Healthy Skin with Dr. Trevor Cates: Rational Wellness Podcast 053

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Healthy Skin with Dr. Trevor Cates: Rational Wellness Podcast 053

Dr. Trevor Cates discusses how to create healthy, glowing skin with Dr. Ben Weitz.

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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, 

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,  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:

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

                             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, 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, 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

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.

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