Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Ketogenic Diet with Dr. Josh Axe: Rational Wellness Podcast 107
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Dr. Josh Axe discusses The Ketogenic Diet 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

5:05  One of the biggest benefits of a ketogenic diet is balancing insulin levels. And insulin imbalance causes inflammation, PCOS, Alzheimer’s disease, negatively affect brain health, and cause hormonal imbalances.  It also is very effective in helping clients/patients to lose weight. 

7:25  The main components of a ketogenic diet involve a macronutrient breakdown of about 70% fat, 20-25% protein, and about 5% fat. When your body starts burning fat instead of carbohydrates, you are said to be in ketosis.  This diet was created by Johns Hopkins researchers to fight epilepsy and to mimic fasting. Dr. Axe does not believe that the keto diet should be done for too long a period of time. It should be done for 30-90 days, like a long term fast or cleanse. And it can take 4-6 days of being on the ketogenic diet till your body truly gets into ketosis. Drinking matcha green tea, using adaptogenic herbs, keeping stress levels low, taking exogenous ketone supplements and taking other herbs that support thermogenesis like ginger and cayenne can help getting into ketosis.

9:33  If you are highly stressed, your cortisol levels will cause your body to produce more sugar from protein.  If the person has thyroid or adrenal fatigue and they are highly stressed and go on a ketogenic diet, they likely won’t do well on it.

10:18  Dr. Axe usually has his clients on keto consume 30 grams of carbs per day or less.  He does not like counting calories, so he will tell them that they can only have one serving per day of carbs and it’s either blueberries, beets, or carrots and that’s it for carbohydrate rich foods per day.  The carbohydrate rich foods are grains, legumes, fruits, and the starchier vegetables, like beets, carrots, potatoes, yams, butternut squash, etc.

13:15  Dr. Axe said that exercise is not required to follow a ketogenic diet and you can lose weight following a keto diet without exercising.  But exercise will help to lower stress, increase your metabolism, burn up carbs, and help you get into ketosis more easily.

14:23  Dr. Axe explained that it is o.k. to have small amounts of alcohol while following a keto diet, such as a 3 1/2 oz glass of dry farmed red wine once or twice a week.

14:58  Dr. Axe pointed out that there is a right way and a wrong way to follow a keto diet. He said that he saw the ultimate keto recipe posted on Pinterist and it involved taking conventional shredded cheese, fried in butter, with bacon in the middle, and then you more cheese fried on top, and you have a keto quesadilla. But that is not healthy on any diet. Dr. Axe recommended eating real, healthier fats like avocados, coconut, tahini, almond butter, grass fed butter. ghee, olives, etc.  Dr. Axe goes through a 30 day keto meal plan and has lots of recipes in his Keto Diet book that make it easier to follow a keto diet. 

16:51  A ketogenic diet will not be detrimental to your microbiome if you do it the right way with lots of fermentable fiber and fermented foods. If you do keto with loads of vegetables and you include some nuts and chia, flax, and pumpkin seeds, and berries, you will be getting plenty of fiber. You want to include some fermented foods like sauerkraut. You also want to include plenty of spices and it can be helpful to include matcha green tea, turmeric, ginger, and the supplement, triphala.  Dr. Axe pointed out that some ancient civilizations, like Eskimos and the Hadza lived on a keto diet and they had very diverse microbiomes.

19:00  The most beneficial nutritional supplements to take while following a keto diet are: 1. Probiotics, esp. Soil-based Probiotics, 2. Collagen protein or bone broth protein for tissue regeneration, 3. An organic green powder, 4. Adaptogenic herbs like ashwaganda, 5. Exogenous ketones, and 6. A multivitamin/mineral or drink celery juice or some other green vegetable juice.

22:18  The ketogenic diet is difficult to stay on long term, so Dr. Axe recommends doing it for 30-90 days and then adding back in some healthy carbs, say 30-40%.  That’s about 100 gms of carbs per day, which would be a serving of blueberries, a half a sweet potato, and one serving of rice.  Some people also do well cycling keto, such as doing keto and then adding some additional carbs every third day.

 



Dr. Josh Axe is a Doctor of Chiropractic, a certified doctor of natural medicine, and a clinical nutritionist. He has the No. 1 natural health website, Dr. Axe.com, with over 17 million monthly visitors, and he created a supplement company, Ancient Nutrition. He has written several best-selling books, including his new book, Keto Diet, and Eat Dirt.

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 The Rational Wellness Podcast on iTunes and YouTube, and sign up for my free e-book on my website by going to drweitz.com. Let’s get started on your road to better health.  Hey. Rational Wellness podcasters. Thank you so much for joining me again today. For those of you who enjoy listening to The Rational Wellness Podcast, please give us a ratings and review. That way, more people can find out about The Rational Wellness Podcast. Also, check out the YouTube page where we have videos that are not included in the podcast.

Our topic for today is ketogenic diet with Dr. Josh Axe. The ketogenic diet is a high-fat, medium protein and very low-carb diet. By severely restricting carbs, your body gets used to burning fat for energy instead of carbs. And this can facilitate the loss of body fat. When your body is burning fat, it produces ketone bodies in the process. This means that your body is in ketosis. Dr. Josh Axe is a doctor of chiropractic, certified doctor of natural medicine, and clinical nutritionist. He has the number one natural health website, draxe.com, with over 17 million monthly visitors. He’s written several bestselling books including his new book, Keto Diet, Your 300-Day Plan to Lose Weight, Balance Hormones and Reverse Disease, which is what we’ll be speaking today.  Dr. Axe, thank you so much for joining me today.

Dr. Axe:               Awesome. Hey, thanks for having me Dr. Ben.

Dr. Weitz:            Excellent. So, Dr. Axe, can you tell us how you became interested in a Functional Medicine approach to health?

Dr. Axe:                Yeah. So for me, I got into the natural medicine space through a health crisis in my family. My mom growing up was always into fitness, but we were never into nutrition or natural health. And so she was surprisingly diagnosed with cancer at 40.  We lived in that medical model.  We were always getting put on medications, and my mom decided to go through all the conventional medical treatments.  So she had a mastectomy.  She went through rounds and rounds and rounds of chemotherapy. And I remember her losing all of her hair. Just being so sick.  And she went through all those treatments, and then she was diagnosed as being cancer-free and healthy but really, after that, she seemed sicker than ever.  She got diagnosed with chronic fatigue syndrome, depression, anxiety, got put on multiple medications.  And she was just sick and tired all the time.

And that’s really, essentially, what inspired me to become a Functional Medicine doctor and a chiropractor, and nutritionist, and want to learn natural medicine. And so, I went to school, started studying to become a doctor. And about a year before graduation, get a call from my mom, and she says, “I’ve got bad news. I’ve just been diagnosed with cancer again. What do I do?” And I said, “I’ll be home.” I flew back from Florida back to Ohio where I grew up. We sat down and prayed together. And we felt led to take care of her all naturally. And so, she started juicing vegetables every single day. We started doing natural remedies like reishi mushrooms, and turmeric, and vitamin D. She started getting chiropractic adjustments every week. And using essential oils like frankincense.  And also doing positive affirmation.  We worked on her spiritual and emotional health.  We followed this plan for about four months.  We went back to Columbus, Ohio and redid a CT scan with her oncologist.  And they called us the next day and they said, here’s what their exact words were, “This is highly unusual.  We don’t typically see this, but your tumors have shrunk by more than half.  We want to see you again in nine months for another scan.”  She went back nine months later, complete remission.  And now, my mom’s in the best shape of her life.  She just turned 67, and she’s running 5Ks, and she water skis, and feels better now in her 60s than she did in her 30s.  And so for us, that’s a big part of what inspired me to start practicing natural medicine.

Dr. Weitz:            Just out of curiosity, did the oncologist ever call you and say, “Hey, Dr. Axe, what did you do?”

Dr. Axe:                No, no. Of course not. Well actually, on that call, they kind of said, “What have you been doing?” And their long-winded response was, “Hmm.” Was what it was. And at the time-

Dr. Weitz:            They really thought about it deeply.

Dr. Axe:                Exactly. Now another thing what my mom was doing as the time though diet-wise, all the vegetables she did were green vegetable juices, she was sort of doing a form of the keto diet. We removed all sugar, all grains from her diet. Her only source of carbohydrates was, she was doing about a half a cup to a cup of blueberries a day, some beets and carrots, and that was really it in terms of carbohydrates. And so, that was another thing that we felt like was pretty important as part of her treatment plan.

Dr. Weitz:            Great. So what is some of the primary benefits to following a ketogenic diet?

Dr. Axe:               So, the keto diet, big benefit there is balancing insulin. And most people, of all the macronutrients we eat, we overconsume sugar and carbohydrates are the most. We know different organ systems have to deal with different macronutrients, and so your kidney and your stomach, and to a degree, your liver, have to do with protein digestion. We know that fat digestion’s primarily your liver gallbladder, but your pancreas, in a big way, is responsible for carbohydrate digestion. And so for that, most of our pancreases are just worn out. So, when you can balance insulin… When people think of insulin, they tend to just jump to diabetes and think that’s what it does, or if it’s imbalanced that’s the disease it causes.

The truth is, research today is showing insulin imbalance causes severe inflammation. It causes PCOS, that’s polycystic ovary syndrome. In fact, Alzheimer’s disease is called type three diabetes because of insulin issues. And so, and then most hormonal issues, whether it be cortisol or progesterone or estrogen or testosterone, those hormones, a lot of times are at certain levels because of where insulin is at. And so, again, I think it’s really critical that we keep insulin balanced. But again, the benefits can be especially neurological in brain health. It can be big for that. Digestive health. Certain types of hormonal health, especially PCOS and fertility. And weight loss, of course. Probably of all the things, probably it’s most well-known for its ability to help people lose weight and fight diabetes.

Dr. Weitz:            I just did an interview with Dr. Bob Rountree, and he was talking about fatty liver disease, which is also related to insulin sensitivity. And that’s a tsunami of problems that’s coming down the pipe that is going to be the leading cause of liver transplant.

Dr. Axe:                Absolutely. So again, as you can… insulin resistance is a huge… And most people don’t think, unless they have diabetes, they think, “Oh, I don’t have insulin resistance.” Most people are sitting in that sort of syndrome X, that level of not full-blown diabetes, but most people, if they’re carrying an extra 20 pounds of body fat especially, there’s a great chance that they’ve got insulin issues.

Dr. Weitz:            Absolutely. So what are the main components of the ketogenic diet?

Dr. Axe:                So, a keto… Now, here’s the other thing too. There’s a right way and wrong way to do keto. So, keto tends to be about 70% fat, 20-25% protein, and about 5% carbohydrates. That gets your body in state of ketosis, where your body starts burning fat for energy because it doesn’t have carbs to burn for energy. And the other thing important to note about keto is, is that it was created by John Hopkins Medical researchers to fight epilepsy. And to mimic fasting. So think about it like that. The keto diet, for me… By the way, the keto diet is not a lifetime diet.  The keto diet is a long-term fast or cleanse. That’s why most of the time it can be done for 30 days or up to 90 days. Most people, unless somebody has maybe MS or Alzheimer’s or certain forms of cancer, those people may do it for longer periods. Or severe obesity. But for most people, if somebody’s looking to lose 20 pounds, or somebody’s looking to get rid of diabetes, for most of those people, the keto diet should be done 30 to 90 days. And then transitioning into just generally adding some good healthy carbohydrates back in. But it’s really meant to be like a long-term fast or cleanse. But the key is, your body’s getting into ketosis where your body breaks down body fat. That body fat is turned into ketones, which then your brain and other parts of your body can use as fuel.

Dr. Weitz:            From what I’ve seen, it’s not easy to get into ketosis.

Dr. Axe:                No. It does take typically four to six days for a lot of people to get in. There are secrets and ways I cover in my book, Keto Diet. Some ways to get into ketosis faster, such as using certain types of healthy caffeine like matcha green tea, using adaptogenic herbs, keeping stress levels low, keeping those cortisol levels low, taking exogenous ketone supplements, taking other herbs that support thermogenesis like ginger and cayenne. So there are ways to get into ketosis faster, but it does take at least four days for most people, if not six days, to get into that state.

Dr. Weitz:            I think if your cortisol levels go up because you’re stressed, that’ll cause your body to produce more sugar from protein.

Dr. Axe:                Absolutely. And that’s a huge deal. The people that I see that don’t do well on the keto diet, are the people that have… At the same time they’re keeping their stress hormones are very, very high. And, because I had somebody ask, “Is the keto diet good for people with thyroid disease like hypothyroidism?” The answer is, it depends. For the people that are to, with the diet, keep the stress hormones low, yes. Those people will do well on keto if they have thyroid disease. But if somebody has thyroid or adrenal fatigue, and they’re doing keto and they keep stressing out that entire time, they’re just going to create more problems for themselves.

Dr. Weitz:            So, do you have people actually count a specific number of grams of carbs? I saw in your book you said 5%, but that’s kind of hard to figure. How did they determine how many carbs they should be on?

Dr. Axe:                I have most people do 30 grams or less a day. Some people, if they’re athletes, can do 50 grams or less a day. But I… it tends to be… I’ve never been one into counting the calories. It’s more eat these foods. And eat some of them liberally. Eat your avocados liberally. Eat your coconut liberally. So, that tends to be how more I have had patients do it in the past. I found that hey, you add an extra stress on weighing everything, measuring everything, journaling everything. Some people want that. 20% of people may like to do it that way. But 80% of people, they just want to know what foods can I eat and not eat. Or I tell people, “Don’t eat carbs. You can have one serving of carbs a day, less than 30 grams and it’s either blueberries, beets or carrots. Outside of that, just don’t eat any carbohydrate-rich foods.”

Dr. Weitz:            And basically, carbohydrates are grains, legumes, most fruits and the starchier vegetables, right?

Dr. Axe:                You got it. And some squashes I think are fine. I think if somebody’s doing some spaghetti squash like a serving of a cup, that’s going to be fine for most people on the diet, versus if somebody’s doing butternut squash or sweet potatoes, of course. That’s going to get them out of ketosis for sure. Just too carbohydrate rich.

 




 

Dr. Weitz:                          I’ve really been enjoying this discussion, but I’d like to pause for a minute to tell you about our sponsor for this podcast. I’m proud that this episode of the Rational Wellness Podcast is sponsored by Integrative Therapeutics, which is one of the few lines of professional products that I use in my office. Integrative Therapeutics is a top-tier manufacturer of clinician-designed, cutting edge nutritional products with therapeutic dosages of scientifically proven ingredients to help our patients prevent chronic diseases and feel better naturally. Integrative Therapeutics is also the founding sponsor of Tap Integrative. This is a great resource for education for practitioners. I’m a subscriber to Tap Integrative. There’s videos. There’s lots of great information constantly being updated and improved upon by Doctor Lise Alschuler who runs it. One of the things I really enjoy about Tap Integrative is that it includes a service that provides you with full copies of journal articles and it’s included in the yearly annual fee. And if you use a discount code, Weitz, W-E-I-T-Z, you’ll be able to subscribe for only $99 for the year. And now, back to our discussion. Here is the link to TAP Integrative.

 



 

Dr. Weitz:             How important is it to exercise while you’re following a ketogenic diet?

Dr. Axe:                It’s not. It’s really not important. I mean, people may expect me to say it’s very important. Listen, I believe everybody should be moving. Everybody’s healthier doing some form of exercise, whether it be intensity, high-intensity interval training, or yoga or Pilates or barre or weight lifting or cardio, whatever it is. But what I encourage people to do is just move 20 minutes a day. If it’s that’s walking, that’s fine. But what I tell my keto… people I care for, is “Hey, just move 20 minutes a day.” But I don’t… I think people could lose lots of weight if that’s their goal, or balance their blood glucose levels and insulin levels very easily, even if they aren’t exercising if they’re doing keto the right way.

Dr. Weitz:            But doesn’t exercise make it easier to get into ketosis?

Dr. Axe:                It does. Yeah, absolutely. So again, I think movement is going to support your body in doing that. In fact, movement helps all kinds of things from lowering stress hormones to elevating your metabolism, to start to burn up any of those carbohydrates that might be in your diet. So, yes, it definitely can.

Dr. Weitz:            Good. So, can you drink alcohol while you’re following a keto diet?

Dr. Axe:                You know what, you can in small amounts. And it depends on the type of alcohol. Beer, absolutely not. Maybe some dry farmed red wine. Probably one glass or less a few times a week.

Dr. Weitz:            Now what if the glass is about this big, and you fill it to the top?

Dr. Axe:                Right. So we can stay, I think the-

Dr. Weitz:            Have you seen some of the sizes of some wine glasses?

Dr. Axe:                I have. So we’ll say three and a half ounces or less.

Dr. Weitz:            There you go. So what are some of the biggest problems people have trying to follow a keto diet?

Dr. Axe:                Well one, knowing what… Let me say this. I think one of the things people have to know too, and I alluded this earlier, there’s a right and wrong way to do keto. I was on Instagram and I saw somebody post the… Or maybe it was Pinterest. They posted the ultimate keto recipe. And they said you take conventional shredded cheese, you fry it in butter, put bacon in the middle, and then you fry another shell on top, and you have a keto quesadilla. That’s not healthy on any diet.

Dr. Weitz:            Right.

Dr. Axe:                It’s pure conventional beef and butter. That’s… No, that’s not good. Versus eat real, healthy fats. Eat avocados. Eat coconut. Eat tahini. Eat almond butter. Eat grass-fed butter. Do ghee. Eat olives.

Dr. Weitz:            Can you fit some hummus in there?

Dr. Axe:                Yeah. I think a little bit of the hummus is fine. People do fine if they’re just eating that with their vegetables. But I think that’s a big thing to know is that you got to get a lot of these sources of healthy fat in your diet. And that’s what’s important. So knowing, and in my book Keto Diet, I go through a 30 day meal plan of what a keto breakfast looks like, keto lunch, keto dinner, keto desserts, keto snacks. And so we have all those recipes in the book as well. But I think if you have the recipes in the 30-day meal plan like I have in my book, it’s actually… I don’t think it’s that difficult to follow then.

Dr. Weitz:            No, I appreciate the fact that you emphasize the importance of doing it a healthy way with avocados and vegetables, because that’s one of the things that really turned me off to the whole idea of the Atkins diet which was kind of the progenitor of the keto diet, which people are eating bacon and cheese and all this unhealthy food. And I just, it was like, I get it. I understand how fat could be healthy, but there’s just no way that eating pork bacon can be good for you.

Dr. Axe:                Totally agree. And it’s not. In any setting.

Dr. Weitz:            So, will a keto diet be detrimental to your microbiota?

Dr. Axe:                So the answer is, not if you’re doing it the right way. It’s important to remember, certain civilizations lived on keto. Eskimos lived on a keto diet. Sometimes the Hadza possibly did. We know sometimes people lived on keto diet. But the thing is, you got to be getting the right fermentable fiber in your diet. That’s key in probiotic rich foods. So when you do keto, you got to get fiber. So again, one serving of berries a day, and then loads of vegetables and some nuts and seeds like chia and flax, pumpkin seeds, almond. But getting the fiber in your diet, and then getting some of those fermented foods like sauerkraut in there, and all the vegetables. If you’re doing loads and loads of vegetables, and then herbs or spices. Doing matcha green tea. Doing tumeric. Doing ginger. Doing supplements like triphala which is an ancient Ayurvedic yoga gut digestive support.  But doing those types of things, your microbiome will be healthier than ever. In fact, there’s an animal model study for people with ASD, autistic spectrum disorders. And they found that actually, their gut microbiota dropped especially the bad bacteria which improved behavioral outcomes, their overall digestion, their memory, their focus. So, if anything, it’s actually going to have a great benefit on the gut microbiota if people are doing loads of vegetables, herbs and spices and fermented foods.

Dr. Weitz:            Cool. Do you have people measure to see if they’re in ketosis? Use those urine dipsticks?

Dr. Axe:                Most of the time I don’t have people do it. Now if somebody’s having some issues, absolutely. And if somebody loves to measure things, that’s great. What I’m looking for is how you’re feeling. And are your symptoms changing? How do you look? And so people noticing, oh, I can tell my face is leaning in. I can tell I’m leaning out here. I can tell my energy now is better. I can tell my hormones are… I have people more so listen to their body than I do using the strips. But I think using ketone strips can be great.

Dr. Weitz:            What are some of the most beneficial supplements to take when following a ketogenic diet?

Dr. Axe:                I think number one would be making sure that we’re getting plenty of probiotics. So getting quality probiotics, especially the soil-based organisms, those SBOs. So I would look for a good quality soil-base probiotic supplement that also contains herbs and spices like triphala and ginger that support digestive health. But a probiotic supplement would be number one. Number two, collagen. I think collagen is critical for tissue regeneration. When people go keto, I not only want them to balance insulin and to lose the extra body fat, I want them to regenerate and heal. And so in that case, I’d say number two would be a collagen protein or a bone broth protein. Bone broth protein’s probably even the best, because that also has hyaluronic acid and glucosun and a chondroitin. So a scoop of that a day in a smoothie.

Dr. Axe:                The third supplement I would say would be… I think you want to stay alkaline. I think doing lots of greens. So something like chlorella or spirulina or organic super greens powder of some sort could be great for people. Just a couple more. I think taking adaptogenic herbs can be good. I think ashwagandha is one of those that can be very good to help keep those cortisol levels lower. And for some people, exogenous ketones, if somebody really wants to amp up the weight loss and get into ketosis faster. For a period of time, I think that’s another good one that people can consume.

Dr. Weitz:            Probably minerals too, right? Because there’s a lot of electrolyte imbalances that result from a keto diet.

Dr. Axe:                That’s the other thing I was going to say. In fact, one of the things I have a lot of people do when they’re on the keto diet is drink loads of celery juice. But celery juice to get the minerals. Lots of steamed spinach.

Dr. Weitz:            The cure for everything. Celery juice.

Dr. Axe:                Listen. I do want to say this. I’m not… And by the way, I’ve never met the guy, Medical Medium. He seems like… Obviously a lot of his stuff has a very, just polarizing effect in terms of the way he markets.

Dr. Weitz:            My wife read it. Had her first dose of celery juice, got sick as a dog, concluded this must be good for me. So now every time I go to the market, I have to call ahead and have them stock up on celery.

Dr. Axe:                I was actually recommending celery juice before that guy ever came out with the celery juice book or whatever he came out with. Which at least it’s better than the book before, not by him. Two years ago, it’s the grapefruit juice diet. At least this time it’s celery. So, but I do think some vegetable juice that’s mineral rich, especially celery, cucumber, spinach, ginger, lemon, that sort of… I think can help. But, you’re right, a multi-vitamin mineral can also be great for people that are looking to… That they’re on keto.

Dr. Weitz:            Now, you talk about using the keto salts. But isn’t the whole idea to get your body to produce those ketones?

Dr. Axe:                Yeah again, I’m not… Anytime I’ve done keto in the past, I’ve never used the salts or the exogenous ketones. Again, it’s just a supplement there for people if they want to see, get into ketosis faster, or they’re going to do it for 30 days and want to sort of reap the ultimate benefits. I think it’s fine thing to take. But do I think it’s number one on the list? No, by any means, in terms of supplements. But again, a lot of people I have do it without it.

Dr. Weitz:            Now since the ketogenic diet is hard to stay on long-term, once your recommendation for them to do it for 30 or 60, 90 days is over, what should they do then long-term?

Dr. Axe:                So, I recommend eating a healthy amount of carbohydrates. And so I think, realistically, now what we think of as normal is not normal. I think what the normal amount of carbohydrate consumption is probably close to, let’s say, 30% maybe. Maybe 40. But it’s not 50, 60 or 70.

Dr. Weitz:            You mean Big Mac, fries and Coke is not a reasonable way to eat?

Dr. Axe:               That’s not it. That’s definitely not it. So, I do think that keeping that protein around 25%, keeping the fat around something like 40%. What does that leave? 35% probably for carbohydrates. So, I do think about a third of your diet at carbohydrates is fine. It’s probably 100 grams or less is probably going to be about 100 grams a day for most people is great, and that’s three. It’s a serving of berries. It’s a half a sweet potato. It’s one serving of rice. It’s the right amount.

Dr. Weitz:            And I saw in your book you also talk about keto cycling as a way to sort of integrate some keto diet into your-

Dr. Axe:               I think for some people if they sort of liked being on keto but they wanted sort of a break, to be able to go out with friends and be able to do something long-term, keto cycling can be great. It’s sort of carb cycling meets keto diet. My wife actually did this. I hadn’t thought of it necessarily until my wife said, “Hey, I’m going to try this.” She did keto 30 days and then she started doing sort of these just a carb day every third day. And she said she actually felt better doing that than actually full-on keto, and she actually, the result she saw were just as good and long-term, better. She noticed, and my wife is a chiropractor. She’s a fitness instructor, yoga instructor. She’s super healthy. But she ended up losing just a few… Just leaning out a little bit more and getting her body to kind of ideally where she wanted it to be doing that. So I think the keto cycling as we cover in my book, is a great thing for a lot of people to do.

Dr. Weitz:            Cool. Well, thanks for the interview, Josh. How can our listeners get a hold of you and find out about your books and your supplements?

Dr. Axe:                Sure. Well, you can follow me on Instagram, Facebook and draxe.com. Here’s the new book that just recently came out, Keto Diet. You can see it here. You can buy it on amazon.com. In fact, it’s been ranking as one of the top-selling health books the past three months. International best seller. But in this book, we have 80-plus recipes, 30-day meal plan, and also a keto cancer plan and others. So people can check out this book here, and check it out on Amazon, read some of the reviews there we have. And then-

Dr. Weitz:            No, I read it.

Dr. Axe:                Awesome.

Dr. Weitz:            It’s an easy read. It’s great.

Dr. Axe:                Awesome. And then draxe.com. It’s D-R-A-X-E dot com, my website. But I want to say, Dr. Ben, thanks so much for having me on your show.

Dr. Weitz:            Thank you so much, Josh, Doctor Axe.

Dr. Axe:                All right, God bless.

 

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Cancer Related Fatigue with Dr. Lise Alschuler: Rational Wellness Podcast 106
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Dr. Lise Alschuler discusses Fatigue in Cancer Patients with Dr. Ben Weitz.

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Podcast Highlights

1:45   Fatigue in cancer is under reported, underdiagnosed, and undertreated.  That’s because cancer doctors tend to focus on patients pain and tend not to pay attention to fatigue even though many patients report that the fatigue is their most distressing symptom. 

3:33  Cancer related fatigue is a very severe fatigue and not the kind of fatigue that you can sleep off or easily recover from. 80% or more of cancer patients suffer with this type of fatigue. Dr. Alschuler explained that “from a functional perspective, we would think of this kind of fatigue as the fatigue that is happening on a cellular or even mitochondrial level and, has really gotten to a point where it’s influenced our endocrine system. So, it’s obviously going to take quite some effort to get people out of this type of fatigue.” And for up to 50% of these patients will have this fatigue for years after the cancer is gone, and this where a Functional Medicine approach can be helpful.

5:22  Dr. Alschuler feels that most of the fatigue is related to the cancer more so than the cancer treatment, though the treatment adds to it. The mechanism is the release of inflammatory cytokines by the cancer cells or the stromal response around those cancer cells, like Tumor Necrosis Factor alpha (TNFalpha) and Interkeukin 6.  This is the initial cause of the fatigue and one of the next phases of cancer related fatigue is the circadian rhythm disruption and the hypothalamic/pituitary/adrenal access dysfunction that occurs.

7:06  Sleep is very important in being able to recover from cancer and many patient have their circadian rhythm and their normal sleep cycle disrupted, so you want to help the patient to reinstate their circadian rhythm and their normal sleep pattern.  We’ve discovered clock genes, which occur in every cell in our body and they are tied to our circadian rhythm.  These clock genes are also involved in really important things like cellular repair, cell cleanup, autophagy, so we want to have our circadian rhythm in tact. Dr. Alschuler will often measure the adrenal stress profile with the cortisol awakening response.  She will also measure cytokines, including C Reactive Protein and Interkeukin-6, which are acute phase reactants, 11-Dehydrothromboxane B2, which is a measurable metabolite of the arachidonic acid LOX and COX pathways, and 8-hydroxy-2-deoxyguanosine, which is a good indicator of oxidative stress.

12:46  Cancer and chemo both result in a lot of oxidative stress on the body, so everybody who goes through cancer and cancer treatment will be depleted of antioxidants. They need some antioxidant repletion either from antioxidant supplements or from a good plant based vegetable and fruit diet. The oxidative stress contributes to the HPA hypothalamic/pituitary/adrenal/circadian rhythm dysfunction, as well as a contributing factor to mitochondrial dysfunction, both of which are related to fatigue.

13:45 It is understood that chemotherapy and radiation use oxidative stress (free radicals) to kill cancer cells and we need to be careful about recommending antioxidant supplements while treatment is occurring.  We now have a lot of data to be able to determine which particular nutritional supplements might help or interfere with specific chemo drugs.  But it is a different story with the newer targeted drug therapies of cancer, like the molecular based, antibody based, or immuno therapies and new drugs are being released quite often. And we are still learning whether there might be interactions with natural therapies. We need to understand how each of these drugs work and how they are metabolized and then try to figure out if there is a likelihood that there might be an interaction between a given supplement and a targeted treatment. 

21:44  The best type of diet for patients with cancer is the one that is going to lower inflammatory cytokines. Intermittent fasting for 13 hours helps to lower inflammation. Fasting for a day or two before, on the day, and the day after chemo infusions helps to minimize toxicities, esp. to the digestive tract, and may improve their energy a bit.  While cancer patients should avoid a high carb diet, they shouldn’t necessarily follow a ketogenic diet.  But should make sure that they get plenty of healthy fats like omega 3 fats, though one recent study found that soy oil was better than fish oil in reducing cancer related fatigue:  Multicenter randomized controlled trial of omega-3 fatty acids versus omega-6 fatty acids for the control of cancer-related fatigue among breast cancer survivors.  Coconut oil and MCT oil also reduce cancer-related fatigue. The effects of virgin coconut oil (VCO) as supplementation on quality of life (QOL) among breast cancer patients. Dr. Alschuler also recommends that cancer patients consume high quality proteins like legumes, tofu, seeds, nuts, eggs, grass fed or wild meats, fish, and organic poultry.  When it comes to consuming legumes and seeds, one prominent Functional Medicine doctor–Dr. Steven Gundry–has been claiming that the fact that these foods contain lectins is a problem for our health.  In advocating consuming legumes and seeds I asked Dr. Alschuler if she worries about lectins and her response is “You know, there’s many thing’s we can worry about but, no, lectins hasn’t made my list recently.”  Dr. Alschuler also recommends branched chain amino acids, which have been used in several studies that show benefit for cancer-related fatigue. 

27:18  Recommended nutritional supplements for cancer-related fatigue include:  1. Panax quinquefolius (American Ginseng) when taken at a dosage of 2 gms per day during cancer treatment and continued for 8 weeks after reduces cancer-related fatigue.  2. Rhodiola rosea is an adaptogenic herb that makes cancer patients more energetic. 3. Ashwaganda is also an adaptogenic herb that may be helpful. 4. CoQ10, esp. the ubiquinol form helps with mitochondrial support, 5. Reduced Glutathione can help support the mitochondria, 6. L-carnitine helps with fatigue at a dosage of 4 gms per day, though if the patient is on ataxane chemotherapy it can make peripheral neuropathy worse and 7. Acetyl L-Glutathione may be better for both fatigue and also cardiovascular support. 

32:14  Exercise is important in rebuilding the mitochondria and their functionality.  Exercise also helps to increase hypothalamic/pituitary/adrenal resilience and reinstate the normal circadian rhythm.  It is beneficial to do a combination of aerobic and resistance exercise for at least 45 minutes per day at a level that is moderately strenuous.

34:02  Some organic coffee with caffeine or green tea can stimulate sympathetic nervous system responsiveness and help reinstate normal circadian rhythm and enhance cognition.  And both coffee and tea are inversely associated with cancer risk.

 



Dr. Lise Alschuler is a Naturopathic Doctor with board certification in Naturopathic Oncology and she was past president of the Oncology Association of Naturopathic Physicians. She is the executive director of TAP Integrative, a nonprofit educational resource for integrative physicians. If you use the discount code WEITZ you can subscribe for only $99 for the year.  Dr. Alschuler wrote The Definitive Guide to Cancer and The Definitive Guide to Thriving After Cancer. She sees cancer patients in Scottsdale, Arizona and is a sought after speaker at conferences around the world and she co-hosts a ratio show, Five To Thrive Live! on the Cancer Support Network. Her website is DrLise.net.

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 the Rational Wellness Podcast on iTunes and YouTube. And, sign up for my free ebook on my website by going to doctorweitz.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 ratings and review. That way more people can find out about the Rational Wellness Podcast.

Our topic for today is fatigue and cancer with Dr. Lisa Alschuler. The National Comprehensive Cancer Network says that, “Cancer related fatigue is a distressing, persistent, subjective sense of physical, emotional and, or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning.”  Pain is very common in cancer and, up to 80% of patients receiving chemotherapy or radiation and, cancer survivors report that fatigue is a disruptive symptom months and even years after treatment ends. I meant to say, fatigue is a common symptom in cancer. Fatigue in cancer is under reported, underdiagnosed, and undertreated.  That’s because cancer doctors tend to focus on patients pain and tend not to pay attention to fatigue even though many patients report that the fatigue is their most distressing symptom.

Dr. Lise Alschuler is a naturopathic doctor with board certification in naturopathic oncology, she was past president of the oncology association of naturopathic physicians, she’s executive director of TAP Integrative, a non-profit educational resource for integrative physicians, which I use regularly and very, very helpful.  They have tons of great educational videos and other information, and the service also includes free retrieval of full journal articles all for the price of the annual membership, which I take full advantage of.  Dr. Alschuler wrote, The Definitive Guide To Cancer and, The Definitive Guide To Thriving After Cancer, and The Definitive Guide To Cancer is just an amazing resource and, anybody who sees cancer patients, you have to have that book as a resource.  Dr. Alschuler sees cancer patients in Scottsdale, Arizona, she’s a sought after speaker at conferences around the world, she co-hosts a radio show, Five To Thrive Live on the cancer support network and, she’s also a cancer survivor herself.  Dr. Alschuler, thank you so much for joining me today.

Dr. Alschuler:                     My pleasure, Dr Weitz. It’s nice to talk to you again, its been a while so, looking forward to it.

Dr. Weitz:                          Absolutely.  So, what are some of the reasons that cancer patients get fatigue?

Dr. Alschuler:                     You know it’s a really, first of all, I want to just emphasize the introduction that this kind of fatigue is not the kind of fatigue that maybe we all think of. Like, the fatigue that we get when we’re working too hard and, we just need to sleep in on the weekends and then, we kind of wake up rejuvenated. This is not a fatigue that people can sleep off, it’s not something they can recover from, it’s a very debilitating fatigue and, it’s associated, actually, with anxiety, with depression, with cognitive dysfunction. It’s a very, so, it’s a very deep seated fatigue.  I think, from a functional perspective, we would think of this kind of fatigue as the fatigue that is happening on a cellular or even mitochondrial level and, has really gotten to a point where it’s influenced our endocrine system. So, it’s obviously going to take quite some effort to get people out of this type of fatigue.  But, so I just wanted to really emphasize this type of fatigue is quite different and, as you said, the majority of people going through cancer and treatment, upwards of 80% have this kind of fatigue. It may not be severe, it may be sort of mild but, even mild cancer related fatigue is pretty significant and, some people fortunately probably over half do kind of spontaneously, as we would say, their innate healing process takes over and they can overcome the fatigue, maybe six months out from their diagnosis but, the rest can have it for years and, years and, years.  So, this is something, I think, our prime opportunity for integrative practitioners to really jump in on. And now that I’ve taken us on this tangent, I don’t even remember your question.

Dr. Weitz:                          That’s great.  How much of fatigue do you think is related to the cancer versus the cancer treatment?

Dr. Alschuler:                     Yeah, I think that the majority of fatigue is related to the cancer and, I think that the treatment is basically jumps onto that.  The reason I say that is, because there seem to be some emerging underlying mechanisms that are becoming commonly accepted. So, one is, that there’s clearly a cytokine aberration in cancer related fatigue. We think that it probably is, that sort of the main culprit is high levels of Tumor Necrosis Factor Alpha and, then along with that, of course, that Interleukin six, those two, when they’re in high levels, the classic symptom is fatigue.  So, there’s definitely something to do with cytokines and cancer when you have the malignancy, there is cytokine aberrations as a result of the malignancy, either the malignant cells are secreting these cytokine’s in high levels because of up-regulated NF Kappa B in those cells or, and, or the stromal response in and around those cancer cells, there’s a high level of inflammation.  So, I think it’s mostly the cancer but, you take that kind of inflammatory, simmering mix and, you throw some chemo in there and, you’re just going to aggravate those inflammatory cytokines.  One of the next phases of cancer related fatigue then is, the circadian rhythm disruption and the hypothalamic/pituitary/adrenal access dysfunction and, that system, as we know, is also very sensitive to cytokine induced oxidative stress. So, I think that that’s kind of a secondary event in the continuum of cancer related fatigue. 

Dr. Weitz:                           So, you mentioned the circadian rhythm and, cancer patients often have trouble sleeping, either as a side effect of treatment or, due to stress or, due to other factors. What role does sleep play in this?

Dr. Alschuler:                    Yeah, it’s a really important point.  So, as I mentioned earlier, if somebody has cancer related fatigue and, they just say, “Okay, I’m just going to sleep for eight hours a night,” they still may have cancer related fatigue if the mitochondrial dysfunction is not addressed, if the inflammation isn’t mitigated and, if the circadian rhythm isn’t reinstated.  That being said, all those three things won’t do anything for somebody if they’re not sleeping so, sleep is essential, it’s an essential component to recovery and, as you mentioned, a lot of people go through this disease and treatments because their circadian rhythm is so disrupted and, so shifted their sleep cycle gets very disrupted as well.  So, one of the key cornerstones, if you will, of addressing recovery and survivorship is to reinstate circadian rhythm and, as a component of that, sleep.

Dr. Weitz:                            So, let’s say the person normally wakes up every day at 6:00 or 7:00 or, 8:00 in the morning, goes to work, goes through their day, et cetera, et cetera. Now they get cancer and, maybe they’re off work and, their schedule changes so, it kind of throws their circadian rhythm off. Is it better for them to just go back to waking up every day at 7:00 and, having their regular schedule? Is that something that’s beneficial?

Dr. Alschuler:                     Yeah, I think it is. There’s, you know, now that we’re learning more about the circadian rhythm, I think that we understand how sensitive it is to what I call, ritual and rhythm and, the more ritual and rhythm we have in our day-to-day lives, the easier it is for us to have a healthy circadian rhythm.  And, remember, that even within the last 10 years, we’ve just now discovered clock genes, which occur in every cell throughout our body, are directly tied to the circadian rhythm. They only function or turn on in accordance with the circadian rhythm and, most of the genes controlled by clock genes are involved in really important things like cellular repair, cell cleanup, autophagy, so we want to have our circadian rhythm in tact for lots of reasons, that being the primary one.  So, yes, to go back to your question, if somebody had kind of a rhythm, ideally a rhythm that were used to, now they’re off work, their rhythms kind of all crazy, it would really be helpful to try to go back as closely as possible to what they had before, assuming that that rhythm was optimal for them.

Dr. Weitz:                            When you’re treating a patient who has cancer related fatigue, do you, when you work them up, do you try to sort through which, you know, what are some of the causes of the fatigue?  Like, for example, do you measure cytokine’s, are there certain questionnaires you use?  Do you try to figure out how much is hormonal, how much is related to different factors in coming up with a treatment plan?

Dr. Alschuler:                     Yeah, I often do.  You know, not 100% of the time if I have a good kind of, I don’t know if it’s intuitive hit or, just having done this for a while hit but, if I’m really wanting to be very precise then, yes.  So I’ll do an adrenal stress index test and measure cortisol at four points over the 24 hour period. Get a really good sense of their cortisol awakening response, as well as their full circadian rhythm and then, I do often …

Dr. Weitz:                            That’s just, that’s the new part of the adrenal stress test, is the cortisol wakening response where you are measuring how their cortisol changes in the first 30 minutes after awakening.

Dr. Alschuler:                     Yeah, haven’t seen a normal one yet but, I’m still holding out for it.  But, I think it is important, this is really actually a pretty substantial body of literature just on cortisol awakening response in relationship to depression and, anxiety and, all sorts of things.  So, yeah, adrenal function, for sure. I do measure cytokine’s for this purpose and also, just as a way to assess, to some extent, what’s the milieu of this person like so that I have a, kind of I can determine whether or not they are more or less at risk for occurrence.  So, for cytokine’s, I will most commonly measure include C reactive protein as an acute phase reactant, Interleukin 6, I definitely look at and, those two alone are usually enough to do it. There’s another inflammatory test that I have started to use quite a bit, it’s a urine test and, it measures 11-Dehydrothromboxane B2, which is a measurable metabolite of the arachidonic acid LOX and COX pathways.  So, it’s a very important way to assess the eicosanoid side of inflammation, and then the CRF and the IL-6, sort of measure the genetic side of the inflammation, the NF Kappa B, up regulation side so, all that together can give me a pretty good sense of what’s going on.  And then sometimes I might also look at, see if there’s any evidence of oxidative stress, which would be another indication of the fact that there’s up-regulated inflammation so, looking at 8-hydroxy-2-deoxyguanosine would be kind of my go to.

Dr. Weitz:                            Okay so, oxidative stress means that there’s not enough antioxidants to block some of the excessive oxidative stress.  And, of course, oxidative stress is often part of the chemotherapy if they’re getting chemo.

Dr. Alschuler:                     Yeah, most everybody who goes through cancer and its treatments will be depleted from an antioxidant perspective at the conclusion of that treatment.  So, typically, some degree of repletion is necessary.  It doesn’t necessarily have to be supplementation, a good plant based vegetable and fruit rich diet can restore people’s antioxidant capacities but, yeah, it’s very common and, that oxidative stress is a contributor to the HPA hypothalamic/pituitary/adrenal/circadian rhythm dysfunction, as well as, a contributing factor to mitochondrial dysfunction, both of which, as we talked earlier, are related to fatigue.

Dr. Weitz:                            I know we’ve discussed this in the past but, where are we in terms of the use of antioxidants during cancer treatment?

Dr. Alschuler:                     You know, again, I think that the controversy, I will say is a little bit muted right now and, maybe because we’re starting to get a little bit more savvy and realize that when you say, antioxidants, we’re talking about such a large and diverse group of compounds, some of which are problematic with certain chemotherapy agents or, certain radiation treatments, some of which are actually very helpful.  So I think we have to sort of say, the question shouldn’t be, are antioxidants safe or not? The question should be, can I use X, Y or, Z?

Dr. Weitz:                            Right.

Dr. Alschuler:                     Then we have data now to answer that very specific to the actual treatment that somebody’s getting, the cancer type even and, figure out, yeah, you were a prime candidate for using this antioxidant or, nope, this is not good for you.

Dr. Weitz:                            Okay, good, good, good.  And, does that apply to the newer drugs, the targeted drugs?

Dr. Alschuler:                     So, you know, as you mentioned, cancer treatment is changing and, hopefully, some day, chemotherapy will be a thing of the past but, we’re not quite there yet.  But, more and more we’re moving towards molecular based therapies or, antibody based therapies or, immuno therapies so, these all target tumors in one way or another by either, capitalizing on a genetic aberration in the cancer and targeting that very precisely or, by stimulating our own innate healing mechanisms, like the immuno-therapies are essentially un-breaking the immune system to attack.  And, we’re getting a lot more sophisticated with all this now. Because this is all new and, it’s happening so fast and, there’s new drugs in trial all the time, we, in the integrative space, are playing catch up, for sure and, we just are really in a place of trying to understand what we have that’s helpful, not contraindicated.  Generally speaking, this is an area where it would really be important to be under the care of an integrative practitioner with an expertise in integrative oncology because, like even me, when I had a patient that, and that’s all I do is, integrative oncology and, when I have patient, I get patients every week with new drugs I haven’t heard of so, I have to go, I have to research the drug and, really understand its mechanism, it’s metabolism and then, I have to apply that with a knowledge of it’s side effect profile, figure out what I have to use, see if there’s any potential for a reaction and, be very cautious around that whole thing. So, it takes a lot of time and effort so it’s not, you know, we’re still learning, that was a long-winded answer.

Dr. Weitz:                            You know, I was looking at some studies on some of this stuff and, a couple of the papers were mentioning the part of the cytochrome P450 pathway that this nutrient affects and that could interfere with this drug. And you start going, oh my God, you can’t take this, you can’t take that and then you start looking at the drugs and you realize that this cocktail of cancer drugs are actually interfering with each other.  And, you know, nine other things that they’re taking to control their blood pressure and, everything’s interacting on these cytochrome P450 pathways and so, it occurs to me that, if you use that as the basis for not eating something, it’s way to complicated to use that as a rule out, don’t you think?

Dr. Alschuler:                     Well, I think, so eating for sure but, I think that with supplements the challenge is that, so, yeah so, first of all, a good practitioner, conventional practitioner will do a drug/drug interaction check when they’ve introduced chemo to make sure, because, and sometimes I’ve seen patients get pulled off of pre-existing antihypertensive drugs, or whatever, because of potential interaction.  That being said, there are some that are left but, the degree of the interaction can really vary so, it may have a little reaction but, it’s not clinically significant. So a lot of the nutrients in herbs, the data we have is pre-clinical and, that has almost no relevance to what happens in the human.  So, really, I look for human pharmacokinetics studies so that I can see, is there really a potential for interaction here?  And, that being said, if somebody’s on a small targeted molecule type of therapy, which has a very small dose and, a very narrow, kind of a very, the blood dose, the concentration that is targeted is very narrow, I don’t want to mess with that because, if I mess with that, I could run the risk of increasing side effects and, you know, who knows what.  So, you know, in general it’s best to be cautious with drugs that have a high percentage of toxicity.

Dr. Weitz:                          Right, okay.  So, back to the fatigue. What role does anemia play, which is a common side effect of a lot of chemo?

Dr. Alschuler:                     Yeah so, it’s a really good point.  So, generally speaking, when we’re talking about care to related fatigue, that’s, in medical kind of perspective, that has the assumption that we’ve ruled out known causes of fatigue.  So, if somebody comes to treatment, I’m tired, you need to check, are they anemic, do they have thyroid dysfunction or, are there any other obvious causes of fatigue and, obvious nutrient deficiency, for example? Address all that and, if that takes care of the fatigue, we’re good, if they’re still tired, then they have this cancer related fatigue.

Dr. Weitz:                            Do you have a certain panel you like for assessing nutrients because, there’s a lot of controversy as to the best way to assess nutrients because, a lot of times just serum levels are not indicative of tissue levels, et cetera.

Dr. Alschuler:                     Yeah so, I don’t run serum vitamin levels except for vitamin D and, vitamin D deficiency is associated with fatigue so, that’s one that we want to check.

Dr. Weitz:                          Right.

Dr. Alschuler:                     I do look at red blood cells zinc, red blood cell magnesium, I think those are very accurate and nice reflections.  To get at B vitamins in general, I typically run a urinary organic acids test.

Dr. Weitz:                          Okay.

Dr. Alschuler:                     Yeah, which kind of looks at the metabolites from the TCA or the Krebs cycle where, we use the vitamins to make energy so we can tell by the ratio of metabolites whether we’re lacking certain B vitamins or, we have kind of a blockage in that pathway.

Dr. Weitz:                          Yeah.  Have you used the NutrEval? Do you like that test?

Dr. Alschuler:                     I have ordered that on occasion and I think that it is, it provides a really broad view of nutrients, nutrients status so, I think it can be helpful.  I’m not 100% sure and, this could just be my ignorance, the data but, I’m not 100% sure that that snapshot in time is truly representative of an ongoing functional deficiency that’s related to symptoms or, pathology.  So, I’m not sure how actionable some of that information is. And there’s always a range so like, what’s really the cut off? You start to, what indicates, yes, we need to give this person this supplement.  So, I still have some questions around that but, I think it could be a guide.

Dr. Weitz:                          Yeah, because it includes an organic acids and then, there’s also some red blood cell minerals and so, throw in some other stuff.  So, what type of diet?  So diet is very controversial when it comes to cancer and, when we have patients with cancer with fatigue, you want to make sure they’re getting the right nutrients to give energy. We often think of carbohydrates for energy but, these days, one of the more popular strategies for dieting cancer is to use a lower carb approach, a ketogenic approach, maybe intermittent fasting.  What’s your take on that?  How does that interact with fatigue?

Dr. Alschuler:                     Yeah, excellent question.  So, with cancer related fatigue, again, because it’s primarily a cytokine disorder, the diet interventions that are going to lower inflammatory cytokine’s are going to be the ones that would be most effective.  So, for example, intermittent fasting, we know lowers CRF, sorry, high sensitivity to reactive protein. So, we know that when we intermittent fast, we lower inflammation in the body so, that’s a perfect dietary strategy for somebody with cancer related fatigue. My goal is 13 hours as an overnight fast, anything above that, bonus but, 13 hours is kind of the magic number from a research perspective. And then, beyond that …

Dr. Weitz:                          What about fasting, some clinics are recommending fasting the day of chemo, maybe the day before, the day after or, some level of complete fasting all centered around when they get their chemo.

Dr. Alschuler:                     Yeah, so that’s kind of a separate strategy in terms of minimizing some of the toxicities from the chemo, particularly to the digestive tract.  It does appear, maybe, in some people to also improve people’s energy a little bit within the time of getting chemo, whether that has any impact on post treatment, cancer related fatigue is, to my knowledge, not known. I haven’t personally observed a strong correlation there. But, it may, I don’t know.

Dr. Weitz:                          Okay. I’ve thrown you off track.

Dr. Alschuler:                     Yeah, no, that’s fine.  But, yeah, post treatment, I think, intermittent, overnight fasting, definitely. I would not go for a high carb diet unless you’re talking about complex carbs from vegetables through whole grains but, simple carbs, although they give us immediate energy, are very oxidative over time.  So, that’s going to worsen the cancer related fatigue. So, really what’s more important is, two things. Number one, fats and, it doesn’t have to be necessarily a ketogenic diet but, we know that omega three fatty acids and, actually there was a very recent study that somewhat surprisingly found that soy oil was more effective than fish oil in reducing cancer related fatigue.

Dr. Weitz:                          Really?

Dr. Alschuler:                     Yeah, which is kind of crazy that they attributed that to the soy oils content of omega six and omega nine.

Dr. Weitz:                          What?

Dr. Alschuler:                    And that that had a decreasing effect on tumor necrosis factor alpha.  Kind of interesting, I don’t know, its just sort of an outlier for me but, I think really what it speaks to is, we need good fatty acids, that our body needs.

Dr. Weitz:                          Was that study funded by the American Heart Institute?

Dr. Alschuler:                     No, I don’t think so.

Dr. Weitz:                          Okay.

Dr. Alschuler:                     And, the other things so, fatty acids so, fish derived fatty acids for sure.

Dr. Weitz:                          Coconut oil, MCT oil.

Dr. Alschuler:                     Coconut oil, yes.  I think that, actually, has been studied and seems to improve cancer related fatigue.  And then, protein, you know, people really need a lot of protein. The range, generally is, just for an average person is like point 0.6 to 1.2 kilogram or, grams of protein per kilogram of body weight so, after treatment, I go to the high side of that. 1.2 grams of protein per every kilogram of body weight and, try to get people eating really high quality protein.  And so, high quality protein, high quality fats, overnight fast, from a dietary perspective, are kind of the keys and then …

Dr. Weitz:                          When you say, high quality protein, you’re advocating animal products, right?

Dr. Alschuler:                     I’m fine with animal products, you know, I think that if so, high quality proteins for me, for my vegetarian perspective include, legumes, tofu, seeds, nuts, eggs. And then, from my non-vegetarian perspective, grass fed or wild meats, fish, organic poultry.

Dr. Weitz:                          Okay.  You worry about lectins?

Dr. Alschuler:                     You know, there’s many thing’s we can worry about but, no, lectins hasn’t made my list recently.

Dr. Weitz:                          You mentioned protein, I saw one of the studies used branched chain amino acids as part of the protocol.

Dr. Alschuler:                     Yes. I think branched amino acids are really helpful for cancer related fatigue and, I think that that’s probably where supplementation is the easiest way to get that in.  So, getting a protein powder with a good whey or, amount of branching amino acids, people can really subjectively feel the difference pretty quickly with that.

Dr. Weitz:                          So, which nutritional supplements can be beneficial for patients with fatigue, cancer related fatigue?

Dr. Alschuler:                    So, from a, there are many, first of all and, the first thing that comes to mind, of course, when we’re thinking about circadian disruption are, adaptogenic herbs. And there was actually a really nice study that was done using Panax quinquefolius so, American Ginseng, specifically on cancer related fatigue and, they started the Panax quinquefolius, it was, I think two grams a day during the treatment, and then they continued it beyond treatment for eight weeks and, there was a substantial reduction in the degree and, the severity of the fatigue and people taking the Panax quinquefolius and so, that really just speaks to the role of preserving the circadian rhythm, which is one of the things that these adaptogenic plants do.  So, I use Panax quinquefolius, American ginseng, often. I also use an adaptogen called, Rhodiola rosea, which is, although adaptogens aren’t sort of like energy pills, there are some adaptogens, which are a little more energetic than others and, so Rhodiola is one.  It just really increases people’s physical stamina, their mental clarity so, I find that very helpful.

And, there’s also adaptogenic blends, which work beautifully for people. If people are really depleted, really depleted coming out of therapy, I’ll probably start a little more gently, something like, ashwagandha and, you often dose that at night because, it has a little bit of a sedative effect to it.  So I definitely use that. Then I think about mitochondrial support and, you know, mitochondrial support can get very complicated but, I think, fundamentally, CoQ10 is critical and, I happen to favor, ubiquinol as the form of CoQ10 and, I dose it pretty aggressively so, I’m giving people 100 milligrams, two or three times a day to really try to get their CoQ10 levels up and, to try to improve their mitochondrial health. Because, the mitochondria themselves become oxidized and, they need to get that redox balance back.  Along those same lines, I’m also a fan of glutathione and I will use glutathione, reduced glutathione post treatment.  That’s not something I use concurrent with treatment but post treatment, to help replete people’s redox potential or, antioxidant levels. Typically dose that in the morning and, that can be quite helpful for people too. And, that supports, of course, mitochondrial function.

Dr. Weitz:                          You like a liposomal form?

Dr. Alschuler:                     You know, I don’t need a liposomal form, actually, there’s some good data by a researcher, by the last name of Ritchie, at Pennsylvania, Hershey State, the University of Pennsylvania, I can’t quite get his university quite right but, he really eloquently demonstrated that glutathione is very well absorbed orally and, it increases glutathione levels in various bodily compartments in accordance with the dose. Doesn’t need to be liposomal.  Liposomal, I think, probably does enhance the glutathione absorption even more so, especially if there’s compromised intestinal integrity, which often is another sequelae of chemo, for example or, radiation, then liposomal might be even better.  But, you know, it’s a cost issue, whatever, I think just straight up, reduced glutathione works well.

Dr. Weitz:                           L-Carnitine?

Dr. Alschuler:                     Yeah so, L-Carnitine’s a good one, you know it’s been studied and it for sure reduces fatigue, particularly kind of muscle fatigue.  And it’s particularly good for people who have had radiation and, L-Carnitine is effective but, it needs to be dosed the four grams a day. Anything less than that just doesn’t work.  The challenge with L-Carnitine is that, if somebody’s had ataxane chemotherapy, it can make peripheral neuropathy worse. So it’s contraindicated in people who have had ataxane chemotherapy.  Other people seem to do fine with it.

Dr. Weitz:                          Is that just Acetyl L-carnitine or, does it not matter?

Dr. Alschuler:                     No, it’s all of it, all carnitine and acetlyl L-carnitine.

acetlyl L-carnitine is the one that I use when I want to address the fatigue and I’m also concerned about heart function, which I didn’t really speak about, it can be another contributor to fatigue. There are some cardio-toxic both chemo’s, some radiation and, even in these targeted therapies or, hormonal therapies that can make it a little harder for the hear to function optimally.  So, supporting heart with CoQ10, acetlyl L-carnitine can be very effective.

Dr. Weitz:                            Good, interesting.  What about exercise recommendations?

Dr. Alschuler:                     Oh, I’m so glad you asked.

Dr. Weitz:                            I remember going, I met you at that 2010 Institute of Functional Medicine conference about cancer and, I think Keith Block showed a video of patients rollerskating attached to their getting their chemo infusion at the same time and, he had a treadmill in his office and the patients were on the treadmill getting their infusions.

Dr. Alschuler:                     Yeah so, exercise is absolutely critical.  So we know that exercise rebuilds mitochondria and rebuilds their functionality. We also know that exercise helps to increase hypothalamic/pituitary/adrenal resilience or, reinstate circadian rhythm. So, I’m very specific about my exercise recommendations for cancer related fatigue.  So, most people are very tired and it’s hard to exercise so, I talk to them about figuring out where their fitness level is, being right on the edge of their fitness, exercising at that edge and then, continuing to move that edge out so that they’re getting more and more fit.  But they have to be reasonable, start where they are and then just keep pushing.  So, that exercise, as I say, should always be fun and never really easy.  And, what we know from a data perspective is that, people who exercise aerobically and, actually a combination of aerobic and resistance exercise, it seems to be for at least 45 minutes a day, at a level that’s moderately strenuous or, strenuous to them, at least five days a week, have a much lower duration and severity of cancer related fatigue.  So, exercise is absolutely an evidence based, very effective recommendation.

Dr. Weitz:                          Great.  What about a little bit of caffeine from organic coffee or, green tea?

Dr. Alschuler:                     Yeah, I’m all about it.  Not only because caffeine in, as you said, a little bit so, you know, in the morning, not kind of getting too much stimulation to the nervous system towards the end of the day but, in the morning, caffeine not only helps to in some ways actually reinstate circadian rhythm by creating that sympathetic nervous system responsiveness but, caffeine and coffee, both and, tea, are inversely associated with cancer risk for almost every cancer that we study.  So, coffee drinkers have a lower risk of occurrences, therefore and, plus, from a botanical perspective, coffee has been used to address people with mental fuzziness so, it’s a cognitive enhancer and, that’s one of the symptoms of cancer related fatigue.  So, coffee’s also going to help stimulate cognition.  So, yes, I think it’s actually very medicinal suggestion.

Dr. Weitz:                          Great so, thank you so much for spending some time with us, Dr. Alschuler. How can listeners get a hold of you to find out about your programs?

Dr. Alschuler:                     Yeah.  Well thank you for having me, first of all and, I’ll give a couple of things for listeners.  For practitioners, you mentioned TAP Integrative, I really encourage you to check it out. TAPintegrative.org. And, if you use the code, WEITZ, then you get your membership for only $99.00 which is an awesome deal.  Clinical protocols and all that stuff and, Dr. Weitz doesn’t make any commission on that, just so you know, it’s just, it’s because we love him.  So, yeah, TAPintegrative.org, you can send, find me on that site as well. There’s place to shoot an email there.

And then, for patients, I think you mentioned our radio show, which is, Five to Thrive Live and, that’s now streamed on iHeart and, Spotify and, so that’s easy to find.  And then we have a personalized online cancer survivor program, which I really encourage people to check out. It’s actually available now through AICR, which is really cool and, you can also find it directly on, ithriveplan.com.

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

Dr. Alschuler:                     Thank you.

 

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
The Mitochondria in Complex Illness with Dr. Eric Gordon: Rational Wellness Podcast 105
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Dr. Eric Gordon discusses The Role of the Mitochondria in Complex, Chronic Illness 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

2:07  According to Dr. Gordon, understanding chronic illness requires a larger perspective than the traditional one of finding the triggering event, removing it and then the body heals and we’re back to health. Chronic illness is not often an isolated response to a toxic exposure or an infection. Chronic illness is more a stuck note in a complicated sonata of the interaction between the triggering event and the complexity that’s you. Dr. Gordon explained that complex chronic disease is indeed complex it is difficult to understand for doctors who are trained to find the simplest explanation for a given problem. In philosophy, this is known as Occam’s Razor. Interestingly, Dr. Lawrence Afrin, a former oncologist who’s practice is now focused on patients with Mast Cell Activation, wrote a book on Mast Cell disorders called Never Bet Against Occam.  But when you deal with patients with complex chronic illnesses, there often is not a simple cause. In fact, there may be 10, 20 or even 50 causes.  

8:08  Dr. Gordon explained that the way he got involved with treating patients with complex chronic illnesses is that he tends to believe his patients. Dr. Gordon often sees patients with chronic fatigue (myalgic encephalitis is a preferred term) and with chronic inflammatory response syndrome, which was termed by Dr. Shoemaker, or chronic Lyme Disease. The body ends up in a state of chronic inflammation.

11:58  A number of years ago patients with chronic disease were being diagnosed with hypoglycemia and then it was hypothyroid and then it was adrenal fatigue and then it was candida and then it was Lyme Disease, etc.  Dr. Gordon explains that in these complex, chronic diseases the body is stuck in a pattern of response. This same kind of stuckness also exists at the mitochondria level.

16:37  We’ve always been taught that the mitochondria are the energy producers, but they are also the main modulators of the immune response, which Dr. Robert Naviaux has been writing about.  Dr. Naviaux has written several landmark papers on the cell danger response, which is that cells will turn down the energy production for survival purposes when they sense danger.  If the cells sense that there is a virus in the cell and the virus is starting to reproduce, the cell will turn down energy production and  they will use less oxygen, which means that there will be more oxygen in the cytoplasm, which helps kill the virus. Dr. Gordon pointed out that many of the herbs that we consider antioxidants, like resveratrol and curcumin, are actually pro-oxidants which cause stress to the body and make it stronger. This is in a similar way to how exercise tears down your tissues and then your body rebuilds them to be stronger.  There is a cycle of stress and response.

20:14  I pointed out with all this talk about how fasting creates autophagy, we have forgotten that one of the best ways to create autophagy is with exercise.  Dr. Gordon pointed out that “when the body is in a fed state, it wants to build tissue and when its in a less fed state, like at night when you are sleeping with the fast, your body works at breaking down old tissue and using those parts to rebuild with. But as we get older, if all we keep getting is the signal of fedness and is that we keep old half dead cells alive and we wind up with a whole body burden of half, like people are talking about zombie cells.  Basically, they are cells that are growing and living but they really are not communicating well with each other and they’re not doing the cellular function. Like the liver, they’re in your liver and they’re alive but they are not processing chemicals like they should be. They’re just busy trying to stay alive and so when you exercise, you stress them but if you want to stress your liver cell, you’re better off doing it by not feeding it for awhile.” 

22:22  If you have a patient with adrenal fatigue or hypothyroidism and you support them with dietary changes like getting off gluten and nutrients and possibly hormones, they can get better. If their mitochondria are just not working well, then you can give them mitochondrial nutrients like CoQ10 and carnitine and they will get better. But in these cases of complex, chronic illness, like chronic fatigue, the mitochondria have turned themselves down and changed function and giving them more raw materials to make energy doesn’t work.  The mitochondria have reprogrammed themselves to modulate your immune response.  To stimulate change we can look at it from different perspectives, such as the structural component with chiropractic and bodywork, and the cranial mechanism and the vagus nerve.  In the Functional Medicine world we are trained to figure out what some of the triggers are, like Lyme or HH6 [aka, Human Herpes virus 6, aka HHV-6] or EBV [Epstein Barr Virus] or other viral infections or heavy metals or toxic load, etc. and treat them, and this may help to some extent, but many of these chronic complex patients don’t respond as well as most other patients would.  80% of patients will respond to this type of care, but the chronic, complex cases will not as well, since in some of them the trigger is either gone or not as important anymore.  We have to look at how to treat these patients from different perspectives. Because these chronically unwell patients don’t respond like other patients do to the same treatments, they are often labelled as having psychological disorders, as being depressed. 

32:47  We do not understand these chronic patients and we need to focus on why particular individuals get such severe and long term reactions to some of these diseases like Lyme, which Dr. Gordon feels is ubiquitous, or herpes, which nearly everybody has.  But most of us with exposure to Lyme or herpes don’t get sick.  Everybody gets exposed to mold and heavy metals at some point, but depending upon your biochemical individuality, some people detoxify them, while others get sick.  The challenge is how to analyse each person to see how their genes are being expressed.  We are getting closer to being able to measure a person’s expression of their genes (transcriptomics) and which proteins they are making (metabolomics), so we can see which pathways are most stressed and need supporting.  There is hope for many of these patients but there is no on easy answer.

 

 

 



Dr. Eric Gordon is a the Medical Director of Gordon Medical Associates, a medical practice focused on serving patients with complex chronic illness in Santa Rosa and San Rafael, California.  According to Dr. Gordon, understanding chronic illness requires a larger perspective than the traditional one of finding the triggering event, removing it, and then the body heals and we are back to health.  Chronic illness is not often an isolated response to a toxic exposure or an infection.  Chronic illness is more a stuck note in a complicated sonata of the interaction between the triggering event(s) and the complexity that is you. His website is GordonMedical.com and he has started to see new patients again.

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 sign up for my free e-book on my website by going to drweitz.com. Let’s get started on your road to better health.  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 gives us a ratings and review, that way more people can find out about the Rational Wellness podcast.

Our topic for today is a complicated one. We’re going to talk about the role of the mitochondria in complex chronic illness. The mitochondria is the organelle that’s most responsible for cellular energy and it plays a crucial role in chronic diseases. Every cell in our body contains several thousand mitochondria and mitochondria produce 90% of the energy our body needs to function. Mitochondrial dysfunction is understood as a decline in the ability of the electron transport train to generate high energy molecules like ATP and this is often seen with aging and virtually all chronic diseases. Including neurodegenerative diseases, heart disease, diabetes, autoimmune diseases, autism, bipolar disorder, cancer, chronic infections, chronic fatigue, and fibromyalgia.

Dr. Eric Gordon is the founder and medical director of Gordon Medical Associates. A medical practice focused on serving patients with complex chronic illness in Santa Rosa and San Rafael, California. According to Dr. Gordon, understanding chronic illness requires a larger perspective than the traditional one of finding the triggering event, removing it and then the body heals and we’re back to health. Chronic illness is not often an isolated response to a toxic exposure or an infection. Chronic illness is more a stuck note in a complicated sonata of the interaction between the triggering event and the complexity that’s you. Dr. Gordon thank you so much for joining me today.

Dr. Gordon:        A pleasure. A pleasure Ben. Yeah. It’s good to be here.

Dr. Weitz:          So how did you get interested in treating-

Dr. Gordon:       A stuck note sounds easier to me.

Dr. Weitz:          You seem to have a musical orientation towards health.

Dr. Gordon:        Well, it’s funny. I’m actually tone deaf but I love the complexity of the orchestra and the possibilities. And it’s always been clear to me once I started treating people that it is an orchestration because it’s not … in health and in disease, you rarely have one player that stands out. It really is an interactive whole, and that’s what makes … it makes medicine hard to understand and is why I think doctors fall back on the single cause for the illness routine because that’s how our minds tend to work. We tend to have engineering minds. That’s just the nature of people. The animal. We see a problem, we want to figure out what caused it and the idea that you can have 10, 20, 50 causes for an outcome is difficult for us to get our heads around.

Dr. Weitz:          Absolutely. I was trained in philosophy and in philosophy there’s something called Occam’s Razor and you always prefer the simplest explanation for any problem that you are trying to solve.

Dr. Gordon:        Absolutely. It’s funny because that’s the title of Dr. Afrin’s book on mast cell disorders.

Dr. Weitz:           Oh really?

Dr. Gordon:        Yes. Never Bet Against Occam. And I’ve had this discussion with him, Dr. Afrin, the whole thing … he’s one of the proponents … proponents? Yeah. He’s one of the people who helped introduced us to the concept of mast cell activation syndrome and he got there, just a little quick aside, by looking at being … he’s a very bright man who is an oncologist but he actually would listen to his patients.  So when other doctors, other oncologists had patients that didn’t fit what they thought they should have, they knew that Dr. Afrin would actually listen and try to keep figuring it out rather than just go, “This isn’t in my box. Go somewhere else.” They did send them somewhere else, but they sent them to Larry to think about. And so he started to see these people who had multiple symptoms. They had irritable bowel syndrome. They had asthma. They had migraines. And they had rashes. And maybe they had interstitial cystitis. And he goes, “Why should somebody have five different diseases?”  And being an oncologist, and being familiar with something called mastocytosis, which is a disease, a cancer of mast cells when you make too many of them. Mast cells make histamine and they cause allergy responses, but they also when they make … Histamine is a big part of each one of those things. Irritable bowel, migraines, asthma, interstitial cystitis, inflammation. He thought, “Huh. These people look like the mast cell people.” And he started treating them with anti-histamine medicines and many of them significantly improved. So his point is Occam’s Razor, look for the single … let’s make it simpler. So that being said, I thought that was a brilliant piece of medical detective work. But, that’s really not how the body works though. The body is a symphony where there are … very simple with genetic diseases. One of the reasons genetics has been kind of a lot of noise but not a lot of … hasn’t been as helpful in chronic diseases is because there are only a few hundred genetic diseases and they are very rare that involve one to five genes. Okay?

Most chronic illnesses, heart disease, Parkinson’s, we don’t even know about Parkinson’s but esp. heart disease, we know. There’s hundreds of genes interacting that you wind up there. So, Occam’s Razor doesn’t work so well there. Looking for the simple answer. It does in the things that kill us quickly. An infection that’s overwhelming. But if your body can deal with the infection and it just hangs around, then you’re no longer dealing with the bug, you’re dealing with your biochemical individuality’s response to the bug. And that’s what chronic illness is, is it’s about the individual. Rather than about the population. And that’s why it’s been so difficult to work with. My favorite subject.

Dr. Weitz:          Yeah. You know what? I would like to-

Dr. Gordon:        Let’s go back to mitochondria a little bit.

Dr. Weitz:          Sure. Yeah. Sure. How did you become interested in treating patients with chronic diseases?

Dr. Gordon:        Well, I had that bad habit of, I believe people. Okay? And when you are a doctor, especially when you are in the hospital, you’re used to people who come in and they have a big … like a pneumonia. A gallbladder attack. A heart attack. But lots of them, even when you take care of that, they still feel terribly, and they felt terribly in ways that didn’t make sense to me. Because they didn’t make sense to medicine. They’re again, they’re the people kind of like Dr. Afrin was seeing. They had so many complaints and they had complaints that moved around. One day they had really bad shoulders. The next day they had bad knees. That doesn’t make sense.

Dr. Weitz:            Right.

Dr. Gordon:        We don’t have a … But I believe them. These were people who I didn’t think we’re coming to lie to me.

Dr. Weitz:            Right. I’d like to clarify for those of us out there listening when they hear the term chronic disease, yes, it’s true that chronic disease is like heart disease and diabetes or the predominant diseases of today. But, what we’re talking about is these complex chronic diseases. What you might call the chronic-chronic diseases. There’s acute diseases, like you get an acute infection and you take an antibiotic, it’s over. And then there’s these chronic diseases like diabetes and you have these blood sugar problems and there are strategies that can fix some of these people by following diet, lifestyle, et cetera. And sometimes these strategies work and they’re totally under control. In other cases, maybe they have to be managed. But we’re talking about a third category of chronic patient who have these unexplained diseases.

Dr. Gordon:        Chronic fatigue. I mean people don’t like … people prefer the term myalgic encephalitis or chronic … And I agree because chronic fatigue is insulting to many people because it sounds, “Oh, you’re just tired.” Which is far from it. It’s much … yeah. Much more life defeating than that and intrusive. But yeah, it’s when people are left with inability to function and we don’t know why. Often it’s precipitated by an infection but it doesn’t have to be. It can be a minor trauma, car accidents. I mean just things happen and the body winds up in a state of chronic inflammation and it doesn’t always have to have pain. Sometimes the inflammation is mostly in the brain and in that case, it just might be difficulty thinking and being able to organize your day. I mean, it’s amazing how debilitating these illnesses are.  Now they are often lumped under this chronic fatigue, immune deficiency syndrome or chronic Lyme disease, or post-Lyme. I mean these are all names depends on which doctor you go to. Or, some people they are called CIRS, chronic inflammatory response syndrome. Dr. Shoemaker has put forward. But basically, these are illnesses that we do not understand. We have lots of theories about and thankfully in the last few years, we’re actually beginning to get research which has been quite amazing. So anyway, so those are the people that I work with-

Dr. Weitz:            Isn’t it interesting how there’s almost this chronic disease de jour diagnosis? So, you get a lot of these patients at one time were all being diagnosed as having hypothyroid. And then they’re all being diagnosed as having adrenal fatigue. And then everybody’s being diagnosed as having Lyme disease. And then everybody’s being-

Dr. Gordon:        Absolutely. When I started, everybody had this in these … like I said, in the 80s, it was everybody had candida. Actually, hypoglycemia was the first thing. But what it is is that this is the blind men and the elephant okay? Each thing, number one, there are some patients who that is their problem but this is what they look like. And otherwise, as doctors learn things, the problem with being a doctor is that it’s a, as you know, it’s a very difficult business because you get good at pieces of it. It gets too broad for most people to be good at everything. I mean nobody’s good at everything in this business. So, the tendency is to get better and better at one aspect of it. I happen to have a little ADD so I kind of go all over the place, but that’s why I have people who work with me who really go deep in certain aspects, because there’s just too much to know.  So the problem is that many people who have “adrenal fatigue”, quote on quote, now some of them do. Some of them really are people who are fairly healthy who just overdid it. Okay?  And those folks do great with rest. Graded exercise, proper nutrition. Fix their guts and kind of maybe address their hormone and support them with herbs or some hormones and they do phenomenally.  But, they’re the kind of like the outskirts or the suburbs if you will of the people that I see.  The people that … I used to see those folks.  But the people that I see have failed that, okay?  They kept staying sicker because their system is more stuck, okay?  When you have adrenal fatigue, usually, if you remove the stressor, the body kind of comes back online. Generally.  And with a little bit of support. Okay?  But with these chronic … what I’m calling the chronic complex illnesses, you are now in a system that’s not allowing you to get better. And this goes back. We’re stuck. I hate to use psychological … actually I love to use psychological terms but I always wary of them because these are not psychological illnesses, you know?

Dr. Weitz:          Right.

Dr. Gordon:        I just find that the story that psychology weaves, it’s a little bit like Chinese medicine in the sense that it’s much more fluid and able to explain things that aren’t linear. I mean, because it’s the idea that the body is stuck in a pattern of response and so a great example of that is like behavior. I mean some people have trouble with time. No matter how often, they are always late. They are not doing it on purpose. It’s just how they’re wired. They don’t quite believe … they really think that they can get something done in a minute or five minutes, that’s going to take half an hour, and they just can’t get through their heads that every day they do the same thing. I’m going to be on time and they forget that they got five things to do. They’re not going to do them in five minutes.  So that’s the kind of same stuckness that we have at the mitochondria level.  At the biochemical level in the body, in these chronic complex illnesses. The body is stuck in a behavior, and even when we remove the inciting event, like the infection or the stressor, the body doesn’t turn back on and go back to the health.  And go back to health. It is stuck in a lower level of functioning. But it’s doing that as a survival mechanism. It’s not doing that … it’s just that it’s a survival mechanism that is no longer probably useful as far as we can tell.

Dr. Weitz:          Right.

Dr. Gordon:        So, and that’s where the mitochondria come in because we’ve always been taught that the mitochondria were the energy producers and they are. But also serve as one of the … well, you never know but we believe main modulators of the immune response which is something people haven’t thought about or hadn’t quite put into the words. Dr. Naviaux, Robert Naviaux from the University of San Diego has been writing about this a lot and he’s well … well, well known or should be better known for … He developed a treatment that may work for autism that involves trying to restore how you say … mitochondrial communication with the rest of the cell, or cell to cell communication. But I don’t want to go too far afield. It’s like the mitochondria, when they sense danger, they are … I mean in single cell organisms, and in your body, as soon as they can tell like a virus is in the cell and the virus is starting to use your raw materials to make more virus, the mitochondria sense that and they begin to turn down energy production, okay?  And when they turn down energy production, they use less oxygen and suddenly there’s more oxygen in the cytoplasm, in the material that’s in the rest of the cell, and that creates an oxidative stress that helps kill the virus. And it also gets the nucleus to make proteins that will help kill the virus and at the same time increase oxidative stress and then after a short period of time, begin to make more things like glutathione, and NfKB, which will begin to reduce the oxidative stress. You see, this cycle, there’s a cycle in health. It’s not linear. It’s a circle. Okay? You get … your body gets stressed and then you respond. Like a lot of the herbs that we use. That most of the herbs that we consider antioxidants are actually pro-oxidants, okay?

Dr. Weitz:          We’re talking about things like vitamin C and vitamin E and folic acid and …

Dr. Gordon:        I’m thinking more like some of the herbal things like-

Dr. Weitz:          Resveratrol or carotenoids.

Dr. Gordon:       Especially resveratrol is a good example and-

Dr. Weitz:          Curcumin.

Dr. Gordon:        Curcumin. These things actually cause stress but the body’s response to the stress is stronger, okay? And you make more of the antioxidants, but you need that little stress. I mean just like exercise. I mean, when you exercise, you actually are tearing down, you are disrupting tissues.

Dr. Weitz:          Absolutely.

Dr. Gordon:        And it’s the healing that makes you stronger. And that’s happening … that’s orchestrated by, or conducted by the mitochondria. And it’s a separate function but it’s a dance. The mitochondria are constantly moving between this stance of producing, of using oxygen up or sometimes just not increasing the oxygen content in the cytoplasm to kind of stress the system.

Dr. Weitz:          Right. By the way, I just wanted to go astray a little bit. I wanted to point out that there’s all this talk these days about fasting creating autophagy. Well, guess what? Exercise creates autophagy. That’s how it works. We’ve known about this for a long time. This idea of that you have to do this special kind of fast to get rid of old, damaged cells to create autophagy, exercise.

Dr. Gordon:        Yeah, no, exercise does it. But the problem we have, if it’s just exercise is that if you, for instance, if you take a lot of antioxidants before you exercise, you don’t get the training effect because you got to stress the system. It’s just nice because when the body is in a fed state, it wants to build tissue, and when it’s in a less fed state like at night, when you are sleeping and with the fast, your body works at breaking down old tissue and using those parts to rebuild things with. Because the problem we have is when you are young, and you’re healthy and you’re rebuilding tissue, it’s really great. Those signals for growth are perfect. But as we get older, if all we keep getting is the signal of fedness and is that we keep old half dead cells alive and we wind up with a whole body burden of half, like people are talking about zombie cells.  Basically, they are cells that are growing and living but they really are not communicating well with each other and they’re not doing the cellular function. Like the liver, they’re in your liver and they’re alive but they are not processing chemicals like they should be. They’re just busy trying to stay alive and so when you exercise, you stress them but if you want to stress your liver cell, you’re better off doing it by not feeding it for awhile.

Dr. Weitz:            Right. Okay. Well let’s get back to mitochondria. So how is mitochondrial issues related to this chronic disease cycle?

Dr. Gordon:        Okay. Well I think the big thing is it was kind of like I was saying in the beginning, if you have somebody with quote on quote, “adrenal fatigue” or hypothyroidism or things of that nature, usually if you support them either with the hormones or even better, with lifestyle changes that will allow these things to happen, maybe getting rid of the gluten so you stop causing the inflammatory response in the thyroid, that’s great. But, if … one second. I’ve lost my train of thought there for a second. But when you are in complex disease, what I call the chronic complex diseases, it doesn’t work anymore because the problem isn’t that the mitochondria are low in let’s say CoQ10. I mean CoQ10 is very important in the electron transport train and if you give lots of people like with sometimes with adrenal fatigue, as they’re getting better, CoQ10, carnitine, which helps get the fatty acids into the mitochondria. Those things really help.  But, that’s because their mitochondria are functioning normally and they just needed a little help. But in things like chronic fatigue, you are actually … your mitochondria have turned themselves down for a reason. So it doesn’t matter. It’s like they have locked the door. So it doesn’t matter how much you are giving them, okay? They’re not going to use it and they’ve turned themselves down because they’re trying to … instead of just working right now as a energy production machine, because when they are working as the energy production machine, you give them more CoQ10. They’re able to move more electrons along that chain more efficiently, okay?  But when they are now working as to modulate your immune defense system, they’re not producing energy. They’ve changed what they’re doing.  So, I guess it’s like if you have a factory that’s making cars and you’re delivering carburetors, that’s great.  But if suddenly the factory decides now to start making artillery, the carburetor isn’t used anymore.

Dr. Weitz:          Right.

Dr. Gordon:        And that’s basically it. So the mitochondria have changed function, partially. Obviously it’s not 100%, but it’s a significant change.  So giving them more raw materials to make energy doesn’t work because they’ve reprogrammed themselves to actually modulate your immune response.

Dr. Weitz:          So how do we fix these people? How do we change their mitochondria? How do we-

Dr. Gordon:        Well, that’s the million dollar question. That is what everybody is working on from different perspectives. Remember, this is one way of looking at the problem. I don’t want to tell you that this is the issue. This is one way of looking at it. But because the body is a system, we keep trying to get at it from a multitude of ways because ultimately, if you are stuck in one way, we start looking at others. So structure is one of the ways that I often begin to work with people who have been chronically ill because the vagus nerve has two components and one of the most basic component, the older component, is about self-defense. The newer component of the vagus nerve is about love and relaxing and feeling good. But the primitive part of the vagus nerve is there for self-defense and it also has a lot to do with controlling the gut.  And if we can begin to get the cranial mechanism and the thoracic spine and all that working better, we take some of the stress off the vagus nerve and we change the information because remember, this is an information system. What we’re talking about, I think, in chronic complex illness, is often the trigger is either gone or not as important anymore. The thing that caused it. And I have spent my life trying to get rid of the triggers. Treating Lyme disease. Treating all the HH6 and the EBV and all the viral infections. The heavy metals and the toxic load. So, these are all triggers and perpetuating factors that we have to address but in many people, that doesn’t work so well because when you try to treat the infection, you make them sicker because they can’t detox. They can’t detox because their whole body is stuck in this self-defense mode and it’s like frozen.

Because it’s very simple. Like when you get scared normally you can jump and then you can run. But when you get really scared, you freeze. You don’t even move. That’s the ultimate defensive mode. Like ontologically, how organisms are wired. It’s not about personality. It’s just about, you scare anybody, anybody deep enough, they will just freeze. And that’s what your cells do. That’s what your whole system does. When it’s significantly stressed, it stops moving. So any way we can return movement to the system might signal the body that it’s safe and the mitochondria are sensing danger signals. And this is what gets confusing. People always, once we start talking about safety and danger, people think we’re talking, oh this is a psychological problem. But safety and danger signals also operate, yes in a psychological space but on the chemical space.  Smells can trigger danger.  Viruses trigger danger signals.  There is no psychological body separation.  Every immune cell has receptors for the neurotransmitters that deal with mood.  Serotonin and dopamine.  There’s no psychological, physical separation. I get so frustrated when people try to make things, oh this is a psychological illness.  One of the things that I’ve been interested in is something called metabolomics, which is looking at a few hundred chemicals in the blood and we can see depressed people by the biochemical signature.  This is a strict … so it doesn’t mean that … so yes, you can be depressed because you’ve been divorced. Your mother died. But ultimately, it’s a biochemical state. And that biochemical state is what controls the organism and because the mitochondria are just sensing those small chemicals that affect mood, that’s the same chemicals that your mitochondria are sensing. So when you get infected by a virus, you get sickness behavior. What happens? You get tired. And you don’t want to be around people.  I mean not many people when they get sick want to go to a party. They want to go quiet … in a quiet room, by themselves. That’s a strictly physiologic response, but it’s driven by the same chemicals. This is driven … this is what we call a sickness behavior and it’s biochemical. It has psychological outcomes. And so I just … I might be killing this but I just always worry that people are going to hear me saying that these are psychological illnesses, when they’re the farthest thing from it. Most of my patients were successful, highly motivated, and not depressed human beings. The problem is is that when they go to the doctor, and the doctor, their blood tests are normal. Their regular blood test, like their blood count, and their kidneys and liver functions look good. And their EKGs normal, and their chest x-ray is normal and whatever else they test-

Dr. Weitz:            But patients think those are very sensitive tests to how their body’s functioning but those are very insensitive tests and your liver enzymes are only going to be positive if there’s significant destruction of liver cells.  It doesn’t tell you whether your liver is really functioning very well.

Dr. Gordon:        At all. Absolutely. So the bottom line is, is that these people who I see are almost always labeled for the first five or 10 doctors that they see as being depressed, and that’s why I am so sensitive to the idea that I’m talking that this is a psychological illness. But it is not. But that is what medicine has always done. And multiple sclerosis. 40 years ago, half the time that people were diagnosed as depressed. Okay? And before we had … well, we had an MRI 50 years, but still, before the diagnosis was made conclusively by physical, by evidence, people were told that they were depressed.

Dr. Weitz:            Right.

Dr. Gordon:        And that’s what we do. So we do not understand these illnesses well. We’re developing more and more treatments, and they work. The problem is, we’re now dealing, like I said in the beginning, the disease of the individual. Because I think Lyme disease is ubiquitous. I think it’s all over. I think millions of people have Lyme disease. But they don’t have any symptoms. Just like how many people have the herpes infection? Everybody’s got herpes.

Dr. Weitz:            Or get exposed to some mold or get exposed to some heavy metals. You start measuring trace amounts of mercury.

Dr. Gordon:        Everybody. It’s just that … but some people because of their biochemical individuality, and the number of environmental stresses they’ve had, they wind up with illness, and that illness is just a reflection of their body and their life exposures. And that is why we don’t do well with them in a medicine that is looking for treatments that are going to work for 80% of the people. So it gets difficult and we start having to look much more at the individuality and we’re getting there, because finally in the last five years and maybe hopefully in the next two or three, we’re going to get enough ability to look at what’s called transcriptomics, what RNA … not just your genes, but what genes are you actually expressing, okay? So what proteins you’re actually making, plus what I call the metabolomics, what small molecules you’re making and maybe when we put these together, we’ll actually be able to see which pathways in you are most stressed and need supporting or addressing.

Because right now, the more information we get, we’re actually getting almost more … I think I’m getting more confused, anyway. I don’t know about the other people out there. It’s because individual chemicals … I mean, you can be very high in succinate, but succinate can be used all over the body for different processes. So we only think of it in terms of the Krebs cycle. But, it’s a building block. You used to make porphyrins, and just make hemoglobin and all these parts of your body. So when it’s high or low, assuming it has something to do with the Krebs cycle, is a huge assumption. And that’s the problem.  We have to look at the body from multiple viewpoints. And we’re almost there. I think we’re almost there but-

Dr. Weitz:            And by the way, for those listening who are not familiar, succinate is something that might show up in an organic acids profile, right?

Dr. Gordon:        Yeah. Exactly. Exactly. Yeah. Because it’s like … and these tests are … I mean, I don’t mean that we shouldn’t be doing them because occasionally, they do give us insight but lots of times, the insight isn’t really useful for that person because it’s not like when we measure your blood count, and you’re anemic, we know that for most … I mean, that’s not always true, but for most people if they are anemic, their blood count is low. We measure their iron is low. We go, oh, give them iron and their blood count goes up and they feel better. That’s wonderful. Right. But if you have chronic disease, many times your iron can look low but giving you iron might even make you worse because your body has turned down production of the red blood cells for a reason and when you give more iron, you’re just increasing oxidative stress because iron really … excess iron might be one of the more toxic things we have.

There are some people in the longevity world that are actually busy donating blood a few times a year because they want to keep their iron stores low. It’s … that’s what I meant about the symphony. All these things play a role but if they don’t play a role at the right time, if they’re making discordant notes, then we get disease. And it’s just a … I guess my plea to patients, I should say actually the point of all this. I don’t want to sound overwhelming. Like oh my god, we know nothing. The beauty of all this mess is that we still know a lot of what to do for the individual but what happens is that people get very frustrated because as you said in the beginning is that when you start off with this complex disease, and if you go to one doctor, you’re going to be told you have hypothyroidism. You try that, it didn’t work. Then adrenal fatigue. And then you’ve got mold illness and then maybe you go to somebody else and you got Lyme.  And it’s frustrating. The point is, there’s a lot of doctors out there right now who are getting the experience and beginning to be able to tell when you just have a positive test, or whether that test is being expressed. Whether the symptoms you have really fit the Lyme or the mold or more importantly, it’s often … many people … what really makes this tough is that in my experience, most people don’t develop significant mold illnesses. Mycotoxin sensitivity … Now I’m talking about allergy, but sensitivity to the toxins that molds can make. Most of us can be exposed to that and we can detox them and deal with them fine. Okay? It’s the people who’ve often had Lyme disease, and Lyme changes how your immune system responds and then they have difficulty with being able to metabolize the mold toxins. So it’s a house, not of cards, but it’s a house being built in your body of reactions to things because it’s a interactive dance between your immune system and these bugs.  Because these are the bugs that want to live with us. They’re not trying to kill us. They want to be part of our community.

Dr. Weitz:            And should we think of it in terms of cumulative overload? Some people refer to the, you have this giant bucket and when it’s close to the top and you get exposed to something that stresses your system, it overflows and you get all these symptoms and if you could empty out several pails of water from the bucket, now you’ve got a reserve so you can deal with things.  

Dr. Gordon:          Well, yes. I think that always has been a good analogy.  

Dr. Weitz:            Right. That’s kind of the model that we look at.  So okay, we take the mold factor out. Maybe we get rid of the heavy metals, and now we’ve removed some of the triggers, so now you … yeah, rebuild some of your cellular reserves. So now if you do get exposed to something, it maybe is not problematic for you. Whereas if you are always close to the top, you’re going to react to everything.

Dr. Gordon:        Well, yeah. I mean, and another lens on that is that when you remove, let’s say the heavy metals, then suddenly your immune system is now working better and then it can keep Lyme or the viruses in check.

Dr. Weitz:          Exactly.

Dr. Gordon:        And so if you remove them slowly, they’re not making you ill. Because you see, or more importantly, sometimes I think you actually can control your own immune response because many times, there are people who’s significant symptoms in Lyme and the tick borne illnesses are not the bugs, but their body’s response to the bugs are overwhelming. They create this … The cellular defense response is so heightened that it makes you sick because remember, most symptoms of inflammation, the swelling, the redness, that’s your own cellular response. That’s not the bug. Your body does that while it’s fighting. And like I said, the sickness behavior. Wanting to go lie down. Fatigued. Not losing your appetite. That’s not the bug. That’s the body’s own self-defense response that’s now stuck on. So when we remove some of the toxic exposure, your immune system can often come back and stop overreacting and stop acting like a three year old. I mean, that’s the problem. The immune system goes into a primitive place where everything is danger. Everything is no, or screaming at …

Dr. Weitz:          And then the immune system starts tweeting in the middle of the night and declaring national disasters and where there aren’t any.

Dr. Gordon:        Exactly. That’s it.  But it goes back to a primitive pattern. Right, a fear. Very similar to yes, our midnight tweets. Yes. Fear. Instead of reacting like an adult which can grade and realize that life … You see, that’s it. It’s very interesting is that life, in the complexity of life in the organism only happens when there can be learned of cooperation and balanced responses because that’s how your body works. In fact, that’s how we interact well with viruses. Viruses will succeed if they learn how to have a balanced response, if they kill us, which is the … like not the win-win, but I win, you lose situation, they don’t do well in the long-run.

Dr. Weitz:          Right. No, they want a host that they can reproduce and go into another host. Right.

Dr. Gordon:        Exactly. That requires cooperation which is another … but that’s really what happens. So getting back to the idea is the toxicity of our world. One of the points that I’d like to make that I think is so important is I been doing this now since 19 … so close to 40 years. And I can tell you that … autoimmune diseases, like Hashimoto’s for instance, thyroiditis, I mean when I started in medicine, we could test for it. It was not that common. Now it’s a dime a dozen. I mean, all the autoimmune … it’s called autoimmune diseases, the kind of Lyme symptoms we see. When I … Joe Verscano, like my partner, like Wayne Anderson, he started treating Lyme in like 1990, ’91. It was still often relatively easy. The people have gotten sicker, and sicker and sicker and sicker. I don’t think the bugs have gotten … maybe the bugs have changed. But I think it’s us. I mean, the toxic load in our environment has gone like not linearly but logarithmically up over the last 40 years.  And I think that is why we’re seeing these illnesses and we’re seeing so much dysfunction at the mitochondrial level because when the mitochondria sense toxins, part of their job … They are smart but they are not that smart. If the toxin ties up the biochemical reaction that is going to produce the raw materials that the mitochondria need, the mitochondria can’t tell the difference between that and a virus using those same raw materials. All I knows is that it’s not getting the raw materials that it should get. The NADH and NADPH. It’s not coming in, into the mitochondria from the cell. And that triggers the, what we call the cell danger response. Where the mitochondria stop producing as much energy. They start using ATP, the energy molecule, as a messenger, okay? The ATP, they start sending ATP outside the cell.  So normally, there’s a very tiny amount of ATP around the cell because actually, it’s a neurotransmitter in a way. There’s actually 17 receptors on the cell membrane and different cell membranes for what they call purinergic ATP, and AMP and all these energy molecules. They actually work to communicate. They’re part of the cell’s cell signaling function and when the mitochondria sense danger, they start sending more ATP outside the cell and this gives the signal that the cell’s in danger and they’re also making less energy so toxic load acts the same as a virus on your body.

Dr. Weitz:          Cool. So I’m going to have to bring this discussion to a close in the next few minutes.

Dr. Gordon:        We were definitely not linear.

Dr. Weitz:          Definitely not. So how do we want to end it?

Dr. Gordon:        Oh.

Dr. Weitz:          What kind of final thoughts you want to have?

Dr. Gordon:        Final thoughts. Is I think the most important thing is to if you’ve been ill for a long time, is to not give up hope. Okay? Is that it’s … the unfortunate part of this illness I think is many more people actually run out of money than of hope. Because, honestly, because we don’t have perfect treatment regiments. We don’t even have … I don’t even think we have decent treatment regiments. So much of the time, I said what that doctor knows how to do, that you wind up spending a lot of money and not getting very far. But the reason I say don’t give up hope is I’ve seen people who have been sick for 20, 30 years, get better. But, to be fair, I’m not going to tell you. I don’t get everybody better. Far from it. I mean, I wish I did. These are difficult illnesses. But so many people do get better because there are so many different reasons that you can wind up with chronic fatigue. And I think that’s the thing. Don’t give up because somebody you know didn’t get better. You are different, and it might turn out that with you, the pick-up sticks model that’s need is maybe just getting out of the moldy environment for you.

Maybe that’s going to be the big deal. Maybe getting the toxins out of your system. Maybe just getting the right structural work done. I mean, there’s so many pieces that can then allow the body to enter the healing cycle and really go back to normal. I mean, that is my message of hope. The frustration is picking the first step, is not always clear. But don’t give up because there is a step that will help you. We just have to find it for you.

Dr. Weitz:          Great. So how can listeners get a hold of you or find out more information about you? Are you accepting new patients?

Dr. Gordon:        Yeah. I started to again. For awhile I wasn’t and it was getting … but now I started seeing new patients because I like to send people on quicker. I find that what I’m really good at is evaluation and giving people pretty good idea of where they need to go. But I like to send people because I do so many things, I prefer to send people on to other doctors who kind of specialize in the area that they need the most support in. And then they can come back to me and we can go to the next level. So with that being said, I am concentrating my practice, as of May, in San Rafael. Our website, or what is it … I think it’s gordonmedical.com, I believe. I don’t know these things. Okay. Yeah, is the website and they can find the information there. But I just … what I’m hoping to do is more research. I’m trying to get, I said some of the right called leaders together because the more brilliant doctors are, often the harder it is to get them to work together.

Dr. Weitz:           Yes. Absolutely.

Dr. Gordon:        And that is my dream, because I don’t know everything. I need a lot of help.

Dr. Weitz:          You sure know a lot and thanks for sharing with us today, Dr. Gordon.

Dr. Gordon:        My pleasure. Really. It was fun, Ben, and next time we get to chat, we’ll talk more about … I would love to talk to you about the body.

Dr. Weitz:          Absolutely. Yeah.

Dr. Gordon:        That to me is what’s missed by so many physicians. The structural…

Dr. Weitz:          The structural component. Yeah.

Dr. Gordon:        How important structural component is.

Dr. Weitz:          Yeah. Great. Excellent. Thank you, Eric.

Dr. Gordon:        Be well.

 

 

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Gut Bacteria and Detoxification with Dr. Grace Liu: Rational Wellness Podcast 104
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Dr. Grace Liu, the Gut Goddess, discusses Gut Bacteria and Detoxification 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

1:20  Gut bacteria play a role in detoxification, esp. since our air, water, and food is so contaminated.

2:03  Gut bacteria also produce toxins. They transform arsenic into a more dangerous form. Gut bacteria can also produce TMAO from food or supplements containing carnitine or choline, which Dr. Stanley Hazen from the Cleveland Clinic has argued is a marker for heart disease. Dr. Liu points out that vegans don’t eat foods that have a lot of carnitine (like red meat) or choline (like egg yolks) or contain TMAO (like fish), but yet still get heart attacks, strokes, and embolic events. Our gut bacteria protect us and create this non-leaky permeability of the gut lining.

6:04  We have evolved being close to the earth and eating food off the earth, covered with soil, which contains soil-based bacteria.  We used to ferment foods to preserve them, since we had no refrigeration, which contain lactobacilli and other acid-producing bacteria.  But now we refrigerate our food and don’t eat as much fermented food and due to c-sections we no longer get our flora from our Mom during delivery. This has created a generation without a firewall of protection. Also, during childbirth, many mothers are given an IV with pitocin and antibiotics to prevent the risk of sepsis or infection and this has a negative effect on our microbiota.  We also get exposed to antibiotics fed to the cattle and sprayed on the grains and other crops. We also get exposed to glyphosate, which is an herbicide and pesticide and it has been shown to cause a kind of soil dysbiosis. Our guts are reflecting our earth right now.

9:53  People who have a healthy gut flora, like hunter gatherers and people living in very rural communities and in Europe, have very few of the unhealthy, putrefying bacteria, like Klebsiella, Citrobacter, and E. Coli.  These unhealthy bacteria produce TMAO and other toxins that can damage our heart or cause cancer.

12:07  Dr. Liu talked about a genetic obesity study where they used a diet very high in prebiotics and they found that this would grow good flora and lowered their BMI. 

13:29  Dr. Liu likes to look at various markers to assess gut health, including urinary organic acids, like Cresol, which comes from Claustrium Diffocele. She likes to look at other fungal markers, including Furans and tartaric acid.  There are 9 markers on a standardurinary organic acids profile, such as the one from Great Plains.  She will also look at the Oxalates that tells a lot about fungal overgrowth. When looking at the microbiome, Dr. Liu focuses on what she calls the A,B,C s, which stands for Akkermansia, Bifido (like Bifido longum, lactis, and infantim), and Clostridiales (butyrate producers like F prausnitzi, Roseburia inulinovorans, Eubacteria etc) and Christiansenella.  Healthy people like hunter gatherers, people without disease, and centenarians have lots of these bacteria in their guts. 

On the other hand, Akkermansia eats mucous and if there are high amounts of it, this indicates that the there is too much mucous in the gut and this is not healthy.  There are also good and bad forms of Bifido bacteria. The bad Bifido tend to eat a lot of sugar and carbs and they are not foundational bifido. The good bifido include strains like bifido longum, bifido infantis, and bifido lactis.

16:50  I commented that when we consume probiotics by mouth, they are only temporary visitors, so I questioned how we can change our gut bacteria to have more Akkermansia or whichever other strains you’re trying to promote by consuming probiotics?  But Dr. Liu disagreed and stated that our good gut flora follow us everywhere and some come in a pill and some come in food and they are not just transient visitors. The species that are core to our guts are our Mucosa-Associated Microbiota (MAM) and they eat the mucous and they do become permanent visitors and its called anchoring and engrafting.

21:35  I asked if it is more effective to consume the bacteria as probiotics or to consume perbiotic fuel to cause those bacteria to grow that we’re trying to promote? Dr. Liu pointed out that some bacteria eat fiber like inulin or oligosaccharides, but when she starts working with a patient who is suffering with a gut disorder like IBS or inflammatory bowel disease, she won’t use fiber at the beginning because it might aggravate their symptoms. But she will use polyphenols, since only the good gut bacteria can eat these and the pathogenic flora have not adapted to eat polyphenols.

23:31 The strains of gut bacteria that help us to detoxify heavy metals and arsenic and xenoestrogens, etc., are the ABCs, such as the Bifido longum and L. Rhamnosus, that are in high amounts in the Bifido Maximus probiotic formula that Dr. Liu has formulated. There is a study from Dr. Gregor Reid where they found that probiotic yogurt containing L. Rhamnosus GR1 reduced mercury by 36% and arsenic by 78% in pregnant women in Tanzania.  Here is a Townsend Letter article discussing this issue and this study: Probiotics vs. Heavy Metals: A Win for the Good GuysDr Liu’s protocol for removing toxins is glutathione, binders like Quicksilver Ultra Binder, which has a bunch of different resins like charcoal, clay, sulfur-based resins, and a biological one called chitin, along with probiotics and polyphenols.  Dr. Liu mentioned that if estradiol is higher, it’s a marker for stress, esp. for gut stress, due to aromatase. To correct it, Dr. Liu will use DIM and botanicals like olive leaf and bitter melon.

34:14   High blood sugar is just leaky gut, according to Dr. Liu.  She cited the work of Dr. Patrice Cani, such as this paper: Gut microbes and health: A focus on the mechanisms linking microbes, obesity, and related disorders.

37:19  Some probiotics can help us to detoxify mycotoxins from mold. esp. soil-based probiotics, but also B. Longum and L. Ramnosus. Dr. Liu says that she likes the Shoemaker and some of the other Functional Medicine protocols for eliminating mycotoxins, but she stressed the importance of having a good microbiome, which help us to lower mycotoxin concentrations. Certain botanicals can shut off the genetic expression translation for mycotoxins.  B. longum and L. Ramnosus also degrade glyphosate and help with heavy metal remediation. 

40:42 Dr. Liu would ideally like her patients to have both a DNA based stool test like GI Map from Diagnostic Solutions or Thryve and also a culture based stool test, since they both provide different information that can be helpful.  Dr. Liu explained that she works with clients with four phases and she goes big to small. She starts by focusing on parasites, helminths, and eukaryotes, then she goes fungal, then she focuses on bacterial, SIBO, and finally she looks at viral, spirochetes, and phages. E. Coli is a major problem these days, but there are also good forms of E. Coli and one form of E. Coli probiotics can be used to treat SIBO.  Dr. Liu pointed out that many commercial forms of probiotics contain the wrong form of step (Streptococcus Thermophilus) and many people have antibodies against strep. Dr. Liu also does not believe in using Saccharomyces probiotics since many patients will also have an immune reaction against this as well.

 

 



Dr. Grace Liu, the Gut Goddess, is a Doctor of Pharmacy and a Functional Medicine practitioner. She consults with patients, offers courses, teaches practitioners through her Microbiome Summit, and develops and sells probiotics and other nutritional products, all available through her website, The Gut Institute.   Dr. Liu offers an incredible masterclass to learn how to manage gut health: Master Your Microbiome.

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 by going 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 sign up for my free ebook on my website by going to DrWeitz.com. Let’s get started on your road to better health.  Rational Wellness Podcasters. Thank you so much for joining me again today. 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 can find out about the Rational Wellness Podcast.

Our topic for today is the role that our gut bacteria play in helping us to detoxify toxins. Dr. Grace Liu is a doctor of pharmacy and a Functional Medicine practitioner, and she’s known as the Gut Goddess. Grace, thank you so much for joining me today.

Dr. Liu:                Dr. Weitz, thank you so much for having me here. I’m so grateful and glad for this opportunity to talk about all our good friendlies in the gut.

Dr. Weitz:            So, what the hell do gut bacteria have to do with toxins?

Dr. Liu:                Well, it’s a very, very minor role that they may play, but because our world is like a big toxic soup that we live in currently, our air, water, food is all very much contaminated, it may be playing more of a major role. Even in Functional Medicine, their role is not fully known. I actually wasn’t even fully aware of all their roles for our detoxification pathways until more just recently in the last few years, because the studies now are available, which are just amazing. We don’t have a lot, but just like a lot of Functional Medicine studies, there’s not a lot out there unless you have a big, deep pocket pharma behind you.

Dr. Weitz:            Right. It’s interesting. It seems like it goes both ways. There are a number of ways in which the gut bacteria actually create more toxins. I had a discussion a couple of podcasts ago about TMAO, which is this marker for heart disease, and TMAO actually is produced by the gut bacteria in the presence of carnitine and choline, either from food or supplements. So, there is several ways in which gut bacteria actually create toxins for us. I also saw a study where arsenic, gut bacteria change arsenic and make it from inorganic to a more dangerous form of arsenic.

Dr. Liu:                I know. Yeah. Those are fascinating, controversial points, which we often talk about as practitioners on your amazing forum in the closed group. I love that.

Dr. Weitz:            Yeah. The TMAO thing I think is really interesting, because the Cleveland Clinic is really touting that as a major factor in heart disease.

Dr. Liu:                Yeah. And as we know, vegetarians and vegans who don’t eat those high carnitine sources, they still get heart attacks, strokes, and embolic events.

Dr. Weitz:            Absolutely, yeah. I don’t buy this TMAO thing because carnitine and choline are so important for our health.

Dr. Liu:                And detox.

Dr. Weitz:            And for detox and even the health of the heart, so I just can’t believe that those are bad things to consume, especially when one of the foods that most causes TMAO is fish. Anyway, so, how can gut bacteria help us get rid of toxins?

Dr. Liu:                So, what I do at the Gut Institute, I’m founder of the Gut Institute, and we are an educational platform. We love to share about how our amazing gut flora, the probiotics primarily, are really what we need to safeguard our health. They protect us. They keep our health tight, as well as our butts, and create this non-leaky permeability of the gut lining.  All our guts are leaky. Babies are born leaky so they can take in immunoglobulins from breast milk and mom. They have no immune system when they’re born, so it’s mainly what mom shares with them, right? And actually, their probiotics. They get baby probiotics through Mom through the breast milk. It’s not sterile. It starts there.

Dr. Weitz:            Do you test for that or do you just sort of assume we all have it?

Dr. Liu:                Yeah, there’s no point in testing. Our modern testing methods are just so lame and primitive, actually. We can presume if someone has a chronic condition and the degree of it, there’s quite a lot of permeability. So depending on the test you decide to choose on, you may find it or you may not. It may be just selective permeability. It actually has to do with-

Dr. Weitz:            Do you find zonulin of any benefit?

Dr. Liu:                No. A lot of times, I suspect it, but 90% of the time it won’t be all abated on the testing that you pull. Actually, now, it’s good these test companies are reconciling what we see because they’ll have a disclaimer, “Oh, just ’cause it’s negative, it doesn’t mean anything.” Well, yeah, hello. Just like we do stool testing, we don’t find fungal overgrowths, just ’cause it’s negative doesn’t mean it exists there. You just pulled the wrong test. You pulled a lousy test. You’ve got to pull your organic acid out.  So how we look at the environment is very important for what we do. We do terrain medicine now in functional medicine, and this is how conventional may be moving eventually if there’s not a lot of barriers, because sometimes there’s not a lot of money for the things that recover our terrain. Yeah. So it doesn’t behoove FDA, who are not always for the health of the populous.

Dr. Weitz:            Yeah. It’s hard for me to see conventional medicine moving towards terrain medicine because it’s complex medicine and it’s not part of the model.

Dr. Liu:                 Maybe, yeah. So when we lose this legacy from Mom, then we don’t have our protection and our firewalls, just like our computers have firewalls, right? Do you have a cleanup system, a malware protection on your computers, Dr. Weitz?

Dr. Weitz:            Sure. Yep.

Dr. Liu:                Yeah. So our bodies have that, as well. We’ve co-evolved with it for the last one million, two million years, soon as our kind emerged, if you believe in evolution, and moved toward that. We have always been near the earth, eaten off the earth. Things were covered with soil. There’s soil bacteria, as well as vegetation has different kind of bacteria.  A lot of above ground have lactobacilli, so when we ferment foods like kimchi, sauerkraut, kombucha, we’re getting a lot of those lacto strains and other acid-producing strains. And then when they go anaerobic a bit without oxygen, without air, when we seal a system, those flourish, right, and they prevent mold from growing. So we didn’t have refrigeration up until 1500 years ago chilling our food, so we always relied on preserving our food via actually our bacteria. So we had many ways of replenishing.  But now, we refrigerate now and we don’t eat these foods, Mom’s legacy may be disrupted and broken. The flora that Mom used to have is no longer conferred to the baby, and this new generation is moving without a whole firewall, even our generation a bit.

Dr. Weitz:            When you’re talking about the Mom, you’re talking about the fact that we have so many C-sections and-

Dr. Liu:                Formula.

Dr. Weitz:            Formula, right.

Dr. Liu:                If you get pitocin as a mom, a pregnant mom, if they need to induce the baby, they give something called pitocin. If you’re in the hospital, a hospital gets many fines or negative points if there’s complications that arise, so to prevent a complication like sepsis, which is a bacterial infection in the blood, or abdominal skin infection as a result of hospital procedures, they give everyone IV antibiotics with pitocin.

Dr. Weitz:            Right.

Dr. Liu:                Does that make sense? Yeah. So now you have high dose IV antibiotic in the system that literally wipes everything clean. Can you imagine, you’ve wiped clear your hard drive every time you go into a hospital?  No more memories, no more pictures. Your documents are gone, right?  You’re kind of screwed, right?  So this is what’s happening. It’s not just C-sections. It’s also any surgery. Some of my worst cases are where they’ve had … I mean, something happened, an accident happens, a knee breaks, right, you need to have surgery, so guess what? Sometimes IV antibiotics or many oral antibiotics, by mouth antibiotics are given.   And it’s also permeating our food now, right? The last 20, 50 years, domestic farmers found that if they gave antibiotics to their herds, they’d instantly gain weight, so it meant more money for them, but they were really causing diabetes and morbid obesity, but animals don’t live that long. They just got many fat, right? They got fat, so it meant more profits for them, but we’re eating fat animals that are also ill and sick and they’re just fat. Not more muscle, necessarily. They’re just weighing more. It helped the farmer, but it doesn’t help our kind.

Dr. Weitz:            Right.

Dr. Liu:                Yeah. So grains are laced with pesticides. Pesticides are actually antifungal, or the good ones, and they’re antimicrobial in a bad way. Glyphosate has shown over and over that it causes a kind of soil dysbiosis. So really, our guts are probably reflecting our earth right now. It’s horrible to imagine how it’s going to go forward the next 20, 50 years. It’s not really sustainable to have soil with such a low diversity and having plants that are just full of yucky flora.  So it’s really great. I think you brought up the TMAO.  If we dig longer and further, deeper, the signature of people who have heart disease is one of really severe, deep dysbiosis. They’re lacking all the good flora.  So I’m going to delineate what the good flora are. In healthy control guts, whether they’re in rural communities, hunter gatherer societies, European tend to have better, healthy controls. I wouldn’t look at any of the last 20 years of US studies, their ideas of healthy controls. If you look at their BMIs, they’re not healthy. They’re very obese. They have yet to manifest something. But if you look at the BMIs, they’re not actually healthy, or if you look at a liver test, they all have non-alcoholic fatty liver. They’re not healthy. Yeah. They have early dysbiosis or really severe dysbiosis.

But if you look at European studies, all their functional markers rack up to a really healthy person. All their conventional labs as well as functional labs tend to fall in place.  So if you look at them, they have a really healthy signature.  I kind of look at things like a financial portfolio.  So you can have assets, right, and you can have liabilities, debt, right?  The worst debt might be multiple credit card debt, right?  I mean, assets are like a diverse portfolio.  It’s got bonds as well as S&P 100 stock and real estate maybe, good real estate, right?  We know this for many things, for financial things.  Now we have to think about that, apply those analogies to the gut. When we look through the signature of people who are healthy, they have very few of the TMA-producing, putrefying bacteria actually, which are known as Klebsiella, Citrobacter, E. Coli. We all know these to be very, very, not very good. There’s many reasons. They are producing toxins that may kill our heart or cause cancer.  It’s not that we want to eradicate these. This whole idea like, “Oh, let’s eliminate, eradicate,” it’s actually not good because along there, we’re going to also be messing up the terrain further. Yeah. So we have to think about how to rejuvenate maybe.

Dr. Weitz:            So maybe TMAO is a marker for dysbiotic gut.

Dr. Liu:                Yeah, exactly. Yeah, exactly. There’s an amazing study by someone I really follow ’cause he has a lot of great protocols and studies. So we have adapted things in Functional medicine, but one is Dr. Jolly Pink. He had a genetic obesity study. He had just conventional obesity, as well as genetic. There’s a condition called Prader-Willi, Willis, I think, and it’s genetic.

Dr. Weitz:            What is it called?

Dr. Liu:                Prader-Willi.

Dr. Weitz:            Okay.

Dr. Liu:                Yeah. There’s various genetic mutations that allows these people to get overweight really quickly. It’s genetic. He applied a diet very high in prebiotics and found that he could grow all the good flora. So the good flora eat fiber. They don’t eat garbage. And he was able to shift it. They lowered their BMI, very slowly. I would’ve done things a lot differently for faster results. We tend to get really good results with reduced brain fog, body fat and fatigue in usually six months or less. So his is a very long story, over six months long.  But they did see results with that. What they did was they focused on how to regrow the good flora, and then naturally, the good flora, they’re going to help change the terrain, eliminate, eradicate for us the bad flora, the TMAO-producing flora. So what they found in the study was that TMAO levels went down in the treatment group, not compared to the control group, who were eating a standard diet.   Yeah, so we have many markers.

So I look at the urine organic acid. We look at Cresol, which comes from clostridium. We look at various fungal markers, Furans, as well as tartaric acid, many others. There’s nine markers on a standard urine organic acid testing from Great Plains, and then three other markers known as Oxalates that tells a lot about the fungal overgrowths.  This is easily overlooked by a lot of functional medicine practitioners. They don’t know how to look for this, and so they’re missing a whole side of the terrain. In fact, I would say for disease, maybe 90% of the terrain.  All our protocols, yeah, we combine anti-fungal botanicals, and even prescription sometimes if needed to the protocols to see what we’re trying to help to change in the terrain in terms of negatives.  In the portfolio, what I look for is to see the good stuff growing back up, lactobacilli, bifido. Our ABCs start with the As. You don’t have to remember all these technical names, but Akkermansia is one of our big ones, A for Akkermansia.  Yeah. It’s actually like a U-shaped curve. Too low is not great, and we may over-focus on that. Actually, excess levels aren’t great, either. Akkermansia love to eat mucin as their prebiotic. Their fiber is more gooey things, like our mucous, as well as RO mucous, so they’re mucous-eaters.  So Akkermansia muciniphila, that’s the name of the A, the species that stands for A, that all the healthy people have. Centenarians have high amounts of it. Healthy people in the ruralest areas, hunter gatherers, people without disease, people without cancer.  Now, going, swinging on the other side, ’cause it eats mucous, if someone’s sick, it’s kind of like having a runny nose, like if you have allergies or hay fever, right, or ill, you have a cold. Same like the gut. The gut can get runny. If there’s a lot of stress and inflammation in the gut, it may get runny, so there’s excess mucous.  And then if we see high, high levels of Akkermansia, it’s not a good sign. So it’s always the context of what’s going on. Sometimes people are a little over-focused on high or low and you totally ignore the context of the host, right, the whole ecosystem, the whole terrain.

So part of ABCs, the B is called the bifido. We think of these as our standard probiotics, but there’s actually good bifido and bad bifido in our little financial portfolio. The bad bifido tend to eat a lot of sugars and carbs, and they’re not the foundational bifido that we need. We need some but we don’t need a ton. For a lot of people, they’re overgrowing and they don’t have the other Bs.  The other good bifido, like bifido longum, bifido infantis, bifido lactis … Just by the way, too, these probiotics, they cost an arm and a leg. They cost more than coke per kilo. So I’m a probiotic formula maker.

Dr. Weitz:            Can we make money selling our gut bacteria short?

Dr. Liu:                Yeah. One of my friends, I told them, their kids have great flora. When I looked at their portfolio, I’m like, “You should start saving for their college,” and they have. They submit the stools to the FMT banks.

Dr. Weitz:            Oh, really?

Dr. Liu:                Yeah, yeah. My kids ignore me when I talk about this. They don’t want to get involved at all.

Dr. Weitz:            They don’t want to eat capsules filled with poop, huh?

Dr. Liu:                Yeah, yeah. They’re contributing to society. It’s awesome.

Dr. Weitz:            There you go.

Dr. Liu:                People can make a grand or two a month.

Dr. Weitz:            Yeah.

Dr. Liu:                Yeah. Income, off of poop.

Dr. Weitz:            One of the interesting things when we talk about trying to improve your gut bacteria and your microbiota is that we know that when you take probiotics, they’re only temporary visitors. They don’t continue to live there. So, how is it that you can actually change your gut bacteria to have more Akkermansia or whatever strains you’re trying to promote if the probiotics we consume are only there for a short period of time and then gone?

Dr. Liu:                So first of all, there are various studies that show actually that’s not true, Dr. Weitz. Yeah. So I don’t know if it’s a fallacy, yeah, promoted by people who don’t read super deep in the literature, but our good gut flora, they follow us everywhere. Some come in a pill, in a capsule. Some come in food. But they aren’t just transient visitors. The ones that are core to our … They’re called the MAM, mucosia-associated microbiota. Let’s say this is our GI tract, right?

Dr. Weitz:            Okay.

Dr. Liu:                Here’s the muscle, right, smooth muscle.

Dr. Weitz:            Right.

Dr. Liu:                You have several layers. There’s two layers of mucous. The inner layer is full of some flora, good flora, but they don’t trespass beyond, and there’s an inner layer of mucous, which is pretty much almost sterile. Our flora, when they’re present, the ABCs are present and they actually make all these chemicals that keep the boundary tight and target certain pathogenic flora that really like to invade. So that inner mucous, the deep, deep mucous actually is very sterile.  And then we have some flora that live there, and they’re very few. It’s called the MAM, mucosis-associated microbiota. These actually include the good bifido lacto, and also good Roseburia that eats inulin, Roseburia inulinivorans. There’s other Roseburia that actually aren’t so good for us.  So we can actually drill down a lot of the strain, just like you know there’s good strep, right? There’s even good strep that help our gums and combat cavities. There’s good strep, but there’s also bad strep. In fact, almost all the other strep are kind of bad. Strep sanguinis, strep mutans, those cause cavities…

Dr. Weitz:            Are you saying that some of the bacteria contained in probiotics, whether it be lactobacillus or bifido, et cetera, et cetera, that those have become permanent residents in our gut?

Dr. Liu:                Especially yes, if they eat the mucous, yeah. It’s called anchoring and engrafting. It’s really awesome. In my last year in pharmacy school, I spent a year at Stanford as part of my rotation. I was so lucky. I did one rotation actually in the transplant unit. It was so cool seeing different protocols that would inhibit something called graft-versus-host disease. It was a rejection syndrome, graft-versus-host disease.

Dr. Weitz:            Okay.

Dr. Liu:                What studies show now for transplant, and actually, even same with implantation after IVF, in-vitro fertilization methods, transplantation and then the implant of a human cell requires actually good flora in the terrain.

Dr. Weitz:            Okay.

Dr. Liu:                Now, a lot of these floras are our ABCs, it turns out. They need to be present to help facilitate the organ to stay there without rejection. Basically, this is going to save the person’s life, or for a woman who’s infertile or barren, trying to have kids, that means success for her, for her body to actually take what is evolutionary, our full right to bear children. Yeah, but it requires flora, the right flora, the good flora, not the bad versions of the flora.

Dr. Weitz:            Right.

Dr. Liu:                Yeah. So it has to do with their DNA, too. They all share DNA. One minute, they may be resistant to high dose antibiotic, and another minute they’re not. They’re always sharing their DNA. It’s called conjugation. They’re an amazing organ for us. They’re a silent organ.  So when we think about them, we don’t think about them as … They weigh as much as our brain, actually, two or three pounds or more. The light is starting to be seen by what they do for us and what they don’t do. They can prematurely end our life easily. It’s usually when the ABCs aren’t there.  It’s not hard to get them back in, too. It takes some protocols actually, a little bit, to help open up ecological niches for them so they actually have a chair to sit in. It’s like magical chairs in a way. My goal is to open some of these niches so we can get the high dose probiotics in.

Dr. Weitz:            So is it more effective to consume the bacteria as probiotics or to give them the proper prebiotic fuel to cause those bacteria that we’re trying to promote?

Dr. Liu:                Oh, that’s a great question. It depends on the stage of healing. So early on, I don’t use actually a lot of fiber. For instance, some of the really nifty, swifty kind of bacteria, like for instance, strains that secrete TMAO, they also have adapted. They can eat some of our fiber that we tend to think about as really great, awesome prebiotics. Some eat inulins. Some eat oligosaccharides.  For instance, some people with dysbiosis, they don’t tolerate FODMAPs.  Not everybody, but a lot of people, when they find that they eliminate the FODMAPs, they find out, “Oh my gosh, my bloating and brain fog actually go away.”  Well, they have actually flora, it could be good or bad even, but they’re in the wrong place.

Dr. Weitz:            So you’re saying when we’re working with a patient who’s suffering from a GI disorder like IBS or inflammatory bowel disease or something like that, you won’t use fiber at the beginning.

Dr. Liu:                No, but I use a different kind of prebiotic. They’re called polyphenols, antioxidants. So we utilize a lot of these in Functional Medicine. Little did we know that actually, we’re super-feeding our good gut flora, the ABCs primarily. It’s really interesting. The bad flora, the pathogenic flora, they have not adapted yet to eat polyphenols. Polyphenols are usually low quantity. They’re very bitter. They’re medicinal. Usually besides feeding good gut flora, they actually antimicrobial benefits.

Dr. Weitz:            Okay.

Dr. Liu:                Yeah. They actually will kill them. So, they have not adapted to learn how to eat them, fortunately. So we can really create this selective ecosystem and terrain by using the right ones. A lot of them are found in ancient Russian medicine, German medicine, Chinese, Korean medicine, TCM, traditional Chinese medicine, Japanese medicine.

Dr. Weitz:            Okay. So let’s get to the gut bacteria. Which gut bacteria help with detoxifying heavy metals and arsenic and xenoestrogens and things like that?

Dr. Liu:                It turns out our ABCs are the ones that do that for us.

Dr. Weitz:            Okay.

Dr. Liu:                Not the bad signatures that show up, the bad signatures which are contributing to disease, the ones that putrefy TMAO, the ones that cause a lot of cancer chemicals or are associated with cancers, not those, but our ABCs, the good ones.

Dr. Weitz:            Okay.

Dr. Liu:                They all do that. Yeah. So let me tell you about Bifido longum and L. Rhamnosus. These are high amounts in our Bifido Maximus probiotic, actually the highest strength in the market right now.

Dr. Weitz:            That’s a probiotic that you sell.

Dr. Liu:                Yes, Bifido Maximus is only sold by us here at the Gut Institute.

Dr. Weitz:            Okay.

Dr. Liu:                Yeah, and the way I formulate it is that it’s based on all the studies where healthy controls have the good gut flora, they don’t have celiac, they don’t have gluten intolerance, and they also don’t have heavy metal problems. They don’t have other health issues.  So for instance, one study by Gregor Reid, he’s a big, big probiotic formulator. They were able to get funding to do studies in Africa, Tanzania in particular. There’s a lot of silver mines and metal kind of mining there. In the process of silver mining, they leech out a bunch of heavy metals that are toxins for humans and other animals and fish. They go into the water. So, even their small fish. Usually we say, “Oh, the big predator fish have a lot of concentration of heavy metals.” Well, it turns out in Africa, in Tanzania, even the small fish that the villagers were eating ended up being very high and toxic in heavy metals.  So what he designed was a yogurt, a 200 gram yogurt with 10 billion L. Rhamnosus GR1, strain GR1, and they made it into a yogurt and they gave it to pregnant women and children. This would not pass IRB in the US.  Maybe it would. Who knows, right?  ‘Cause there’s no other solutions, really.  In that village, people were able to also create little economies, too, to make the yogurt.  So it actually could increase economic advantages for the impoverished here.  So what they showed was in pregnant women, the women who took the yogurt, they found that they had 36% less arsenic in the body compared to the controls who did not have the yogurt and had the placebo, 36% less mercury, and 78% less arsenic, which is so substantial for this population that they actually have really high heavy metal toxicity. All it was was just a daily yogurt.

Dr. Weitz:            Which particular strain was in that yogurt?

Dr. Liu:                 It’s called L. Rhamnosus GR1, but it turns out, many of the L. Rhamnosus strains also have this benefit to detox. In an in-vitro plate, they can lower the concentrations of all kinds of heavy metals. Yeah. And it would go out in the system.

Dr. Weitz:            So these are particular strains of bifido longus, right?

Dr. Liu:                Lactobacillus rhamnosus is a lactobacilli.

Dr. Weitz:            Oh, lactobacillus rhamnosus.

Dr. Liu:                Yeah. They also did the same study with bifido longum, and many strains of bifido longum also contributed to this benefit. So it’s believed actually it’s a class effect.

Dr. Weitz:            Okay.

Dr. Liu:                All of them have this ability, unless they’re a weird mutation or something. Yeah. I would say for our probiotic, invariably, when people go through our program, they’re always using high doses of Bifido Maximus.  We don’t always do testing in the beginning, but we test later. No one has glyphosate after provocation with glutathione for a month. That’s the typical way to do it. You provocate with glutathione.  We check using a glyphosate study from Great Plains.  People had not really any detectable levels at all.  Then people start with those, we do really gentle chelation. We don’t really do a ton, ton, ton. It’s not so healthy when you don’t have a good gut anyway to do that. But we will see people also, their numbers go down. I didn’t know where to attribute it, but I think actually the probiotics make a big difference. We do so many different things. I can’t say that’s the factor that accomplished that result.

Dr. Weitz:            So how do you discover that a patient has heavy metals? Does it come from history? Does it just come up on one of your routine testing? And then when you do suspect somebody has heavy metals, how do you like to test for it?

Dr. Liu:                 I look at sometimes their genetic SNPs. If they have mutations on glutathione, several, several of the MTRR, MTHFR mutations, and then APO E4, any of those will contribute to more heavy metals. I don’t always test, ’cause I know our protocols end up lowering it, but some of my clients, they’re great bio hackers. They come to me and they already have a lot of this testing from prior practitioners.  Yeah. Sometimes we will test. So we’ll do different kinds of testing, either hair provocation. You could do urine. Again, it depends on the variants they have, the genetic variants. Some don’t release. You have to provocate for not just on month, but even two months to actually see something, ’cause they hold onto it.  Also, they all have poor guts in the beginning, too. They may not release. Even though they look like a picture of heavy metal toxicity, they don’t always release. A lot of our protocols help to move those pathways. We try to look what the genetic SNPs are so we can start to bypass them. It’s not necessary to bypass all of them in the beginning. It’s also going to be like 20 million supplements. So what we do is just try to get the gut back online. We try to get the ABCs back online because they do it all.  So for instance, bifido and lacto, what’s so awesome about these strains is that as you know for detox, we can use different resins, right? Questran, Welchol, these are all resins, pharmaceutical resins, so they pull mycotoxins. They also pull xenoestrogens and they pull glyphosate pesticides. They pull heavy metals often, right? We use also Quicksilver Ultra Binder. It’s got different resins in there.

Dr. Weitz:            Right.

Dr. Liu:                  Yeah, right. Charcoal, clay, as well as sulfur-based resins, and a biological one called chitin, chitosan or chitin. So these bind. Well, it turns out, the cell wall, certain strains of the good bifido and the lacto, again, they’re in the Bifido Maximus, their cell wall acts as an ionic resin.  So whether it’s a highly, highly charged positive heavy metal or highly, highly negatively charged heavy metal, from mercury, arsenic, cadmium, all of them have different charges, they still get bound up. We don’t use too much of them. Sometimes we pulse these, ’cause they also can, I think theoretically, also bind our good stuff, our good zinc, good mag, good iodine. So we don’t want to pull too much of the good stuff, especially if people are already depleted. We want to make sure they get repleted as safely as we can.  But as they bind them, especially at a high dose, they anchor and then some are going to leave and die, and then they’re defecated out. They take with them all these yucky things. Yeah.

Dr. Weitz:            So your protocol for heavy metals is glutathione binders and then specific probiotics? Is that it?

Dr. Liu:                 Exactly, yeah, and opening up biofilms is really important. A lot of people don’t realize, the higher dose of antibiotic they had–Rifaximin–it selects for toxic strains that are super weedy. They’re like weeds. They’re also super nasty. So once the drug leaves the system, they’re only left with these nasties. If you don’t have the good ABCs in there, they’re just going to proliferate.  Only the ABCs keep them in check. You can meditate, do prayer, yoga, all the F you want. They are not going to keep out the bad guys as soon as stress happens. Everyone’s got stress now. We have real life stress, right? All kinds of stress we’re not even aware of, EMFs, smart meters. I don’t need to really go in depth on all that, but go take a class, right? But all these bombard us all day, like you mentioning assaults to our gut. We have multiple assaults on the gut that did not even exist like two years ago.

Dr. Weitz:            Okay. Now, you mentioned biofilms. Do you try to address biofilms in some way?

Dr. Liu:                 We must, yeah, especially when people have more of those genetic mutations that I mentioned to you. FU22 is a big one, as well. All our clients, 99% all have mutations on FU22. The healthier ones, like I also work with MMA fighters and endurance athletes, Spartan racers, champions, iron men, iron women. Actually, the better genes someone has to withstand environmental assaults, they’re usually going to excel in life through athletics, or I work with executives, too, multi-tasking ones. They tend to all excel in life, but they also have a few of these relevant kind of genetic markers and variants. But they also have-

Dr. Weitz:            MMA fighters probably have plenty of bacteria. They get their faced rubbed in those mats and-

Dr. Liu:                 I know, and they withstand all of them. They withstand all of them because they’re usually not FU22 and they’re not APO E4 ever. When you look at their MTHFR reports, I use MTHFR Support, the Sterling’s app. They’re like seas of green, just all green, green, green, green, green. Yeah, especially next to mine, I’m like, “Wow, what a difference.” They’re genetically like another species, and their hormones kind of show it, as well, too. They have all the healthy longevity hormone patterns.  We do something called fertility physics. No matter how old someone is, there’s certain ratios where higher anabolic is going to be higher than the estradiol. Estradiol is just a marker. It’s usually a stress marker, so we pair it up against there and look at it.

Dr. Weitz:            What is that now? Estradiol is a stress marker?

Dr. Liu:                Yeah. So it’s released when aromatase goes high, especially with gut inflammation.

Dr. Weitz:            Estradiol goes higher with gut inflammation. You mean because estrogen’s being recirculated instead of excreted out?

Dr. Liu:                There’s a hormone called aromatase. It gets lit up when there’s central stress going on, central inflammation going on. Gut stress is literally 90% of the stress I see people in. When we eliminate that using four phases, we target different things, and always at every phase, we’re trying to bring back the ABCs, the polyphenols and our protocols and really high, high dose. We even use a trillion a day probiotics every day of the Bifido Maximus. You’re able to massage all that. Yeah. We see aromatase go down.  Also, I use specific botanicals to lower the aromatase activity, so it’s not so turned on for people, and they feel better…. Oh, way more than that. Way more than that.

Dr. Weitz:            What do you use?

Dr. Liu:                Olive leaf. Bitter melon’s amazing, which is like an ancient Chinese-

Dr. Weitz:            Bitter melon? I always think of blood sugar, but that helps with estrogen detoxification?

Dr. Liu:                High blood sugar is just leaky gut. All these people on the keto diets, awesome. What they’re trying to do is just repair their gut, but they don’t realize without polyphenols and certain prebiotics, they’re going to keep losing their ABCs. That’s what studies show. They particularly lose the Cs, the butyrate producing Clostridiales.

Dr. Weitz:            Wait a minute. High blood sugar isn’t just leaky gut, right? I mean, it’s also-

Dr. Liu:                You should read the work from Patrice Cani. [Here is one paper from Dr. Cani on this topic: Gut microbes and health: A focus on the mechanisms linking microbes, obesity, and related disorders. ]

Dr. Weitz:            Okay.

Dr. Liu:                He’s from Belgium. Yeah. He did all the seminal landmark work.

Dr. Weitz:            But I mean, it’s also eating the junk that people eat, the sugars and the breakfast cereals and the Hostess Twinkies and on and on and on.

Dr. Liu:                It’s so fascinating. There’s a group called Ilan Ilanoff. They’re from Israel. They have a certain stool kit that’s pretty interesting. What they found is that they checked people’s blood sugars eating the same food. Let’s say rye bread, for instance, okay? Some people, based on just blood sugars alone and their microbiome data, some people had, let’s say, high blood sugars with eating rye bread, right? We see this often. They have gluten allergies. They have the whole bad signature of bad gut flora, right?  He was looking at all kinds of people, and other people had low blood sugars, better blood sugars, better insulin sensitivity eating rye bread. Rye bread also is full of really good prebiotics. Grains actually can have really great oligosaccharides from the bran part, rye bran and whole grain, and there’s a lot of fiber, both soluble and insoluble fiber, right?

Dr. Weitz:            Okay.

Dr. Liu:                Legumes, too. They have a lot of these good fibers. And they would see low blood sugar. It was all dependent on a microbiome signature.

Dr. Weitz:            But you’re being sacrilegious right now. In the religion of Functional Medicine, though shall not say anything positive about grains.

Dr. Liu:                All the longevity societies eat grains and beans all day long. I can’t think we could dismiss their data. Did you ever watch the Longevity film with Jason Prall and Michael Wesley?

Dr. Weitz:            I never saw it. Is it worth watching? Yeah.

Dr. Liu:                Yeah, I think so. If you’ve never interviewed Jason Prall, you should interview him, too.

Dr. Weitz:            Okay.

Dr. Liu:                Yeah. The diet of our ancestors is very important. I’m also … At one point … Well, I kind of gave it up now, but I was chapter leader for our area for Weston A. Price. Are you a fan of Weston A. Price?

Dr. Weitz:            Not necessarily, but I know everybody else is.

Dr. Liu:                I’m Chinese. When I took rice out of my life, my health went down.

Dr. Weitz:            Okay.

Dr. Liu:                Yeah. I can’t tell you how. I’m also APOE2. We’re agrarian adjusted.

Dr. Weitz:            Oh, okay.

Dr. Liu:                Yeah. Even when I was sick and I had Hashimoto’s and I was eating 400 grams of carbs a day and a lot of sugar, my triglycerides didn’t go over 100.

Dr. Weitz:            Wow.

Dr. Liu:                Yeah.

Dr. Weitz:            Okay. So, which goes to show, there’s no one diet that’s right for everybody. So, as far as gut bacteria-

Dr. Liu:                That’s Functional Medicine for you, right, Dr. Weitz?

Dr. Weitz:            Exactly.

Dr. Liu:                Customized. Yeah.

Dr. Weitz:            So as far as helping us detoxify mold, mycotoxins, how do we accomplish that with probiotics?

Dr. Liu:                So I love the Shoemaker Protocol and all these other mold ideas and stuff, but I go back to the microbiome, right? If we don’t have a good microbiome, we also aren’t going to survive mold.  We have mold everywhere. Our ancestors grew up with mold all over with them.  So, it turns out, a lot of the soil probiotics, many strands like L. Rhamnosus in our probiotic and B. Longum, they have the ability to actually, in in-vitro, lower mycotoxin concentrations. It’s pretty amazing, amazing.  We also have different protocols using certain botanicals. They shut the genetic expression translation off for mycotoxins. So mold may be present in the ecosystem. Doesn’t mean it has to be super bad all the time every day.  It turns our food, if we eat an ancestral diet, which is high in polyphenols, antioxidants, and prebiotics, even grains, okay, we feed these bacteria. Guess what B. Longum and L. Rhamnosus eat, right? They eat a lot of FODMAPs. They eat our mucous. Also, studies show, I don’t know if they eat polyphenols, but polyphenols increase their growth and proliferation.

Dr. Weitz:            Can we really eat an ancestral diet?

Dr. Liu:                I have a hard time. I don’t eat as much fermented foods as my ancestors did, for sure. I don’t eat as much plants, either.

Dr. Weitz:            I mean, none of our fruits and vegetables at all resemble the fruits and vegetables and tubers that ancient humans ate.

Dr. Liu:                No. A lot of GMO now, too.

Dr. Weitz:            Yeah.

Dr. Liu:                Exactly.

Dr. Weitz:            And the hybridized farming for hundreds of years.

Dr. Liu:                A lot of the fruit aren’t as high in antioxidants, either. They’re all farmed. Our fish is farmed. It is difficult.

Dr. Weitz:            Yeah.

Dr. Liu:                I would say it’s not impossible, but it would be a part-time job, right? If I did eat all the vegetables and fruit, I’d be gnawing like a horse and cow all day, right? I don’t have time for that, either. I do like something called bionic fiber to make up for it. It makes my stools like Bristol 4 twice a day. [Dr. Liu is saying that her stool corresponds to the Bristol Stool Chart, which is a diagnostic medical tool designed to classify the form of human feces into 7 categories and it describes the ideal stool as either type 3 or 4]  I don’t even worry about it. 

Dr. Weitz:            Oh, okay.

Dr. Liu:                Yeah. That’s the only thing I bring on travel sometimes. I get bummed when I lose that.

Dr. Weitz:            I was looking at some studies on a mycotoxin thing, and I saw that the soil-based probiotics have been shown to have some benefit, as well.

Dr. Liu:                Yeah. The bacilli all do. Just like bifido and longum, the strains that I mentioned, they also degrade glyphosate and have helped with heavy metal remediation. Yeah. But bifido and lacto might be our mainstay. They are in much higher concentration than the bacilli. With the bacilli, you just need a little. A little bit goes a long way.  With bifido and lacto, literally, they can be, healthy controls can be .5 to 1% out of the whole gut consortium. With bacilli, you’ll see the strains, but they’re much lower, much, much lower, like .1% or way lower, like when you’re looking at a 16S analysis like from uBiome or Thrive Kit.  Yeah. The Vibrant kit they don’t give percentages right now, or they’re going to give number quantities.  On the GI Map from Diagnostic Solutions Lab, you can also see quantity. I kind of look at that as we look at our clients, but it’s also great to get a culture.  So, we have media when we culture using CDSA, a comprehensive diagnostic stool analysis-

Dr. Weitz:            So it might be beneficial to get a culture stool sample, as well as a DNA based stool test?

Dr. Liu:                I’ll take any data. All data is limited to information, but yeah, I like seeing it all, but then it ends up costing thousands of dollars.

Dr. Weitz:            Right, right, but if you had a patient who’s willing to do whatever and cost wasn’t a factor, you would get a genetic stool test and a culture-based stool test?

Dr. Liu:                Absolutely, yeah, yeah. Absolutely, yeah. You see just a different picture. The media is still old school, but it still shows us our most vile kind of bacteria that grow out.  With the DSL, Diagnostic Solutions Lab, GM map, it’s awesome. They probably over-visualize right now. I’m sure some of it’s kind of noise. You can’t see to that degree, but what we see is with each of the phases we work on, we always go big to small. We work with people for four phases. We go big parasites, helminths, eukaryotes, then we go fungal, then we go SIBO, bacterial, and then lastly, we do viral. Viral, spirochetes, phages, small things. We go in that order. We always are looking at other eukaryotes through the whole thing. Fungal is really big, so we look at fungal throughout the whole thing.

But with the GM map, it’s really cool. Because the flora live in layers, the first layer is kind of the most needy kind, more toxic, severely toxic, like the C. Difficiles, right, and campylobacter, the enterohemorrhagic E. Coli. They can’t really drill down E. Coli well. You have to do genetic tests, so that’s why the culture’s not going to work so well. You have to use genetic testing to look at the different toxic species in there.  E. Coli is such a menace right now, but what studies show is L. Rhamnosus, B. Longum, all are ABCs. They have all natural anti E. Coli abilities. Not all E. Coli is bad, either. There’s a Canadian and other European strains of good E. Coli. These are our first bacteria that were used to treat SIBO, actually. We gave 50% success rates, but we couldn’t use that in the USA.

Dr. Weitz:            Killing SIBO with probiotic bacteria. Yeah.

Dr. Liu:                Yeah. Depending on the study you look at, it could be 60, 80%, or even a higher percent, 97% improvement in SIBO. I see 100%.

Dr. Weitz:            A lot of practitioners are still dead set on not using probiotics when treating SIBO.

Dr. Liu:                That’s probably ’cause they’re using strep ones, right, and they have a form of PANDAS. They have antibodies against strep. You can’t use step probiotics. Many of the probiotics in the functional medicine field have very high amounts of strep. Strep thermophilus is not a natural native of the human gut. If people are reacting to it, it’s like a food allergy. Would you give gluten to someone who’s reacting with a high IGG, IGE with gluten? No, right? You take it out temporarily.

Dr. Weitz:            Would you say the probiotics on the market have the wrong form of strep?  That’s-

Dr. Liu:                Yeah, and they may also have Saccharomyces. Our Saccharomyces is our-

Dr. Weitz:            You don’t use Saccharomyces?

Dr. Liu:                No, I don’t use any Saccharomyces.

Dr. Weitz:            How come?

Dr. Liu:                We look at the IGG panel from either Cyrex or Great Plains. When there’s a reaction, you definitely don’t want to use it. But some of the IGG panels, they’re not graded or calibrated to a person’s immunoglobulins. Some are under-producing a lot of immunoglobulins ’cause they’re immunocompromised.  80% of our immunity’s in our small intestine, so if they’re not lacking our ancestral core, like the ABCs, you can’t trust the immunoglobulins. They’re immuno suppressed, so their SigA isn’t going to light up. It’ll be even zero. You can look at total immunoglobulins. Let’s grade them against everything. Vibrant now has a free add-on you can just-

Dr. Weitz:           Cyrex does the same thing. If the IGG is low, they’ll recalibrate the numbers.

Dr. Liu:                Yeah, so you actually will see if it’s lit up. Yeah. So a lot of our clients, they light up for Saccharomyces. You definitely don’t want to be giving Saccharomyces, but we take it away from everybody ’cause again, we don’t always trust the testing.

Dr. Weitz:            But what about for C. Diff? We find it really helpful for C. Diff, and also for fungal infections.

Dr. Liu:                B. Longum’s even better. Yeah. They did a study in babies, ’cause all babies now are born in hospitals, right? The higher in the gut B. Longum was present, the lower the C. Difficile colonization. All babies get C. Diff. They’re colonized. It doesn’t mean anything. But the second they get stress or antibiotics or formula, this increases their risk to express it, right?  C. Diff, literally spores are all over hospital workers, nurses, doctors, everybody. It’s on all the surfaces, doorknobs, everything. The more bleach they use, the more antiseptic they use, the more it becomes heartier. Spores last forever. Studies have found spores that are millions of years old embedded in the amber of different insect guts. Yeah. So C. Diff is one that is virtually indestructible.

Dr. Weitz:            So, one more time, why don’t we want to take Saccharomyces boulardii as a supplement?

Dr. Liu:                Saccharomyces, as you know, is a wild yeast. It’s actually one of our number one healthy, good flora in the gut, good fungi in the gut. But when someone’s permeable or they have toxic flora, they have the signature of toxic flora … They could be selectively permeable. Wherever these bad flora are, they’re causing little ulcers, so then they can enter the bloodstream, right?  When Saccharomyces enter the bloodstream, what happens? The body launches an attack against it, right, just like it would for gluten or dairy or, yeah, who knows what. We see a lot of joint problems, fibromyalgia. A lot of times, it’s Klebsiella Citrobacter, right? It’s growing in the gut. It’s entering the bloodstream. The body’s launching an attack.

Unfortunately, a lot of our tissues look like the cell walls of Klebsiella or Citrobacter, and then it can be muscles or mitochondria even, and then they get attacked, so people feel achy. They don’t feel well.  As soon as people go on a certain diet and they also fix their gut, all these aches go away. Even if they’re 60, 70, 80 years old, their aches go away. Aching is not really the best sign. It’s not normal. It’s not part of our aging process. It’s a sign of decrepitness, right? Sarcopenia. Muscles go down, as well, typically as well, too. So there’s a lot of different ways to assess leakiness or what’s going on in the gut.

Dr. Weitz:            As a chiropractor, we get a lot of decrepit patients.

Dr. Liu:                I know, I know. So looking at the fungal markers on the Great Plains lab is really the best ’cause you’ll see the fungal there. The thing is, it’s not direct, so we don’t know if it’s Saccharomyces. I look at the IGG to Saccharomyces. If it’s even in the upper green or yellow zone on the IGG Great Plains panel, that means they’re going to potentially be having IGG against Saccharomyces. It’s not safe to give it if that’s the case, nor is it safe to eat any of the foods that are slightly yellow, until one or two months later, then they heal the gut and immune system calms down. They’re kind of having this hyperimmune thing, right? They’re attacking everything that falls into the bloodstream.  But we can assuage the immune system. There’s so many ways to calm the immune system down. Treating the adrenals. We use something called NanoMojo. Mojo is amazing. Using certain botanicals that balance TH1 and 2. We use mistletoe now. We use actually cancer treatments for educating our clients to help them normalize their immune system.

Everyone’s at risk for cancer now. Even some of our best Functional Medicine leaders, they’re drug-addicted. There are mental issues, depression, cancer. Why is that? They’re missing something. They’re missing the probiotics, I have to say. They don’t have actually a great financial portfolio. I’d say it pretty much sucks, actually. If they’ve never evaluated, they don’t know, right? Better be ignorant I guess.  But it’s good to know there’s steps that can be done. Not to go overboard crazy, but not to ignore ancestral past. We’ve always co-evolved with this legacy of our flora. The first time in the human history now, kids are dying before their parents, or even before healthy grandparents. It’s insane. We must change this tide. It’s not good for us to ignore it and ignore the earth terrain, too, yeah, ’cause we’re just reflections of the earth terrain and how we treat the animals and the plants and the way we do farming.

Dr. Weitz:            Yeah. We’re not doing a good job of that. Well, I think we have to bring this to a close. So, any final thoughts you want to give our listeners and tell us how we can get in touch with you and find out about your programs, et cetera, et cetera?

Dr. Liu:                Absolutely. I’m at TheGutInstitute.com. We also do Facebook Live every Tuesday at 2:00 Pacific Time at our Facebook, The Gut Institute page. You can contact us through our website, TheGutInstitute.com.  I also teach practitioners. We have a 50 hour gut certification immune certification program and love sharing our protocols for what works and the cases. I have a very concierge practice, so yeah, usually we don’t have a lot of openings, so we don’t have a lot of openings. I have a class, like a Master Gut class if people are interested, as well, just to learn. We have a lot of practitioners and coaches that go through it, as well. They learn all the basics and get their gut a lot better.  But thanks so much for having me on. I think everyone should be happy and have a look at their gut flora. Test it, don’t guess it.

Dr. Weitz:            Great. Excellent. Thank you, Grace.

Dr. Liu:                Thank you, Dr. Weitz.