Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Medical Intuition with Wendie Colter: Rational Wellness Podcast 99
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Wendie Colter discusses Medical Intuition 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. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]

 

Podcast Highlights

2:32  Medical Intuition is a skill set of being able to view the body and energy systems using visual intuition.  While there are medical intuitives, this can also be used by physicians and healthcare practitioners in helping to support a diagnosis by adding the information derived to the history and test results to help the patient to find the correct path to healing. 

5:50  One of the advantages of medical intuitives is that they can help in difficult cases where there is no clear diagnosis based on the test results and history.

8:16 When a doctor or practitioner is choosing which type of treatment or recommendation, intuition can play a helpful role. Wendie said that sometimes those practitioners who use and trust their intuition are often the doctors who are the most successful and sought after.

14:37  From a physician’s perspective, this intuition can be developed with the proper training. Wendy’s Practical Path program that teaches medical intuition helps healthcare providers to be able to better use their intuition and to learn a protocol of asking and receiving instructions from the body using the “meta sense” of visualization. This means seeing things through your mind’s eye–using your visual sense to see into the body and discern information about it.  Wendy notes that she developed her medical intuition over time and does not feel she was born with it.

 

 



Wendie Colter is a Medical Intuitive and she has effectively taught doctors, nurses, psychologists, therapists, energy workers and health professionals of every kind, how to use medical intuition in their practices.  She founded The Practical Path in 2009 to present her unique programs in intuitive development for health and wellness, including the Medical Intuitive Training, which offers certification and accreditation for continuing education. 

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



 

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.  Hello, Rational Wellness podcasters. Thank you so much for joining me again today, and for those who enjoy listening to the Rational Wellness podcast, please go to iTunes and give us a ratings and review. That way, more people will find out about the Rational Wellness podcast.

Our topic for today is medical intuition, with Wendie Colter. Medical intuitives often feel like they can see inside of the body and detect physical problems without physically examining the purpose or looking at any test results.  Intuitives often link illnesses to any individual’s thoughts, emotions, and past traumatic experiences, but such intuition can also be included within an evidence-based doctor’s approach to treating patients, though many physicians are reluctant to talk about or accept such ideas.

Wendie Colter is a professional medical intuitive for 20 years, and she’s one of the very few medical intuitive trainers in the United States. Based in Los Angeles, Wendie founded The Practical Path in 2009 to help her present her educational programs in intuitive training, and she has effectively taught doctors, nurses, psychologists, therapists, energy workers and health professionals of every kind how to use medical intuition in their practices. Wendie, thank you so much for joining me today.

Wendie Colter:                  Thank you, Ben. A real privilege to be here.

Dr. Weitz:                          And I want to say to all my listeners that this is a little bit outside of my normal wheelhouse. Definitely more right brain, more … I tend to be very analytical and scientific-based in my thinking. So Wendie, can you start by explaining, what is medical intuition?

Wendie Colter:                  Absolutely. Medical intuition is a skill, that’s a skill set of being able to view the body and the energy systems using visual intuition. And that’s a very specific kind of intuition, and it’s an interesting thing to teach, and it’s an interesting thing to talk about, because it is very right brain, but it’s also a wonderful melding of left brain knowledge and right brain intuitive ability.

Dr. Weitz:                         What are some of the benefits from medical intuition?

Wendie Colter:                 Well, the certified graduate students of the program, who are from a broad variety of areas in healthcare, from physicians to nurses to complementary alternative and integrative, and mental healthcare too, they all use it in different ways. But what they’re doing is getting deeper information on the issues that their clients or patients have, so that they can help them find the correct paths to healing for them.  So, for someone like you, and perhaps an MD, it might be a support for diagnosis. And we’re finding that a good deal of the physicians are using it in case review time when they really have time to take a look at what’s going on for there patient, and they’re finding … and I’ll talk a little bit about the survey that we’ve done and the study that’s coming up through USCD School of Medicine, where we’re finding these very, very, high accuracy rates in terms of what they’re discerning from the body’s energy bio field, and the information that they’re getting or receiving through this process.

Dr. Weitz:                        So, is medical intuition essentially a form of energy healing, or is it, you know …

Wendie Colter:                It’s actually not. People tend to put this sort of thing in with other forms of energy or biofield work like reiki or healing touch or things along those lines, but it’s actually not that. It’s a foundational skill that can be used in any healthcare protocol, or any healthcare perspective.  And that’s, again, why we get this very broad scope of practitioners in the program, because it gives you some wonderful abilities … “Abilities” is a funny word, but wonderful skills in being able to receive information that you wouldn’t necessarily have gotten from a blood test or an examination, that has to do with the underlying causes and reasons for the imbalance.  And that’s a perspective that’s just starting to get into the medical world, that your emotions actually have something to do with your physical body, and your life experience and your life history actually will make a difference in terms of what kind of issues you’re experiencing. And that’s really the cornerstone of medical intuition, is that that is the case. We see that. We understand that. And that’s not new to medicine at all, right?

Dr. Weitz:                       So now, medical intuitives, I mean, one of the advantages … Is one of the main advantages for cases that are difficult to solve or understand, where maybe the tests aren’t clear? Is that one way to think about this?

Wendie Colter:                Oh, definitely. And just for that reason alone, that’s a huge, huge value to medical intuition, right off the bat.  And I have many case studies and whatnot, case reports from my own career as a medical intuitive, from my own work, and from my students.  In fact, one of the things we’re doing right now is surveys with a cohort of patients at UCSD, who call themselves Project Apollo. Wonderful people, about 30 to 40 patients, who put together this group because they are the hard-to-diagnose people.  They’ve got difficult issues that span a range of potential causes, and that group and my certified graduates, we’re doing surveys with them and finding just a ridiculously high, in the upper 90% accuracy rate in terms of the medical intuitives being able to see where in the body and what’s going on, where the imbalances are, where the blockages are, where the history is for these wonderful people to find paths to healing.  And as a medical intuitive, you might imagine I get all the tough cases, right? People who haven’t had a satisfactory diagnosis. People who feel like they’ve been ping-ponged around the medical world, and not really had anything definitive come through.  And so, you asked if it was a healing modality. Healing happens, and if you think about mind-body-spirit, or mental-emotional-physical and all the rest of it, that is absolutely part of it.  However, what I do as a medical intuitive is see where healing can occur.  There are just not biases about it, in other words. It may absolutely be the surgery, the drug.  It might be complementary alternative, but I have sort of a broad job in terms of what I need to do when I look at someone’s energy.  I think I went off the track with your question, I’m sorry.

Dr. Weitz:                            Okay, okay. No, that’s okay. So, to understand how maybe it fits into my practice or somebody like me, so I’m thinking that when I’m treating a patient, after I’ve done a diagnosis, done some physical exam, taken their history, on the chiropractic end, I have certain protocols.  But then, there’s always some selection involved in, “How exactly am I going to treat this patient? What’s sorts of adjustments am I going to use?” Part of it’s just indicated by what I feel, but there’s also a choice.  I realize that there’s some intuition in that this person’s gonna be respond to this type of therapy or to this type of adjustment, and on the Functional Medicine end, I may do a lab test and find out they have an imbalance in their gut with an overgrowth of certain bacteria or a parasite.  But then there’s a choice of different possible therapies, and a lot of times it’ll be a choice of different supplements, and I think there’s some intuition there in how I’m thinking each person’s going to respond without actually consciously saying I’m tapping into my intuition, right?

Wendie Colter:                  Well, yes. And most people in the medical world don’t even like that word. But here’s the thing. What patients know, and certainly what other doctors know and people in healthcare know, is that those particular practitioners who are using their intuition and trusting it, those are the ones everybody recommends. “You’ve gotta go see my chiropractor. He’s amazing. He just knows.” You know? That kind of thing.  And that’s really valid. I mean, that’s really the bottom line in terms of why anyone would want to learn how to develop that, because that’s what we’re talking about. Now, I don’t diagnose. I’m not licensed to diagnose, although many of my students are.  And some are not.  So we don’t ever diagnose.  We will assess and evaluate, and we’ll tell our client to go take this to their primary care physician. And that’s really part of the ethical stance.  Now, I know that wasn’t quite your question, but that’s about scope of practice, and so from your scope of practice, you would be able to use medical intuition to narrow down that focus on what the best treatment is.  And that is huge. I mean, that’s really huge.  People can spend a lot of money and time following a line that’s not gonna work for them or doesn’t work for them. It’s just frustrating for everybody.

Dr. Weitz:                          Right.

Wendie Colter:                  So in order to get people to the correct protocols quickly, medical intuition is pretty right on.  We’ve found, in our surveying, in our testing, that it’s pretty accurate in that respect.

Dr. Weitz:                         I also think, with diagnosis, even though I’m not using some intuitive sense in the beginning to sort of figure out, “Hey, you have a herniated disc” or, “You have SIBO.” A  lot of times patients present with a complex set of issues, so on the musculoskeletal end, they’ll have pain in their hip.  They’ll have pain in their back. There’s some indication that it’s a hip problem.  It’s a back problem.  And so, there’s layers of doing … Even though I use all the scientific procedures and the orthopedic tests and X-rays and MRI and all these other things, there’s still layers of different problems, and so I think that there’s probably still some intuition as to, “Am I gonna focus on the hip first and try to clear that out, instead of the back?”

And on the Functional Medicine end, I often get patients with complex sets of problems and maybe they’ll have some bacterial overgrowth that’ll come up on a stool test or a parasite, and then maybe they’ll also have some mold and they’ll have some mercury toxicity or a nutritional deficiency.  And I have found that it’s not efficient to try to treat all those things at one time, and so there’s a certain amount of choice what to prioritize, and let’s focus on this. And there’s probably some intuition going into that too, right?

Wendie Colter:                Without question. And this is one of the gifts and the challenges of Functional Medicine, isn’t it?

Dr. Weitz:                        Yes.

Wendie Colter:                You know so much more. You know that those other things that you looked at, the nutrition and how the gut microbiome is and you name it, affects the musculoskeletal. All the bones are connected to all the other bones, so to speak.  So this is where medical intuition is really, really helpful to look at the full picture, which is what a medical intuitive will get right off the bat. It’s one of the first things I teach, is how to get a good view of everything that’s going on in the physical body from every system perspective, where it takes … It’s a very short process, but we can see where the highlights are, so to speak, in the full physical body. And from there, we can start delving into various areas, and see what’s going to help get the balance right.

So here’s the premise, then. It’s that the body actually has all of this information for you, which it does. And in Western medicine and traditional medicine, we have all these tests to try to discern it, and we figure out what the priority is, et cetera, as you just so beautifully said.  A medical intuitive sees a similar picture, but from a different perspective. We’re asking the body to show us, “What’s the priority? What’s going on where, and what needs to be dealt with sooner than later in the priority line?” And then, “How? What’s the best way to treat that? What does the body want to heal?”  So from the physician perspective, the practitioner perspective, that intuition you’re talking about can actually be developed by using this method to say, “Okay, we’re gonna go in this line.”

Dr. Weitz:                          And this is something that we can get better at by training?

Wendie Colter:                  Gosh, yes. Yeah. So the point is, is that most people use their intuition like this. They kinda get a hit or they sorta go, “Hm,” and they kinda feel through it. And that’s a wonderful way to use intuition. That’s the way most healthcare providers do, if they choose to call it that.  In my program, this method gets you from A to Z by following a very specific protocol of asking and receiving answers through an intuitive process, and that process gives you a set of instructions from the body. The body is basically speaking, in a manner of speaking, to the medical intuitive practitioner.  And there’s a lot of question/answer that goes on, question-asking. “Well, is it this? Is it this? Let’s look.” And when I say “look,” I’m talking about an intuitive visual process that has to do with using intuitive sight. And this is where we’re going to get a little woo woo here.

Dr. Weitz:                          Oh, so as a medical intuitive, you’re helping to come up with … I don’t know if you call it a diagnosis, but essentially a diagnosis without touching the person, without doing any testing?

Wendie Colter:                  Yes.

Dr. Weitz:                          So explain how that works.

Wendie Colter:                  Okay. So how that works is through what I call a meta sense, meaning beyond your typical senses of our five senses. Meta sense is sort of an expanded version of those, and in my work, I use the meta sense of visualization. In other words, seeing in the mind’s eye, which our culture understands that. If we visualize, visualization skills.  We see that a lot in mindfulness training, in all kinds of meditation, where we’re asked to visualize or do guided imagery, things like that. It’s a similar skill, but what we’re doing is, we’re using our visual sense to see into the body.  Now, that’s a leap for many people, but actually, when they start to learn how to do it, it’s a very natural skill. Which is what’s so unusual and so wonderful to me about teaching intuition, is when people start to work that muscle, so to speak, of their visual intuition, it actually is not that difficult to do once they get the hang of it.

So within a very short period of time, people are able to discern information in the physical body, and I’ll tell you how it looks to me. And hang with me here, because I know it’s going to  sound a little unusual. It looks to me like looking at a functional MRI, so if I look at your physical body in the medical intuitive state, I’m literally seeing how the organs are working, how the body is functioning, what the systems are doing, and where the imbalances are.  And that’s something you can train. And I know that sounds as farfetched as anything that we take as … These days, seems normal to us, that 20-50 years ago sounded like, “Whoa, what are you talking about?” But it actually works, and our studies and our surveys have shown that it does, so there you go.

Dr. Weitz:                          Are you familiar with muscle testing?

Wendie Colter:                  Yes. No, I think kinesiology is a wonderful thing, and it’s not dissimilar, in that the body has a knowledge and that’s the premise of kinesiology, right? More or less?

Dr. Weitz:                          Yeah. Yeah, so I’ll just preface it by saying this. When I first got into chiropractic, and I saw people doing muscle testing, I said, “Come on. Get out of here. What kind of nonsense is this?” And then people said, “Well, you know, you could even test somebody without even being there and then you can …” “Come on, there’s no scientific basis for this.”  And to this day, I still have a tough time with it, but a lot of practitioners use it, and I’ve experimented a little bit, and I’m thinking that really what they’re tapping into is, is medical intuition of the body, don’t you think?

Wendie Colter:                  Well, yes and no. The premise of kinesiology is wonderful, and that is that the body has a knowledge. And so you can do these techniques with muscle testing, and the body can give you a yes or a no and that sort of thing. And it’s terrific, and I love that it’s kind of permeated certainly into chiropractic and things like that.  Medical intuition is actually more finely-tuned, and a lot of kinesiologists are gonna be not thrilled with me saying that, but we’ve found that the testing is more … When we’ve tested kinesiology against medical intuition, we’ve found more accuracy rates, in terms of finely tuning, in medical intuition. Because the premise is the same. The technique is different.

Dr. Weitz:                          Okay.

Wendie Colter:                  Yeah. But it is along the same lines of, “What are we talking about here? We’re saying that the body knows, so how do we find out what the body knows?”

Dr. Weitz:                          Are you just born with this medical intuitive capability?

Wendie Colter:                  No. I actually developed it over time. I wouldn’t say I was born with it.

Dr. Weitz:                          Okay, so this is a skill that other people, anyone could develop or only … Okay.

Wendie Colter:                  I’ve taught a lot of skeptics, Ben.

Dr. Weitz:                          Okay.

Wendie Colter:                  You really have to be skeptical, particularly in the world of healthcare. We’re dealing with people’s most potent issues, and yeah. It’s good to be skeptical. So, yes. You don’t have to be born with it, and you can learn.  You know, I equate it to learning a language. If you wanted to learn Italian or some language, you wouldn’t think, “Oh, I can just do this.” You would go to school or you would take a course or you would do something to learn things you don’t know. Even though, once you get facility with a language, it feels like maybe you could have done it all along, I don’t know, on your own.

Dr. Weitz:                          Give me an idea of how I could start to develop medical intuition. I mean, I’m not asking you to give us your whole course, but just give us an idea of what sort of training would mean.

Wendie Colter:                  Well, the program is two levels, level one and level two. I’ll kinda give you an outline and then I’ll give you some info on it. The first level is getting to understand and use the visual intuitive skill. So we’re taking a look at the physical body and all the body systems. We’re looking at the energy systems as well, the chakra system, that auric field, the biofield.  And we’re getting comfortable with the idea and the practice of really looking at something with visual intuition and getting feedback on what we’re seeing. So right off the bat, in the very first module of that four-module program of level one, people are using that skill.

Level two is a five-month program, and that is about really mastering this practice from all perspectives, so we’re looking at everything, Ben. We’re looking at the physical body, the DNA, anything you can do a test with and things you can’t do a test with, we’re looking at.  But we’re also looking for the underlying root causes of these issues, and that’s really where medical intuition shines, and can really shine for people.  Because what does your patient want to know? I mean, if there’s a trauma, a physical trauma, and from your perspective perhaps as a chiropractor and there’s some musculoskeletal issue, that is obvious.

But what if there’s something that comes from a deeper root? For example, the gut microbiome. Where’s that connection emotionally, mentally, right? Not just physically. So medicine generally works on just the physical stuff. Patch people up, get them right, get them healed. Get them out the door, all that. But medical intuition takes a broader view, and that is, “What circumstances in life led to this imbalance?” Because that’s where a lot of the healing can happen, in that area.  Now the psychologists, you can imagine, love this because it supports that perspective too. But this is all informational for the patient or client. We’re noticing that kind of information that comes through that’s held in the body or the energy systems is extremely valuable for people in understanding what the trajectory of their health is, and how to move forward.

Dr. Weitz:                          Can you share any examples or cases that you’ve been involved with, where you were able to help a client?

Wendie Colter:                  Yeah, absolutely. I’ve got a million of them. The one I like to talk about, because it has sort of the whole picture of the emotional with the physical, is a client of mine, a woman in her mid-40s, successful businesswoman. She wanted me to take a look at her wrist, because she had a very persistent case of tendonitis.  And you know, tendonitis can take a long time to clear up, but she wanted me to look at it. She’d had it for about a month, and she’d been the doctor’s and she was wearing the bandage and she’d been icing and nothing was working. It was just as bad when she saw me as it was when she first flared up.  She wasn’t someone who had tendonitis a lot. It was something that came up out of the blue, and so when I took a look at it with medical intuition, my job is to look at it from two perspectives. One is the physical perspective, what’s happening physically. And the other is what’s happening emotionally, mentally, et cetera.  So the first thing her wrist wanted me to see was those inflamed tendons. Remember, I said I kinda see an fMRI visual. So I saw those tendons. They looked pretty inflamed, but underneath the tendons, I saw a healed bone scar in the wrist bones. So there was something else going there, her body wanted to show me.

Dr. Weitz:                          Now, did you actually see that?  Or you saw it through your mind’s eye?  In other words, was it visual?  Could you actually look at her arm and see that?

Wendie Colter:                  I wasn’t looking at her arm. I was looking at using my visual intuition in the mind’s eye.

Dr. Weitz:                          Okay, so it didn’t matter if she was covered up with a long sleeve or anything else.

Wendie Colter:                  Didn’t matter.

Dr. Weitz:                          Okay.

Wendie Colter:                  That’s the nice thing, because the skill is, you can use it remotely or in person. So it’s really pretty wonderful that way. There’s no real limitation in that respect.  So what I saw was the workings of the wrist, and there was this bone scar, and I also saw, it looked like a bit of a cloud around her wrist, and it was an emotional energy of grief and heartbreak.  Now, I didn’t know about her life. I didn’t know any of the circumstances of her life, and that’s another key point, is that I look at people’s energy that I’ve never met before. So what I saw was a little scene from her life.  

So the first part’s the physical. The second part of how we use our mind’s eye visualization is, we’re looking at circumstances, life experience, and the body holds that too. And again, that’s not unusual to medicine. Anyone who’s worked with muscle groups and things like that, very often emotion is held in the body in those ways.  So there’s life experience that goes with that. So what I did see was about … She was in her early 20s, so her body showed me a little scene from her life, and I saw that she was playing tennis with her boyfriend. She tripped and fell and broke that wrist, and that’s what that bone scar was from. That bone healed bone.  And the body wanted to show me this because the next thing it showed me was her in the ER after she broke her wrist, getting her wrist taped up, and her boyfriend breaking up with her in the hospital room there.

So her wrist was holding onto this experience, not only of physical trauma, but emotional trauma. And that was what was causing the flare-up of the tendons in her wrist today, now. Now, what was interesting about this is that at that moment, my client said that she was going through an emotional breakup with her partner, who she’d been with for 10 years. And when she gave it just a moment’s of thought, she said, “Well, you know what? We broke up about a month ago just before this flared up.”  And that’s a very common experience, and it may sound farfetched, but to the body, it’s actually quite rational. So her body was holding onto this experience in her wrist, and this breakup in the present activated all of that unhealed emotional trauma from that time.  Now, what’s interesting about this particular case is that there was more. The wrist had more to show me, and when I asked again, “Is there anything else?” It showed me an image of her around five years old, and she was in a dark closet and she was holding her wrist up like this, and there was a cane coming down and striking it, right in that same spot. And my client, at that point, said, “My mother was mentally ill. She used to beat me with her cane and lock me in a closet.”

Dr. Weitz:                          Wow.

Wendie Colter:                  That’s pretty dramatic. Intense. But here’s the thing. I had no conscious awareness of that, but her body had been holding on, her wrist, right in that spot, had been holding onto all of this grief and emotion from her life history, and it doesn’t take much to trigger that, and that’s what happened for her.  Now the good news is, part of my job is also to ask, “Well, what does this body part, what does this issue need to heal?” On all levels: physical, emotional, mental, spiritual. And for her, her wrist said, “It’s really not about the physical in this case. It’s really about the emotional and so she just needs to process the emotions and maybe a little more ice and rest would be good.” You know, that kind of thing. And I gave her a call a couple of days later to see how she was, and she told me the pain was gone. It left within 48 hours.

Dr. Weitz:                          Wow.

Wendie Colter:                  Yeah. And she felt more able to process the emotions of this intense breakup. So it’s not an unusual story. Put it that way. It’s not an unusual case that the body hangs onto things from early life experience, kind of re-experiences it when there are triggers.

Dr. Weitz:                          Now, I’m sure some out there are gonna be sitting there thinking, “Whoa. Somebody just goes to see a medical intuitive, and they tell them … give them some diagnosis. They may be really missing out on some life-threatening disease that wasn’t diagnosed because they didn’t get the proper examination and testing from a medical professional.”

Wendie Colter:                  Well, you’re talking about ethics here. And the way I use medical intuition, the way I train people in medical intuition, is that everything needs to be backed up. Everything has to have … I will not take a client who’s not willing to see a medical provider. This is a support system, medical intuition, is to give the client or patient information that will help them in their healing journey.  And for someone like you, who is a functional medicine practitioner, that information’s gonna help you in how you work with the patient. For me, from my ethical perspective and scope of practice, my client absolutely has to take all of this information to their primary care physician, and to be totally honest, what I’m working towards is the day when a medical intuition becomes someone you would call on, or someone a physician would call on, as part of the care team. Because that’s really the job. That’s really the best placement for medical intuition.

Dr. Weitz:                          And would it be best for somebody to see a medical intuitive after they’ve seen a conventional or a functional practitioner who’s come up with a diagnosis, and then you step in either as an adjunct or in cases where they can’t figure out what’s going on? Or is it reasonable for you to see them first, and then maybe the medical or functional or other practitioner take into account your insights in figuring out what the diagnosis is?

Wendie Colter:                  All of that. Any version of that is fine. I mean, it really is up to … Well, let me put it this way. There are some pretty visionary doctors out there who are calling on medical intuitives to assist them in that perspective.  There’s a medical intuitive who works in the ER. She’s a volunteer at UCSD. She works with one doctor who’s brought her in. Now, these are ER cases. That’s very immediate. And I don’t know what their history is in terms of outcomes, but she’s been working here for over 10 years.

Dr. Weitz:                          Wow.

Wendie Colter:                  So there’s definitely a value there, and that’s really where I see medical intuition helping, because it’s a support skill that can really help. If you don’t mind, I can give you another case report that outlines this.

Dr. Weitz:                          Yeah, that’d be great.

Wendie Colter:                  So, this particular case report, this was a client I had about 15 or so years ago, and this one really changed the idea of medical intuition for me personally, from this really cool thing that you can do, it’s kinda neat and really interesting, you know, there’s all kinds of groovy information, to something that looked like, “This is very, very critical in healthcare.” So it kind of flipped the switch for me in that regard, and that’s why I started thinking, “I need to train people. I need to teach people this.”  So as a young woman in her 20s, an actress … I’m in Los Angeles, so we get a lot of entertainment people here. Lovely, waif-like young girl, who had pretty severe kidney pain. It was in that part of the back of the body, and she’d been to specialists. It had been going on for quite a while. She was really affected by it, and all of the tests came back negative. They couldn’t find anything. They didn’t know why she was in such pain.  And so, she was prescribed antidepressants because she was not super functional at that moment with all that, and also opioids. They didn’t really have anything else for her, and when I looked at her kidneys area, I actually saw what it was, and it was a crystallization. A little kidney stone that was too small for the tests at the time. The testing might be better now, I don’t know, or more refined.   But it was under two millimeters or whatever it was. It was tiny. But it had come out, just out of the kidney, and into the ureter tube, and kind of lodged there, and it wasn’t budging. And it was causing her physical pain.

So what I did was, I asked her kidney system, her urinary system, “Can this just flush out? Will it leave on its own? What needs to happen here?” And what her kidney said to me was, “This needs a surgical intervention.” Those were the words that her kidney said, right?  And so, what I did was I said, “Look. I’m seeing this. It really looks like you need the right physician to help you with. Perhaps a surgeon who’s willing to take a look.” And I drew her a little picture of her kidney and the ureter tube. I said, “Right here.”  And she took it, and that was it, and I didn’t find out what happened for her until about, at least a couple of years later. She actually found somebody who was willing to do a little more exploratory work. She’d had a surgery. It was successful, and the pain was gone and then she was able to get on with her life.  And what was interesting about this story and actually tragic is that she got addicted to the opioids, which was something that happens. And when she wasn’t able to get the pain medication anymore, she turned to heroin, and she died of an overdose.

Dr. Weitz:                          Wow.

Wendie Colter:                  Yeah. And that was a real wake-up call for me. I went, “Oh my goodness. This should have never happened.”

Dr. Weitz:                          Right.

Wendie Colter:                  And I think about, if her doctors had had a medical intuitive to ask, to call on, or were trained in medical intuition themselves, those tests that were inconclusive, where the patient was still showing these symptoms, they could have looked, and in my opinion, she would still be alive. One would hope.  Now, that’s a dramatic story and a tragic one, but it does outline the use and the usefulness, and kind of the critical usefulness for many, many patients and clients, of the need for this kind of look, rather than going through the traditional … When your client is asymptomatic, or … Not asymptomatic. Atypical symptom-

Dr. Weitz:                          Right. You know, when we were studying diagnosis, something came up that you would see in some of the textbooks was “etiology unknown,” and at time was the most common diagnosis. And so, there’s far too many conditions where patients present with symptoms. They have dizziness. They have brain fog. They have some abdominal discomfort, and nobody can find anything.  And so then they give them opioids or they give them prednisone, or they give them something to sort of cover up the symptoms. And that’s, of course, as a functional practitioner, that’s one of the things we pride ourselves on, is trying to dig deeper and find some of those underlying causes. But I see that your role can be equally beneficial in trying to find some of those causes that aren’t readily apparent from their traditional methods of diagnosis and examination and history-taking.

Wendie Colter:                  Absolutely, and I will tell you that … Oh, there’s a point I wanted to make here that I thought was so perfect, and it just went right out of my head.

Dr. Weitz:                          Probably my long, winding-

Wendie Colter:                  No, no, no. It’s perfect. Yeah. No, no, you’re absolutely right. And again, we’re finding in our surveys that the medical intuitives … Well, so one of the questions on our survey is, “Did the medical intuitive match the diagnosis you got from your doctor?” Which is a really interesting question for that very reason.

Dr. Weitz:                          Now, what in terms of studies are there, to give some … I don’t wanna say “credibility,” but I guess credibility, to medical intuitives?

Wendie Colter:                  Well, we need that credibility because this has been a skill that’s been practiced for decades, maybe hundreds of years, with no accurate testing. So last year, we started a survey process with the certified graduates of my program, to test their accuracy level.  And we found 94 to 99% accuracy amongst these questions we’re asking, “Did the medical intuitive locate the part of your body, the issue that you were having, accurately? If you received a diagnosis, does it match the diagnosis?” Which is an interesting question for the very thing you said, because sometimes it does and sometimes it doesn’t, because the diagnosis may or may not be accurate.  I know what I was gonna say. I was gonna say that working in intuition and medical intuition for 20 years, I’ve seen issues in people’s physical systems, there is no name for yet, and years later, there will be articles upon articles. For example, SIBO. Big question about SIBO, small intestinal bowel overgrowth.

Dr. Weitz:                            Talk about it all the time.

Wendie Colter:                  All the time. I was seeing bacterial overgrowth in intestines 15-20 years ago, with no name for it. So this is not uncommon in the world of medical intuition. It’s interesting, when things catch up.

Dr. Weitz:                            Very interesting.

Wendie Colter:                  You know, it becomes tricky because at the time, what were the treatments? Now there are more specific treatments. And I’m gonna segue for a second and get back to what I was saying before. One of the famous medical intuitives in the United States in years past was a gentleman named Edgar Cayce.  He had a clinic in the 1920s in the south, and he would go into some kind of little trance, and he would be extremely accurate with his medical intuition, and he had doctors verifying it and corroborating.  And when he opened his clinic … You’ll find this fascinating. It dealt mostly with the gut microbiome. He didn’t call it that. He called it the digestive system. And working with people in terms of food and stress, things like that, to help the gut microbiome, in the 1920s. I mean, this gentleman was way ahead of his time.

Dr. Weitz:                            Yes, definitely.

Wendie Colter:                  That’s what he was discerning from medical intuition, as you said, medical intuition. Which, it wasn’t called that at the time. Okay, I completely lost my track. What was your question?

Dr. Weitz:                            That’s okay. So, what are some of the hospitals or medical centers that you teach or have taught at?

Wendie Colter:                  Yeah. So I’ve been very lucky and blessed, and I’ve been brought in by physicians who are quite visionary in this area, who see the value of the work, and I’m teaching now at Scripps Health in San Diego at the Prebys Cardiovascular Institute Center. They brought me in, I teach there once a year. And I also teach live online, so I teach people all over the country, and now all over the world.  I also have been very … It’s a wonderful experience teaching at the integrative medicine elective rotation at Dr. Andrew Weil’s Center for Integrative Medicine in Arizona, and hopefully I’ll be able to go back there. And that’s wonderful, because I’m teaching fourth-year medical students and residents, and they’re just … It’s a phenomenal experience, just to speak with a roomful of MDs, you know?  Because their perspective is right on, and people who have been trained as yourself in such a deep way about the physical body and the systems, to look at it from the perspective of intuitive visual or energetic frequency and all that jazz, is really fascinating. So it’s lovely to see that, and I do see that functional medicine in particular, and integrative, have really changed the game in medicine, even from five years ago, Ben.  You know, talking to rooms full of physicians and whatnot is just a joy to me, because people kinda get this. You kinda go, “Oh yeah, you know? I had that feeling once.” And the question is, can you think about it as something you can actually develop as a skill? The answer is yes, but many people just haven’t even thought about it that way.

Dr. Weitz:                          So, how can we find out about your programs, your training programs?

Wendie Colter:                  ThePracticalPath.com is my website. And I teach the program, level one, twice a year, and level two twice a year. So it’s about a nine-month sequence, and there’s a lot of case reporting and things like that, and whatnot.  So you can find it on the website, the practicalpath.com. And you had asked me one other question, if you don’t mind me going backwards, about the surveys. Yeah, I was telling you about the surveys we’ve been doing. The surveys and the outcomes of the data on the surveys is also on the website, under the tab “about,” there’s a little page called, “What is medical intuition?” And I’ve posted the outcomes of the surveys, which have been just phenomenal in terms of what we’ve been seeing.

That data has led us to a wonderful … The Center for Integrative Medicine at UCSD, and the people there have wanted to partner with us. So I’ve partnered with a wonderful doctor by the name of Paul Mills, who together we’re collaborating on a full-fledged study through UCSD School of Medicine, the first study of its kind that I’m aware of, on medical intuition.  There have been studies in the past, small studies and single medical intuitives or whatnot. We’re gonna do a broad scope, full-fledged study. So we’re in the process of raising funds for that. If anybody listening is interested, let me know. Go to the website, because we really wanna get this off the ground. It’s just a very groundbreaking kind of a skill. And the study will be really …

Dr. Weitz:                          Good. Yeah, good luck with that. We definitely need more information to help our patients, and sounds like medical intuition is something that’s just starting to come into its own as an adjunct form of diagnosis, care, et cetera.

Wendie Colter:                  Yeah, and evaluation assessment. A lot of the nurses that take the program use this in their practices. They can’t legally diagnose either, so what they’re doing is they’re bringing that information to their doctors. Whether the doctors listen to them, I don’t know, but that’s what they do, and that’s really part of their job. And what’s interesting about the nursing profession is that nurses are told to use their gut instinct, aren’t they? They’re told to-

Dr. Weitz:                          Are they really? Yeah.

Wendie Colter:                  Yes. They’re told to just use their hunch or their gut instinct. That’s another way to say intuition. And if they just kind of discern or feel or get or feel that something’s not right, they need to say something.  So those nurses who have studied and practiced medical intuition can not only say that, “Something’s wrong here, but here’s what I’m discerning that looks like it could be needs some looking into.”

Dr. Weitz:                          That’s great. Excellent. So, thanks for bringing some intuition to us today.

Wendie Colter:                  To your rational podcast here.

Dr. Weitz:                          Exactly. Okay.

Wendie Colter:                  Yeah. It’s quite rational when you figure out and you learn how to use it.

Dr. Weitz:                          And I’ll put links in the show notes for listeners and viewers who wanna contact you afterwards, so check out your intuitive learning programs. Thank you, 

Wendie Colter:                  Oh, thank you so much.

 

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Dried Urine Hormone Testing with Dr. Carrie Jones: Rational Wellness Podcast 98
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Dr. Carrie Jones discusses Dried Urine Testing for Hormones 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. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]

 

Podcast Highlights

0:58  What is the best way to measure hormones? Serum testing is the gold standard and is the most cost effective, often covered by insurance.  However, hormones fluctuate throughout the day and in the Functional Medicine world we have come to appreciate the value of also measuring the hormone metabolites, so doing 24 hour urine testing is one good option. The downside of 24 hour urine testing is that you have to carry around carrying around a large container of urine that must be kept in the fridge between samples.  Testing hormones via dried blood or saliva offer the advantages of being done at home by patients instead of requiring a blood drawer, which can be tricky if you are trying to get their sample done at a particular point during their cycle, which could be a weekend. Also saliva seems to be a better way to monitor topical hormones, since these don’t always show up well in the blood.  Dried urine seems to offer some of the advantages of urine testing with the ease of a saliva or dried spot.  It can also measure hormones at particular points during the day or month.

4:17  Dr. Jones explained that dried urine testing (DUTCH) offers ease and convenience with the benefits of being able to also look at metabolites. If you are a practitioner focused on estrogen, you want to know which metabolite your estrogen is going to turn into, which urine testing offers. With testosterone and DHEA, if you’ve got somebody you’re concerned about their acne, their male pattern baldness, their prostate issues, their PCOS, urine can tell you which androgen pathway they are going down. DHEA and testosterone can go down primarily the more androgenic alpha or the less androgenic beta pathway or it can be split 50:50 down both pathways.  If testosterone is primarily going down the alpha pathway of androsterone, dihydrotestosterone (DHT), and 5 alpha Androstanediol, this will tend to contribute to PCOS in a woman and to cystic acne, male pattern baldness, and prostate issues in a man. If a patient tends to be more alpha dominant, we’ll also see this in their progesterone metabolites. What pushed you more down the alpha pathway can be genetic, but the following factors can be modified to change this: 1. Inflammation, 2. Insulin, and 3. Stress. We can also look at the following supplements that are natural 5-alpha blockers: 1. saw palmetto, 2. stinging nettle, 3. zinc, 4. EGCG from green tea, 5. reishi mushroom, and 6. pygeum africanum. These are often found in prostate formulas, but they work for women as well.

9:23  Some people have criticized dried urine testing as having no studies to validate it, but the scientist who developed the DUTCH test, Mark Newman, recently published a study validating the testing of the estrogen and progesterone metabolites via dried filter paper and mass spectometry, which was shown to be comparable to serum: Evaluating urinary estrogen and progesterone metabolites using dried filter paper samples and gas chromatography with tandem mass spectrometry (GC-MS/MS)

10:08  When it comes to estrogen metabolites, we have the 2, 4, and 16-hydroxyestrone pathways. We used to measure the 2:16 ratio as the holy grail of breast cancer risk with the 2 as safe and the 16 as carcinogenic. But later studies showed this simple concept doesn’t really hold up.  Dr. Jones explained that the 2 and 4-hydroxy estrones are considered catechol estrogens, which means that they form adducts. The 2 is safer because when it becomes an adduct and if it doesn’t get methylated and go through phase two detoxification in the liver, then it can bind to DNA and form an adduct. It will stay in the DNA and wait for the DNA repair system to excise it. When the 4 becomes becomes an adduct, it breaks out of the DNA and leaves a hole, and the more 4 adducts you have, the more holes in your DNA. Your DNA repair system then is put under pressure to fix all these holes, so the risk for mutation goes up. The 16 pathway doesn’t increase the risk for DNA adducts, but it can increase proliferation, so it is good for bones, but bad for breasts. It can lead to heavy periods and their breasts may tend to get large and tender during the periods. It probably doesn’t increase the risk of breast cancer, but if you have breast cancer, it’s proliferative, so it may add fuel to the fire, so you definitely don’t want a lot of 16.

13:06  The key when looking at these metabolites is how do we fix the estrogen metabolism so that we decrease cancer risk without over methylating?  Dr. Jones said we should do SNP gene testing to look for variations in the MTHFR and COMT genes, which will give us some idea.  While the DUTCH test does include the 2-methoxy Estradial and Estrone but unfortunately, at this time, it is not possible to accurately measure the methoxy/methylated forms of the 4 and 16 estrogen metabolites, so there is no way to know for sure.  DUTCH does include the Methylmalonate (MMA), so this can give you some idea of the B12 status, which is an indicator of methylation.

16:39  Dried Urine Testing can be used to map out a woman’s cycle and DUTCH calls it Cycle Mapping. You basically urinate on a piece of paper almost every morning of your cycle and let it dry and then mail it in. It’s really great for women who have cycle irregularity. Maybe they’ve had a partial hysterectomy or an ablation or they have the Marina IUD and so they have ovaries that function, but they don’t bleed, so they don’t quite know where they are in their cycle.  It’s helpful for women with fertility issues (PCOS) or whom have symptoms all month long.

19:12  Dried urine testing can be an effective way to monitor bioidentical hormones, though no testing is effective if somebody is on the birth control pill, the patch, or the ring because of the mechanism of action of those synthetic hormones.  It works well for monitoring oral progesterone, DHEA, vaginal estrogen, bioidentical estring (which is a prescription ring but it’s estradiol), the estrogen patch that menopausal women use, and pellet therapy.  Topical hormones can be a challenge for dried urine testing.  Part of the problem with monitoring hormone levels in women or men who take topical hormones depends upon where they apply it, which can drastically change how much gets absorbed and systemic levels. Topical hormones are problematic for any type of hormone testing, even for saliva testing.

21:05  With salivary cortisol testing you’re looking at free cortisol at 4 times during the day.  With dried urine cortisol testing you get metabolized cortisol, free cortisol, and cortisone, which is the inactive form.  If cortisone is higher it usually means that you are in a long term state of stress or you have recently been sick. 

23:43  Dr. Jones explained that there is no such thing as adrenal fatigue or burnout, since the adrenals never run out of cells and never stop being able to make cortisol. Rather, the adrenals receive signals from the brain, the hypothalamus, to make less cortisol. It is a feedback and receptor issue.  When Functional Medicine practitioners recommend adaptogenic herbs to help the adrenals, like ashwaganda, rhodiola, or eleutherococcus, these may be helping but not just because they support the adrenal glands. They support not just the adrenals, but they are thyroid supportive, immune supportive, neuro supportive, GI supportive etc. Adrenal glandulars may work not just because they support the adrenals, but because they provide nutrients like amino acids and other nutrients that support many glands in the body and not just the adrenals.   

28:00  The cortisol awakening response (CAR) is what happens during the first 30 minutes upon awakening.  Your cortisol is supposed to go up at least 50% in that first 30 minutes.  When you open your eyes in the morning your brain signals your adrenals to make cortisol, which goes up in the first 30 minutes. It shows your body’s response to stress. If you’re too high or too low, then you’re not going to get the rest of your day right either. And then after 60 minutes it starts to fall back down. Most saliva testing companies require you to spit into a tube and fill it up before getting out of bed without drinking any water, which can be difficult and even stressful to do. But the DUTCH CAR test only requires you to place a cotton swab in your mouth to collect saliva, which is much easier to do.  The DUTCH Adrenal test can also help with insomnia, so if you awake in the night, you collect a saliva sample when you awake. If you are using DUTCH for both adrenals and hormones–the DUTCH Complete test, then the rest of the cortisol and cortisone samples after the CAR will be with dried urine.  Here is a paper that I found helpful in understanding the utility of the Cortisol Awakening Response: Daily life stress and the Cortisol Awakening Response: testing the anticipation hypothesis.

 



Dr. Carrie Jones is a Naturopathic Physician with a Master’s in Public Health and over 12 years experience in Functional Medicine. Dr. Jones is the Medical Director for Precision Analytical, creators of the DUTCH, dried urine hormone test. The website is DUTCHTest.com and the phone number of the lab is 503-687-2050.

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



 

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.  Hello Rational Wellness podcasters. Thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness podcast, please go to iTunes and give us a ratings and review, that way more people will find out about the Rational Wellness podcast.

Our topic for today is dried urine testing for hormones with Dr. Carrie Jones.  While conventional medical doctors typically measure hormones only in serum, in the functional medicine world, we’ve come to appreciate some of the advantages of measuring hormones in urine so we can capture the hormone metabolites to see if and how these hormones are being processed by the body. However, hormones fluctuate throughout the day so measuring 24 urine is a way to capture that. But it requires carrying around a large container of urine that must be kept in the fridge between samples.  We’ve also come to appreciate some of the advantages of testing hormones via dried blood and saliva since it can be done at home by patients instead of requiring a blood draw which is especially tricky if you’re trying to get a patient to get their sample done at a particular point during their cycle, maybe that’s going to be a weekend day or at a particular time of the day since hormones fluctuate throughout the day.  Dried urine seems to offer some of the advantages of combining urine testing with the ease of a saliva or dried spot. Now look, there are advantages and disadvantages of every form of hormone testing. Serum testing has some advantages since it’s most likely to be covered by insurance and it may be the most cost effective. But 95 to 99% of hormones measured in serum are tightly bound by binding proteins which doesn’t reflect the unbound or free hormones that are available to the tissues. And serum testing cannot measure estrogen or androgen or adrenal metabolites.  And it also does not appear to be a good way to monitor men and women who are taking hormones topically.

Saliva testing may be a better way to monitor levels of hormones taken topically, however, some of the problems with saliva testing include that it appears to be less consistent, it’s adversely affected by eating, drinking, gum chewing and tooth brushing which can result in micro-damage and can result in elevated salivary testosterone levels for up to an hour after brushing. Even in the absence of visible signs of bleeding.

24 hour urine testing has the advantage of being able to measure hormone metabolites over the course of the day though these will essentially be averaged. The disadvantages of urine testing include that it’s only measuring hormones that have been excreted and it’s not a direct measure of bioavailable hormones. An analogy would be, measuring how much food people eat by going through their trashcans. Also, urine testing cannot measure thyroid hormones.

Dr. Carrie Jones is a naturopathic physician with a Masters in public health and over 12 years of experience in Functional Medicine. She’s the medical director for Precision Analytical, the creators of the Dutch dried urine testing. Dr. Jones, thank you so much for joining me today.

Dr. Jones:            Thanks for having me on. That was definitely one heck of an introduction. You sure covered all the key highlights. I think we’re done. That’s it. I love it.

Dr. Weitz:            Good. Why would a Functional Medicine practitioner want to do dried urine testing versus serum or saliva or 24 hour urine?

Dr. Jones:            Definitely well one of the big things that you touched on was ease and convenience. If a lot of people are afraid to get their blood drawn. A lot of people can’t come with the saliva to do a saliva test. To spit in a tube. They don’t want to carry the jug around 24 hours and collect every single last drop of urine they make and so the dried urine test was created for this happy medium.  You get to do it multiple times in the day. You don’t have to spit. You don’t have to get your blood drawn or your finger poked and it’s little pieces of paper that you urinate on so convenience is huge and pretty much everyone can manage that. To urinate on a piece of paper. But the second thing is what you also mentioned are the metabolites. One of the things you said is that urine doesn’t have bioavailable but in fact it does. It’s the bioavailable that actually, that comes through as the free. That’s what comes through, not the bound. ‘Cause if it’s bound it can’t be metabolized, so it’s only the bioavailable that can. It does.

But, metabolites are super important if you’re looking for pathways. If you’re a practitioner focused on estrogen and you want to know which pathway, which metabolite your estrogen is going to turn into, urine is the way to do it. You can’t get it in blood and you can’t get it in saliva. Just like testosterone or DHEA, if you’ve got somebody you’re concerned about their acne, their male pattern baldness, their prostate issues, their PCOS, and you’re looking to see if they’re going down that sort of androgen pathway of naughtiness then urine is the way to go. Saliva and serum will tell you your testosterone in the moment, your DHEA in the moment but that could be normal, however it’s going down the pathway with all the side effects.

Dr. Weitz:            Okay, well why don’t we explore that? Because I think a lot of people are at least somewhat aware that the metabolites of estrogen can affect cancer risk but I think a lot of folks are not quite aware what the advantages of looking at testosterone metabolites are.

Dr. Jones:            Yeah, so when the body makes either DHEA or testosterone, obviously just like estrogen, it can push it into other metabolites. Most everyone’s familiar with the metabolite DHT, dihydrotestosterone. You can check it in serum but there’s other ones and they all have fancy big names. I don’t know who decided to name them but it’s things like etiocholanolone, androsterone, 5-alpha, androstenediol, these crazy names. But basically what they do as a family is they tell us when you make DHEA or you make testosterone, which side does it go down? Is it pretty much split 50/50 or does it go down the androgenic alpha side primarily? Or the less androgenic beta side?  Let’s say you’ve got somebody like I was saying with PCOS or you’ve got a man who has cystic acne, he’s got male pattern baldness, he’s maybe having some prostate issues and you do a serum testosterone or you do serum even DHEA and it’s normal. You’re like, well that’s weird, he has all these symptoms. When you know this pathway, when you can look to see if his androsterone, his DHT, his 5-alpha, androstenediol are elevated then you know this gentleman or even this female is going right down that alpha pathway, causing all these symptoms and more importantly you can do something about it. You can intervene and try to help.

Dr. Weitz:            If the testosterone is going down that pathway of DHT, that’s going to increase risk of male pattern baldness, that’s going to increase prostatitis, does that increase prostate cancer risk as well?

Dr. Jones:            The research is interesting when it comes to prostate risk, prostate cancer risk for DHT. There’s some of the testosterone metabolites yes, they can increase. Not all of them but some of them, yeah. It’s good to follow.

Dr. Weitz:            What are the best ways to push it the other way?

Dr. Jones:            Well lifestyle factors is a big one. What pushed you down the alpha sometimes is genetic. Some people are just genetically alpha folks and we’ll see this as well in their progesterone. Men and women of course both make progesterone but if their alpha progesterone’s more dominant, we know they’re just an alpha person. But, other things like inflammation, insulin, stress. We’ll sort of see those common themes will push the alpha more. Working on addressing that helps but then we look at we call 5-alpha blockers. They’re natural supplements like saw palmetto, stinging nettle root, zinc, EGCG, that’s in green tea, reishi mushroom, pygeum which is known as pygeum africanum. All these things help lessen the load on the alpha side and kind of push it a little bit more towards the beta side. It works in men just as much as it works in women.  I tease women all the time, you’re going to see these products in prostate formulas, you’ll probably need the same formula, just pay no attention to the title.

Dr. Weitz:            Yes. I recently interviewed Frank Nordt from Reine Labs. They do 24 hour urine testing. He said, “There’s no scientific validation for dried urine testing.”

Dr. Jones:            It’s not true. In fact we have a great study that just came out.

Dr. Weitz:            I read it. [Here is the paper: Evaluating urinary estrogen and progesterone metabolites using dried filter paper samples and gas chromatography with tandem mass spectrometry (GC-MS/MS)

Dr. Jones:            It’s public. No, there’s research coming and we have another one coming behind that as well.

Dr. Weitz:            What did that paper show?

Dr. Jones:            That one was in particular for estrogen and progesterone in blood and it showed that it has great correlation. Dried urine when you’re looking at estrone, estradiol, comparing it to serum, had great correlation. You can effectively use it for hormones.

Dr. Weitz:            Cool. When it comes to women’s hormones, I’d like to touch on the metabolism of estrogen and what increases risk of breast cancer. For years we used to measure the 2 to 16 ratio and we thought was the holy grail and more two was safe. That was anti-carcinogenic and 16 was bad and 4 we weren’t quite sure about. And then they started being a bunch of papers that seemed to show that it really wasn’t valid. 16 wasn’t necessarily correlated with anything and then it seems like more of the interesting research has been with the four as potentially being related to cancer but I did a quick literature search and I saw several papers from 2017 that seemed to be validating the two to 16 ratio again. Where do you think we are?

Dr. Jones:            Here’s the thing with cancer that what originally said the 2, 16. The 2 and the 4 are considered catechol estrogens which means they can form adducts. A-D-D-U-C-T-S, adducts. The reason the 2-hydroxy is considered safer is that when 2 becomes an adduct, if it doesn’t get methylated, if it doesn’t go through phase two, and it binds to DNA and forms an adduct, like a very obedient child, it just stays in the DNA. It’s not supposed to be there but it stays there and it waits for your DNA excision, your basically your DNA repair system to come in, notice it’s a problem, and then fix it.  Whereas the 4, the 4 pathway, when it becomes an adduct with the DNA, it’s a very naughty child and it breaks out of the DNA and leaves a hole. And when the four adducts break off and the more 4 adducts you have breaking off, the more holes you have in your DNA. Now your DNA repair system is like, crap, I’m full of holes and it has to increase repair so to speak and the risk for mutation goes up. It’s like a factory that’s been given a double, triple, quadruple order and yet you don’t have the people, the machines, the what have you, to make it happen so mistakes happen. Things get missed. Things slip through that quality assurance maybe before would have been fine. Now you have this increased risk for mutation.

The 16 pathway doesn’t increase the risk for adducts but it can increase proliferation, so good for bones, bad for boobs. It’s also bad for other things. Heavy periods. If I see somebody who has a higher 16 in their result and they report clotty periods, heavy periods, their breasts get large and tender, then I know that they’ve got this proliferative effect. If you have breast cancer, it’s proliferative so you definitely don’t want a whole lot of 16 because it’s just going to add fuel to the fire but it’s the four that really increases your risk for that adduct mutation when it’s trying to fix it, fix the hole.

Dr. Weitz:            Based on looking at these metabolites, how do we know how to fix the metabolism so that we decrease cancer risk without over methylating?

Dr. Jones:            Now with urine testing, you cannot tell if somebody is an over or hyper-methylator. You can only do that through SNP testing. On urine, any urine, dried urine, 24 hour urine, Frank’s urine, doesn’t matter, Rheine Labs, if somebody has quote high methylation, it just means the ratio between their ability to get from phase one, the hydroxy phase, to phase two, the methoxy phase, looks really in the favor of methylation. But does that actually mean they have the fast COMT? I don’t know. I won’t know that until you do SNP testing.

Dr. Weitz:            Couldn’t we tell by looking at B12? I notice that you have a marker, B12 in some of your testing now.

Dr. Jones:            We do. We have one of the, we have MMA. We have the organic acid methylmalonate, yeah, we do have that marker. And we also have HVA and VMA which are also of course broken down by MAO as well but they are broken down by COMT.

Dr. Weitz:            Do you think that is a way to tell how much you’re methylating?

Dr. Jones:            It’s still not absolute. It’s still not absolute. They are good markers, good indicator markers but if somebody’s like, does this mean that I have a fast COMT, I don’t know. A 100% I don’t know until I actually see your SNP test.

Dr. Weitz:            But even if you have a snip, still how do you know how much?

Dr. Jones:            Correct. Correct. ‘Cause you could have normal. You could have heterozygous, not even a fast COMT. You can have a heterozygous COMT but yet whatever you’re doing and something is speeding it up. And then if you knock that off, it’ll go back to normal or slow back down. Maybe if you are a homozygous fast person but on testing everything looks normal and you’re like, well it’s not manifesting. I have a fast comped but it’s not showing up on test. But if you have things on testing that look like it should be fast and you know on SNP testing you have the fast results then, there you go. You’re fast. Then it lines up, absolutely, yes.

Dr. Weitz:            Now does your test measure whether the 4 is getting methylated or not?

Dr. Jones:            We don’t look at the 4. We don’t look at the 4 and the reason we don’t is because the result for 4, it’s so tiny that the accuracy gets very, very messy and that’s what we find when we look at a lot of the other companies. Is that when you look at the reference ranges it’s like .000 or .00 whatever and once you get into the more than one zeroes it can be really messy, really quickly. I have heard from other people who use other companies that it’s a struggle because it often looks core but when it’s in the cancer world, that’s really concerning ’cause then you freak out, oh my gosh, my four is not methylating, I’m going to get cancer but really it might just be noise and messiness. We choose, we can run it, we choose not to run it to not mislead practitioners since we’re not a 100% when it comes to that, something that small.

Dr. Weitz:            It’s too bad that there’s not some way to measure that ’cause that might be a way to decide how much methyl B vitamins to give.

Dr. Jones:            Yes, yeah, yeah, exactly. Exactly. It’s definitely a work in progress in trying to figure out the best way. Yeah, most definitely.

Dr. Weitz:            Right. How can we use dried urine testing to map out a woman’s cycle and what can that tell us?  How can that help with fertility problems or PCOS or things like that?

Dr. Jones:            Definitely. In fact, ours is called they cycle mapping. I just did mine. I do mine every January and so much like saliva, a lot of people are familiar with doing the month long saliva collection. You can do the month long dried urine testing if you’re looking for the entire month. It’s very easy. It’s very straightforward. Basically, almost every morning of your cycle, you will urinate on a piece of paper and let it dry and then by the time your next period comes and you mail everything in and the estrogen and progesterone is tracked out through the month. It’s really great for women who have cycle irregularity. Maybe they’ve had a partial hysterectomy or an ablation or they have the Marina IUD and so they have ovaries that function but they don’t bleed so they don’t quite know where they are in their cycle.  Women with a lot of fertility issues. Women who have symptoms all month long. I have a lot of women that say, “I’m symptomatic at ovulation, I’m symptomatic from ovulation until my period comes.” And so you need a much bigger picture, you need all month long as opposed to just a one day snapshot. I do mine every January. This January I was doing the fasting mimicking diet so I did it at the same time I was doing the fasting mimicking diet, I was doing cortisol collection and the cycle mapping and I’m doing my washout next month. I will collect a cycle map again, I’ll be a month removed from the fasting mimicking diet to see how it looks.

Dr. Weitz:            What did you find with the fasting mimicking diet and cycle mapping?

Dr. Jones:            My cycle mapping I did it last year, so all I have to compare it to was last year’s. Last year my progesterone rise is pathetic. Oh my gosh, that is pathetic. So sad. But my estrogen’s really high in the luteal phase and then this, when I just got the result back, my progesterone looks better and my estrogen’s not nearly as high which I don’t know yet if that’s my normal or if that because a year is spanned and I’ve done a lot of work. Or if that was the effect of the fasting mimicking diet. I’m waiting a month and then I’ll do it for the month of March and I’ll compare January then to March and if they look the exact same then, or maybe March will look better. Maybe March will look worse and then we’ll compare and see what’s going on. I’m collecting a lot of my own data points to see what’s happening. Including cortisol.

Dr. Weitz:            How well does dried urine help us to monitor women who are on hormones?

Dr. Jones:            As long as it’s bioidentical hormones, great. Obviously if it’s synthetic if like for example, they’re on the birth control pill, no testing is good if somebody is on the birth control pill, the patch, the ring because of the mechanism of action of that synthetic hormone. But, if somebody’s on oral progesterone, DHEA, vaginal estrogen, even bioidentical estring which is a prescription ring but it’s estradiol, the estrogen patch that menopausal women use. Pellets, lot of pellet therapy out there right now. Great, it works really great for that.

You did mention the topical hormone. Topical hormone can be a little bit of a challenge of course for dried urine but we find that topical hormone as you probably know, is challenging in really any testing realm. There’s no great, we can’t control topical hormone, it depends on the tissue it’s in. If you rub it in the inner thigh, if you rub it on the belly, if you rub it on your inner arm, if you’re far away from the saliva gland, close to the saliva gland, they’ve shown that the levels can definitely vary. If you rub it on topically, what it is in the endometrium, what it is in the breast tissue, what it is in that skin right there, varies. And that’s what makes it challenging, especially topical progesterone. Especially, progesterone’s just it’s own beast when it comes to the topical nature.  But as far as other hormone monitoring goes, great. It’s used often.

Dr. Weitz:            Right. I understand it’s not as effective for progesterone monitoring, right?

Dr. Jones:            Topical. Topical. Just like saliva. Saliva has a lot of caveats with topical progesterone, yeah. But with oral progesterone, people can, we much like saliva we adjust the ranges to account for first pass.

Dr. Weitz:            Okay. Let’s talk about the cortisol test. Dutch urinary cortisol test compared to the salivary cortisol test.

Dr. Jones:            Yeah, very different. With salivary cortisol you’re looking at free cortisol at certain points through the day. Usually salivary does first thing in the morning, around lunch, around dinner and before bed. That gives you the free inactive cortisol. With dried urine, you get three things. You get metabolized cortisol which sort of gives you the idea of can your adrenals even make cortisol in the first place? What’s your potential? You get the free cortisol, the bioavailable ’cause that’s what comes through. And you get cortisone which is inactive. I can tell you, can you make it? How much is free in the pattern? And then, what’s getting deactivated?  Because some people might have really low free cortisol and it’s not a production problem, it’s a deactivation problem. And the treatment’s different. It’s nice to see. And some people have everything. They don’t make it. They don’t have a lot of free. Whatever they do make, they deactivate and then those people are tired.

Dr. Weitz:            What do you do if it’s deactivated? What’s it mean for your cortisol to be deactivated?

Dr. Jones:            Your body always preferentially makes cortisol and it can deactivate it to cortisone. Not hydrocortisone, what everybody’s used to. Hydrocortisone, the topical that you get at the pharmacy, that’s actually cortisol, it’s just a pharmaceutical naming thing. Cortisone is inactive. It’s the inactive form of cortisol and the body can flip it back and forth depending on the location, the receptors it’s around and the need of the body. You may, if you systemically have an up regulation in the enzyme that deactivates cortisol then you’re going to have a lot more cortisone. Your body is not going to have a lot of cortisol available.

We see this a lot with chronic long term sort of stress states where the body is trying to get you to slow down. When it’s like, my analogy is like the body is tired of you burning the candle at the both ends so it will force you to slow down. It will convert to cortisone. The other time we see it all the time is immediately after illness. You’ve been sick, you got the flu this season, you’re back at work but you’re super tired. You see patients but you need to sit down in between, you’re out of breath. We see that a lot of times the body as part of the healing, will convert into cortisone, sort of one of those, if we slow you down, try to get you to heal longer, or hopefully you’ll rest so that you can heal faster, versus people who get sick and it seems to linger around for a while.   Those are the two big reasons that we’ll see cortisone be a lot higher on testing.

Dr. Weitz:            Does this tie into the whole issue about adrenal fatigue and if we see somebody with a fairly flat cortisol level and we’ve traditionally thought that the adrenal gland is burned out and can’t produce cortisol? That really what’s happening is is a lot of it’s being deactivated?

Dr. Jones:            It depends. If the metabolized cortisol is low and remember, unless it’s Addison’s disease, which is the autoimmune condition, the adrenal glands don’t burn out. They don’t run out of cells. It’s the brain where all the communication comes from. If the metabolized cortisol is low, then that means the brain is not telling the adrenal gland to make cortisol, therefore the free cortisol’s low.  If your cortisone is high though, then you may have low, flat cortisol because everything’s getting deactivated to cortisone.  In that case it’s not an adrenal issue at all. It’s not an HPA, meaning the brain is not telling the adrenal to make cortisol.  It’s getting deactivated.

Dr. Weitz:            Why would the brain tell the adrenals to make less cortisol?

Dr. Jones:            Lots of reasons. Over time you get a lot of feedback up to the brain to make less cortisol. You’ve got receptor issues. You’ve got tissue issues. But a lot of times it’s like a child that’s trying to get its mom’s attention and so it says it over and over. Mom, mom, mom, mom, mom and so you get this down-regulation because the body initially puts out lots of cortisol and then it’s like, oh good gracious and it starts to down regulate the cortisol. And so it’s more of a brain down as opposed to the adrenal gland itself. Again, this is assuming it’s not Addison’s it’s just over time, people get this down-regulation.  We also get assaults from all sort of environmental toxicants.  We’re surrounded by viruses and mold and these and other infections.  Again, initially it might bring your cortisol up but over time, it’ll start to drop it down.  The brain starts to down-regulate the cortisol response.

Dr. Weitz:            Now, myself and a number of other, a lot of Functional Medicine practitioners I’ve spoken to over the years, when we have patients who have this fatigue and you do one of these salivary cortisol tests and it shows that the cortisol levels are lower, flat lined, or something like that and then we use various sorts of supplements to help support the adrenal glands. Either we use adaptogens or we use glandulars or combinations and a lot of times those patients get better.  If it’s not that the adrenal glands are not producing, what are we really doing?  And why is it working?

Dr. Jones:            Right? Well think about it.  Everybody and I point this out all the time in lectures and people are like, oh yeah, of course.  We give herbs that adrenal adaptogens. Ashwagandha, rhodiola, Eleutherococcus, but they are not just adrenal adaptogens. They don’t just hone in on the adrenal glands.  They’re very immune supportive.  They’re very thyroid supportive.  They’re very digestive supportive depending where they are.  They’re very neurologic supportive.  And so when you give a quote unquote adrenal adaptogen, the title is misleading.  Yes, absolutely it helps the HPA access but it’s a very broad spectrum helper type of herb.  You’re getting the immune support, you’re getting the neuro support, you’re getting the GI, the thyroid support.  You just forgot ’cause you called it an adrenal adaptogen or you told the patient, “Oh, it’s ashwagandha.  It’s for your adrenals.”  But ashwagandha is supportive to the thyroid absolutely and the immune system.

Dr. Weitz:            Maybe with the glandulars we’re getting a good quality amino acid product?

Dr. Jones:            Absolutely. Absolutely. And it depends what glandular that you use. A lot of companies will mix a few together. They’ll put adrenal and they’ll add in some other thymus or spleen or whatnot or brain. They’ll put in hypothalamus or thyroid. You’ve got this minute blend of some other really good glandulars that are helpful for other parts of the body and now things are working again ’cause you’ve got support from a systemic point of view, you just patient’s just didn’t realize it.

Dr. Weitz:            Cool.  Can you talk about the cortisol awakening response and how you measure it with your test and what incidence of this is?

Dr. Jones:            It’s one of my favorite tests actually. The cortisol awakening response, the CAR, when you wake up in the morning, when your eyes open up then the signal goes from your brain to your adrenals to make cortisol right now. While you were sleeping, the signal is starting to get bigger and bigger and bigger but the adrenals aren’t listening because you haven’t yet opened your eyes. Once you open your eyes, all bets are off. Signal goes up, cortisol comes out.  Your cortisol goes up exponentially in about 30 minutes. It goes up in about 30 minutes-ish and then after about 60 minutes, starts to fall back down and that initial up down in 30 to 60 minutes is what’s known as the cortisol awakening response. It’s super important. They call it the mini stress test of your day because it’s what gets your butt out of bed. It’s what helps you deal with the fact that you haven’t had breakfast yet. It’s blood sugar balancing, it helps with inflammation, your immune system. It helps reduce autoimmunity. And if you can’t get that right, if you overshoot, if you’re too high or if you undershoot, you’re too low, you’re flat lined, then you’re not going to get the rest of your day right either is what they say. If you can’t get that right, you’re going to miss a lot of other important parts of your adrenal response because you can’t get that part.  You’re going to have inflammation issues. You’re going to have blood sugar issues. You might have autoimmune issues because you don’t get that initial CAR right. It’s a neat little test for those people who are really struggling with all sorts of symptoms.

Dr. Weitz:            And so let’s say somebody has, doesn’t have that initial response, but then the rest of their adrenal pattern is normal.

Dr. Jones:            But, remember, it’s going down. It’s easy to go down. It’s hard to go up. With the rest of the day normal, what you’ll see is maybe their afternoon and their dinner point in range but what you don’t know is if their response to things have been normal. You don’t know if those people are having normal responses to stress, normal responses to blood sugar issues, normal responses to pain.

Dr. Weitz:            I got it.

Dr. Jones:            All you see are the point in the afternoon and the point at night. And usually I’m sure you have your patients tell you, “No, I don’t feel normal.” Usually they say, “No, I have hyper, hypoglycemia. Yes I have pain. I feel more inflamed. My autoimmune is worse. I can’t sleep.” You’ll get these symptoms.

Dr. Weitz:            Now I know one of the issues with the salivary cortisol testing is that it seems especially to women, say “I can’t fill up that little tube.” I know your testing uses a different method, right?

Dr. Jones:            We do. The cortisol awakening response can only be done in saliva. While we are a dried urine company, when we do the cortisol awakening response, we do have a saliva component of it. Our saliva component are on these little sort of microfiber, basically like a cotton swab, like a wad of cotton. People just put it in their mouth and get it wet as they’re doing the testing. There’s no spitting, they just have to put cotton in their mouth and get it wet and then put it back in the tube.  The reason we can do that is we don’t pull other hormone off of the cotton swabs. You can’t pull hormone, especially progesterone off of those cotton swabs. There’s a lot of interference and so saliva companies have tried in the past to do the cotton swabs but then they realized to get the rest of the hormones they need free flowing saliva but cortisol does not have that problem in the cotton swab so that’s why we can use ’cause we pull hormones off the dried urine and cortisol when we’re doing the cortisol awakening response off the cotton swab.

Dr. Weitz:            Yeah, I’ve heard some discussion of one of the issues with doing this kind of test with the spitting into the little tubes is if the person’s stresses out about it then they’re going to create an adrenal cortisol response just trying to fulfill the test.

Dr. Jones:            And the other, and I hear this response as well is you’ve got 30 minutes. When you’re doing the cortisol awakening response so you wake up, let’s say you wake up at 6:00 in the morning and you immediately have to fill up the tube with saliva, and then but you have to it again at 6:30 in the morning and then you have to it again at 7:00 in the morning and that can be really time consuming if you’re also trying to live your life or get ready for work or get your kids ups and going. And if it takes you 10, 15, 20 minutes to fill a tube but you have to do it every 30 minutes, I have definitely had that feedback that it is a challenge.  Some companies what they’ve done to counter that is they’ve shortened their tubes. There are a few companies that have heard people’s complaints and now make smaller tubes for the cortisol awakening response. Not as much saliva’s needed.

Dr. Weitz:            I see. The first test tube, the first tube, has to be done within five minutes, right?

Dr. Jones:            Right. Which is the other problem because if you’re still trying to spit in a tube 20 minutes later, you’re sort of missing the point.

Dr. Weitz:            And you can’t get up and get a glass of water and things like that.

Dr. Jones:            No. You’ll dilute it. You can’t do it. You can’t eat. You can’t drink. You can’t wash your mouth out. You can’t do any of that because you will dilute the saliva. You can’t dilute the saliva.

Dr. Weitz:            Now, but what about doing a urine test? What if you can’t urinate? Do you just drink as much water as you can? Or does that throw it off?

Dr. Jones:            You can’t. No. The first morning, the first test is very easy ’cause usually most people have to wake up and go to the bathroom. With the Dutch test when we’re doing the hormone part, you do it on waking and then two hours later. In between those two hours, we suggest people drink no more than eight ounces of fluid. And the reason is we’re a urine test so don’t dilute it. Just like with saliva, you don’t want to drink water and then spit in the tube ’cause you’ll dilute it. If you drink copious amounts of water and hope to help yourself urinate, then you will dilute the results.  We do suggest no more than eight ounces in between that two hour mark. Which can pose a problem for some people still but so far, most people, we don’t require much and so just a little bit to saturate the filter paper.

Dr. Weitz:            Cool.

Dr. Jones:            Yeah.

Dr. Weitz:            Good, good. I think those are the questions that I had prepared for you for today and I think that was good amount of information.

Dr. Jones:            Yeah, covered a lot.

Dr. Weitz:            How can our listeners and viewers find out about the Dutch testing?

Dr. Jones:            Easy enough, website, dutchtest.com, everything on there is free. You don’t have to be an actual practitioner. Right now all our videos and webinars and guide sheets and whatnot are all on there and they’re all available so people can go learn.

Dr. Weitz:            And what about patients? Can patients order the test directly themselves?

Dr. Jones:            They can order the test directly themselves.  Unfortunately, when they do order it from themselves, we do have quite a markup on there and we don’t give any medical support. If somebody orders it themself, we do refer them.  We have a Dutch provider referral network that we refer to every day all the time but we strongly encourage people to find a provider first and go through their provider to order the test because then of course they’ll get good quality care as opposed to floundering around by themselves.

Dr. Weitz:            Right. Their best bet, find a Functional Medicine practitioner.

Dr. Jones:            We can help with that people.

Dr. Weitz:            Themself.

Dr. Jones:            Yep, come see you.  Call the lab.  Let us know where you live.  We can direct you to somebody who’s Dutch qualified and then they can help.

Dr. Weitz:            Excellent. Thank you Carrie.

Dr. Jones:            Yeah, thanks so much. I appreciate it.

 

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Preventing Autoimmune Disease with Dr. Shelly Sethi: Rational Wellness Podcast 97
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Dr. Shelly Sethi discusses Preventing Autoimmune Disease 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. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]

 

Podcast Highlights

4:37  In the Functional Medicine world instead of just treating the overactive or dysregulated immune system that we see in autoimmune diseases, we search for some of the underlying triggers, such as leaky gut, food sensitivities, toxins, infections, nutritional deficiencies.  Dr. Sethi said that the first place we should look for potential triggers for autoimmune diseases is the gut. We now have discovered that there are certain specific bacteria and viruses and parasites that are associated with specific autoimmune diseases.

6:55  Dr. Sethi said that food sensitivities can play an important role as triggers for autoimmune diseases, so she will often start her patients with an elimination diet that eliminates all grains, esp. gluten, dairy, soy and sometimes eggs and nuts, for at least 30 days and then she will test each food back for three days.  Sometimes she will get a patient who has had a food sensitivity test run that shows that they have a lot of different sensitivities, then she will focus on healing the leaky gut.  She will often then look at the gut and do a GI Map stool test from Diagnostic Solutions and an organic acids test from either Great Plains or Genova Labs to look for evidence of bacterial or fungal overgrowth. Dr. Sethi will also look at the secretory IgA on the stool test as an indication of the status of the gut immune system. If the secretory IgA is low, she will support the gut with things like vitamin A, vitamin C, Saccharomyces, and she will sometimes use amla. She may use colostrum or a dairy free colostrum product.  If the secretory IgA is high and she also sees organisms like Citrobacter or Klebsiella, which are highly associated with autoimmune conditions, she may refer to a gastroenterologist to get scoped to look for Inflammatory Bowel Disease.  Once the immune system is supported, if they have a parasite, she will use a product that contains Mimosa pudica.  If there is bacterial overgrowth, she may use an antimicrobial product that contains berberine.  She may use mucilaginous herbs like diglycerized licorice (DGL) and marshmallow to soothe the gut.  Zinc carnosine can also be helpful. She will often used a product with a blend of these. She will often follow an antimicrobial protocol with some liver support such as milk thistle.  She may add some binders like activated charcoal or zeolite clay or fulvic acid for two to three months.  She also will use spore based probiotics.

20:22  Exposure to toxins like heavy metals, plastics, phthalates, BPA can negatively affect the gut microbiome and lead to leaky gut or dysbiosis or SIBO.  Also, if the gut membrane isn’t healthy, then you can become nutrient deficient. This is why Dr. Sethi will include an organic acids test with her initial testing.

22:10  I asked Dr. Sethi to go through a few case studies, starting with a case of Hashimoto’s autoimmune thyroiditis.  She said that often she will get a patient with Hashimoto’s and they have been given Synthroid by their conventional doctor as their only option.  Either nobody has even measured their thyroid antibodies or they only measured after the TSH is elevated. Dr. Sethi mentioned that she has some kids in her practice now who are 10, 11, 12 years old who’s parents or relatives have Hashimoto’s and she finds that their TPO antibodies are already elevated.  She will then look at their lifestyle for triggers like food, stress, toxins, or bacteria or parasites in the gut. Dr. Sethi has a 12 year swimmer who’s in chlorinated water every day of the year, which could be triggering her thyroid problems, since chlorine competes with iodine. Dr. Sethi talked to her patient’s endocrinologist, who disagreed that chlorine could be a problem, but the girl took a break from swimming in the summer and they also got inflammatory foods out of her diet, got her sleeping better, and had her introduce a meditation practice every day. By the end of the summer, the rash that she had had on her skin, which looks to be some sort of scleroderma-type thing, had actually shrunk to half the size. Her dermatologist was shocked.  Dr. Sethi talked about the importance with patients with hypothyroid of replenishing selenium and zinc and magnesium. Also we are starting to see more iodine deficiencies, esp. in vegetarians unless they are eating seaweed. Also people are no longer eating iodized salt and are buying sea salt or Himalayan pink salt in bulk and iodine evaporates when it’s exposed to air. Salt should be kept in a darkened container and you should go through it quickly.  Also much of the public water has both chlorine and flouride added, both of which compete with iodine.  And then there’s the gluten thing, since if your immune system reacts to gluten, it can cross-react and attack the thyroid tissue.

31:34  If a patient wants to prevent autoimmune diseases but does not currently have any symptoms, Dr. Sethi says that autoimmune diseases are really all related and tend to have similar triggers. We should start by looking at the microbiota with GI testing with the pcr stool test and the organic acids urine test. She will look at inflammatory foods that might be in their diet and either eliminate them for a month or do food sensitivity testing. She recommends making sure you are having your drinking water filtered with reverse osmosis or at least a Berkey filter. Make sure that you are not getting exposure to mold. Consider a HEPA filter in your bedroom.  Look at nutritional deficiencies. Everybody should at least be taking a high quality multivitamin. Dr. Sethi cautioned to be careful about doing some of the autoantibody testing, esp. on kids, since there can be some false positives. 

 



Dr. Shelly Sethi is an integrative, Osteopathic Physician who is board certified in integrative medicine.  She has written a best-selling book, Built To Thrive.  Dr. Sethi’s website is Dr.ShellySethi.com and you can make an appointment to see her by calling 512-215-9984.

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



 

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 doing to drweitz.com. Let’s get started on your road to better health.  Hello, Rational Wellness podcasters.  Thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness podcast, please go to iTunes. Give us a ratings and review. That way, more people can find out about the Rational Wellness podcast.

Our topic for today is the natural treatment for autoimmune diseases, and we’ll be speaking with Dr. Shelly Sethi.  There’s been a significant increase in autoimmune diseases in the last several decades. We also have come to realize that a number of diseases that we didn’t understand the autoimmune origin, that now we’re starting to understand. Now there are approximately 100 different autoimmune diseases. For some reason, 75% of these occur in women. Having two X chromosomes seems to create a lower risk of infection in women, but a higher risk of autoimmune diseases.  According to the American Autoimmune Related Diseases Association, there are approximately 50 million Americans suffering with autoimmune diseases. Some of the more common autoimmune diseases include Alzheimer’s disease, Parkinson’s, asthma, hypothyroid, rheumatoid arthritis, lupus, psoriasis, celiac disease, irritable bowel syndrome, Crohn’s disease, multiple sclerosis, and type 1 diabetes.  

Our immune system is designed to protect us from pathogens, like bacteria, viruses, and parasites, as well as to help us repair our tissues when they’re damaged. But what happens in autoimmune diseases is that our immune system mistakenly attacks our own cells and organs. The conventional medical approach is to treat autoimmune diseases either by controlling the symptoms, such as by providing thyroid medication in the case of Hashimoto’s thyroiditis, or by using medications that suppress the immune system, such as corticosteroids steroids or chemotherapy agents or the newer immune-blocking drugs, like HUMIRA and REMICADE.   These drugs simply block part of our immune system, which is a problem because you do need a properly functioning immune system, and they have potential side effects, like infections and cancer. But functional medicine treats autoimmune diseases by looking at some of the underlying factors that lead to the immune system getting dysregulated, such as leaky gut, food sensitivities, toxins, infections, nutritional deficiencies. This is all very important.

If I have a patient with hypothyroid, and it’s autoimmune in origin, and all this patient is treated with is thyroid medication, it doesn’t do anything for these smoldering fire of the autoimmune disease underlying it. This will continue to attack the thyroid gland. Chances are, it will continue, and the patient will need higher dosages of thyroid medication. Or, they may end up with another autoimmune disease because, statistically, they have a much higher risk of that. So, from a Functional Medicine perspective, not just regulating the thyroid, but also putting out that smoldering fire of autoimmunity is crucial for this patient’s long-term health.  Dr. Shelly Sethi is a board-certified family physician with an emphasis on integrative and functional medicine. She studied integrative medicine with Dr. Andrew Weil and was also certified by the Institute of Functional Medicine. She also practices yoga and meditation and has written a number-one best-selling book, Built to Thrive. Dr. Sethi, thank you so much for joining me today.

Dr. Sethi:             Thank you for having me.

Dr. Weitz:            What do you think are some of the most important triggers for autoimmune diseases?

Dr. Sethi:             Yeah. That’s such a good question and, I think, really under-addressed in the conventional community as you let us know. I feel like one of the first things that we should be looking at, really, is the gut because we know that many of the triggers that are coming to light for a number of these autoimmune diseases really do stem from what our microbiome or microbiota look like. In the advances in research in this field, we’ve really found that there are a number of various bacteria as well as viruses and parasites that have been associated with very specific autoimmune diseases. So, I think we’re really coming to a new era in the diagnosis and treatment and prevention of autoimmune disease.

Dr. Weitz:            Cool. How do we diagnose autoimmune diseases?

Dr. Sethi:             Yeah. In conventional care, the typical way to diagnose is to run a series of blood tests. Typically, what you’re looking at are a number of things like antibodies that are related to various types of proteins that are produced in the blood. For example, looking at an anti-nuclear antibody, an ANA, would be a screening test, an initial test that’s typically run for somebody who might be presenting with things like fatigue and joint pain or inflammation, something to really trigger the doctor to think that maybe there’s something going on that’s autoimmune-related.  Then, from there, that is … Standard conventional care, that’s kind of the screening test. We also typically had been taught in medical school that if somebody presents with symptoms of rheumatoid arthritis that you would also run the RA panel, which also will look at antibodies. Then, from there, typically a patient would be referred to a rheumatologist who would then run a series of additional tests, which are highly specific to certain autoimmune conditions, and there’s a number of those different antibodies.

Dr. Weitz:            Cool. What’s the role of diet and food sensitivities in autoimmune diseases?

Dr. Sethi:             From my training in integrative medicine and Functional Medicine, I can tell you it’s huge.  I will also say that what’s happening now, at least in my practice, is that I’m getting a number of referrals from the conventional rheumatologist into my practice because they are starting to recognize that food and diet and lifestyle have a significant impact. But unfortunately, the training isn’t there. Right?  They’re just not taught in medical school, and I know because I was there myself, what to do about it.  What they’ve been telling their patients is, “You need to change your diet, maybe even anti-inflammatory diet, and maybe reduce stress a little bit,” which isn’t enough information for patients. What I’ve found is that over that last couple years, the number of referrals to me in from rheumatologists into my practice has really increased, which is really exciting-

Dr. Weitz:            That’s great.

Dr. Sethi:             … because we’re able to then really get into it, look specifically at food sensitivities, look at whether or not they’ve been tested for celiac, which, of course, is more specific to gluten sensitivity or gluten allergy. Then, of course, the lifestyle component is huge, and we do a lot of that in my practice. I find that the combination of being able to really work with food sensitivities, dietary changes, lifestyle, medicine, along with what the rheumatologists are doing to help their patients once they’re so far along into the disease process I think is really effective.

Dr. Weitz:            How do you screen for food sensitivities? Do you just tell them to avoid some of the most common food sensitivities, like wheat, dairy, soy? Do you do an elimination diet? Do you do food sensitivity testing?

Dr. Sethi:             I do all of the above. I sort of have an order to that, and it’s because what I’ve found is that, oftentimes patients will come to me because they’ve had a food sensitivity test done by another practitioner or a nutritionist or somebody who is running this panel, and suddenly, they’re allergic to … 50 things show up on their panel, and they’re really stressed because they don’t know what to eat. They’ve lost some weight. They feel really nervous and fearful of eating different foods, and part of my job is to say, “Let’s really look at this from a standpoint of what makes sense.”  I don’t really believe that the body would come to a place where it would be allergic to 100 different food items. I think that in that situation, when you’re seeing that sort of thing turn up on a food sensitivity test, what you’re really looking at is leaky gut. When you begin with the gut-healing process, and you fix leaky gut, and you repeat that food sensitivity test, oftentimes, you find that it just might be a couple of items.  That being said, the gold-standard still is elimination. Right? A full-elimination diet, eliminating each of those foods for at least 30 days and then replacing them one by one over the course of three days is really the only way to truly understand whether or not somebody has a true sensitivity to a food, at least that’s what I’ve found in my practice.

Dr. Weitz:            So, how do you do … Let’s say you do have a patient. They come in. They have this food sensitivity panel, and they have 50 different positives. How do you do an elimination diet? You’re not going to eliminate all of those. What are you going to eliminate in your elimination diet? How many foods are you going to include?

Dr. Sethi:             Yeah. To start with, I would actually probably put that aside for now and begin treatment of leaky gut. Right? I would first say, “Well, let’s fix the gut.” Now, in part of that fixing of the leaky gut, we are going to remove from the diet kind of our top five things that seem to be quite inflammatory regardless, right, so of course, gluten. I typically eliminate dairy, soy, grains from somebody’s diet for at least a time period. I think that if we’re really thinking there’s an egg allergy, nuts, we can do those as well, but I try not to give them a lot of things to do at once. What I find is patients get really overwhelmed. We want to try to meet them where they’re at but also really be kind of strict about the fact that we need to get some of these top items out of their diet, so that’s what I found-

Dr. Weitz:            So, you said gluten, dairy, soy. What else?

Dr. Sethi:             Grains, initially.

Dr. Weitz:            All grains. Okay.

Dr. Sethi:             All grain initially is typically what I do for 30 days.

Dr. Weitz:            Okay.

Dr. Sethi:             If that’s really difficult, then we will focus on the non-gluten grains for them. Then, depending on … Sometimes I also really get a food history and say, “Well, what do you eat a lot of?” If there are a lot of eggs in their diet, like if they’re eating three eggs a day, and they’re presenting with skin rashes, then we might also say, “Let’s eliminate that for 30 days as well and see what happens.” Oftentimes, that gives us a really good idea of what really might be happening in the gut.

Dr. Weitz:            Then, do you test for leaky gut?  Or you just figure they must have leaky gut because of the way they present?

Dr. Sethi:             Yeah, I’ve gone back and forth on that. I have used Zonulin. I haven’t found it to be as helpful, in all honesty, as I wanted it to be. I think we get a lot of information. I typically actually run the PCR stool tests, so I’m usually looking-

Dr. Weitz:            You use a GI Map?

Dr. Sethi:             I use a GI Map. That’s one of the very first things that I do with my patients. I also combine that with an organic acids test so that we can look at small intestine and look to see if there’s bacterial overgrowth or fungal overgrowth, and those two tests together-

Dr. Weitz:            Is that through Great Plains or Genova?

Dr. Sethi:             I use both. It just depends on insurance and cost for the patient, so I’m familiar with both of those and offer either one of those tests, depending.

Dr. Weitz:            Okay.

Dr. Sethi:             Yeah, so we’ll start with that typically. Then, that gives me enough information to get started.  Usually, we’re looking at a number of different organisms that either are imbalanced or an overgrowth.  Or, oftentimes, we’re picking up parasites or C. diff or H. pylori, all of which we know now have been associated with very specific autoimmune conditions, like ankylosing spondylitis, and MS, rheumatoid arthritis.  So, I feel like that’s the best place to start for most patients. We get enough information to move forward.  Then, once we’ve really fixed up the leaky gut situation, then we’ll run a food allergy panel, especially if they’re not getting the results that I would expect.  But if they are getting the results that I expect, I don’t always run those panels.  I still really urge my patients to be gluten-free and dairy-free because I do think that, no matter what, those are two foods that I feel are quite inflammatory in most of our diets these days.

Dr. Weitz:            Let’s say you run those two initial panels. You do the GI Map, and you do the organic acids testing. Say, the organic acid testing has maybe some indication that there might be a little fungal overgrowth and the GI Map shows some bacteria that are overgrown or maybe a protozoan or something like that. What sorts of treatments will you then do?

Dr. Sethi:             Yeah. Usually, I’m also looking at what their immune status looks like in the gut as well. Right?  Secretory IgA is a really good marker for that. If they look like they need a little help there … First, we’ll work on supporting the gut with things like Saccharomyces, vitamin A, vitamin C.  I like to use amla in some of those patients.

Dr. Weitz:            In other words, if their secretory IgA is low, that might indicate that their immune system in their gut is not functioning properly to help them get rid of these pathogens, so then you’re going to try to support the immune system?

Dr. Sethi:             Yes, absolutely. If the secretory IgA is high, it actually gives me another indication that their immune system is really turned on, and it’s trying to fight something.  So, it’s a nice marker.  I also look at the calprotectin and other inflammatory markers in the gut.  I’ve actually diagnosed a number of patients with inflammatory bowel disease just from that GI Map and got them over to the GI and 

Dr. Weitz:            Just because they had a elevated calprotectin?

Dr. Sethi:             Mm-hmm (affirmative), elevated calprotectin. Sometimes, there’s blood in the stool and a particular sort of look to what their dysbiosis looks like as well, so-

Dr. Weitz:            Oh, really? What sort of things do you see in the dysbiosis factor?

Dr. Sethi:             Well, with IBD, oftentimes, I’ve seen organisms like Citrobacter or Klebsiella, which are highly associated with autoimmune conditions. That tends to come up quite a lot, actually, just in my experience working here with patients.  At that point, I say, “Let’s just go a little further and get a colonoscopy and figure out what’s going on.”  Supporting that secretory IgA, the immune system, it really doesn’t take very much.  A lot of it is-

Dr. Weitz:            Do you use-

Dr. Sethi:             … natural foods, like-

Dr. Weitz:            Do you use colostrum as part of that protocol?

Dr. Sethi:             I do if we’re not very concerned about a dairy allergy. I know there’s kind of mixed evidence on whether or not it should be avoided with a dairy allergy or not. I’ve found most people-

Dr. Weitz:            And then use a non-dairy colostrum product as well out there.

Dr. Sethi:             Yes, and so sometimes we’ll use that as well. But I also think Saccharomyces boulardii is one of the best ways to increase and help the immune system of the gut as well.

Dr. Weitz:            Cool.

Dr. Sethi:             Yeah. Vitamin A, vitamin C, those are two other big ones that we usually start our patients out on and get that immune system working.

Dr. Weitz:            Then, once you got the immune system working, what’s the next level of protocol?

Dr. Sethi:             Yeah. Then, it would be really getting rid of what’s there. If they have parasites, I actually really like the parasite protocol from BioCore Cell Sciences or Core Cell Sciences. They use a product that has Mimosa pudica in it, which … In the work that I’ve done trying to work with organisms like Dientamoeba and some of those ones that are a little bit more difficult to get rid of from the gut, this is the one product that works immediately, so that’s my go-to for parasites.

Dr. Weitz:            Interesting. Mimosa, okay. Cool.

Dr. Sethi:             Yeah, it works really well. Then, if they are dealing with a bacterial overgrowth, it really depends if it’s H. Pylori or some of the other ones like Klebsiella or Citrobacter, we’ll start using … Products that contain berberine, that’s a very, very effective antimicrobial. Things that contain mucilaginous-type botanicals as well, like DGL and marshmallow’s one of my favorite- Yeah, all of those. Zinc carnosine is really nice to add in there as well. There’s a number of products, and I typically … In order to reduce the number of supplements that a patient’s taking, I have my mixed blends of products that I like to use to get rid of the overgrowth or the parasites.

Dr. Weitz:            So, you’ll use anti-microbial herbs and also supplements to help strengthen the gut at the same time?

Dr. Sethi:             I do, yeah. I’ll do typically the support for the immune system. Then, it’ll be followed by an antimicrobial-type protocol along with some liver support. Because a lot of times, as there’s die-off from those organisms, we want to make sure that they’re on some milk thistle and other things to support the gut, sorry, the liver. Then, of course, something to sort of bind to those things as they’re dying off as well, so either an activated charcoal or zeolite clay or fulvic acid or something of that nature. That’s usually going on for about two to three months with most patients.

Dr. Weitz:            Okay.

Dr. Sethi:             Then, once we kind of get them through that phase, the killing phase, I’ll retest. Usually, I retest at that point and look to see whether or not we’ve really budged with the balance there and gotten that secretory IgA increased. If so, which in most cases, I would say three months is typically enough, we’ve been able to get rid of C. diff or H. pylori or some of those more aggressive organisms or the fungal overgrowth.   Then from there, we really go into kind of soothing the gut. There I like to use zinc carnosine, marshmallow, chamomile, all of those sorts of things, antioxidants, quercetin, those sorts of things that really do help the gut kind of restore, and, of course, some of the spore-based probiotics as well at that point.

Dr. Weitz:            Cool. L-glutamine as well?

Dr. Sethi:             L-glutamine as well, yes. Yes.

Dr. Weitz:            Okay. What part does toxic exposure play in the etiology of autoimmune diseases?

Dr. Sethi:             Yeah. I think that there’s a lot of different things that we are starting to understand can affect the gut. Right? Heavy metals for one, which can come through the air that we’re breathing. Can also come from exposures through amalgams and things like that. Certainly, plastics, phthalates, BPA, all of those things do affect the microbiome. I think what we’re seeing now is that, as they’re doing more and more research on a lot of these different toxic substances in our environment, we’re really finding that the way in which they actually affect our bodies the most is probably mitigated through the microbiome itself.  I always tell my patients, “You’re only going to be as healthy as your gut is.” So, if the gut’s not healthy because of toxic exposures, poor lifestyle, poor sleep, increased stress, poor nutrition, then you’ve already got a situation where you’re set up for leaky gut or dysbiosis, SIBO, SIFO, all of those various things.

Then, on top of it, you’re really going to become nutrient deficient because if the gut membrane isn’t healthy, you’re not going to be able to absorb the nutrients that you should be absorbing just from your food. So, you could have the cleanest diet, and have all this organic food, but not absorbing all those nutrients, which is why I also include that initial organic acids test so I can really understand what their vitamin deficiencies and nutrient deficiencies look like from the outset. In addition to doing a gut treatment, I will replenish them with nutrients that they’re deficient in so that the cells can really begin to heal with all of those nutrients that they need.

Dr. Weitz:            Cool. Let’s go through a few case studies. I understand you’re not going to have all the details, but just sort of in general, some of the ways you would approach a few patients.

Dr. Sethi:             Sure.

Dr. Weitz:            If you have a patient who comes in, and they have Hashimoto’s autoimmune thyroid, and as far as we could tell, no other blatant symptoms … Obviously, you’re going to do a careful history and find out if there’s anything else going on. But in general, how would you investigate this patient? What direction would you look at? How would you try to find some of the underlying triggers? What tests would you consider running?

Dr. Sethi:             Yeah. That’s a great question. I get a lot of patients with Hashimoto’s because when they see their conventional doctor, they’re typically just given Synthroid. That’s their option. They start to do their own reading. Many of them have been … They’ll come across somebody like Dr. Izabella Wentz’s book or other books out there in the functional medicine community, and they know that there’s more they can do. So, they usually come in with a diagnosis, hopefully fairly early in their diagnosis so we can get them going, and one of the-

Dr. Weitz:            Unfortunately, a lot of times, antibodies aren’t even measured. Or, if they are, they don’t really know what to do with them, so they’re just sort of ignored.

Dr. Sethi:             Absolutely. I am finding that a lot more of the conventional docs are starting to measure the antibodies, but only at the time of when TSH has been found to be elevated, right, which is a little too late. You really want to be measuring your antibodies for thyroid a decade in advance because you can actually start to see that number rising. I mean, I’ve actually got patients in my practice right now who are 10, 11, 12 years old. Their parents have … The mom has Hashimoto’s. The aunt has Hashimoto’s. The moms are concerned, so they’ve brought them into me for testing, and we’re finding those antibodies already.

Dr. Weitz:            Wow.

Dr. Sethi:             Yeah, which is shocking to me. Because when I was in medical school, Hashimoto’s was a funny name for a disease we would never see, and it is one of the more common calls that I get these days is help with Hashimoto’s. So-

Dr. Weitz:            Interesting. I’ve kind of had a little running debate with another prominent Functional Medicine doctor who says, “Wait until the TPO antibodies get over 500, you shouldn’t really worry about it.”

Dr. Sethi:             I disagree with that because I think there’s a lot you can do, so why don’t we talk about that for a minute?  Because I think that’s really, really important. What it does for, I think, patients’ family members and just people in general is give them hope, where they don’t … In conventional practice, we wait till we see the disease to give the patient any hope.  And it’s not even really hope.  It’s really just a pill.  But here we can say, “No, this is … Your body has the capacity to heal itself,” and that is my bottom-line premise of my practice is that the body has the capacity to self-heal. It’s one of the very first osteopathic tenets, which I learned in DO school. I abide by that, and I let my patients know there’s a lot that they can do. Just because you have the genetic predisposition for something does not mean that’s your destiny. There have to be triggers, and the triggers typically come from the environment and your exposome, so all the things that your body is exposed to. That might be food. It might be stress. It might be toxins. It might be neuroendocrine disruptors. It might be bacteria, parasites that live and thrive in the gut. It might be a number of things.

When I see these young kids that are already showing signs of elevated antibodies, it’s telling me that something is triggering that process on to where the body is now attacking the thyroid gland. So, what can we do about that? We begin to look at their lifestyle. This 12-year-old girl that I’m treating right now, she’s a swimmer. She’s in chlorinated water every day of the year. We live in Texas, so that’s a lot of the year. I had to have a talk with her that the skin rashes, the antibodies … She’s already to the point where the TSH is elevated, and so her endocrinologist wants to put her on medications already. We really have to consider taking breaks from the chlorine if not considering what it means in terms of giving that up. So-

Dr. Weitz:            For those of us who are not aware, chlorine is in the same row in the periodic table as fluorine and iodine. So, potentially, chlorine could interfere with iodine, which is an essential nutrient for thyroid function, correct?

Dr. Sethi:             Absolutely. That’s exactly how we think it interferes. I did have her talk to her endocrinologist about it. He was in disagreement with my theory. But I will tell you that, in the summer, I asked her to take a break, and she did. Of course, we did interject a lot of the lifestyle changes. Got inflammatory foods out of her diet. Got her sleeping better. Had her introduce a meditation practice every day. But at the end of the summer, the rash that she had had on her skin, which looks to be some sort of scleroderma-type thing, had actually shrunk to half the size. Her dermatologist was shocked.  Now, I can’t tell you this was a large multi-study, multicenter, randomized, controlled trial, but I think we’re past that point of really considering that to be the gold standard in medicine. Patients, they are individuals, and we have to think of them as an N-of-1. To me, this was a study in what happens when we remove chlorine from her life? What happens to her symptoms? Her mom was in agreement that they really did think it had a lot to do with her not having that chlorine exposure for at least three months. So, there’s a lot that can be done earlier for prevention, which is why I really do advocate for testing our girls early, especially if there is a family history.

Dr. Weitz:            You ever test for halides, like chlorine and fluoride?

Dr. Sethi:             I haven’t really gone down that path… I did with her, but it’s not something I typically do on a routine basis. It’s something I do want to look more into, but I think that we get a lot of benefit just from doing things like replenishing selenium and zinc and magnesium, which so many of these girls are really low in, all of these things being really, really important for the thyroid.  Our vegetarians typically can be iodine deficient. Oftentimes, I’ll test a urine iodine to look for iodine levels because that’s a hugely missed thing now in our society, especially as people have migrated over to using sea salt, which is oftentimes not iodized. There are also vegans, so they’re not eating seaweed. They’re not eating fish. They’re not getting any source of iodine in their diet.  Also, people are buying salt in bulk. Iodine evaporates when it’s exposed to the air, so I oftentimes advise people to buy small amounts of salt. Keep it in a darkened container, and go through it quickly. That’s a huge area where we’ve been able to find that we can do something about as well.

Dr. Weitz:            Yeah, no. In the natural medicine community, a lot more people are using sea salt, Himalayan pink salt, Redmond Sea Salt, so they’re not getting as much iodine as they used to get. Then, so much of the water has chlorine in it and also fluoride, and they may be brushing their teeth with fluoride toothpaste or using fluoride mouthwash.

Dr. Sethi:             Absolutely. Yes, and they do have to look at their city to figure out whether it’s chlorinated or not. We talk about water filters. That’s just another easy way to be able to have a decrease in some of these toxins in the environment. I do think there’s a lot you can do to reduce exposures, which then really do affect whether or not those genes are turned on or not, really.

Dr. Weitz:            Right. Then, of course, foods like gluten can cross-react with thyroid tissue. Right?

Dr. Sethi:             Yeah. There’s always that debate early on with my patients about gluten, so what I ask them to do is I ask them to do 30 days. I think probably 80% of them come back after 30 days and say they feel significantly different. Then, that’s typically enough for them to stay motivated to really stay as gluten-free as possible. There’s a good 10 to 20% that are like, “I’m going to have my pizza.” At least now we have cauliflower pizza options.

Dr. Weitz:            You mentioned a girl whose relatives have hypothyroid. What about somebody who comes to you who’s just concerned about autoimmune diseases because a number of their relatives have had a number of autoimmune diseases? I know that there’s one lab that actually has a multiple autoimmune panel. How would you approach somebody who says, “I don’t know that I have any symptoms of autoimmune disease, but I just want to prevent it. It seems like I have a high family history of it”?

Dr. Sethi:             Yeah. I think there’s a number of steps to really consider. Depending on what the autoimmune condition is, and again, the way I describe this to patients is that if you have a family history, then you do probably have some predisposition to a particular kind of … I think of it like a tree. You have the roots, and then how it branches out may look different in you than somebody else, but all autoimmune conditions are really related. It’s just how it presents itself in your body or maybe what your specific triggers were in the environment.   So, knowing that they’re all related, I think there’s a lot that can be done early. In a patient like that that would present to me, I would absolutely want to really look at the gut. Right? We want to look at the GI mucosa. We want to look at the microbiota. I think there’s a lot we can do there. I typically recommend getting those tests once a year. I do it on my entire family. I’ve got two young kids, six and eight. We all get our GI tests done once a year so we can keep things going and healthy.

I also usually do look at any inflammatory foods that might be in their diet, and we talk about that. Removing those from the diet early on can really have a long effect on chronic disease processes in the later life. Then, we want to look for potential food sensitivities and eliminate those. So, if it seems as though something’s presenting like a food sensitivity, we’ll do removal or maybe even do a food sensitivity test around that.  Some of those are quite easy to tell. They’ll say, “Oh, every time we have nuts, I get a little just itching around my mouth, or I notice stuff when I eat this particular …” I had a guy last week who … He’s been going to an Indian restaurant and eating Saag Paneer every week, and he’s like, “You know, it just occurred to me that every time I eat that, I get this rash.” I was like, “Yeah, I think that’s probably, you probably have a sensitivity to either the dairy or the oil that they’re using, peanut oil or canola or something. Probably want to leave that out of your diet for a month.” He did, and lo and behold, he’s allergic to something.   So, some of these are quite easy and obvious when you really kind of focus in on them. Then, of course, we want to really eradicate any toxins in the environment. So, I’m really big on everybody having their water filtered that does an adequate job. I love the Berkey filter as kind of a quick and easy if you’re not going to do a reverse osmosis in your house. Making sure that if you live in an older home that you’re thinking about things like mold. If you’re living near a road where there’s a lot of traffic, considering a HEPA filter in your bedroom. Thinking about where you’re working if you have a lot of exposure there.

I think that looking at the gut, eliminating toxins from the environment, eliminating inflammatory foods or foods that you might be sensitive to from the diet, and just chronically looking at nutrient deficiency. I’m at the point now in my career where I believe everyone should be on a really high-quality multi-vitamin. I didn’t believe that a decade ago. Like many physicians, I thought that you don’t need vitamins. You can get everything from your food. But knowing what I know now and noticing even in myself how everything changed for me when I started supplementing with high-quality vitamins, I think everybody needs to have that as their foundation.  Our food sources have changed. We just don’t have enough nutrients in our food. We don’t have healthy guts anymore. Many of us have decreased ability to digest, so sometimes digestive enzymes are necessary. There’s a number of reasons why I think that could be really helpful. That’s how I would approach, really, any patient who is concerned about an autoimmune condition because they have a family history.

 Then, as far as … You asked about testing with the autoantibody test. I do think we have to be a little bit careful. I think as a screening, an ANA, an antinuclear antibody, is fine, especially if there’s a family history of autoimmune conditions. I think that doing a rheumatoid arthritis is fine if there’s a family history and maybe some presenting signs or symptoms. Then, of course, the Hashimoto’s antibodies as well.  Other than that, when you’re talking about things like the anti-mitochondrial antibodies and the endomysial DNA, I mean, those are really … You have to understand the sensitivity of the test and also the age of the patient. I’ll just give you a case example. On my son, we had a situation with him where he had presented twice with this acute hip pain. It didn’t look like it was an infection. He wasn’t walking, and presented with these high fevers and had this whole pattern going on that really looked like it might have been some sort of autoimmune condition.  Well, of course, me being a doctor, I’m like, “Let’s run all these tests,” and so I did. He came back with a very high ANA, and he also came back high with a really high anti-centromere antibody, which, if you look it up, can be really scary. It can mean that there is some sort of a autoimmune condition that affects the brain going on. Of course, I got very nervous and pulled some strings and got him in with the one of two pediatric rheumatologists that work here in Austin very quickly because …

Being a doctor and having this information, I was quite nervous and upset. We went in, and he explained to me and showed me the studies and the percentages of children that have positive ANAs and positive autoantibodies that then grow out of it that may not mean anything at all. Right? They have a different presenting percentage of these antibodies, and so they don’t oftentimes test the same tests in pediatrics as they do in adults because it can mean something very different.  Now, being a functional integrative doc, I’m thinking, okay, well, we’re just going to make sure he’s living a clean lifestyle anyway because maybe there’s a potential there, though we don’t have any autoimmunity in our family. But it was really interesting to hear that because I think it does really paint a case for being careful about testing for some of these autoantibody tests and really creating fear in our patients when maybe there doesn’t need to be that situation. So, really focusing on the things that we can do, which there’s a lot we can do preventively and maybe leaving some of those more advanced tests for the people that’ve specialized in that. That’s how I like to approach it.

Dr. Weitz:            That sounds great. I think that’s all the questions I have. I think we covered some good information. Any final words you want to leave the viewers? Then, if you could give us your contact information so we can find out about getting ahold of you, and your book, and any of the programs you have to offer.

Dr. Sethi:             Absolutely. I mean, the final thing I’d like to say is I think it’s … We’re really in a time of change around some of these chronic illnesses, our understanding of them. So, if you’re listening to this, and you’re in a situation where you’re working with a doctor who is not open to believing that lifestyle can make a big difference and even potentially put you into remission with your disease, then please seek out somebody like Dr. Weitz or myself or any of those other integrative functional docs out there doing this work. Because we’ve all seen it with our own eyes how even just holding hope for this can really make a big difference in our patients’ lives, so really kind of trying to change your mindset around that and finding help where you can get help.  Patients can find me at my website, drshellysethi.com. It’s D-R-S-H-E-L-L-Y-S-E-T-H-I dot com. If they go to my site, they can actually download my book, Built to Thrive, for free if they wanted to get a PDF copy of it. I’d love to interact with anybody who has any further questions, but I really appreciate you addressing this and bringing this awareness to your patients and to the public at large.

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

Dr. Sethi:             Thank you.

 

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Al's Cancer Journey with Dr. Al Danenberg: Rational Wellness Podcast 96



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Dr. Al Danenberg talks about his Journey with Cancer 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. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]

 

Podcast Highlights

3:20  Dr. Danenberg explained that he’s 71 years old and he has been a practicing periodontist for 44 years.  He wasn’t always a really healthy guy, but about 6 years ago he became primal (paleo) in his nutrition and lifestyle and dropped 30 lbs.  He was able to get off all of his medications and he was feeling great and was speaking at conferences about the paleo, primal lifestyle.  He was doing a seminar at a dental group in April 2018 and he was walking through the Atlanta airport and was carrying a heavy bag and felt some pain in his shoulder. Then he started to get some back pain and then he started to get a lot of pain in his chest and rib cage area. He though his pains would just go away but then in September 2018 he went to see his primary care MD and he had some blood work and everything was normal except he had an elevated CRP (3.5 or 4 instead of his normal 0.5).  Then he had an MRI and his doctor told him that he probably had either Lymphoma, Leukemia, or Multiple Myeloma. And there was a soft tissue mass next to his spine, two broken ribs, a cracked vertebra, and a cracked pelvis. He saw an oncologist and on September 19th, 2018 he was diagnosed with IgA Kappa Light chain Multiple Myeloma, which is a very aggressive form of cancer. The radiologist told him he had multiple lytic lesions throughout his entire spine, his ribs, and his pelvis. His bone is literally dissolving away, since the malignant plasma cells are creating a cytokine reaction and Interleukin 6 is destroying the bone. His oncologist recommended that he do a cocktail of chemotherapy and IV bisphosphonates to strengthen the bone and some focused radiation to his sternum for the severe pain he had there.  At some point, a bone marrow transplant would also be recommended, but the oncologist explained that this is not a curable disease. The oncologist explained that he would do better for a little bit but then the Multiple Myeloma would retake over and eventually he would die from the complications of the Multiple Myeloma.  This oncologist also told Dr. Dananberg that if he did not follow this course of treatment, that he would be dead in 3 to 6 months.

Dr. Danenberg decided that since it was almost certain that he would die from this disease, that he didn’t want to put himself through this chemotherapy that would tremendously decrease his quality of life and his family would have to deal with this dread for an extended period of time till he died.  He also didn’t want his wife to be saddled with 100s of thousands of dollars of medical bills after he was dead. He did agree to do some focused radiation to his sternum, which did decrease the sharp pain he was having there.  He decided to follow an integrative, alternative plan using diet and nutritional supplements and so far he feels great and has a good quality of life.  He feels his natural plan is starting to work but he understands that he could die next week.

12:40  Dr. Danenberg addressed the question of why he might have developed this cancer when he was leading such a healthy lifestyle.  He pointed out that when he went to dental school 45 years ago he was exposed to a lot of ionizing radiation from all the x-ray machines and being in the dental office all days for six years. Some research does show that dentists have a higher incidence of multiple myeloma. The other factor is that he was trained, like most dentists are, to put in mercury fillings. when Dr. Danenberg went to school they used to take the liquid mercury and mix it with some powder to make an amalgam. Then they put in a cotton square and squeeze the excess mercury out of it and throw the excess mercury on the floor of the dental clinic.

19:00  Dr. Danenberg’s natural plan changes every few weeks a little but it currently consists of the following: 1. Autoimmune, Paleo eating style, excluding sugars,  carbs from grains or legumes, processed foods, GMOs, and any chemical additives;  2. Intermittent fasting by having his last meal by 8 pm and not eating until 1-2 pm the next day; 3. Pulsed Electromagnetic Field mat that he lays on three times per day to help repair his mitochondria; 4. A variety of nutritional supplements to support his immune and detoxification systems, to help target cancer cells, assist in bone metabolism, and to help repair his gut including: 1. Salvestrol, 2. Fucoidan,  3. Andrographis Complex (Mediherb)–3/day, 4. Catalyn GF (Standard Process)–6/day, 5. CBD powder capsules–2/day, 6. Fermented Cod Liver Oil/Concentrated Butter Oil (Green Pasture)–1 tsp/day, 7. Mega Mucosa (Microbiome Labs)–1 scoop/day, 8. Megaquinone K2-7 (Microbiome Labs) – 4/day , 9. MegaPrebiotic (Microbiome Labs) – 1 scoop/day, 10. Megasporebiotic (Microbiome Labs) – 4/day, 11. Neurotrophin PMG (Standard Process) – 3/day, 12. Ostrophin PMG (Standard Process) – 6/day, 13. Turmeric Forte (MediHerb) – 4/day, 14. Vitamin D–5000 IU/day

 

 



Dr. Al Danenberg can be contacted through his website:   https://drdanenberg.com/   Here is the link for his book, Crazy Good Living: Healthy Gums, Healthy Gut, Healthy Life     https://www.amazon.com/Crazy-Good-Living-Healthy-Gums-Life-ebook/dp/B073QD6FWV/ref=sr_1_1?ie=UTF8&qid=1500647091&sr=8-1&keywords=crazy+good+living  

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



 

Podcast Transcript

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 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.

Hello Rational Wellness podcasters. Thank you so much for joining me again today, and for those of you who enjoy listening to the Rational Wellness Podcast, please go to iTunes and give us a rating and review that’ll push us up in the ranks and more will people find out about the Rational Wellness Podcast. Our special guest today is Dr. Al Danenberg. He’s a periodontist and a certified functional medicine practitioner and a certified primal health coach and the author of “Crazy-Good Living: Healthy Gums, Healthy Gut, Healthy Life.”

But today, we’ll be speaking with Dr. Al Danenberg about his own health and his battle with a form of bone marrow cancer known as IgA kappa light chain multiple myeloma. Multiple myeloma is a relatively uncommon cancer of the plasma cells in the bone marrow. Traditional treatment for active myeloma typically involves a combination of chemotherapy drugs. A stem cell transplant is sometimes done following the chemo with stem cells from a donor.  Bisphosphonates may be given to stimulate healing of the damage bones, and radiation may be offered to treat specific areas of bone pain. Dr. Danenberg has chosen to forego traditional chemo therapy and has decided to take a natural integrative approach. I’d like to give listeners one more piece of information that is gonna inform the discussion that we will have, which is that Dr. Danenberg has chosen to be very public about his own health care situation. He’s been publishing a series of blog posts where he’s been very openly and talking about his situation, and very courageously, facing down a terminal illness. I appreciate you talking about your situation, Dr. Danenberg because I think it’s a great glimpse into the human condition and I think it could be very informative and instructful for other patients out there. Al, thank you so much for joining me today.

Dr. Danenberg:                 Hey, Ben. Thank you. This is quite an exciting experience. As you know, you and I have had a conversation before about mundane things like gum disease and gut bacteria and all that great stuff.

Dr. Weitz:                         Yes.

Dr. Danenberg:                 Now we’re talking about a little higher level of a challenge that I’m actually personally experiencing.

Dr. Weitz:                         Why don’t you tell us what were your first symptoms of your cancer and when did you first find out about your diagnosis?

Dr. Danenberg:                 Sure. So, most people who know me, and if you don’t, I’m 71 years old and I have been in practice for 44 years, practicing periodontics. I didn’t start off as a really healthy guy, but about six years ago, I became primal in my nutrition and lifestyle and became amazingly healthy. I’ve dropped 30 some pounds from when I started at the age of 66 through last year. I completely eliminated all medications that were prescribed to me from previous issues that I had. And basically, I was a healthy guy.  So I was doing, and I speak around the country, so I was doing a seminar at a dental group somewhere and I was progressing to one of the airports in Atlanta, which is a very large airport, as you may know, if you have gone.  And when I do that, if I have time between flights, I don’t take the train, I walk the concourses. So, if you know Atlanta airport from A the E concourse or F concourse, it’s a long walk. I had a very heavy bag on my shoulders, it was April last year, 2018, and I just carried that from one flight to the other flight. I started to develop, by the time I got to my connecting flight, some soreness on my shoulder and I thought, well, maybe I pulled a ligament and did something stupid and it would go away like any muscle pain would go away. So, the next day it was still sore. Did my thing, got back to Charleston. It was sore on the rights of my shoulder and then it started to go away, to some extent, went into my back area.

And then, a few weeks later it went away from my back area, went into my chest area and it was starting to get really painful, and I thought this is not a normal muscle issue. So, I went to my physician in, Charleston around September or so, 2018, and he looked at me and press around my rib cage, which was very, very tender. And he said, “Let’s do some blood work.” So, he took some blood, did the conventional type of blood work, everything was pretty normal, and I see him every year. So, it’s basically the way it had been except my CRP, this C reactive protein was elevated.  Generally, my CRP was usually less than 0.5, very healthy, no chronic inflammation, and it was something like 3.5, 4.0. To me, that was an alarm bell. And so, he said, I don’t know what’s going on. Let’s do an MRI. So we do an MRI and he calls me up and says, “Al”, and he’s known me for 30 plus years. He says, “Al, do you want to come into the office, and we’ll discuss it or just talk about it on the phone.” I said, “Great, let’s talk about on the phone.” He said, “If I were you, I’d be very concerned.” He said, “My initial differential diagnosis is either, I think you have lymphoma, leukemia or multiple myeloma.” None of the three doors were the doors that I wanted to open.

He said, “In addition to that, I see a mass, a soft tissue mass on the side of your spine and I also see two broken ribs, a cracked vertebra, and a cracked pelvis. What happened?  Did you get beaten up?  Did you fall down some steps?  What happened?” I said, “I don’t know. I only was carrying this bag when it got sore, and it stayed sore.”  So he called in an oncologist, we did a CT scan, a PET scan, a tissue biopsy of the mass on the side of my spine. A whole bunch of more detailed blood work. And September 19th, 2018, I was diagnosed with IgA kappa light chain multiple myeloma, which is very aggressive. And the radiologist who read the CT scan said in his report there were innumerable lytic lesions throughout the entire spine. That means holes everywhere. That’s the reason why I had cracked ribs and vertebrae and pelvis because it’s almost like severe osteoporosis. Something’s happening and the bone is dissolving away.

What’s happening is malignant plasma cells are setting up a cytokine reaction and IL6 I believe is basically destroying the bone. Well, he said to me, and my family came in at that appointment, so they were all there, and he said to me, “Based on what I see today”, and that is in September 2018, “I’m gonna recommend what I think you should do, but if you don’t do anything, I predict that you have three to six months to live.” Now, here’s a healthy guy, at least I thought I was healthy until now, and I am side struck with this diagnosis that is truly life threatening. What would you do? I thought a little bit about it. We’re sitting there, and I’m telling, my doc’s name is George, and I said, “What do you recommend?”  He said, “Immediately I would recommend we start on a cocktail of chemotherapy drugs and then maybe IV bisphosphonates to strengthen the bone.” And because I had such severe sternal pain from the loss of the bone in that area, do some radiation and, and see what’s going on.” And he said, “But you have to understand this is not a curable disease.” I asked him to explain that, and he basically said what generally happens. You go through chemotherapy, you get remission cause you’re killing all these plasma cells. And in addition, which he didn’t obviously tell me so much, and that is we’re killing everything in the immune system and everything else in your body. And then, you’ll do fine for a little while. And then, the multiple myeloma, the malignant plasma cells were going to a retake it’s itself and we’ll have to use a different chemotherapy cocktail because it will not respond to the original chemotherapy, so it needs to be more aggressive.

And then, maybe even stem cells. Either we get them from you that we can cultivate, or we have to get it from a donor and maybe that will work. But just stem cell therapy, because of what I have, isn’t so successful. Eventually, I will die from the complications of multiple myeloma. I said, “Well, wait a minute. You’re telling me I’m going to die from this disease, and it’s going to be in stages and every time it exacerbates, it’s going to be even more caustic for me to get treatment, and I’m still going to die from this condition. Why do that? Why put myself through the tremendous decrease in quality of life and dignity of life?” And not to mention the practical side.  First of all, my family would have to deal with this dread for an extended period of time until I die. And then, financially, and let’s be realistic here, a lot of these drugs are not covered by medical insurance, and some of them that are just in the investigative stage, if you’re not in a clinical trial, definitely is not covered by medical insurance. So, I could die and my wife could be left with a $500,000 medical bill and then she’ll have to deal with that. It makes no sense to me. And it made no sense to me to treat my disease by killing everything else in it. So, I decided what I needed to do is get rid of the pain in my sternum, which is the mediate radiation treatment for 10 days that was successful, and I investigated an integrative alternative plan, which I’m doing now.  And by the way, it’s more than six months. I am still alive, and I feel fantastic. And my doctor says, “Wait a minute, maybe I made a misdiagnosis, I don’t know.” You didn’t make a misdiagnosis. Maybe my alternative therapy is starting to work. Now, I don’t know that that’s going to happen, and I don’t know that I’m not going to die next week, next month or five years from now. But I have taken a course that is keeping me alive in a way that creates quality of life. I feel great, a little things are bothering me we can talk about, but basically, I feel great and I’m grateful for that.

Dr. Weitz:                         Tell us about your natural plan that you use to help your body fight off and heal from this cancer.

Dr. Danenberg:                 Sure. As you know, diet is everything. And maybe I should go back and first give you an idea of why I think I contracted this because I have some people that read my stuff and they blurted back to me and said, “Well, everything you were doing that you thought was so healthy, doc, obviously didn’t work, doc.” And I’m saying, Oh my God, this is ignorance, but I need to address this. When I was in dental school, and that was a long time ago, 45 plus years ago, I was in undergraduate dental school, four years and then specialty school for periodontal training for two years, so six consecutive years. In the dental clinics, there were x-ray machines everywhere, and we learn how to take x rays on people and whatever.

In those days, I don’t know how well the x-ray was collimated, I certainly don’t remember wearing all the protective clothing that maybe I should have, so I am assuming that I was exposed to excess ionizing radiation, dental x-rays, over the course of six years on a pretty regular basis. Well, one of the actual causes that has been known for multiple myeloma is ionizing radiation, dental-x rays. As a matter of fact, there was a study that was done some years back that showed that dentists, male dentists in my age group have a higher incidence of developing multiple myeloma than the general public. Very interesting. Very interesting.  I had to dig for that research. So, I’m thinking that is a possibility. All you have to have is one malignant cell and then you have a malignancy because that cell doesn’t die naturally, it keeps growing, and it can replace other healthier cells.

Dr. Weitz:                         By the way, I noticed when I’m my dentist’s office, there’s no lead lined walls. There’s not even a complete wall separating one room from the other. There’s just these thin walls sometimes with little windows. So, it doesn’t seem like the x-ray machines in dental offices that there’s really a proper shield. Is there supposed to be …?

Dr. Danenberg:                 Today there is shielding and the walls, theoretically. I don’t think that you can even build a dental office and get it approved by the people to be that tell you everything is okay and you can start seeing patients. But without these lead shields built into the walls or the x-ray is behind some type of a lead device. It’s a scary thing. I mean, the amount of radiation that you can get just yourself in a dental office is not that much, but if you’re there all the time forever and ever, six consecutive years, I’m gonna tell you, I had a lot more radiation than you ever had in your life.

Dr. Weitz:                         Of course.

Dr. Danenberg:                 But you need to ask them questions when you go to doctors. If you had CT scans all the time, you are bombarded with a lot of ionizing radiation. I’ve refused to do more CT scans, for example, at this point because I’m not interested in exacerbating what’s already there.

Dr. Weitz:                         Or getting a secondary cancer somewhere else.

Dr. Danenberg:                 Exactly. Unless it was critical for that type of biomarker or x-ray picture, it’s not going to do my health any good. The other thing that when dental-

Dr. Weitz:                         And you’re opting for MRIs, is that right?

Dr. Danenberg:                 Correct. So, I am doing my next MRI at the end of this month and we’ll see where we are. It’s not completely telling, but it’ll tell a lot and that’s all I need. See if I’m progressing in a positive way. The other thing is, and this will amaze you, dentists have been, and even still are trained in many dental schools to put in mercury fillings. Oh my God, I can’t believe that, but it is true. In those days, here’s how we did this. It’ll blow your head away. We took the liquid mercury, which is a beautiful thing in a little jar, silvery liquidy mercury, and dropped it into a little dish and mixed it with some powder to make what’s called the amalgam. Now, you have this silvery mushy mess and it has a lot of mercury.  So, you put it in a little piece of cotton, like a cotton square, squeeze the excess mercury out of it. And we’re talking about with hands. Squeeze it and throw the excess mercury on the floor, on the clinical floor of the dental school.

Dr. Weitz:                         What?

Dr. Danenberg:                 Everybody did it. 45 years ago, everybody did it. I am sure that the entire dental school was toxic because this mercury vaporizes quickly and it’s everywhere. So, the excess mercury and the ionizing radiation on a continuous basis possibly created what went on in my bodies. But with me being as healthy as I have been, my oncologist who’s a conventional, but fantastic oncologist explained to me probably my lifestyle and diet kept everything under control and it didn’t manifest until it just got out of control. And that’s why I developed multiple myeloma. So, how am I treating it?

One of the things, of course, is a healthy, clean diet, and I don’t want anything that’s gonna interfere with my ability to having an enhanced immune system that I can. So, I am eating basically a Paleo type autoimmune diet, less carbs than normal, but not strictly keto. And I do intermittent fasting. I don’t do multi-day fasting, although I had done that every now and then, but I definitely do intermittent fasting. So, my last evening meal is literally ending by 8:00 PM one night. And then, I won’t have anything to eat until maybe 1:00 even 2:00 PM the next day. So, I have just a small window of eating. I basically am a fat burner. I had no problems with hunger. It’s just not a problem. But you have to develop to get to that point.  You just can’t say, I’m going to do intermittent fasting, have a piece of cheesecake last night, and then all of a sudden, not eat until 2:00 PM and not feel hunger pains. So, you have to get into that state. I’m doing that and I think that’s a critical factor. Another factor that I’m doing …

Dr. Weitz:                            Are you having any trouble keeping your weight up by doing the fasting?

Dr. Danenberg:                 No, because I do eat things like sweet potatoes. So, I got the starchy tubers that take care of my diet and my calories. I am not exercising like I used to because I just physically can’t. I do have some pain and I have a lot of tiredness. So, I know that could have a problem. Generally cancer patients lose weight, but a lot of that is because of chemotherapy, not necessarily the cancer cells are just digesting all this food so fast. So, my diet is critical. I’m working with an integrative physician, not in my town, but in another town. I have conversations basically every three weeks to tweak different supplements. So, I take a variety of supplements, which I’ve never taken before, but I take these supplements to support my bone metabolism, to support my immune system, helped me with antimicrobials that he feels are necessary.  Certainly, good digestion, I take a number of things to really improve my gut microbiome, spore based probiotics basically because they actually do germinate in the gut. They’re not killed by acids.

Dr. Weitz:                         Would you mind going into your whole detailed supplement program?

Dr. Danenberg:                 Actually, it has been like 30 supplements five times a day. It’s kind of crazy. I could send it to you for your perusal by …

Dr. Weitz:                         Would you want to go into some of the highlights?

Dr. Danenberg:                 Yeah, so let me tell you what I think is really core. There is a product called Salvestrol. Salvestrol is a product from well ripened fruits and it is, especially the berries. And it is loaded with the FIDO nutrients. And what that Salvestrol does, which is unique, is that it gets into the blood system and it is attracted to certain enzymes that are dominant in cancer and precancerous cells. These enzymes are part of the Cytochrome P450 process of creating digestion and detoxification in the body naturally. And these enzymes are called CYP1B1 enzymes. They, like I said, are highly concentrated in precancer and cancer cells, very little is in or none is in normal cells.  So, these enzymes attach or bind in some way to the Salvestrols. The Salvestrols and the enzymes react and metabolites are created that literally kill the cell. So, if these Salvestrols were attacked by enzymes in normal cells, it would kill normal cells, but these enzymes are not in normal cells, are just produced by the cancer cells, interestingly enough. And there could be some rationale for the reason why it’s there. These are natural occurring phytonutrients. So, I do take quite a bit of this. There is some great peer reviewed research about Salvestrols. There are a variety of sources of Salvestrol I get from Canada. I know Europe has plenty. There is ongoing research, and I think that this is a major factor.

There is another product from a brown seaweed called Fucoidan, F-U-C-O-I-D-A-N.  Fucoidans have some other interesting properties. They do help cancer cells with apoptosis or self death, but it may be along the lines that it actually ends improving the mitochondria of the cancer cells because cancer for some researchers is basically a result of mitochondrial dysfunction. Every cancer cell has mitochondrial dysfunction, but all chronic disease has mitochondrial dysfunction. But if there are cancer cells that have mitochondrial dysfunction and you can repair the mitochondria, you can help these cells maybe create self death and or prevent them from becoming cancer cells.  So, Fucoidan has the benefit of helping the mitochondria and helping kill cancer cells. So, I do take this brown seaweed in a very concentrated state. Those are the two things. And then, a lot of general supplements to repair or help bone metabolism. I got a few products from MediHerb and …

Dr. Weitz:                         Standard Process.

Dr. Danenberg:                 Standard Process. Thank you. Thank you, my memory’s going away. Standard Process, and then a few other types of supplements that are going to help with digestion and antimicrobial.

Dr. Weitz:                         I noticed you include curcumin in your-

Dr. Danenberg:                 Yes, curcumin definitely. And there’s a lot of great research about curcumin in cancer cells. So, I’m doing certainly curcumin. There’s a MediHerb product that I use, but there are a variety of products. As long as you get a biologically active curcumin, that’s great. It’s not generally bioactive because it has to get absorbed properly, so you have to have a vehicle that’s gonna get absorbed properly.

Dr. Weitz:                         Are you monitoring any lab tests to go along with your supplement program to see if the interventions are …

Dr. Danenberg:                 Yeah, so the lab tests are very specific for multiple myeloma, and I get that every month. Originally, now, I’m only on every two months because my doc says things are more stable. But there are some tests that will determine the degree of the malignant antibodies that are floating around and the ratios of these malignant antibodies that are critical. Right now, I’m so way, way, way high, but it’s not as bad as it used to be. So, yes, I do monitor that. Now, let me tell you another thing that is, in my mind, a very critical element to what I’m doing.

And that is, I just touched upon it, and that is mitochondrial dysfunction in the cancer cells. The mitochondria needs repair and there is a process that actually can repair mitochondria. Let me just mention that one of the destroyers, there are a lot of destroyers of mitochondria, a lot of prescription drugs, certain foods that we’re eating, the chemicals that are in foods, but dirty electromagnetic fields that are generated between you and me right now because of what we’re doing are damaging the mitochondria. What they’re really doing is breaking down the calcium channel passages between cells and it’s also breaking down the protein complexes within the mitochondria that create ATP. And ATP, as you know, is the energy of the cell. If that energy is not there, the cell weakens and eventually dies, theoretically.

 So, what I am doing is using a process, a therapeutic process called pulsed electromagnetic field therapy to help repair the mitochondria in my body. I’m not, and I don’t think there’s any way to be specific to the mitochondrial repair, and I don’t care. I just want my mitochondria to get repaired as fast as possible. So, I lay on a mat from a company, now we can talk about later if you want, but it is a flexible mat, looks like, feels like a very thin, soft pliable yoga mat and it lays underneath my bed cover and we have timers that can go on and off on that mat and during the day I can lay on it and I do it three times a day. And there are different settings and the company that I work with has settings for cancer as well as many other things.

So, I use this mat to help stimulate the mitochondria to repair as well as to improve the calcium channeling within the mitochondria. I believe that this is repairing my body. Now, I do know from reading research, not my personal research, but I do know that NASA has used this type of therapy to help astronauts to prevent osteoporosis because they learned that astronauts being in space for a period of time develop osteoporosis for variety of reasons and pulse electromagnetic field therapy can prevent and cure that kind of problem. So, I’m using this mat that I do three times a day and I think that is a real critical element to my overall protocol to treat my cancer.

Dr. Weitz:                         Awesome. Are you able to exercise right now?

Dr. Danenberg:                 Starting to try that, and actually I got a good bit sore so I have to come back. Zach Bush has a four minute video or a four minute exercise video on YouTube. Easy to Google, “Zach Bush four minute video.” It is a great exercise program. It helps to stimulate and release nitric oxide. He’s a cool guy. Anyhow, brilliant physician. He’s got lots of degrees behind his name. It’s very noninvasive for me. It’s not particularly damaging to my body and I’ve tried to use that. I used to use that on a regular basis as well as other types of exercise, but this I think is the kind of exercise I want to get started with before I move on. My son actually owns a couple of clinics, one in Charlotte and one in Greenville, South Charlotte, North Carolina, one in Greenville, South Carolina, where he works with patients and athletes and does quite a number of therapeutic exercise programs, and he’s going to help me with that.

His company is called Performance Therapy, and he’s really astute in this exercise program. So, he’s going to help me develop a more gentle progressive exercise program as soon as I feel like I can get started.

Dr. Weitz:                         Cool. Maybe swimming might be something you want to integrate.

Dr. Danenberg:                 Swimming would probably be good. It’s not convenient for me. Walking is not a problem. Although walking a distance, I used to walk about five miles a day. Right now, that much walking really puts a lot of pressure on my spine and basically my pelvis and that’s why I have these fractures, so I gotta be careful.

Dr. Weitz:                         Right. Tell us about your latest report when you saw your oncologist.

Dr. Danenberg:                 Yeah, so it’s kind of funny. So, I’m seeing, I guess maybe it’s been three weeks ago or something like that. I see my oncologist, and he is doing his examination, and I’m really feeling quite good. We just did some blood work and most of the results were relatively stable, not progressing in a bad way. And one of the ratios of these unhealthy antibodies has actually significantly dropped, which is great. Still on a very high level. Certainly I’m not cured from this disease, but it had dropped, and he said to me, “Possibly, maybe I made a misdiagnosis, maybe you have not this aggressive form of multiple myeloma, maybe it’s indolent and multiple myeloma.”

He wasn’t really joking at first and then he started to laugh with me, and I said, “Just give my alternative protocol the respect it deserves, maybe what I’m doing is helping me. It’s just that you’ve never seen this before.” He’s a traditional conventional oncologist with a big group working in a major cancer center. So, if he were to tell any of his patients to do what I’m doing, he probably would be kicked out of his group and maybe sued because of malpractice, he’s not following the norm of treating cancer. So, I understand that, but he is interested enough in what I’m doing that he requests me to send to the medical papers that I’m reading, that are supporting and giving me thought as to what I want to integrate with my protocol.

Dr. Weitz:                         Now, how are you supporting your bone health? Because this bone marrow cancer, it leads to damage to bones, and you mentioned that you have several fractures.

Dr. Danenberg:                 Two of the products that I get from Standard Process are bone complex and bios. So, I think maybe bone complex is actually from MediHerb, but MediHerb is sold through standard process. I’m not sure if that’s true or not. And bios, those are two things that are supporting my bone metabolism. That’s the only specific that I’m taking. I definitely do take vitamin D3. I take gobs of vitamin K2 which is so critical.

Dr. Weitz:                         How much vitamin D and vitamin K?

Dr. Danenberg:                 Right now, I’m taking 5,000 international units of D3. Of course, the way you eat, mushrooms or egg yolks, you’re getting vitamin D3 in certain things too, but I am taking an extra supplement of D3. I do take vitamin K2. I use MegaQuinone K2-7 from microbiome labs. It’s 320 micrograms, which is quite a large number. But there’s never been demonstrated any lethal dose to K2 and I think the more the merrier. And recent studies have shown that vitamin K2 actually helps repair and rescue damaged mitochondria, which is brilliant. Actually, this is an aside, but actually I’m doing a double blind study to demonstrate that spore based probiotics and a high dose with vitamin K2 taken orally changes the gut microbiome and eventually changes the oral microbiome to reduce gum disease and improve everything else that’s going on in the mouth. And that is underway right now. It’s been approved by the Institutional Review Board. It’s an exciting area.

Dr. Weitz:                         That’s amazing. Yeah, I think I heard about that.

Dr. Danenberg:                 Yeah, I think maybe we talked about it, but at that time we talked, it wasn’t actually happening yet, but everything has gone through. To do these medical tests is, and they always need to be approved obviously, is a long lengthy process, but once they get approved I can start moving fast as long as you have the participants to do it.

Dr. Weitz:                         And you mentioned supporting your gut health is part of your program.

Dr. Danenberg:                 Yes.

Dr. Weitz:                         Why is that important?

Dr. Danenberg:                 Well, certainly, our immune system is dependent upon the gut microbiome and the intestinal layer which is only one cell layer thick. If I have dysbiosis, I have chronic disease period. And certainly cancer is a form of chronic disease. I need to get that gut as healthy as I can. I think it’s been healthy, but I am doing that much more intensely right now. So, I do take the spore based probiotic. I do take vitamin K2. I use a variety of products that microbiome has. This is not really a commercial. Other than microbiome is funding this study that I’m doing, but they have nothing to do with the independent results. I think they’re on the cutting edge of doing some cross products with lots of research behind them to support, not just the microbiome, which is a very important part, but the mucosal layer in the lumen, which is critical before anything happens to the actual layer of the intestines.  So, these are products that I take to support myself. I think that’s the chronic disease. I wrote a paper called the Big Bang theory of chronic disease a year or so ago that was published in Wellbeing Journal. I believe everything starts in the gut, but there are so many ways things damage the gut. It’s just not the food, but so many things. Well, once that gut is damaged and the immune system is compromised and your host resistance is not where it should be, then other things start to manifest.

Dr. Weitz:                         As a Functional Medicine practitioner, I’m fully in agreement with you that the gut is so crucial for the health of the entire body. I just saw a patient last week who first came to see me because she had seizures that were occurring every few months. She lost her driver’s license and neurologists couldn’t find anything. And then, after talking to her for a while, she had all these gut symptoms that she had just considered normal cause she had them for so long. We did a stool panel and we looked at her gut and her gut was really messed up, and we did some natural protocols to get her gut in order. And now, she’s eight months seizure free and she’s getting her driver’s license back just from fixing her gut.

Dr. Danenberg:                 And that’s amazing. What is not known by the general public is, you don’t have to have gut symptoms that have gut problems. Only 20% of people will have bloating and diarrhea and constipation and issues that are obvious. The other 80%, it’s already systemic. It’s already creating systemic inflammation and chronic in nature and disseminating to other parts of the body. And then, there are the genetic weaknesses in other systems that are breaking down, not related to the gut because of symptoms in the gut, but related to everything else that’s damaged that gut, that damages the rest of the body.

Dr. Weitz:                         Have you done genetic testing on yourself?

Dr. Danenberg:                 No, and here’s the reason why. I understand genetic testing is important for some thought processes. It may be important to give you a heads up as so, “Hey, you really need to be aware.” It’s almost like standing on the train tracks and you let the train slowly get closer to you. Eventually, you should get off those train tracks knowing what’s really coming down. But if I were to know, let’s say I had a snip here or a snip their, or whatever genetic problems I had, I cannot change my genetic code. I cannot change my snips. I cannot do anything therapeutic within reason to do that.

I do know that 80% or so of environment and lifestyle is going to either manifest the disease or not manifested the disease. That I have control over. Stress is a huge factor in health and disease and if I were to put myself under stress, more stress knowing all of these things are inherently wrong with me, and what can I do to correct them, I’m gonna really talk myself into more disease. There are some great papers that prove that placebo effects or not placebo effects, they’re real. And that’s because you have a positive attitude.

Chris Kresser, who I totally recommend. He’s brilliant. He just wrote a paper or an email that he sends to his people today and reviewed a situation where somebody who had all kinds of health issues and he was getting very, very ill. And he said, “Well, if I’m gonna die, I’m gonna be happy and stopped worrying, started eating pizza and coke or whatever it was, beer and pizza.” And he got better, and obviously beer and pizza didn’t get him better. He eliminated his stress. Chris is such a great, great writer. He brings across messages in such an easy to understand way. The point is, stress can be so much more damaging than anything else. If I had a healthy body, but was totally stressed, I wouldn’t have a healthy body.

Dr. Weitz:                         Right. You make a great point and Chris makes a great point, which is, as much as we get caught up into these health promoting practices of healthy eating and everything else, we need to do it in a way that also makes us happy. If it becomes so much of an obsession that creates more stress in our body, then now it’s becoming a negative thing.

Dr. Danenberg:                 You’re absolutely correct. Again, I think this is part of the reason why I feel so good. I’m not going to tell you I look like I’m 30 years old and an Adonis, but I gotta tell you I feel extremely well, and I’ll be 72 years old in a few weeks.

Dr. Weitz:                         How are you maintaining such a positive attitude?

Dr. Danenberg:                 Well, that’s my point. I’m not sure why I’ve maintained this except I’ve accepted it. I have a very strong spiritual sense, but I’m not religious whatsoever. But I have a spiritual sense. I believe in the soul. I believe where I am going to go.  We don’t have to get into that conversation, but it is comforting to me to know that.  And if this time around is the end for my life, I just want to make sure that the quality and the dignity are there until I drop dead. Marxism talks about something like live long, then drop dead. I mean, basically live the life you want to live and then just keel over, and not live a chronically diseased life with all kinds of ailments for 30 or 40 years and then drop dead.  That’s not the way I want it to be.  And if I have any control, it makes my stress level much, much less.  I stress, we all stress, but I have a great attitude and I do feel like I am winning battle more so than general medicine would have suggested. I’ve been told that I needed to sign up for hospice three months ago. I’ve not done that, so I’m okay. I’m good.

Dr. Weitz:                         I applaud you Al.

Dr. Danenberg:                 Thank you.

Dr. Weitz:                         How can our listeners who don’t have access to your blog get on the list and get ahold of it?

Dr. Danenberg:                 Oh, sure. Thanks. So, go to my website, which is drdanenberg.com, which is drdanenberg.com, Or go to my website, click on blogs. You can sign up for email alerts every time I write a post, which is just generally once a week. I talk about all kinds of things, but I certainly am talking about my journey. I’ve got maybe 15 or so posts as to when I was diagnosed and how I’m progressing and doing a variety of other things. So, that’s available. If there’s any comments, you can put them in and there was a contact form if you have questions, you can write a little email to me and I certainly respond to emails.

Dr. Weitz:                         Awesome. Al, thank you so much for sharing with us, and you’re a positive force in the world.

Dr. Danenberg:                  Thank you.

 

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Preventing Heart Disease with Dr. Joel Kahn: Rational Wellness Podcast 95



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Dr. Joel Kahn discusses Preventing Heart Disease 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. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]

 

Podcast Highlights

3:30  Heart disease for our purposes refers to atherosclerosis, narrowing of the arteries, that leads to strokes, heart attacks, erectile dysfunction, chronic kidney disease and even dementia.  According to Dr. Kahn, “…if we could beat this problem, we would add tremendous amount of health to our life, and probably a tremendous amount of life to our life.” 

8:09  Sometimes patients will see a doctor who tells them that they have significant risk or evidence of heart disease and this is caused by genetics and they need to take a statin. End of story. Dr. Kahn explained that this may be because they have seen a conventional cardiologist for their 12 minute follow up visit and the doctor has no time to really talk about diet or lifestyle factors in any meaningful way. Integrative cardiologists like Dr. Kahn take the time to inquire about and make specific recommendations for diet and lifestyle interventions.

9:31  Dr. Kahn wrote in a blog post that erectile dysfunction, going bald, gray hair, diagonal crease in your ear lobe, and calf pain when you walk can all be early warning signs of cardiovascular disease. These are soft signs that you may have atherosclerosis. Unfortunately, there are too many times when people do not have early warning signs and their first symptom is when they have a heart attack or stroke.  These signs should alert you and your doctor to look into whether you have heart disease and besides an advanced lipid panel, you should consider getting a coronary calcium scan, (a CT scan that looks at the arteries of the heart) which is a direct way to see if your arteries are blocked.  Dr. Kahn recommends watching The Widow Maker movie on Netflix.

18:08  Cleveland Heart Lab includes a test for TMAO as a risk factor for heart disease that was developed by Dr. Stanley Hazen. TMAO, trimethylamine N-oxide, is correlated with clogged arteries.  They looked at TMAO in a lab and found that it caused your platelets to clump, which might trigger a clot. It caused your HDL cholesterol not to work well, which is not necessarily good for your arteries. And it caused your LDL cholesterol to get taken up into the wall of the artery more aggressively. So it seemed like in fact, this was now possibly a cause of artherosclerosis. And they went on to show that it seems to be in the blood after a meal that includes a lot of choline from egg yolk, and carnitine from red meat. Vegetables don’t cause it to rise, vegans don’t have it in their blood. Dr. Hazen believes that his research shows that if you eat foods like red meat and eggs that contain choline or carnitine or take supplements of choline or phosphatidylcholine or L-carnitine that you will increase your TMAO levels and increase your risk of heart disease.

But I have several problems with this TMAO test. For one thing, one of the foods that most increases TMAO is eating fish and eating fish has consistently been associated with decreased risk of various chronic diseases, esp. heart disease. Also, while eggs cause your TMAO levels to rise, many studies on eggs show that eating eggs does not increase your risk of heart disease.  Also, taking supplements of choline is very helpful, esp. for brain function, while taking L-carnitine supplements is beneficial for heart health.

25:07  Dr. Steven Gundry is a prominent Functional Medicine doctor who says that grains and legumes and seeds and even certain fruits and vegetables contain lectins, which are harmful to our health.  Dr. Kahn says that Dr. Gundry claims to have lots of published data but he has not published any papers on his diet.  Dr. Kahn claims that many of the references in Dr. Gundry’s book are not really studies that back up what he says, that there are dozens of serious academic errors.  Dr. Kahn said that there are some people with inflammatory diseases who feel better when they avoid foods with lectins and nightshades, like eggplant. But on the other hand, if you look at the blue zones, the areas in the world where people live the longest, the one food they all eat is legumes, so how can legumes be harmful? Here is the video clip of Dr. Kahn debating Dr. Gundry on The Doctor’s Show: https://youtu.be/e61XfKF_NpI

30:10  Some vegans who eat a lot of processed and junky carbs and follow a plant based junk diet are actually more at risk for heart disease than those following the standard American diet.  So if you want to reduce your risk of heart disease with a vegetarian approach you need to make sure your diet is rich in fruits, vegetables, beans, peas, lentils, healthy sources of protein that can include the beans, lentils, organic tofu, tempeh, and such. It’s not a mac and cheese that happens to say vegan on it.  But you should also supplement your diet with high quality fish oil and include 2 tablespoons of ground flax seeds anc chia and hemp seeds eat walnuts leafy greens to get good levels of omega 3 fats. Dr. Kahn also likes his patients to take chlorella and spirulina, and vitamin B12 and vitamin D.

35:16  A Mediterranean diet, which has been shown in many studies to be associated with lowered risk of heart disease, includes plenty of extra virgin olive oil.  But Dr. Kahn is not a big fan of olive oil or of any added oils to the diet.  Here’s a blog post where Dr. Kahn recommends against olive oil: https://drjoelkahn.com/this-doctor-says-olive-coconut-oil-are-bad-for-you-heres-why/  Dr. Kahn feels that a low fat diet is healthier and recommends cooking in water or vegetable broth or wine.  This is especially the case for high risk patients who are especially at risk for a heart attack or stroke.  He cited the work of noted vegetarian nutrition experts Nathan Pritikin, Dr. Dean Ornish, Dr. Esselton, and Dr. Joel Ferman and argued that added oils add extra, unnecessary calories that make it harder to lose weight, esp. since fat contains 9 calories per gram compared to carbohydrates that only contain 4 calories per gram. Dr. Kahn did say that if you were going to use some oil, he would rather have you use extra virgin olive oil than lard or ghee or coconut oil, since it has less saturated fat. 

42:23  Dr. Kahn’ focus in his practice as a cardiologist is the early identification and early reversal of heart disease. He wants to protect his patients from becoming one of the 2,000 people a day who die of a heart attack.  He calls his approach “Prevent not stent”Dr. Kahn says that he did a lot of stenting in his day, but he prefers to practice upstream medicine by going to the root cause and fixing the problem before you’re sick, old, and nearly dead. 

 

 



Dr. Joel Kahn is an integrative Cardiologist, internationally known speaker, and best selling author.  He has a weekly podcast, Heart Doc VIP and he’s written 6 books, including Your Whole Heart Solution, Dead Execs Don’t Get Bonuses, The No BS Diet, Vegan Sex, and The Plant Based Solution. Dr. Kahn’s goal is to prevent heart disease by promoting a plant based diet, exercise, and a healthy lifestyle. His website is  DrJoelKahn.com   

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



 

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 Dr. Weitz.com. Let’s get started on your road to better health.  Hello Rational Wellness Podcasters, thank you so much for joining me again today. And for those of you who enjoy the Rational Wellness Podcast, please go to iTunes and give us a ratings and review. That way more people will find out about our Rational Wellness Podcast. Today, we are going to talk about the early detection prevention, and reversal of heart disease. With our very special guest, Dr. Joel Kahn.

If a patient has existing heart disease, or has had a heart attack, stroke, shortness of breath, or any other symptom of an existing heart problem, they should see a cardiologist before they do anything else. For patients who don’t have a heart problem, don’t have symptoms of a heart problem, early detection and prevention should start with a careful history, and an advanced lipid profile, such as a cardio metabolic test from SpectraCell, or the Boston Heart Lab that I often run, or the Cleveland Heart Lab, or some of the other great tests that Dr. Kahn uses. Though there are many other tests like this on the market.  Such an advanced lipid profile will look not only at the basic lipids, which are total cholesterol, estimated LDL, HDL, triglycerides. But it will also look at LDL particle number and size, and specific atherogenic particles, like Lp(a), and remnant lipoprotein. It’ll also look at inflammatory factors, like Homocysteine, Omega 3 levels, HsCRP, oxidized LDL, it’s also important to screen for the risk for diabetes by looking at blood sugar factors like glucose, insulin, Hemoglobin A1C, and it can also be helpful to test for some of the genes, such as the APOE gene, and some of the clotting factors.

Dr. Joel Kahn is an integrative cardiologist and internationally known speaker, and best selling author. He has a very popular weekly podcast, Heart Doc VIP, and he’s written six books, including Your Whole Heart Solution, Dead Execs Don’t Get Bonuses, The No BS Diet, Vegan Sex, The Plant Based Solution, which I just read recently, it’s a great read, and Young at Heart By Design. Dr. Kahn’s goal is to prevent heart disease by promoting a plant based diet, exercise, healthy lifestyle. Dr. Kahn, I’m so glad that we met at the anti-aging conference in Vegas in December, and that you’re joining me today.

Dr. Kahn:             Oh, thank you very much, happy to beam out from gray and cloudy Detroit. So I imagine sunny Santa Monica.

Dr. Weitz:            No, no, no, it’s raining like crazy.

Dr. Kahn:             Oh wow, wow, wow, okay. Come to Detroit, bring your bathing suit.

Dr. Weitz:            Yeah, we’ve had an unbelievable amount of rain. So since we’re talking about preventing heart disease, what exactly do we mean by heart disease? What is happening in the body anatomically, metabolically?

Dr. Kahn:             Yeah. So the very broad term that ranges from babies being born with congenital holes, and defects, to irregularities in the heartbeat. But for the purpose of this conversation, really for the purpose of your listeners, the one that should dominate 99% of the combination on heart disease, I just have a little model, is when our arteries, whether they supply our brain, our heart, our legs, our sex organs, our kidneys, become narrowed. Become full of a term, people have heard the term, atherosclerosis, which is basically Latin for gruel, I think a little bit like oatmeal, or porridge. That’s what the word means. It’s appearance on an autopsy.  And that is not something we’re destined to have happen. There are people that are 90 and 100, and don’t have that process. And there are people that sadly are in their mid to late twenties now. In fact, you find teenagers, you can find the earliest trace. And we’ve spent easily 50, 60, 70 years in the scientific world trying to identify why that happens. We know a lot more than we did 50, 60, 70 years ago. I think in the late 1940’s, it was just thought to be aging inevitable consequence of aging. But why does somebody 89 years old not have it if it’s an inevitable consequence?

So the reason that’s important is that’s the substance of strokes. That’s the substance of heart attack. That’s the substance of erectile dysfunction. That’s the substance of progressive kidney weakening, which is no joy at all. And to some degree, that’s the substance of dementia, because there’s a very broad group of people that have what’s called vascular blood vessel dementia. So if we could beat this problem, we would add tremendous amount of health to our life, and probably a tremendous amount of life to our life. And that is the focus of what we’ll talk about, and a whole lot of serious science.

Dr. Weitz:            You know, I’ve increasingly had patients come in and say, “Well, I have some existing heart disease, but genetic, it’s genetic.” And it seems like that’s being thrown out quite a bit. Why do you think that is?

Dr. Kahn:             One, it’s not in any way casting a stone at anybody. It’s a convenient excuse to say, “My weight, my blood sugar, my blood pressure, my heart disease is genetic.” Because until we have crisper 9 technology like an ATM machine, you just go stick your finger in and get your genome changed. Which I wouldn’t be surprised 20 years from now you can’t just dial in what you want, maybe 10 years from now. But right now you can’t. So you’re stuck with the genes mom and dad gave you.

We’ve learned on another layer, that your genes aren’t destiny, because there’s something called epigenetics. And I’m sure your listeners have heard the term. But that’s where lifestyle gets it. Something as simple as air pollution, which is worldwide, in some areas worse than others, can dramatically change which genes are turned on, which genes are turned off. Sleep. Good sleep, bad sleep can turn on, turn off. And then the core of what we’re talking about, fitness, choices in diet, smoking, not smoking, and such.  So we can be handed a genome by our parents at the time of conception. But probably as or more important is what are we bathing our genome in? In some kind of visual there. And what’s actually turned on and turned off. I’m very excited, we’re just breaking into an era, we’re going to be getting reports. I just launched this in my clinic, where I’ll actually be able to know not just somebody’s genome, but which genes are methylated, which aren’t methylated, which are turned on and off.

So we’ll get more into that. And the ultimate conclusion is if you take a disease, very complex disease, like hardening of the arteries. Maybe 80, maybe 85% of the development of the disease is lifestyle and epigenetics, and 15% is just some hardcore genetic risk that you’ve inherited. Genes load the gun, but lifestyle pulls the trigger. So it’s never hopeless in the cardiovascular world, that your genetics will inevitably lead you to have a short life span, or a cardiac event. Just you may have to work much harder than the person who was gifted good genes, and a good epigenetic profile. But you’ve got influence. When there’s influence, there’s hope, you’ve just got to do the hard work.

Dr. Weitz:            I think unfortunately, some patients are in a doctor’s office, there’s some evidence of heart disease, or some risk for heart disease, and some of these doctors don’t really have the time to get into a long discussion of diet and lifestyle. So it’s easy to say, “Hey, it’s genetic, take this statin, and end of discussion.”

Dr. Kahn:             Right, and that’s … I was in that world where I had 12 minutes for a cardiology follow up appointment. “And Mr. Jones, your blood pressure is 170 over 105, let’s just double your drug du jour. It’s efficient, it often works. Some of these drugs do indeed have rather beneficial long term advantage. But what it doesn’t get at is, “How’s your sleep Mr. Jones? What’s your diet, breakfast, lunch, dinner, snacks? What’s your alcohol intake? What’s your waist line? Now you’re going to the gym.”  Or the advanced labs you just checked. Are you severely deficient in Omega 3 and CoQ10, and vitamin D, and such? And gives you targets to correct, so that maybe on the next visit, you don’t need to double the blood pressure. So I find it like you find it, much more interesting, gratifying. It’s just very hard to do it in 12 minutes, which is why I’ve had to lengthen my office visits, just to accommodate more teaching, result review.

Dr. Weitz:            Right. Great. So what are some of the best ways to detect some of the early signs of heart disease so we can prevent the progression of this condition? In a recent blog post of yours, you mentioned erectile dysfunction, going bald, gray hair, diagonal crease in your ear lobe, and calf pain when you walk can all be early warning signs of cardiovascular disease.

Dr. Kahn:             Right. Well it would be a better world if every time our arteries got 80%, 90% blocked, we had warnings. We felt poorly, we got short of breath, we felt an elephant weight on our chest during exercise. And many people get those, and they should go seek urgent medical attention, emergency room, or cardiology office, see if they can get it quickly. Unfortunately, even that’s not reliable, and people just die. They die, and autopsy shows they’re 95% blocked and they had no warning. And that happens 2,000 times a day in the United States, and that’s largely preventable. So given the nature of heart disease, number one, it doesn’t reliably give symptoms and warning signs, and some of which can be misinterpreted as heartburn, or just fatigue.

Number two, do you really want to pickup this disease when you’re 80 or 90% blocked? We’ve got this crazy medical system that takes care of you when you’re about to die pretty efficiently, but has very little focus … Although, we have other disease models, I mean why do people get a colonoscopy? If you believe in that, at age 50? Or cologuard when you’re perfectly fine? Because we believe early detection is valuable, why do you get a thermogram or a mammogram of the breast? Same thing.

Heart disease, the number one killer of men and women, 2,000 people a day in the United States alone. We don’t share that. So you just mentioned, I’ll go through real quickly, but succinctly, or efficiently. There are some, I’d call them soft signs, never to ignore. Men, it’s as we’re recording this, the day of love, it’s heart month, it’s February. I’m wearing my pink dye, and all that. Men are having difficulty getting an erection, maintaining an erection, performing a sexual act that didn’t used to be a problem, may have clogging of vascular issues. And if the answer isn’t necessarily vague, or zealous, or horny goat weed, the answer is Mr. Smith, let’s know your cholesterol, your blood pressure, your blood sugar, your lipoprotein A. The whole gambit of the blood panels you mentioned.

And let’s make sure that this isn’t a warning sign, not just of sexual difficulties, but of an impending heart attack or they could even be fatal. And the science says that should be performed, but sadly, family doc, nurse practitioner, you get a blue pill, you don’t get blueberries. And a blue lab slip to really dig deep. There is premature gray hair, premature balding, there is this very unusual … You mentioned it, called diagonal earlobe crease. And if you want to just Google Steven Spielberg and take a look at his earlobes. He’s the most famous resident of LA that has a diagonal earlobe crease. I don’t know if he knows about it. I would imagine, because I use him as my example all the time. Somebody by now has gone to his mother’s deli in Los Angeles, and said, “Check Steven’s ears,” or something.

But a physician in New York City 50 years ago identified, a very bright physician, Dr. Frank. That in my patients who have heart disease, I noticed this unusual physical finding. And he said, “I think it’s a sign of silent heart disease.” And in the last 10 years, multiple studies say that was one smart guy in New York. When we actually can study heart arteries much easier now, and that’s the last thing I’m going to talk about. And it’s about 70% accurate.  If you have a deep diagonal earlobe crease. You may have seriously clogged arteries. Take it as a clue, don’t ignore it, just like erectile dysfunction. Take it as a clue, there’s a common and serious disease, you want early clues wherever you can find them. And finally, why even wait? Why wait until your earlobes look funky, and your sex organs don’t go straight?  And all kinds of other further down the road.  We have had a test for more than 15 years that can tell a person very quickly and accurately, and inexpensively, if their heart arteries are clogged.  It’s often called the mammogram of the heart.  But the majority of primary care doctors, not teaching it’s availability or its utility, it’s a heart artery calcium CT scan. CT scan. You make an appointment at your hospital in Los Angeles, Good Sam, Cedar Sinai, UCLA, Torrance Harbor. You go in, you lie down for 15 seconds, you hold your breath, and you go home. No IV, no injection, it’s a CAT scan. There’s a very small amount of radiation when the machine’s on. And you get a report that says your heart artery calcium score is zero, you are golden for five, 10 years in terms of risk. Almost all. And your heart artery calcium score is 642, you’re 95 years old inside, even though your driver’s license says you’re 52 years old. And you need to get to a preventative cardiologist who can dig deep, and help you with the parameters measured in your lifestyle, and your diet, and all the rest. And maybe if we work on reversing that process, that’s been available, and was developed at UCSF and other places. Used to be $1,000, now it’s often $50, $75, $100.

The real breakthrough, November 2018, after years of this being available.  Fantastic documentary called The Widow Maker movie on Netflix, the Widow Maker Movie, everybody should watch it.  American College of Cardiology, the American Heart Association, which previously had said this is a good test, really elevated their recommendation.  Primary care docs managing somebody 45, 46, 47 cholesterol, weight, blood pressure, blood sugar, should consider this test.  Because if it’s a zero, you have really dropped somebody down in terms of risk, and you have time to work with them on diet, fitness, exercise, like that.  Somebody comes back loaded with calcium hardened arteries, you need to intensify your therapy, they’re now high risk.  And the fact that they endorsed it, and actually said, “Primary care docs, you gynecologists, you family docs, you internists, you nurse practitioners, you PA’s, put this in your toolbox as a test.”  So we aren’t yet ready to say everybody at age 50. I would actually say 45, get this like, like they get a colonoscopy. But in my practice, and in my experience, don’t miss out. Almost everybody has some reason to consider doing it once, and maybe 10 years later.

Dr. Weitz:            It’s interesting, there seems to be a push back actually in medicine now.  I’m assuming it’s coming from the insurance companies. Actually, against doing some of these screening tests.  Recently, they’ve been pushing back against mammograms, and PSA testing, and they’re saying you don’t really need it.  It’s not going to change care.

Dr. Kahn:             Yeah, that’s where this heart artery calcium scan is finally finding its niche. Because it is pretty clear, if you’re in this middle risk, you’re 48 years old, you’re tired, your cholesterol is 220, your blood pressure is 142, you’re just not picture perfect. That your physician might run a little calculator and say, “You’re medium risk for heart disease over the next 10 years.” Well that’s where the calcium score, if it’s normal, you’ve just dropped that. It’s called reassignment. You’ve reassigned that patient to a very low risk. No, you don’t recommend french fries and milkshakes. You say, hey, it’s all lifestyle, maybe you can add to your health.  And if it comes back abnormal, you’ve reassigned them to high risk. Where it’s lifestyle, plus depending on your perspective, it could be prescription, it could be referral to exercise lifestyle change programs. So we’re seeing this turnaround. What we’ll never have is a 10,000 patient study where 5,000 got the scan, 5,000 didn’t get the scan. 15 years later, it’s not going to be done. There’s no money in the game. And the tests can be … University hospital in Cleveland just announced they’re doing these tests for free. They got some research grant, so you can go and find out the truth about your heart like you’ve never been able to. The Widow Maker movie, if you want to learn the specifics for free in Cleveland. And in my city, it’s $75. Most people can afford to pay out of pocket $75 once every 10 years.

Dr. Weitz:            Can you talk about this newer TMAO test that’s being offered by Cleveland Heart Lab as a risk factor for heart disease?

Dr. Kahn:             Fascinating topic, controversial as I’m sure you’ll bring up. But you and I both know, I do believe that blood cholesterol is important, and it predicts the development of aging of arteries. But it never was the only predictor, smoking, diabetes, weight, stress, sleep. We’ve known this for years. So that list has expanded a lot. And you mentioned some of them in your introduction. Lipoprotein little A, Homocysteine, inflammatory markers. Well even that list is clearly not complete. We’re going to continue to add, and at the Cleveland Clinic in 2011, Dr. Stanley Hazen, MD and cardiologist, and his team, identified three molecules they felt might be either markers of clogged arteries, or maybe actually cause clogged arteries. Like we believe some versions of cholesterol do.  And they set out to examine yes, no. They developed a blood test for a molecule in the blood called T-M-A-O trimethylamine N-oxide. They found that the more clogged your arteries, the higher was the blood level in a group of more than 4,000 patients. That’s called an association, that doesn’t prove.  But maybe this is a good bio marker. Then they spent a couple years in basic science labs with a whole team, showing this molecule caused three findings.  It caused your platelets to clump, which might trigger a clot. It caused your HDL cholesterol not to work well, which is not necessarily good for your arteries. And it caused your LDL cholesterol to get taken up into the wall of the artery more aggressively. So it seemed like in fact, this was now possibly a cause of artherosclerosis. And they went on to show that it seems to be in the blood after a meal that includes a lot of choline from egg yolk, and carnitine from red meat. Vegetables don’t cause it to rise, vegans don’t have it in their blood.

Then they showed that if you happen to be taking supplements, and they’ve done this mainly with carnitine supplements, it can also lead you to develop TMAO in the blood. And then the whole mechanism of absorbing choline, carnitine, through some enzymes in the wall of the gut called lyases that can birth those precursors to TMA. And the liver converts it to TMAO. It’s a fascinating group of science, that it only eight years, now there’s way more than 1,000 papers.

So what we do know, it is clearly a pretty good marker. If you’re a diabetic, and your TMAO is up, your prognosis is not as good as normal. If you have congestive heart failure, if you have coronary arteries, if you have kidney disease.  And it can predict the risk of brain disease. Does it cause the disease or not?  We don’t have a blocker, we don’t have a trial that we can say, “Here is 500 people that we lowered or blocked TMAO, and their arteries remain healthy, the patient remained healthy.”  We think it’s the case, and I kind of practice that way. I’ve been able to drop TMAO blood levels since 2015 in probably three or 4,000 patients. And if it’s sky high, I want to know their supplements, I want to know their diet. I’m going to see if I can change their diet to at least a Mediterranean diet, which has been described to lower TMAO. And maybe even more of a plant diet than that. And I’ll stop their supplements for a little bit.

Now you and I both know, we need carnitine for proper muscle function, heart function. We need choline. It may be a matter of how much we need, and cutting back rather than cutting out. So there’s much to be learned. I know the Cleveland Clinic wants to find a blocker. Here’s your TMAO blocker prescription drug that becomes a several billion dollar a year drug. They’re going to have to do enormous and long term outcome studies, so we’re a ways away from that. But anybody can get their blood level checked at a Quest Lab, by asking for a TMAO blood level. And if you read the science, if you’re a heavy meat and egg eater, you might want to do that, and ask if your micro biome is producing a lot of this metabolite.

Dr. Weitz:            Yeah. I’m wondering if this is really a marker for an unhealthy microbiome. Some of the problems I have with this test is one, one of the foods that most increases this, is eating fish. And fish has been associated in a ton of studies with decreasing cardiovascular risk-

Dr. Kahn:             Right.

Dr. Weitz:            And other chronic diseases. And likewise, eggs really, we used to think that they were really atherogenic, and it seems like all the studies recently really haven’t shown that eggs increase your risk for heart disease. I know you don’t necessarily agree with that.

Dr. Kahn:             That may be quantity. But yeah, the fish story isn’t clear. And it’s just like there are all only certain fish that are really rich in Omega 3, like salmon, deep cold water fish. There’s only certain fish that intrinsically in their fish have TMAO. And if you eat them, your blood level goes up by a completely different mechanism than meat and egg yolk, because there’s no metabolism. It’s just you’re absorbing TMAO. And I think it’s very deep water fish, like some unusual fish on your plate. They wouldn’t be the bulk of the fish eaten in the Mediterranean based, and where studies suggest it is part of a healthy diet.  So yes, we need to learn more. It would be premature to say never eat meat, never eat bread, egg yolk, never eat fish based on TMAO. You might choose to do that based on other parameters. But I think it’s good that we’re learning new and interesting pathways. We’ve not … Heart disease is still the number one killer of men and women in the United States. I’m not sure if it’s because we haven’t defined all the parameters, or nobody is following a heart healthy lifestyle. There’s so much data that even what’s called the simple seven.

American Heart Association, you can say good group, bad group. They endorsed Fruit Loops in the past as heart healthy. All that stuff is the shameful episode in their history. But yeah, they have a little thing you can go online, do you smoke? Your cholesterol, your blood pressure, your blood sugar. How many servings of fruit and vegetables a day? How many minutes of exercise a day? What’s your weight? Simple seven measures almost everybody knows.  That simple seven calculator correlates to your coronary artery calcium score.  Correlates to whether your coronary artery calcium score is going to go up. Or whether you’re a zero, and you’re going to transition to somebody who has heart disease.  So you can control, do you smoke, what’s your fitness, how many fruit and vegetable servings a day. I mean we need the fancy new bells and whistles, like TMAO.  But God knows we have too many people that smoke, don’t exercise, and eat Tim Horton donuts during the day.  We don’t want to lose sight of simple measures that mean a lot to health and longevity.

Dr. Weitz:            There’s a prominent Functional Medicine doctor, Dr. Steven Gundry, and he’s been out there saying that grains and legumes, and even certain fruits and veggies, and seeds contain lectins, which are harmful to our health.  What do you think about that assertion?

Dr. Kahn:             Yeah I don’t know, I’m not making a promotion for an LA based TV show at Paramount. But I had the pleasure and the heartburn of being on the show, I think it was around September 2017, debating Dr. Gundry. I learned of his book, I had read his previous book, but his book Plant Paradox came out March 2017. I’m actually pretty open minded, I bought the book and I read it, and I thought some of it was interesting, and some of it was somewhat insane. And subsequently, just to fast forward, because it’s really not me versus him.  He is a University of Michigan trained heart surgeon, I’m a University of Michigan trained cardiologist. He likes to call himself a cardiologist, I don’t know why, I don’t call myself a cardiac surgeon. It’s just the first little chip in the otherwise seemingly perfect argument that Dr. Gundry has. He states that he’s published enormous data of his dietary program in patients with auto immune disease. Indeed, he’s published no articles on his diet, it’s just a matter of fact.  He published one paragraph called an abstract, and it has more spelling errors than a third grader trying to write Shakespeare. It’s insane.

And then his book itself, and this is the biggest problem. He has no actual data published. His book is riddled with serious, serious errors. I mean doc, if you write a book, and I write a book, and I say in chapter two, remember, these are books that are recommending health treatment strategies for people with potentially serious disorders. Putting their trust in Dr. Gundry, Dr. Kahn, Dr. Weitz. And he’s saying in chapter two, third paragraph, a little highlight study research number seven. And you go to the back of the book, you wouldn’t believe that it’s actually a real study on the topic that actually was represented appropriately, and fairly, and honestly.  Dr. Gundry’s book doesn’t believe in that rule. Why not just create a piece of fiction that’s called nonfiction?  So I’m not making this up, there are dozens of serious academic errors.  And I challenged him that on national TV, as well as the lack of publication.  I do believe he really is the emperor that wears no clothes.  Now, taking personalities aside, do legumes cause inflammation in one person in 100?  Are there people that have inflammatory diseases that stop eating beans, peas, and lentils, and either feel better, or some bio marker is better?  Maybe.  It’s not reported consistently in the literature.  Of course, Tom Brady will tell you during the season, he avoids lectin rich foods, and deadly nightshades, like eggplant.  Well Tom Brady is not a scientist. But he’s cute, and we all listen to him. The answer is we don’t know, and have I ever recommended a legume free lectin low diet to a patient with a serious auto immune disease? I have if they’ve tried everything else and they’re struggling. You do what you need to do. But it’s way premature to recognize Dr. Gundry as a Nobel Prize winner for fiction and nonfiction. Nor is it … The flip side of course, just to finish, is if you study longevity, which I know your patients are interested in, and my patients are interested in. And you study the areas where people live to age 100 or more in excess, the blue zones. The single food group shared amongst five regions around the world that are very different is legumes.  Beans, peas, and lentils are the central food of the areas where people live long and healthy. Now, their water is better, their air is better. They exercise, their lifestyles are different. But to call these food groups killers, when indeed, the science says the opposite, is just reason number 37 when Dr. Gundry comes on, you throw tomatoes at the screen. Was that subtle?

Dr. Weitz:            Hey, that’s … Yeah. It’s-

Dr. Kahn:             He knows how I feel, I debated him several times in meetings and in the public.

Dr. Weitz:            Yeah.

Dr. Kahn:             But he’s got one big ass vitamin company, and you and I would like to be CEO of that enterprise. You know, the public is looking for quick fixes.

Dr. Weitz:            Right.

Dr. Kahn:             And they’re being misrepresented.

Dr. Weitz:            Yeah. He tells a good story. I think the reality is, is if beans are properly prepared and cooked, that really inactivates most of the lectins.

Dr. Kahn:             Right. Yeah, and it’s like 10 minutes of cooking. So it’s true, don’t eat raw red kidney beans, it’ll upset your stomach. It won’t kill you, but it will upset your stomach.

Dr. Weitz:            Right, and you know, ricin that comes from castor oil beans, and that will kill you. So you know, but anyway. So in my practice, when I had vegans who were overweight, I have found that a lot of people don’t follow a vegan diet properly. It’s very easy to follow a vegan diet, and end up hardly eating any vegetables. You know? They just end up eating a lot of processed and junky carbs.

Dr. Kahn:             It’s a real struggle, and I agree with you, and I’m on your account. There actually is a study from the Harvard School of Public Health looking at cardiovascular disease, heart disease. And if you eat plant based junk, they had a way to analyze your diet, and calculate healthy plant based diet, unhealthy plant based diet. They actually did worse than the average American eating what seemed to be correlated as an unhealthy plant diet. And you did much better if you ate a whole food healthy plant diet than the average American.  So yeah, the word vegan to me is somebody who is into animal rights, and the environment, and is an ethical standpoint. But vegan food, Tyson just announced they’re creating meats and cheeses that will be plant based, Tyson, the biggest producer of chicken products in America. I mean, the grocery store is going to be filled with non animal products that look like former animal product. Doesn’t mean they’re healthy. It’s actually probably ethically and for the environment, a bit of a move forward.  But my heart patients use the word whole food plant based. I mean it’s got to look like the recent Canada food guideline plate. Rich in fruits, vegetables, beans, peas, lentils, healthy sources of protein that can include the beans, lentils, organic tofu, tempeh, and such. It’s not a mac and cheese that happens to say vegan on it. That’s going to move you towards where you want to go.

Dr. Weitz:            How do you get adequate Omega 3 levels with a vegetarian diet? Because the best source of Omega 3’s is from fish, and fish oil, and the type of Omega 3’s that’s found in vegetables and plant foods is linoleic acid, and it has to be converted into the DHA, and EPA, and that’s done very inefficiently.

Dr. Kahn:             Yeah, yeah. Although, it’s been reported on Twitter that I secretly go to Alaska with Dr. Ornish, and Dr. McDougall, and gorge on salmon once a year. And I’m not joking, that is the language of the beautiful world of Twitter that we have our secret meeting. And I haven’t done that.  … Right.

Dr. Weitz:            It’s just fake news.

Dr. Kahn:             Yeah. It’s yeah, it’s a challenge. Like you, because you mentioned those labs, I do actually get blood levels of Omega 3. There’s a lot of data, the higher your blood level, the better your long term brain health. And it maybe the better your overall health span. Dr. Russel Jaffe, you may know of a Perque Labs that makes a big deal about Omega 3 blood level of 8% or higher for long term health and brain health. So it’s a challenge, and the only people in my clinic that routinely have really good Omega 3 levels either eat salmon five nights a week, or they’re taking four grams of a high quality Omega 3 fish oil a day.

And my meat eaters are low, and my plant eaters are low, very often. And yes, it is important to try and get two tablespoons today of ground flax seed, and make some chia pudding, and use some hemp seeds on a salad, and eat walnuts as your preferred nut, because they and Brazil nuts are the only ones really rich in Omega 3. And leafy greens, now, I’m a big fan of chlorella, and spirulina, particularly chlorella. There’s so many benefits to chlorella.  Detoxifying and cholesterol and blood sugar lowering. But because it’s algae based, it actually has EPA and DHA in chlorella. And it’s a wonderful handful that I do every morning, and many of my patients do organic chlorella. And now there are capsules, you may say we’re mimicking the fish oil business. But there are EPA, DHA capsules. And the highest I’ve seen so far is about 600 milligrams of EPA, DHA in a capsule. Getting close to a good quality fish oil capsule, that might have 850 to 1,000 milligrams. So whatever it takes, I try and get my patients’ levels up.   But for the person on a new vegan diet, I’m teaching about chia, hemp, flax, chlorella, walnuts, and I’m probably going to encourage them to take one capsule a day. There’s an interesting couple of startups now that have a spray that has B12, vitamin D, and EPA, DHA. One spray a day, you’re a plant eater, you covered your bases. And there’s a new company out of Australia that has a tiny little capsule for $22 a month that has those three things in a capsule, if you don’t want to do a spray. So I think the solutions are there, but they do apply outside the vegan world, too, if you do the labs.

Dr. Weitz:            I tend to be a big believer in a low glycemic, Mediterranean eating style. And olive oil is a big part of that program. And I know that olive oil is highly recommended by a lot of people in the Functional Medicine community, including your friend, Dr. Mark Houston. And I recently read one of your blog posts, that you are not in favor of olive oil.

Dr. Kahn:             There’s a small niche, with number one. You’re absolutely right, there’s a small niche of patients. I had a guy gentleman in my office this morning who has had previous stinting, he’s having angina every time he walks to the mailbox. It’s what we call chronic, able angina. He just had a stress test, and documents lack of oxygen to the heart. This is not a low risk patient. This man could go on to have a heart attack, could drop dead. He will not go through another procedure. He wants to work on lifestyle reversal of heart disease.  He’s aware of data from the 50s, 60s, 70s with Nathan Pritikin. Dr. Ornish in the 80s, 90s, Dr. Esselton of the Cleveland Clinic, Dr. Joel Ferman. People that have published data that this gentleman might be able to stop having symptoms, and improve his stress testing coronary status. All those data, which are published peer reviewed, and actually government paid for programs, have used whole food plant diets without added oil. It actually goes back into the 40s, and some data from an internist.

If you go, Ben, to the Cedar Sinai cardiology department, the auditorium where I gave grand rounds about a year ago is called the Lester Morrison MD auditorium. Dr. Morrison did studies in 1948 using oil free diets in heart disease patients, and published dramatic benefits. So the problem is, if you’re the rare patient I took care of this morning, I would … with my knowledge of what’s going on, feel obligated to tell them. It is possible to steam, and saute, and cook with water, and cook with wine, but you don’t have to add oil everywhere. It’s a challenge in restaurants for sure. And I feel obligated to tell, so far that’s the only guy we know that can reverse your advanced symptomatic heart.  When we’re talking to people listening that aren’t like that gentleman, is olive oil of a good extra virgin source better than lard?  I mean in my world, much better.  Better than ghee?  I would say yes.  Better than coconut oil?  There is about 15% saturated fat in olive oil, and there’s 85% in some coconut oil versions. I’d rather people use olive oil. But if you’re struggling with your weight at 4,000 calories a pound per olive oil, and a salad is 100 calories a pound, if you don’t put olive oil on it. I mean my patients that are challenged by weight, I do also recommend them that they recognize the calorie density of olive oils is not favorable to their calorie in/calorie out struggle they’re having every day.

Dr. Weitz:            Yeah, on the other hand, fats are a good source of long term energy, and having a person feel satiated, and not craving a lot of carbs is also an important factor.

Dr. Kahn:             It’s a matter of quantity. I mean a half a teaspoon of olive oil versus four tablespoons, or Dr. Gundry talked about 12 tablespoons a day I think, I don’t want to misquote him, in his book. I mean that’s 1,500 calories a day, what else are you going to eat?  Well if you cut all your legumes out, I guess you might just make it on olive oil.  But I think recognizing that the highest calorie density of any food source on our plates is oils, whether they be standard vegetable oils, extra virgin olive oil, it’s just worth being aware how calorie dense they are.

Dr. Weitz:            One more question for you. I wonder if perhaps now the time has come for individualized medicine?  Maybe the time for making any kind of sweeping recommendations for society for the best way to eat, maybe the focus should be on what’s the best way for each person to eat?

Dr. Kahn:             Yeah.

Dr. Weitz:            Look at their parameters, do some testing, see how they’re eating. If that’s not working for them, find a modification that’s going to work for them.

Dr. Kahn:             I’m intrigued by the idea, as you know, there are ways you can send stool specimens, and get advanced microbiome testing. You could get reports back that tell you your microbiome likes arugula, or doesn’t like arugula. We don’t have any long term studies to say that this action makes a difference. But that’s available. You can do certain genomic studies to say if you metabolize Omega 3 rapidly or not. That very caffeine rapid or not. I mean can we guide, we’re going to spend a lot money for individual, but could we guide an individual to their ideal diet? It’s an interesting concept. I think we’re not quite there, or certainly don’t have long term data to say that they’ll feel better, or live longer.

The other just comment is I mean there’s always two people in the room when we’re talking about diet. There’s the patient, and there’s the earth. And we’ve had two very strong statements in the last four weeks. One by a large group that’s spent two years across Europe called Eat Lancet. Looking at a statement, how do we feed 10 billion people in 2050 nutritiously? But also on a planet that isn’t polluted by rain forest destruction, and landfill destruction, the rest. And their conclusion was shifting towards more plant based diets for the planet will also benefit health.  Those are called plant based. Those are called eating more fruits and vegetables, because there is still such an under representation of adequate … attainment of fruit and vegetable consumption. And then the Canadian government, after 12 year absence of the shared food recommendations, very similar frankly, to the USDA, with the food plate that’s half fruits and vegetables, whole grains, healthy proteins. And they brought in the conversation about the planet. So those are the two factors. Do we have to, as individual practitioners, worry about the health of the planet when we’re recommending a diet to an individual patient? Or do we just worry about individual patient? These are long and deep discussions. Largely, there are words out there. Plant predominant, plant flexitarian, plant based. Doesn’t mean you’re committed to not enjoying a nice piece of grass fed beef, or a nice line caught salmon, or a nice free range organic piece of poultry now and then. And I’m not going to yell at you if you’re doing that. But if your Mondays are meatless, or your breakfasts are meatless, or your plate, just like the USDA, Harvard Public School of Health, Eat Lancet, and Canadian Food Guide is largely a plant based plate, with your choice for a quarter of the plate. I think we’re all moving towards a healthier place for the both planet, and the patient.

Dr. Weitz:            Great. Excellent. Thank you for spending the time with us. How can the listeners and viewers get a hold of you, find out about your programs, and tell us about the restaurants that they can visit as well that you own?

Dr. Kahn:             Well first they gotta Google my great debate with Dr. Gundry on the Doctors Show. If the clip is there, I don’t want you to think I’m completely insane. I did go a little Hollywood on him. But it was a TV show. Here it is on YouTube: https://youtu.be/e61XfKF_NpI

Dr. Weitz:            That’s okay, we just had a Functional Medicine meeting a few weeks ago, and Dr. Vojdani, he also critiqued Dr. Gundry.

Dr. Kahn:             Bravo, I love it. Yeah, I’m all over the web on Instagram and Twitter. Dr. Joel Kahn, D-R-J, K-A-H-N. There’s a Dr. Joel Kahn, America’s Healthy Heart Doctor Facebook page. And I’m very active. There’s new postings every day on Twitter, many, many a day. And I have website, Dr.JoelKahn.com. I’m a real cardiologist, I saw patients this morning, I’m seeing patients all afternoon. I see patients, I have a license in California, and Florida, and Georgia.  I see people from all over the world. Really with the orientation, early identification, and early reversal of heart disease. So you’re not a statistic of 2,000 people a day. So go watch that movie, the Widow Maker movie, and get educated on what I call “Prevent not stent”. I did a lot of stenting in my day, and I know the field, but upstream medicine. That’s what you do. Let’s go upstream to the root cause, and fix the problem before you’re sick, old, and nearly dead.

Dr. Weitz:            Excellent, excellent. Thank you so much, we’ll talk-

Dr. Kahn:             Thank you.