’s actually proven that’s not the case.

                      So, going after the active infection is important. People ask all the time “Well, do you ever really get rid of Lyme?” My personal opinion is I don’t think so. I think it’s kind of like when you get chicken pox when you’re five years old and then get shingles when you’re 55, it’s the same virus that’s stayed in your body for 50 years. Oh, and the immune systems become compromised, it can start to become problematic.  So I think dealing with Lyme is really about controlling the organism, keeping it at bay, keeping it from getting to the point where it tips the scales that you become symptomatic. But because we can’t measure the organism directly in your body, at least not easily, we don’t really know if you completely eradicate it 100%. But my feeling is if we can get you to a point where you’re symptom free, then we’ve done a positive thing.

                   The fourth step is really look at things around your environment that undermine your immune system. So this is looking at things you put on your body, and in your hair, personal hair products that might contain potential toxins. Cleaning chemicals around the house, things you spray on your lawn. All these different chemicals can have a negative impact on your immune system, and we want to give your immune system every fighting chance it can.

                    And the one thing I probably talk the most about in that part is mold. Pretty much no matter where you live in the country, mold can be a bit of an issue. And symptoms of mold exposure or microcytotoxicity look almost identical to Lyme disease. When I have patient where we know they have Lyme disease, we’ve been doing Lyme treatment and we’re really not seeing a lot of progress, the next step is to look and see if mold might be part of the problem, because the treatment of course is going to be very, very different.  So evaluating your home, making sure your home is safe and free of mold. It’s always a good idea, particularly if you live in areas where there’s a lot of moisture or humidity, they tend to be at higher risk of having mold. And you could have a pinpoint hole in your roof and never see it through your walls, but there’s enough water that’s collecting there that creates a mold issue. So always a good idea to check that out.

Dr. Ingels:            And then the last part of it is really looking at lifestyle factors. Looking at things like how well are you sleeping. We know that your brains and your neurons repair themselves when you’re in that deeper start of sleep, and a lot of people I see with Lyme disease will tell me that after they got Lyme they started sleeping very poorly.  So whether they’re not getting enough sleep, or not getting a deep sleep, we have to find ways to encourage better sleep habits, to get you to that deeper start of sleep, because that’s when your brain and your body’s really going to start repairing itself.  And then looking at things like exercise, moving your body. I’m sure you know in your practice too when you get people who are chronically ill, the last thing on earth they want to do is move their body. But trying to find ways to get your blood moving is part of the way that we can help bring oxygen, nutrients to the tissue.

                           So, even for people who are in wheelchairs and are very limited in their abilities, if find that you can do stretching, you can do very mild forms of exercise like Tai Chi or Chi Kung, that are very low impact, but they still have a positive benefit on both your physical body and your mind.  And with regards to the mind, I think teaching people how to deal with the stress of having a chronic illness is really important. We tend to focus so much on the physical aspect of Lyme disease, we kind of ignore that psycho-emotional aspect of Lyme, and what it’s like to be chronically ill. And the impact it has on you, your spouse, your loved ones, your family, your friends. It’s very stressful, and at some point your friends and family get tired of hearing about it.

                           So I think it’s really important that people have a good support network, have a system in place, whether it’s a therapist or a support group they’re involved with. But have some outlet that you can share your experience openly and without judgment. And just finding different ways to help manage stress.  So, that kind of rounds out the five parts to the plan, and then in the book I have one chapter that talks about various therapies you can do in conjunction with your healthcare provider. But those are therapies that really need to be medically supervised, so it’s something you’ll want your practitioner on board with. 

Dr. Weitz:            Yeah, I read through that section and there was quite a number of interesting therapies. One that I didn’t see there that a lot of Lyme practitioners talk about is Ozone. What do you think about the use of intravenous Ozone?

Dr. Ingels:            My experience with oxidative therapy is both Ozone and hyperbaric oxygen, is it tends to be I think more of a short term benefit. I went through Ozone myself, I would feel better for a day or two and then I was right back to square one. And I’ve had several patients that have had similar experiences.  I think Ozone probably has a lot of benefit, particularly for people with acute Lyme disease, because it does have a nice anti microbial affect. But if you’ve gotten to the point where it’s not just the infection anymore, it’s really more of an auto immune issue, I don’t know how well the oxidative therapies are going to help with flipping the switch on the autoimmune process.  So again, my experience with oxidative therapies has been perhaps a little bit disappointing, and I know a lot of my colleagues who do Ozone therapy that tell me how wonderful it works. Unfortunately it hasn’t been my personal experience or my experience with my patients.  So, the other thing we get into is most oxidative therapies tend to be pretty expensive for people, and it requires if you’re going to it you kind of have to do quite a bit of it to get the potential benefit anyway. So again, I find in my population that the cost and the time of doing it for most people is somewhat prohibitive.

Dr. Weitz:            So of all those specialized therapies that you have in that section, which is the one that you would think would be most useful adjunct for most people?

Dr. Ingels:            The one I think I get the most bang for the buck is what we call Low Dose Immunotherapy. Low dose immunotherapy, or what we call LDI for short, was developed by Dr. Ty Vincent. He’s a medical doctor in Hawaii, and it’s basically build on the concept of using a microbe to help turn off the reaction to what that microbe’s triggered.   So in my ways it’s a bit of like homeopathy, of what we call isopathy. We basically take a dead bug, we dilute it out, and we mix it with an enzyme called Beta-glucuronidase. And we’ve found in the allergy world is that this enzyme has the capacity to alter the way your immune system reacts, to whatever it’s mixed with.   So if we mix it with dead Lyme, dead Bartonella, dead [inaudible 00:30:59] virus. If that organism has triggered any kind of auto immune issue, we think it’s working at the level of the immune system that switches that, or flips that switch, to try and help turn off auto immunity.  So I’ve had a lot of patients who’ve undergone a lot of different therapies for Lyme. Didn’t have a lot of success, and this is one therapy that really helped turn the tide for them. So there about 100 or so practitioners I think around the country that are doing this therapy now. So if people get stuck in their Lyme treatment, I think this is a great therapy.

Dr. Weitz:            And for people wanting to learn more about Low Dose Immunotherapy, a few episodes ago I interviewed Dr. Karima Hirana, specifically we talked about Low Dose Immunotherapy.  

Dr. Ingels:            Yeah, that’s wonderful. I know she does a lot of it in her practice, but, again, it’s one of these things that depending on the organism, so whether it’s Lyme or Bartonella Babesia, we can really use it for any of these microbes that might become immune triggers. In some cases it might be more than one, so if you’ve got Lyme and Bartonella, or Lyme and Babesia, we can use these different dilutions to help figure out what’s causing the problem.

Dr. Weitz:            So, of your patients in your clinic, I’d like you to give me just an estimate of the number of patients with Lyme who go through your five step protocol, how many of them are cured permanently would you say?

Dr. Ingels:            Oh gosh, the C word! Cure is a tough word. I mean I’d say probably 80% plus of my patients improve. In terms of what percentage get to the point where they’re 100% symptom free, that’s hard to measure because it happens over the course of such a long time. I’d probably say we can get 50% plus to the point where they’re symptom free. I have a lot of other people that get a lot better and sometimes they still have a nagging symptom.  It’s so hard because … It’s a little bit like filling up a bathtub and draining it at the same time, there’s so many other things going on in people’s lives and world that undermine their immune system that we’re constantly trying to battle all of those different aspects of what they’re eating, what their lifestyle’s like, what their job’s like.

                            My office is in Connecticut, I’m in suburban New York City, so everyone I work with there is pretty much a Wall Street person. You know these Wall Street people work ridiculous hours, and they’re up early for the stock market. So how easy is it for your body to heal when you work 14 hour days, and you’re commuting four hours a day? It’s tough.  So I think that often becomes a limitation on people’s ability to really get well, and sometimes it’s just a practical matter that it’s a little bit challenging to overcome.   But I want people to understand that there is hope, there is a way to get there, and again, I feel like I’ve had as good success, or more, than most other practitioners, because, again, we’re not just focusing on killing the bug, we’re really trying to expand and deal with all these other issues that Lyme creates in the body.

Dr. Weitz:            I know it’s in your book after you go through these five steps and talk about a few other things, you go back and explain how a patient would go back through those five steps again, and elaborate on some of the details that you didn’t elaborate on the first time.

Dr. Ingels:            Yeah, you know when people go through that five step process, if you get to a point where you find that you’re not really getting the improvements you expect, I think it’s important that first and foremost is it really Lyme or is there something else going on? My experience has been when we go through this process, and particularly for people who get no improvement at all, my thought is that there’s probably something else going on beyond Lyme.  And again in some cases it may be that they’ve had some other exposure that we didn’t identify, there was some other chronic stressor that I didn’t know about, that we weren’t really dealing with. So the first step is really look at other aspects of your life that might be contributing to the way that you feel.

                           And then beyond that, I always ask people to be really honest, I mean have you really done everything that we asked you to do? And in some cases people are like “Well, kind of. I kind of followed the diet, but not really, because it’s really hard.” So if you only do it 50% you might only get 50% improvement. So it’s important to take stock and be honest with yourself, are you really following the steps?  But for people who legitimately follow those steps, do everything we ask, get stuck, again, first and foremost I think it’s just a function of looking at other things that might be contributing to their health. And again, sometimes we’ll do other blood tests, other imaging studies, and we’ll find there actually is something else going on that we didn’t identify initially, and that might explain.   So work with your healthcare provider in trying to dig a little bit deeper and find those causes.

Dr. Weitz:            I noticed when you were talking about the gut, I wonder if you don’t find sometimes that patient with gastrointestinal symptoms like gas, or bloating, or discomfort, et cetera? Maybe they have some form dysbiosis, or small intestinal bacterial overgrowth. Do you ever have to go back and treat that, and clear that out in order to get a complete recovery?

Dr. Ingels:            Yeah, and the one you just mentioned there, SIBO, small intestinal bacterial overgrowth, is a very common one. In fact, I had one patient who she went through her Lyme treatment, she did well, and she got maybe 70% better, but she was still having neuropathy, numbness and tingling in her feet. And then we did a SIBO test and she was positive, and when we treated her SIBO her neuropathy went completely away.  So, yeah, we talk about gastrointestinal health, I mean part of my standard workup is we typically do stool testing on pretty much everybody with Lyme, just to make sure. And particularly if you’ve been on antibiotics, but if there’s a lot of gas, bloating, reflux, symptoms that might suggest SIBO, we might also do a SIBO test at the same time just to try and rule that out, because if you’ve got SIBO and you keep doing all the other Lyme treatment, yeah, you’re going to hit a wall at some point because you haven’t really addressed that issue.  So when I talk about gastrointestinal health we’re really talking about from top to bottom, from your mouth all the way down. So what’s going on in the stomach, looking at H Pylori, looking at SIBO, looking at any kind of parasite infection, overgrowth of yeast, all of that becomes very important in how well your gut’s functioning.

Dr. Weitz:            Awesome, Darin, I think we’ve got a lot of very useful, interesting information from you today. Thank you for sharing that. For listeners, viewers, practitioners, who’d like to get hold of you, what’s the best way for them to find out more information and contact you?

Dr. Ingels:            The best way is just to go to my website, it’s dariningelsnd.com, D-A-R-I-N-I-N-G-E-L-S, N as in Nancy, D, .com. And we’ve got a lot of great information, we’d love people to sign up for our newsletter. And I’ve also got a free chapter of my new book that you can download, or we also have a free e-book of my top 10 immune boosting recipes, that we’d love people to have.  So please sign up, follow us, and we’d love to help share some more information about Lyme disease and other things that we deal with.

Dr. Weitz:            And where can they get The Lyme Solution

Dr. Ingels:            The Lyme Solution, well as of now, I’m one week away from when it actually comes out, so it’s available through all your major book retailers like Amazon or Barnes & Noble for pre-order. But the book itself drops on March 27th.

Dr. Weitz:            That’s great, we’ll be looking for that Darin. Thank you for joining me today, and I’ll see you in a few months at our functional medicine meeting.

Dr. Ingels:            All right, thanks Ben.

Dr. Weitz:            Thanks.