Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Immune Strengthening Kimchi & Coronavirus with Dr. Susanne Bennett: Rational Wellness Podcast 149
Loading
/

Dr. Susanne Bennett discusses the benefits of eating Kimchi including strengthening the immune system and we also discuss the coronavirus pandemic with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]

 

Podcast Highlights

6:05  Kimchi is a traditional food that everyone eats in South Korea.  Kimchi consists of fermented vegetables, such as greens, cucumbers, radishes, and cabbage and it is a way that vegetables were preserved long before refrigeration.  Vegetables are brined with salt, which increases the lactic acid bacteria content, and it is the live bacterial cultures that make Kimchi so healthy.  In Korea there are over 250 different varieties of kimchi.  Prior to refrigeration, the Koreans would place large earthenware pots with Kimchi under the ground, which freezes over in the winter and then they would be able to have vegetables all year round.

8:12  Dr. Bennett went back to Korea for the first time since her childhood when she was age 50 and she discovered that Koreans were eating tons of unhealthy noodles, white rice, and sugar.  But the obesity rate in Korea is only 5.8% compared to 35% in the US!  And rates of other chronic diseases like diabetes and heart disease are equally low despite such a poor diet.  It is because Koreans eat kimchi with virtually every meal that they maintain their health.  Kimchi with burgers. Kimchi with tacos. Kimchi with pizza.

11:17  The intro to Dr. Bennett’s Kimchi Diet book, which was published a year ago, talks about the SARS epidemic in Asia, which was also caused by a slightly different coronavirus than our current pandemic.  The South Koreans did so well with that pandemic because of the benefits of kimchi for their immune system that it almost appeared that SARS bypassed Korea. Eating Kimchi contains lactic acid bacteria cause the body to produce immunoglobulins in the gut, which turns into IgG, which helps fight viral infections. Here is a video from Arirang News on how Kimchi Combats MERS. 

17:07  Lactic acid bacteria contained in Kimchi, including Lactobacillus acidophilus, Leuconostoc, and Weissella, are the main bacteria responsible for its health promoting properties. These probiotic strains have a number of powerful health promoting properties, including improving cardiometabolic health. They help to manage cholesterol and triglyceride levels and improve insulin sensitivity. And you get approximately 300 billions CFUs in a daily serving, which is a lot more than you can get in a probiotic supplement.  And you get a larger diversity of bacteria than you get in a supplement. Dr. Bennett recommends that if you are just starting to eat fermented foods like Kimchi that you start with cucumber Kimchi, since cucumber is not a FODMAP food. Cucumber does not contain fermentable carbohydrates. If you start with cabbage Kimchi you might end up getting a lot of gas and bloating and some additional bowel movements.  So you want slowly innoculate your gut. Then after doing the cucumber kimchi daily, you switch to bok choi or mustard greens kimchi, and then you go to radish kimchi, and finally after about 6 weeks you go to Napa cabbage kimchi. Kimchi simulates your gut to produce short chain fatty acids like buyrate and propionic acid.  Propionic acid has been studied a lot in Korea and it has anti-inflammatory, antioxidant, and lipid lowering properties. It also raises nitric acid levels.  It has even been shown to reduce fatty streaks in the aorta.  And kimchi also have anti-bacterial and anti-viral properties. You should start with one tablespoon twice per day and ramp it up till you get to 1/2 cup of kimchi per day.

23:48  You can make kimchi at home and this way you can make sure that you use all organic ingredients and you don’t use any chemicals or MSG.  You take your vegetables and you add sea salt, as explained in Dr. Bennett’s Kimchi Diet book. Himalayan pink salt does not work as well. The salt brines the vegetables, which kills off the bad bacteria, like staph, shigella, klebsiella, and E. Coli.  This results in the proliferation of the good bacteria. Kimchi can be eaten after 2 days but Dr. Bennett feels the sweet spot is in the 14-21 day period, which is when it will be a bit salty, a bit sweet, and there’s also a tang to it.  If you ferment kimchi too long it gets more sour and acidic. 

31:40  Kimchi helps to increase bacterial diversity in our microbiota, which many of us lack.  Many of us are low in Akkermansia muciniphila, which is the good bacteria that’s known to produce mucin, which helps to produce the mucus barrier in our intestines.  And without the mucus barrier, that’s where the toxins that we eat, the junk food, the GMO, the glyphosate, the pesticides, the alcohol, the sugars, the viruses, the bacterias, even parasites can all be penetrating through and creating leaky gut.  Increased intestinal permeability can lead to increased chronic illnesses like inflammatory, cardiovascular, and neurodegenerative diseases.  Kimchi can help to heal leaky gut and reduce LPS penetration into our system and this can help reduce inflammatory reactions in the brain.

36:25  Kimchi is high in a bacteria called Lactobacillus Sakei and studies show that you can take kimchi juice from white kimchi with no red pepper and put it up the nose for help with sinus infections. 

46:30  Dr. Bennett recommends the following nutritional supplements to strengthen your immune system to help protect it from viruses, like the coronavirus: 

  1.  Vitamin D up to 10,000 IU per day
  2.  Vitamin A 5,000-10,000 IU per day
  3.  Vitamin C, like Ultrapotent C from Metagenics
  4.  Selenium 100 mcg twice per day
  5.  Amino acids
  6.  Quinton Isotonic
  7.  Restore minerals
  8.  Liposomal Glutathione and N-Acetyl Cysteine.
  9.  Black current seed oil.
  10.  Herbs, including Elderberry, echinacea, olive leaf, andrographis, and licorice root.

 



Dr. Susanne Bennett is a holistic chiropractic physician with over 30 years clinical experience and advanced study, specializing in allergies, gut and skin disorders, environmental and anti-aging medicine. She’s the #1 international best-selling author of The Kimchi Diet: Revive Your Gut, Get Lean and Live Longer;  Mighty Mito: Power Up Your Mitochondria for Boundless Energy, Laser Sharp Mental Focus and a Powerful Vibrant Body;  and  The 7-Day Allergy Makeover: A Simple Program to Eliminate Allergies and Restore Vibrant Health from the Inside Out.  She also has a very successful talk show, Wellness for Life on RadioMD and iHeartRadio.  Her website is DrSusanne.com 

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



 

Podcast Transcript

Dr. Weitz:                            Today, I’ll be speaking with Dr. Susanne Bennett, who’s an expert on Functional Medicine and she published a book last year called The Kimchi Diet. So we will be speaking about the benefits of eating kimchi and this has particular importance for many parts of your health as well as the immune system. And because we’re recording this in the midst of the COVID-19 Coronavirus pandemic, we ended up shifting the focus a little bit more towards things that you can do to strengthen your immune system to possibly help you if you get infected with the Coronavirus, this new novel Coronavirus that is spreading around the world right now.

I would like to make clear that neither myself nor Dr. Bennett is saying that any of the recommendations that we make in terms of diet or nutritional supplementation will prevent you from getting the Coronavirus or should be suitable cures for the Coronavirus. We are not making any of those types of claims. On the other hand, Dr. Bennett and myself, and I hope I can speak for her, as Functional Medicine practitioners, we’re both big believers in strengthening your body’s own immune defenses and let’s make no bones about it, the reason why the overwhelming majority 80%, maybe 99% of people who get infected with the Coronavirus recover without any additional sequelae is the fact that their immune system is able to fight this off. That is how our body fights bacteria, viruses, fungi, et cetera, that we normally come into contact with every day in our environment.  Now our body has antibodies to certain viruses because we’ve been exposed to them in the past. And this novel Coronavirus, we don’t have any antibodies to, and that’s one of the reasons why it’s more dangerous. But it’s very clear that the people who recover well and that’s up to 99% of us and that’s because we have a healthy, robust immune system and people who have a compromised immune system tend not to do as well. So the recommendations that Dr. Bennett is making in this video that involved diet and some rational nutritional supplementation are simply ways to strengthen your immune system. So I hope you’ll enjoy this discussion.

Hey, this is Dr. Ben Weitz, host of The Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to The Rational Wellness Podcast for weekly updates, and to learn more, check out my website, drweitz.com. Thanks for joining me and let’s jump into the podcast. Rational Wellness Podcasters, thank you so much for joining me again today. For those of you who enjoy the podcast, please go to Apple Podcast and give us a ratings and review. And if you’d like to see a video version of this podcast, go to my Weitz Chiro YouTube page.  And if you go to my website, drweitz.com, you can find detailed show notes and a complete transcript.

Today we are going to speak to one of my close friends, Dr. Susanne Bennett, about her latest book, The Kimchi Diet. Dr. Susanne Bennett is a holistic chiropractic physician with over 30 years of clinical experience and advanced studies. She specializes in allergies, gut disorders, skin problems, environmental and antiaging medicine. She’s the number one international bestselling author of her new book, The Kimchi Diet: Revive your Gut, Get Lean, and Live Longer. And her book before that was Mighty Mito: Power Up Your Mitochondria for Boundless Energy, Laser Sharp Mental Focus and a Powerful Vibrant Body. And her first book, The Seven Day Allergy Makeover. She has a very successful talk show, Wellness for Life, on Radio MD and iHeartRadio. Dr. Bennett, thank you so much for joining me today.

Dr. Bennett:                       Thank you Ben. So good to hear your voice and see you. And you know what? Because of this time right now this is fantastic. Modern life allows us to be able to communicate and see each other.

Dr. Weitz:                            Exactly.  Yeah, absolutely. For those of you who maybe might not be aware, I don’t know who couldn’t be aware, but we’re right in the middle of the COVID-19 Coronavirus pandemic and those of us in California have been given a stay at home order. So we’re supposed to stay away from other human beings, but through the digital media we can still interact with each other. I think it’s really important that we have these forms of communication right now because we still need those social connections, even though we’re supposed to stay six feet away from each other.

Dr. Bennett:                       That’s right. That’s right. And it’s also super important because this is our way of being able to distribute information, information that’s a clear, sound, scientific oriented so that everyone can make their own decisions, what they want to do and how they live their lives right now in these trying times.

Dr. Weitz:                            Absolutely. So Dr. Bennett, you’re originally from South Korea and the traditional food everyone eats in Korea is kimchi. So maybe you could explain to us what is kimchi?

Dr. Bennett:                       All right. So kimchi has been around for thousands of years. It is a fermented food that Koreans have made for like … I mean, I think the numbers that go back at least two to 5,000 years. And what they’ve done was that … during the wintertime, way back when, there was no such thing as having fresh vegetables in the winter, so what they would do is they figure out a way to preserve vegetables, keeping it raw with all the nutrients and the value and by fermenting it, utilizing the brining method with salt and increase the lactic acid bacteria. And that was the magic of kimchi.

Although back then they didn’t know that’s the reason why it was so healthy for you. But the whole idea was for five, six months at a time, you can have fresh vegetables without really having a refrigerator. The Koreans would put big earthenware and that’s like ceramic ware pots into the ground when it was ice cold obviously, doing it before the snow came and then all the vegetables they would harvest and it would be, ah, all kinds of radish and a lot of greens and of course everyone knows about, well not everyone, but the Napa cabbage types. We have over 250 different kimchis in Korea. So all sorts of different forms of vegetation, vegetables. And the whole idea is to get vegetables fermented properly and have it for months at a time without it literally going bad.  That’s what’s great about kimchi is that you got live food, live food because it’s raw, but it also has live cultures. And that’s what I want to talk about and how important it is for your immune system. So yes, can I go on and tell you what happened though and how I really discovered this?  Because I will tell you, when I went to Korea when I was 50 years old … and I’m from Korea originally, I didn’t go back until I was about 50 and with a big family trip.  My son really wanted to go to where his mom was from.  So I go there and I was really blown away by what people ate.  Ben, I’m telling you, people eat tons of sugar, noodles, rice, white rice. There’s everything that we have here. They’ve got, in fact, a ton of those restaurants, there’s coffee shops.

Dr. Weitz:                          Thank you America for spreading American culture around the world.

Dr. Bennett:                       That’s right. The Western culture, I mean, that’s what it is. When I was there in the early … I was born in ’62 and into the 70s, I left in 1975, we barely had anything. That was when the military was there, but we didn’t have any forms of American food except on military base, which I had the luxury to be able to go to school there and all.

Dr. Weitz:                           And I bet the rates of chronic diseases like diabetes were minuscule compared to what they are now that the American diet has made its way there.

Dr. Bennett:                       That’s true. But I’ve got to tell you something, and that’s what was blowing me away with all the crap that everyone was eating there. And they eat enormous amounts of food, bowls and bowls of this white rice. They don’t have any brown rice. I asked for brown rice, there’s nothing there that’s brown rice, quinoa, forget it. So then I started doing some digging because I couldn’t believe how people were lean, and beautiful skin, and a lot of muscles, very active, and even the older folks were very, very energized there. And I really wanted to know their secrets. So when I started digging online, I couldn’t believe that South Korea has obesity rate of 5.8.  Now 5.8 is really low because we know in America it’s pretty much close to 35%.  5.8%, so I’m thinking, “Okay, that doesn’t make sense. They’re eating all this crap. We’re westernizing Korea, but why is it that they’re not at all affected?”  And so I started digging deeper and I started looking at everyone and everyone was eating kimchi, kimchi with their burgers, kimchi with their tacos, kimchi with their pizzas. So I realized the magic was really the kimchi that was affecting and mitigating any of the diseases. So when I got back home, I became a Kimchiologist and all I started doing was looking at kimchi. That was seven years ago. I’ve been implementing kimchi into my patients’ lives. And I started seeing the results that truly backs up the science that I wrote in the kimchi book here, The Kimchi Diet. All the science and majority of the science is in here. And I wanted to share that with everyone, including what it does to immunity.

Dr. Weitz:                           Yeah. I thought it was amazing that in the intro of that book, which was written, what? A year ago?

Dr. Bennett:                       That’s right. Last year.

Dr. Weitz:                           Okay. Last year that you start off by talking about how they had the SARS epidemic in Asia, which was another coronavirus. And this was in 2003. And how the South Koreans did so well, and one of the reasons why was because of the benefits of kimchi for the immune system and even having antiviral properties. So it was just so timely that your whole intro was about the SARS epidemic.  And here we are in another coronavirus epidemic.

Dr. Bennett:                       That’s right. And that’s what was … what I started digging up was that, boy, if we can definitely use kimchi as a way to build our immunity. And what the scientists found was that it actually, kimchi, produces immunoglobulins, immunoglobulin IgA, in the gut, which turns into IgG and which really helps with viral infections. And what they’ve also found was that it pretty much the SARS kind of bypassed Korea. If you looked at a map of the SARS, and I’m talking about the original SARS, the SARS 1, it bypassed Korea because a lot of the doctors really believed, number one, yes, they really cracked down. The Koreans’ ability to crack down and really move fast is incredible.  I mean, when we think about the SARS 2 that’s happening right now, what I understand is they were testing … like they had drive through testing sites.  We have nothing here.  It’s really ridiculous when you compare the level.  And I really hope that Koreans will come out here and start teaching us what to do because that’s what we need state to state because it’s not being done here..

Dr. Weitz:                           But you know what? If I can’t see anything, I don’t think you can teach me. I don’t think it’s a problem here.

Dr. Bennett:                       There you go.

Dr. Weitz:                           It’s going to be gone by next week.

Dr. Bennett:                       Honestly, I think there’s a lot of denial here. People really, they don’t know enough about it. They just don’t know enough of what it is. I’ve already started supporting my two patients who’ve got Corona now, the SARS, Coronavirus two. And one is a 10-year-old child, another one’s in their ’60s. But in California, we’ve got a complete lockdown, as you said earlier, and it’s going to make the biggest difference. But at the same time, I really think we’ve got to use other, food is our medicine and kimchi can do it. Evidence is the loudest voice and the evidence shows that kimchi can definitely help.  I want to ask you something, if I can play something, a little video, if you don’t mind. It’s only a minute and 30 seconds video, but it’s about kimchi. And I found this video … I subscribe to Arirang. It’s a Korean news, Arirang News. And this is a video that I just got yesterday morning…timely. And this was made when the MERS was out. Remember the Middle Eastern Respiratory … that one.

Dr. Weitz:                           Syndrome.

Dr. Bennett:                       Exactly. And this is specifically about how Kimchi with a scientist found out at that time. So it was published in 2015, but it’s specifically about the Coronavirus. So I’m going to show it to everyone here so that you can see … you can get this online. If you go to Arirang, and is A-R-A-I-A-N-G, Arirang News. I think that’s how it is. But you know what? If you can put it in your notes that would be great. So people can watch it directly. But I’m going to go ahead and tell me-

Dr. Weitz:                            [crosstalk 00:15:18] this way, yeah. It’s too bad because through Zoom you can actually share-

Dr. Bennett:                       Oh, you can?

Dr. Weitz:                           Yeah.

Dr. Bennett:                       Shocks. I don’t know if you can see. But let’s see-

Dr. Weitz:                           Well, it looks kind of dark, but let’s see.

Dr. Bennett:                       It does? Maybe you can hear.

 


Kimchi Combats MERS video from Arirang News

Speaker 3:                           The MERS outbreak appears to be winding down here in Korea as we just mentioned. But research is always a mode of health for new ways to treat viruses like MERS and based on results gleaned from animal testing, a team of researchers here in Korea has found that lactic acid bacteria in kimchi is effective rather in preventing and treating similar viruses. Park Se-young has this report.

Speaker 4:                           Lactic acid bacteria found in kimchi are known to have numerous health benefits. In the past year, Korean scientists discovered its effectiveness in preventing and treating viral diseases like Middle East Respiratory Syndrome. All 2000 pigs infected with Coronaviruses recovered completely a week after they were injected with the healthy bacteria.

Speaker 5:                           Lactic acid bacteria from kimchi protects us from viruses by increasing immune globulin A in the intestine. The body then produces more immune globulin G or interferon gamma to prevent viral infection.

Speaker 4:                           The study conducted by university professors from Korea and Malaysia found that using probiotics as an alternative to antibiotics also produce healthier chickens. The researchers also believe kimchi probiotics can prevent influenza and immune system disorders in humans. At a hospital in Gyeonggi province some patients with respiratory problems are already being administered the healthy bacteria. Once proven effective, the researchers plan to initiate full-scale clinical trials. Park Se-young, Arirang News.


 

Dr. Weitz:                           By the way, for those of us who are not aware, lactic acid bacteria essentially is referring to lactobacillus acidophilus and similar probiotics that you often see in probiotic supplements.

Dr. Bennett:                       Right. But just to let you know, probiotic supplements compared to fermented foods is like a drop in the ocean. We get probiotics six, maybe you get 12 strains of lactobacillus or in bifidus. But when it comes to kimchi and its number of lactic acid bacteria, you can have anywhere from 900 to over 2000 strains of lactic acid bacteria. There’s so many different kinds that are in kimchi and other forms of fermented foods. Now, there are a lot of different ferments out there. We know that there’s pickles and sauerkrauts, cavas, even chocolate is considered a fermented food. Many, many different countries have fermented food for the same reason that Korea developed and created it, and it was because of preservation of food for long periods of time during wintertime.

But the interesting thing about the kimchi is that there’s three main bacteria. One is Leuconostoc strain. There is another is Lactobacillus. And then the other one is Weissella. And what I found is that, doing the research, that these three main strains are the ones that are very, very powerful in mitigating health issues. I’d love to chat about each one in a … for instance, starting with cardiovascular, it really helps with reducing cholesterol. Amazing for metabolic syndrome, triglycerides, if you have high triglycerides, diabetes, insulin, and sensitivity. I can go on and on and maybe what we can do is just go through each one, so people could understand how important it is to have high levels of the lactic acid bacteria that you get daily, daily.  I get about 300 CFUs per day, 300 billion CFUs, whereas a supplement would be maybe, if you’re lucky, five, 25, and some are a hundred which are super expensive. You know which ones I’m talking about, right?

Dr. Weitz:                           Sure.

Dr. Bennett:                       Right Ben?

Dr. Weitz:                           Yeah.

Dr. Bennett:                       But if you just ate regularly two servings a day, that’s where you’re going to get a great deal of lactic acid bacteria.

Dr. Weitz:                           A serving is like a tablespoon or two tablespoons?

Dr. Bennett:                       I would start … because I put in the book on how important it is to start to seed you little by little because you will start to feel, how do I say, a little war going on in the gut. Because if you’re not used to eating fermented foods, especially Napa cabbage, then you’re going to have a lot of gas and sometimes it creates extra bowel movements. And for some cases who have … constipation’s a great thing. But remember that in my book I give you four phases because the phase is important to slowly inoculate.

Phase one, I tell people to make cucumber kimchi because cucumber kimchi is not a FODMAP food. And if you know what FODMAPs are, those are vegetables that have fermentable carbohydrates. And if you make kimchi with a FODMAP food such as cabbage and I’d say that you could even make it with Brussels sprouts. There’s many, many vegetables you can make kimchi with. But if you make it with those FODMAP veggies, then you’re going to have a lot more irritation. And I just say a window of a lot of gas and bloating. But if you start with a phase one, the cucumber kimchi, then you go to bok choi or mustard greens, then you go to the radish, and then you finally, after six weeks or so, you go into the Napa, you’re going to gently inoculate and then you’re going to start getting some major power in your gut to build your immune system.  And of course help you with all of the different, different conditions that it can with your skin, with your weight for obesity, like I said earlier, it really helps with obesity. It helps reduce cholesterol, LDL cholesterol. There’s a science, everything that I’m talking about, you can find if you go in and look up in the PubMed and look up kimchi and basically all the health benefits. And interestingly, majority of the studies are coming out of Korea because kimchi is Korean food. They also found that kimchi also produces what’s called short chain fatty acids, short chain fatty acid butyrate and propionic acid. Propionic acid is very highly studied in the kimchi and that has really helped as an anti-inflammatory, antioxidant, and a lipid lowering propionic acid. So these are amazing studies.  Now, some of them are animal studies as well, where streaks of cholesterol, and streaks and fatty streaks, I should say fatty streaks out of the Aorta has been literally reduced in animal studies. They found nitric oxide increases, amazing. People with hyperlipidemia, again it lowers that. And biocidin. Let’s go into the biocidin or the bacteriacidin and the viralcidin and effects as well. So if you were going to eat kimchi and use that, I would definitely start slowly, but ramp it up within the next week or so. So you started about two tablespoons, so one tablespoon for lunch and let’s say one tablespoon for dinner. And then you start to ramp it up and I would get to about a half of a cup if your body can handle it.

Right now I have about three different types of kimchis that are just made. I’ve got cucumber kimchi that I’m making and radish kimchi I’m making today because I want high levels. I just dropped some off in my mom’s a doorstep so that she can have it because it’s really difficult. My mom’s 88 year young and she’s doing great, but I want her to continue by improving.  And kimchi, everyone, you can make it at home.  I really highly recommend you making it at home because if you make it at home, then you know you can get organic ingredients and you don’t use any forms of chemicals, or MSG and there are a lot that’s out there that could be MSG added. And then you can make it all vegan if you don’t want. If you don’t want the fish sauce, if you don’t want the shrimp sauce, you make it all vegan by using Kombu, which is seaweed. And I teach you exactly every little detail on how to make it, all the details. There’s amazing pictures all here on what it is and what you look out for.

Dr. Weitz:                           Everybody has a lot of time now. You’re staying at home so you have no excuse why you can’t make your own kimchi.

Dr. Bennett:                       That’s exactly right. I have a kimchi … it’s called The Kimchi Diet Facebook Group and everyone comes on.  They show how to make … of course I teach about how to make it, but everyone makes it after reading my book and they show their photos.  And there are people that have farms and loads of vegetables.  Share your vegetables so that everyone has the ability to make it. I tell this to everyone, it’s in my book, if you can just have solar sea salt. Solar sea salt basically means salt that you have that’s been dried from the sunlight at sea, sea salt.

Dr. Weitz:                           Can you use any kind of salt?

Dr. Bennett:                       No. You cannot.

Dr. Weitz:                           Can you use Redmond sea salt? Can you use Himalayan pink salt?

Dr. Bennett:                       I would not use Himalayan pink salt. And I’ll tell you why. Himalayan is a beautiful color and it has a bit of iron in it, but also that’s the reason why there’s pink color in the mineral content.  But the reason why I don’t use that, it’s all sodium based.  95% of pink salt is sodium based.  If it’s solar sea salt, sea salt has the most benefit of all of the other minerals.  And what am I talking about?  The magnesium, the chloride, the potassium, calcium, those are in it. And the sodium content in sea salt is about 65 to 75%, and the rest are healthy minerals. So you want a balance, you want an optimal balance. And if you don’t get the Korean solar sea salt, then you can use Celtic sea salt or Celtic sea salt if you want to use that. You can also use kosher sea salt. So sea salt to me is the number one choice.

Dr. Weitz:                           Can we use the Redmond sea salt now?

Dr. Bennett:                       No. Redmond sea salt, is that the one from Utah? I’m asking you this because-

Dr. Weitz:                           It’s from an old, ancient seabed, supposedly.

Dr. Bennett:                       If this an ancient sea, but I would ask them to give you the actual analysis because most of them have it. If it is lower like 75%, I would use that for sure. I’m not familiar with Redmond. I know about it. I’ve read about it in some book. But anyway, I don’t know because I don’t know the details of it. I’ve only done the details on the sea salts I’m talking about.

Dr. Weitz:                           Okay. Okay, sounds good.

Dr. Bennett:                       But anyway what the whole idea of kimchi is, well, if you’ve got salt, and garlic, and ginger, and then basically have a vegetable, you can do this anywhere in the world without any forms of gas, any forms of lighting, nothing. You can do this outdoors. I can teach you how to do it in the deserts of the Serengeti and in the jungles of the Amazon. It doesn’t matter where you’re at, you don’t have to have anything but that. And of course a jar to ferment it. And the salt is the most important. The brining process, I talk about it in detail. The brining is most important because Ben, if you don’t brine to kill off the bad bacterias and bugs that naturally grow on every vegetable, so there’s Staph and Shigella, Klebsiella, all the bad ones, and E. Coli, then you’re not going to have optimal kimchi.

Dr. Weitz:                           In a sense foods like kimchi is a way to get back to our roots before refrigeration and modern methods of storing food.  We used to use things like salt, brining, and fermentation, and that was the only way to preserve our food.  And there were lots of benefits to these, but we’ve gotten to these modern refrigeration and easy methods of storage, so we’re losing out on a lot of that.  So this is a way to get back to our roots.

Dr. Bennett:                       That’s absolutely true. I mean, our ancestors have been doing this in thousands of years and it works. And now because of modern medicine understands why it’s so good for you because they have the ability to analyze all the bacterias and what the capabilities are, that’s the reason why we want to go back and do it. And like I said, regarding the salt and the brining, if we can get rid of the bad ones, and the salt is a medium that lactic acid bacteria loves lactis acid bacteria or LABs love salt. And that’s the reason why it increases as the time goes on. The sweet spot for me where you have the highest level of bacterias and it really starts at about 21 days, 14 days I start to really … the one thing about kimchi is you can make it and in two days start eating it. You can make it, in two days start eating it, whereas saurkraut, it takes three to four weeks minimum, pickles as well.  So remember kimchi, you can start eating it and get the benefits right away and it keeps on growing.  And those three bacterias I talked about keeps on growing. It kind of changes it’s levels one by one, but it keeps on growing. 14 to 21 days is the way I like the taste because there’s a tang to it, there’s a salt to it, there’s a sweetness to it-

Dr. Weitz:                          If you ferment it too long it gets more sour, right?

Dr. Bennett:                       Sure it does. The pH drops very considerably. The pH can go down to five, six, and even down to three, four the higher you let it go, but that’s okay, Ben, because you can leave it in the refrigerator for six months. I have right now old kimchi and I don’t like the taste of it as much, but I use it for cooking like kimchi … it’s called kimchi stew, kimchi jjigae. When you do cook it, all the benefits are gone. So just know that.

Dr. Weitz:                          I want to make two anecdotal comments. I don’t want to throw you off track, but they’re just things that came to mind. One is the acid thing, is among the nutrition world we’re kind of overboard on alkalinizing, alkalinizing as the answer for everything. And I just want to point out that a lot of the bacteria in our gut need a slightly acidic environment. And so let’s not think that acid is always bad. That’s first comment. Second comment is, we talked about cucumbers and there’s some nutritionists out there saying, “Don’t eat cucumbers because they have lectins.” But it turns out that there is actually some reports showing that lectins actually help to kill viruses. They actually have some antimicrobial activity. So just to throw that in there.

Dr. Bennett:                       Hey, that’s great. Absolutely. These are things that we realize and we want to work around. The reason why I like cucumbers so much is because of the taste. Keeping kimchi is by far what everyone … the Western people love the taste of cucumber kimchi. My recipes are all handed down from generations through my mother’s lineage, my grandmother’s, my great grandma, all of them use these recipes. So these are not my recipes per se. I’ve only changed it so that I don’t use a lot of sugar. I don’t use sugar in fact at all. I use the fruit, apples or pears, so that you have natural sugars. I do want to comment something on why kimchi is also important. The thing about what we have in the Western culture, in America, and pretty much everywhere else who do not eat a lot of fermented foods, is that we’ve got a huge problem of diversity issues in our gut microbiome, very low diversity. We don’t have enough.  And not just that, we have very low Akkermansia muciniphila, which is the good bacteria that’s known to produce mucin, produce a mucus barrier. And without the mucus barrier, that’s where the toxins that we eat, the junk food, the GMO, the glyphosate, the pesticides, the alcohol, the sugars, the viruses, the bacterias, even parasites can all be penetrating through and creating leaky gut. All right? Leaky gut. And that is definitely one of the factors that we all … everyone’s talking about it now of course, that when there is permeability is when we start to have more chronic illnesses and diseases, inflammatory diseases, heart disease, brain issues because we get the lipid polysaccharides going in, the inflammation. And by the way, kimchi is known to reduce the LPS penetration and reduces inflammatory reactions in the brain. That is a study done with people that are suffering from brain issues and Alzheimer’s.

Dr. Weitz:                           You just touched your face now. You have to go wash your hand. It’s one of the hardest things not to touch your face. Right?

Dr. Bennett:                       Honestly, it’s ridiculous. I mean, this is … I’ve had for a long time. This mask, I use it for other forms of toxicity like formaldehyde and stuff.

Dr. Weitz:                           Do you want to play ant woman in a new science fiction film?

Dr. Bennett:                       For the life of me, I can’t find anymore masks.

Dr. Weitz:                           No, you can’t get them right now.

Dr. Bennett:                       There’s nothing, there’s absolutely nothing.

Dr. Weitz:                           They’re telling healthcare workers to put a scarf around their face.

Dr. Bennett:                       Oh God, this is awful.

Dr. Weitz:                           That’s America in 2020.

Dr. Bennett:                       Right now I’ve contacted already Korea to see if we can get some. I’m serious. I’m literally serious because one of my best friends called me and asked me for a mask and I don’t have them.

Dr. Weitz:                           You know what’s happening right now in LA?  The TV hospital shows like ER are actually taking the masks that they have on the set and bringing them to the hospitals because the hospitals are in such short supply.

Dr. Bennett:                       This is terrible.

Dr. Weitz:                           That is what a bad state we are in right now in America.

Dr. Bennett:                       That’s terrible. I’m just hoping that-

Dr. Weitz:                           Totally unprepared.

Dr. Bennett:                       Exactly. If you look at pictures and videos of Korea, everyone wears a mask. Everyone. It’s just the nature of … they understand it. Nobody. I went out and I went out with a white mask and I had these goggles on. These are my fashion, Beverly Hills goggles. And I had gloves on at the Farmer’s Market on Wednesday this week. And I’m going to tell you, I think myself and one of the person out of the people at the Farmer’s Market had the mask. Nobody has it. And it’s a serious thing because 50% of us can actually be carriers. And the reason why I’m wearing it, because last week I saw patients. This week I closed it up and I’m not seeing anyone, but who knows? It could have been two weeks ago that I might’ve been exposed and I’m someone that doesn’t get sick in the 30 years I’ve been in practice. I don’t know about you, Ben, but I haven’t at all missed a day of work in the 30 years plus I’ve been in practice and maybe it’s because I’ve been eating kimchi. Right?

Dr. Weitz:                            Absolutely.

Dr. Bennett:                       That’s it. There’s so many benefits. I mean, I will tell you what? There’s a bacteria because it enters through the nose. Lactobacillus Sakei, it’s called. It’s one of the bacteria that are very high in kimchi. And there are studies where they show where you can actually … I tell my patients to do this. If you make white kimchi, I teach you how to do that in the book. White kimchi, which means no red pepper, no red pepper. Let me tell you something, you know Ari Whitten, right? I love that man.

Dr. Weitz:                           Yeah.

Dr. Bennett:                       I did an interview for his podcast last year.

Dr. Weitz:                           The Energy Blueprint, yeah.

Dr. Bennett:                       Exactly. And Ari I am talking to because I recommend you to put basically the juice of the non spicy kimchi. You don’t have to put red pepper in it, non spicy. You can do all non spicy.

Dr. Weitz:                           So he used the spicy one.

Dr. Bennett:                       Yes. Oh, he said that it hurt like a mother, you know what, hen. But can I tell you it totally got rid of his sinusitis. That and he did get off a dairy. And I’m going to tell you why it’s so important not to eat dairy. Dairy has bacterias that causes acne and phlegm. There is a bacteria that’s in dairy. It can be a natural ferment, like let’s say cheese, right? Cheese. I’m talking more about cheese. Cheese’s a natural ferment of milk, cow’s milk and sheep’s milk, et cetera. But there’s a bacteria called Propionibacterium acnes bacteria. Are you familiar with that bacteria?

Dr. Weitz:                           I’m not.

Dr. Bennett:                       Yup. That bacteria is very high in cheese, dairy products. I treat a lot of skin disorders including acne, eczema, psoriasis, neurodermatitis.  I treat a lot of that because my son used to have it when he was young, and so I became pretty much an expert on skin diseases.  But anyway, and there’s the bacteria Propionibacterium acnes and that’s super, super … The bacteria that also is on the skin and that causes acne. So if you cut the cheese out, all dairy out, the acne will go down at least 50% of the time. This includes foods that have dairy in it, and I’m talking about sour cream-

Dr. Weitz:                           That’s a great clinical pearl.

Dr. Bennett:                       Oh, it’s amazing the difference, how your skin will heal. Sugar too.

Dr. Weitz:                           Now what about yogurt? Does that have that same bacteria?

Dr. Bennett:                       Yogurt is different. No. yogurt is more lactobacillus because of the way they use a starter. There’s a difference between yogurt as well as kimchi. Kimchi is a wild ferment. And what I mean by wild ferment, there is nothing you need to put in to start the process. Every vegetable you have in kimchi to make kimchi has its own microbiome. Did you know that ginger has its own microbiome and its own quality of bacterias compared to garlic, compared to the cucumber? On the outside it has its own microbiome. And that’s the beauty of kimchi and all natural wild ferments. Yogurts, the reason why it only has a certain number of bacteria and it’s because of the starter it uses. The starter develops the different kinds of lactobacillus, right? So lactobacillus and streptococcal  thermophilus, lactobacillus acidophilus, bifidus. So that’s the reason why you want to have wild ferments, not just yogurt.  Yogurt to me, again, is a minimal amount and the amount you get is nothing. Nothing like kimchi, sauerkraut, fermented pickles, the cultured pickles. And to me, vegetable ones are better because you’ve got a whole variety and you’ve got the antioxidant properties. Kimchi is known to be an anticarcinogenic. It has properties like mannitol. Mannitol is anti-carcinogenic. If I remember correctly, they found that kimchi helps with pancreatic cell lines and it reduces that more so than liver apparently between the two. There’s many different studies out there. So many, I must have, I don’t know, went over 200, 300 studies for my book. There’s also very, very good high, high levels of GABA. So if you have anyone who has anxiety, sleeping issues, I tell my patients who have that, you take kimchi or kimchi juice and I teach people how to make kimchi juice.

I have a detox program. It’s called Kimchi Detox program and you can be a student of mine and learn how to make kimchi juice. And is basically I use radish and then a big jar of liquid and it creates just juice and you just drink that every day. If you don’t want to eat the veggies, then drink the juice. If you’ve got FODMAP problems, just drink the juice. It’s like the kimchi cure. I’m telling you, it’s the best gut sealant around. And I was talking about GABA. High levels of GABA. It has a lactobacillus [inaudible 00:42:00], I believe it’s called. So if you take it at nighttime or when you’re under a lot of stress, which is right now everyone’s stressed out, you take a little bit of that and drink it or eat it and that will help with GABA levels. GABA is high in kimchi.

Dr. Weitz:                           GABA is a calming neurotransmitter for those of us who are not aware.

Dr. Bennett:                       Yes, thank you. GABA, gamma-Aminobutyric acid. Now you can buy GABA online and also use it. But they say that the GABA doesn’t cross the blood brain barrier. But I’ll tell you why it works for anxiety is because it calms your gut down, and the connection of the gut brain, and then of course the psychobiotics, which is the good bacterias that make GABA. It’s just promoting that and the connection of the vagal nerve to the brain, parasympathetic nervous system and the gut, that’s where you’re going to have it work. And it works. I’m telling you GABA works. And if you combine it with L-theanine, you even have a much better reduction of anxiety. I also, for anxiety, use other nutrients like low levels of lithium, micro dosing lithium as well as some zinc and B6. And that combination is just powerful in addressing anxiety. So I can go on and on about the health benefits.

Dr. Weitz:                           So let’s see. I think we’ve got about 10 more minutes left. I know you wanted to maybe talk about some nutritional recommendations to strengthen our immune system since we’re in this Coronavirus pandemic.

Dr. Bennett:                       Oh, absolutely. I’m a big believer in supplements and the reason is because our food that we have and most of us eat out, we bring food in, take out. We don’t have the opportunity because people to work. We all work across America and everywhere around the world, our mother and father.

Dr. Weitz:                            [crosstalk 00:44:03] that is, we did before yesterday.

Dr. Bennett:                       This is going to pass. This is going to pass.

Dr. Weitz:                           I know. I know.

Dr. Bennett:                       I know there’s a lot of hysteria about millions of people, but if everyone, everyone globally, everyone in America will stay home for the next two to four weeks, then we’re going to contain this virus. There’s no other way and we’re going to contain it for sure. We really need to buckle down and don’t go out. I’m telling all my patients to only go shopping once a week and having everyone wear their garb. There is what’s a seriousness about fomites. Do you know what fomites are.

Dr. Weitz:                           It is part of how the virus spreads, right?

Dr. Bennett:                       Well, you’re absolutely right. It does spread that way. But fomites are anything inanimate, inanimate objects, not a human person, but objects that can actually keep the virus alive or any infectious agent. It can help spread it, a purse, a phone, your sunglasses, clothes, things like that. Those are called fomites and fomites, depending on what it is, it can keep the virus alive a specific amount of time. And like cardboard is a certain amount of hours, stainless steel clothes. So I recommend person who goes out once a week for the food, you get your mask as much as you can or whatever to … you can use a Gator. Let’s say a Gator is like when you go skiing, you put it on your face. Get goggles because you don’t want any type of virus going in. Remember, in your eyes there’s a tube that that goes in the tunnel that goes in from your eye, the duct that goes into your nose. So it’s all connected, all connected.

So goggles, mouth, and wear your gloves, and clothes. And I would say that I would layer it and I’m going to tell you why. Because when you walk back in, before you do that, you take off all your top layer, take it all off. All right? Because those are fomites. Fomites again, carry the infectious agent, anything that’s inanimate. So it’s important that you do that. And if you do that, then the likelihood of you contaminating indoors will be much, much less. So social distancing is important and the recommendation that I make for all my patients to what kind of supplements to take to keep their immunity strong so that they start to create T-cells and immunoglobulins to be able to fight off this virus. And of course, this is a new virus and a lot of people have not been exposed yet, but some of them actually have and they don’t even know it.

Some of them have been exposed and, like I said, 50%. We just don’t even know it. And if you take the following supplements, it’ll make a huge difference. For instance, vitamin D. We don’t get enough vitamin D and I like high levels. Right now you can do about 10,000 IUs a day. That you could take daily so that you can build your immune system. A vitamin A, I love vitamin A. And vitamin A, you could go up to 5,000, even 10,000 per day. Not longterm, because it can be toxic. Both vitamin D and A can be toxic, but at 5,000, 10,000, that’s not going to happen. And then I love zinc. I like zinc lozenges. Vitamin C, of course. Vitamin C IV drips are great, but you can use vitamin C liposomal which delivers much easier.

But I love Ultra Potent-C from Metagenics. That’s my number one go-to because it’s been tested by Dr. Vojdani many, many years ago. This must have been 20 years, 25 years ago, Vojdani did with Immunosciences a test on the natural killer cells, increasing natural killer cells, increasing by taking Ultra Potent-C. Yeah, he and I talked about this I don’t know, three, four years ago we were chatting about it, how long I’ve been taking it. And I knew about it because I read a very old study that he did. Anyway, let’s go into selenium. Many years ago I’ve been using selenium because it works like a … how do I say? It’s like a viral control, birth control for viruses. Yeah, that’s what I called it for a long time, birth control for viruses. But apparently it also reduces the spread of the virus, mitigates the spread.

So anyway, I think selenium is a really great product, maybe a hundred micrograms twice a day, which is what I tell my patients. And then I’m a big believer in immuno acid therapy, mine is called Super 8 Aminos. And amino acids, why is it important? Because all of your immune factors are built through protein synthesis, every one of them. And if you don’t have amino acids, then your ability to build your immunity is altered. So I highly recommend that. I love Isotonic by Kington and that really helps with your gut, microbiome, and the flora, the terrain, and support of micro nutrients, minerals. I’m also a big fan of the ion, which the old name is RESTORE liquid. This is Zach Bush’s work. And I love that because it does help again with the leaky gut and the tight junctions as kimchi does as well.

Kimchi’s known to tighten up those junctions. So use that because remember the mucosal, the gut, you can eat it and it can still get into your body. All right? Because the ACE receptors are also in the gut. It’s in our respiratory mainly. It’s also even in the kidneys, small intestine in our gut. So it’s important that you’ve got to protect your gut. And then let’s dig into … I like herbal remedies for boosting your immunity. Of course, Elderberry, Echinacea, things like that. But antivirals, I love olive leaf. If you don’t have the virus, if you don’t think you have it, and you don’t have any symptoms, you can do a very mild maintenance dose of olive leaf and Andrographis. Andrographis is also really good for viral infections. I love Viragraphis by Xymogen, but I’m all out. I’m getting some more, which is great.

But what’s great about of Viragraphis is it has licorice root in it. And I’m going to tell you why licorice root is so important. One of the problems about this SARS-CoV-2 is that it accelerates very quickly in an autoimmune type of condition where your own immunity fights for the virus and it tags it, but it also attacks your own tissues. And that’s the reason why all the lungs end up being loaded with your own dead tissue. And that’s how white people need to be on ventilators and possibly die. You literally die in your own juices. So the thing that mitigates that is anti-inflammatory agents, but not NSAIDs. And Ben, you know this too, you told me a part of this as well, not NSAIDs. NSAIDs are ibuprofen, Motrin, Aleve, things like that, that reduce inflammation because apparently that actually effects and could spread the virus more.

But I’m talking more about corticosteroids. Natural cortisone is what you need and we all have it, and it’s called cortisol in our own body. And what licorice root does is that it stops the breakdown of cortisol and it keeps the cortisol around longer. And Viragraphis has both the Andrographis and the licorice root. Now, I never give this to anyone who’s got high blood pressure. If you have high blood pressure, licorice root is contra-indicated. So please do not take it if you’ve got high blood pressure. But you can get Andrographis.  It’s a natural herbal formula. You can get Andrographis.

And before I finish, black currant, black currant seed oil and black currant seed extract. I use GMO base stem cells. I like plants’ stem cells because it’s super powerful. You got the stem cells of the bud of the plant and that’s like major power. We all know what now stem cells are. And so I use plant stems a lot. And black currant will do the exact same thing similarly to the licorice root. But before I’m done, we have got to talk about antioxidants such as glutathione and a precursor NAC. I highly, highly recommend glutathione. I like the watermelon flavor because it tastes the best. And that’s by Research nutritionals. It comes in a yellow tube and I use a teaspoon twice a day right now. That’s the dose I use and that’s about 450 milligrams twice a day. And so it’s a high dose. But if you’ve got genetic issues where you can’t make glutathione, for instance, as of myself, then you are going to have more viral infections, so I use that powerfully.

Dr. Weitz:                            And by the way if you’re taking Tylenol because you have a fever or you’re using it for pain because maybe you’re avoiding your ibuprofen because ibuprofen makes it easier for the Coronavirus to attach and you may get a worse response. So you avoid your ibuprofen, you take your Tylenol, Tylenol actually lowers your body’s production of glutathione. So beefing up your glutathione production through glycosomal glutathione or you’re just about to talk about NAC is even more important for that reason.

Dr. Bennett:                       Oh, absolutely, because NAC is the precursor, right? It makes glutathione, so you want optimal levels of N-Acetyl Cysteine. There’s so much more I can go over, but these are the basics that I tell people to get. And then you just got to avoid it, and wear your protection, and eat real food. Make your own kimchi. Kimchi makes glutathione. The studies show that the glutathione levels just spike up when you eat kimchi and they’re finding that in Korea. They’re using it for Alzheimer’s cases because glutathione levels are super low in people who’ve got dementia and Alzheimer’s. But you know what? We need glutathione altogether all around, all around.

Dr. Weitz:                           Absolutely. One more hand for everybody out there. As much as we need to be informed, don’t watch the news all day and especially don’t watch it at night because you’re going to have trouble sleeping.

Dr. Bennett:                       That’s correct. There’s one other thing that I don’t like using hand sanitizers, Ben, because of the chemicals and toxicity in the hand sanitizers, Triclosan is one of them. But anyway, what I use is I use a gel. I like the Silver Silent Gel or Silver Sol Gel. It’s called Silver Sol Technology. There’s a lot of different types of labels that use this. The gel works just as good. It’s more of an expensive product than regular hand sanitizers. But Silver Sol Technology, it kills off all the bad bugs, including viruses within 60 seconds, but it doesn’t get rid of the lactobacillus bacteria. And Dr. [Pedersen 00:55:50] mentioned that in one of his old videos and that was brilliant because we all have lactobacillus bacterias and good probiotic lactic acid bacterias on our skin. So we want to protect that. And Silver Sol Technology products will prevent that from … you won’t kill it as the hand sanitizers do.

Dr. Weitz:                           Awesome. Awesome. Great information. Rapid Fire, great clinical pearls. Thank you so much Dr. Bennett.

Dr. Bennett:                       You bet. You bet Dr. Weitz. I love you guys. i love everyone. You take care.

Dr. Weitz:                           Tell us about your contacts real quick.

Dr. Bennett:                       Everyone can go on my website, drsusanne.com, is at D-R-S-U S-A-N-N-E.com. And I think right now you can get information about the kimchi.  There’s a pop up.  Please sign up because I’ll send you more information about what to do and how you can get into The Kimchi Diet Program, et cetera. But also my recommendation is get the book, everyone make your own kimchi. You will be able to find my email and my phone number to the office. I take care of people. I take care of people. I have consultation all around the world. I’ve been doing that for the last two years, three years now. So most of my patients, in fact, I don’t go to the office much, majority of the time it’s on the phone. So I consult with everything on the phone and I’ll be able to help you boost your immunity, get your energy back, get rid of all of your problems that we’re all suffering from throughout the world. But most importantly right now, let’s get you and your family safe and healthy. Okay?

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

Dr. Bennett:                       Thank you, Ben.

Dr. Weitz:                           Be safe. Talk to you soon.

 

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
COVID-19 with Dr. James Lyons-Weiler: Rational Wellness Podcast 148
Loading
/

Dr. James Lyons-Weiler discusses the COVID-19 global pandemic and what to do about it with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]

 

Podcast Highlights

2:50  This new Coronavirus is different than other coronaviruses, such as the ones that previously caused the SARS (Severe acute respiratory syndrome) epidemic in 2003 and the MERS (Middle East Respiratory Syndrome) outbreak that started in 2012, in various ways, including the distinct spike protein that the virus uses to enter its host cell. These spike proteins bind to the ACE 2 receptors on the cell membrane and this allows the envelope to open and allow the virus to enter the cell and then make more viruses that spread from cell to cell.  This virus has a 4-5 day incubation asymptomatic period and about 80% of people have mild symptoms. But about 14% require hospitalization and a lot of these need intensive care and help with breathing, including a ventilator.  We have instituted social distancing, but we are at least 3 weeks behind the curve due to the fact that the number of positive cases are increasing dramatically, exponentially.

8:00  During the incubation period, you have the virus in your system and if tested, you should test positive. However, the test that the CDC came out with is only about 60% sensitive, which means that a lot of people are getting false negatives.  The US appears to have made a mistake by not using the German test that the WHO offered the CDC and instead the CDC developed their own test that took several weeks of lost time and this may be because the CDC is more like a business corporation than a regulatory regulation.

9:39  The value of coronavirus testing at this point is not to shut the virus down.  We have made our testing available too late to utilize the South Korean model where they were able to identify and isolate each case and all their contacts. But in the US at this point, it has spread too far to really contain it. Testing can help us to allocate resources and to let us know how much time we have to be able to get the supplies and resources that hospitals will need, like intensive care beds, protective equipment like masks, and ventilators. The point of social isolation like we are doing is to slow it down till we can increase our hospital capacity.

14:00  Even if we are asked to quarantine, like California’s Stay At Home rule, you can still go to the grocery store and the pharmacy and there is no reason why you need to horde 3 months of food. And the roof of your house is not going to blow off and the water supply will still work, so there is no need to stock up on water bottles.  On the other hand, stocking up on food does drive the economy a bit.

14:55  In China they were able to flatten the curve through a combination of social distancing and therapeutics. And there is no vaccine in China and they have essentially stopped the spread of this virus.  Forget about waiting for a vaccine and the first trial for a vaccine that is being tested in Seattle is using the spike protein, which is why it may have a high mortality rate, since some of the proteins are very similar to immune system proteins, so it might trigger autoimmune conditions.  When this type of vaccine for SARS was tested on animals, there was a much higher mortality rate due to the autoimmune reaction.

19:40  In Italy we are seeing very high morbidity and mortality right now.  One reason is that Italy has an older population and a lot of people smoke there. If you have a cardiovascular issue, which is more common in older folks, you have a 10% chance of mortality. If you have diabetes, also more common in older folks, you have 6% mortality rate.

22:30  Dr. Lyons-Weiler emphasized that we should contact our US Senators and Congresspeople to push for using convalescent plasma therapy as one of the strategies to help us get out of this COVID-19 crisis. You take blood out of a patient who has been sick and recovered and isolate the antibodies he has built up and these antibodies become a biological product and they can be given to front liners, the military, and the medical staff and they are given a dose of these antibodies, which gives passive immunity. Johns Hopkins University is currently conducting a clinical trial on this therapy with coronovirus patients. If all we do is social distancing for too long, it will completely destroy our US economy. And waiting for a vaccine will take too long, even if it works.  We need to look at other therapeutics, like remdesivir, made by Gilead, which has some value against Ebola, chloroquine phosphate, and other antivirals.  Also, the Chinese have been using high dose IV vitamin C, which appears to have a protective effect by reducing viremia, the number of viruses in your body, so you can’t transmit it.

26:30  There is a huge variance in mortality rates from one country to another. In Italy the mortality rate is 7.7%, whereas the fatality rate in Germany is 0.23%.  Italians tend to be older and smoke more.  Also the soil in Italy has less selenium since Germany was glaciated and deglaciated 16 to 18 times during the Pleistocene period, whereas Italy was not.  Selenium supplementation might really benefit the Italians.  Also, there are a slow and a fast version of the coronavirus with the fast version coming out of Hubei province in China, which is what might have ended up in Italy, and a slower version that resulted from mutations that came from the rest of China.  There are also genetic factors.  Smoking definitely increases your susceptibility by increasing the production of ACE 2 proteins.  Also, if you are on ACE 2 inhibitors or ARBs for blood pressure (like Losartan, eprosartan, and irbesartan), these also make it easier for the coronavirus to enter your cells and increase your risk of a more severe response.  Also, taking non-steroidal anti-inflammatories, like ibuprofen, also worsen your response.  On the other hand, taking corticosteroids actually seem to help, which indicates the significant autoimmune component. 

30:33  Unfortunately taking Tylenol (aceteminophen) might not be a good alternative to NSAIDs, as the health minister of France has recommended, since when you get an infection, your body produces cellular toxins and glutathione is crucial for your detoxification system to get rid of the toxins.  Aceteminophen suppresses the production of glutathione. This is a good reason for taking either supplements of liposomal glutathione or N-acetyl cysteine, which is a precursor for glutathione. It also might make sense to take selenium, zinc, and glycyrrhizin (from licorice extract).

 



Dr. James Lyons-Weiler is a PhD researcher and the founder and CEO of the Institute for Pure and Applied Knowledge, a not-for-profit research institute, also known as IPAK. He is the author of three books, one on Ebola, Cures vs. Profits, The Environmental and Genetic Causes of Autism, which was based on over 2,000 peer-reviewed studies on autism. His website is IPAKnowledge.org.

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.



 

Podcast Transcript

Dr. Weitz:                            Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting-edge health information. Subscribe to the Rational Wellness Podcast for weekly updates, and to learn more, check out my website, drweitz.com. Thanks for joining me and let’s jump into the podcast.  Hello, Rational Wellness Podcasters. Thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness Podcast, please go to Apple Podcasts and give us a ratings and review. If you’d like to see a video version of this podcast, please go to my YouTube page, weitzchiro, and if you go to my website, drweitz.com, you can find detailed show notes and a complete transcript.

Today, we will be discussing the coronavirus pandemic with Dr. James Lyons-Weiler. COVID-19 is the disease caused by the infection with the coronavirus that has made its way from a bat to humans in China and now has spread around the globe creating a global pandemic.  Dr. James Lyons, is it Weiler or Weiler?

Dr. Lyons-Weiler:           Weiler.

Dr. Weitz:                       Weiler, thank you. Sorry about that. Is the founding CEO of the Institute for Pure and Applied Knowledge, a not-for-profit research institute, also known as IPAK. He’s the author of three books, one on Ebola, another on Cures Vs. Profits, and a third on The Environmental and Genetic Causes of Autism which is based on over 2,000 peer-reviewed studies on autism.   Thank you, Dr. Lyons-Weiler, for joining us today.

Dr. Lyons-Weiler:           Thank you, Ben. It’s a pleasure to be part of your experience here on this planet.

Dr. Weitz:                       Thank you, and that’s definitely a good way to phrase it on a day like this when living in Los Angeles and trying to run a chiropractic practice, and people are afraid to come out of their house, and the level of fear, panic and anxiety seems to be rising by the minute. So, let…

Dr. Lyons-Weiler:           You mean, you guys haven’t figured out all you have to do is put a shower curtain between you and your patient and you’re fine like in the movies?

Dr. Weitz:                       So, I thought we’d start with the most important question and that is what part does drinking Corona beers play in this coronavirus pandemic?

Dr. Lyons-Weiler:           I think it’s an essential part. You get the most clear-headed, rational thoughts that come to you. It doesn’t necessarily have to be Corona either.

Dr. Weitz:                       Oh, okay. So, can you explain how this coronavirus… Because we’ve had other coronaviruses before. We had SARS and we had MERS. Can you explain how this coronavirus is different than the other coronaviruses?

Dr. Lyons-Weiler:           Absolutely. On that topic, I’ll be talking about published research and not yet published research. So, in a published research, we know that there are genomic differences that’s at the genome level. And in important parts of important proteins, there are large differences. The spike protein seems to be quite distinct. The spike protein on the coronavirus is the protein that sits on the surface of the virus that allows entry. The virus uses it to enter into the host cell and this partic-

Dr. Weitz:                       Is that when we see those diagrams and those things sticking up?

Dr. Lyons-Weiler:           Yup, exactly. Exactly, so those actually bind to a protein on the surface. It’s called an ACE2 molecule in this virus, and it then fuses to the cellular membrane, and then the envelope opens up and becomes part of the cellular membrane, and then the contents of the virus which is RNA is spilled into the cell. The RNA is seen by the cell as any other RNA and then it starts creating viral proteins. So, then you get a new virion or population of viruses in the cell, and then the cell bursts, and then the virus is spread from cell to cell.  This particular virus has a spike protein that has a number of unique characteristics. There’s a new nature study that I just finished looking over this morning that shows that the spike protein has distinct… Well, it’s citing some previous literature. It has a virion cleavage site which we’ve known about for about two, three weeks but it has a number of distinct elements including one that appears to potentially help the virus target immune cells.

My own research, and this is the unpublished part of it because it’s still under peer review, my own research shows that there is a protein motif signature that is characteristic of this particular spike protein. There are four elements that we’re paying attention to, and it seems to have… And I want scientists to understand this. It has a truncated N-terminal domain in the spike protein, in the first part of the protein that’s unusual compared to other SARS and other related betacoronaviruses. And then it’s missing two other domains that appear to be present in all other coronaviruses that are related to this. And then it appears to have a gp40-like domain. I will say gp40-like domain because it is not a gp40 domain.

So, there are very specific molecular differences in the spike protein. It’s going to have a different molecular function, therefore, because the sequence determines the structure, which determines the function. With that, clinically then, this is a different virus because this virus has a four to five-day asymptomatic period. So, you can get infected and then four or five days later before you have your first symptoms. About 80% of people could be expected to have mild symptoms, but the people that do have serious symptoms, 14% need hospitalization and 66% need an ICU.  So, we’re at the onset of the outbreak here. We are at least three weeks behind where we could have been with accurate testing, initially. We really, really missed the ball in accurate testing, but nevertheless, we’re in the exponential part of the curve. And during that exponential part of the curve, it’s a race between the ability to produce enough tests and the virus to spread. And so, now, we’ve enacted some pretty serious social distancing, if you’ve noticed. It’s impacting everyone’s lives now.

Dr. Weitz:                       Yes.

Dr. Lyons-Weiler:           And two months ago, I was saying that we should stop shaking hands. We should start using the Ebola fist bump and so on. We need to sanitize public places. We need to tell people that are not essential to work from home if they can. And had those policies been implemented then in a gentle way, we would have bought more time.  But now, we’ve already reached the exponential curve. And in the exponential curve then, even 60% on complete quarantine with this virus will not lead to a shutdown. You can force quarantine 60% of the American population, it’ll spread.

Dr. Weitz:                       So, I’ve got a bunch of questions, but one question I wanted to ask to follow-up on the fact that you said there’s this incubation period. During that incubation period, if you get tested, would you potentially test positive or not until you become symptomatic?

Dr. Lyons-Weiler:           Those high levels of viruses in the presymptomatic period or the asymptomatic period, unfortunately, the test that the CDC put out is maybe 60% sensitive, which means that there’s a lot of people that are going to be getting false negatives.

Dr. Weitz:                       Wow.

Dr. Lyons-Weiler:           Yeah, a lot of people are going to be given false confidence that they don’t have the virus and that’s why we’re where we are. I analyzed the CDC’s primer/probe sets and I found that a quarter of them actually amplified human proteins or likely to amplify human proteins as well as a viral protein which could… Unfortunately, the way they set up the test, it was best three out of fours amplification reactions as a diagnostic. So, if a person didn’t have… They basically needed three out of three, because one the primer/probe sets, that reaction was probably not going to lead to a true positive effort. And so, they said that there’s some contamination or something like that, but I sent this information to CDC, and then I sent it to the FDA and they showed great interest. The FDA showed great interest in what potentially could be wrong with this kit.  Now, because we’re already in the exponential part of the curve, places like the University of Pittsburgh Medical Center have announced that they’re making their own test. People are not waiting. We cannot wait for the CDC to distribute accurate testing. That’s what people have decided. I think it’s a clinically ethical thing to do, to want to know…  The value of testing at this point is not to shut it down.  Make no uncertain terms… Don’t be confused by this.  If we have 100 or 200 cases or 1,000 cases, for every one case, there might be 80 to 100 more cases that are out there that we don’t know about.  And so, there’s no way that the medical community is going to find all those people at this point.  We’ve lost contact tracing. The asymptomatic period, contact tracing is not going to be useful.  The only utility of testing at this point forward that I see would be expeditious use of resources, like ICUs.  So, we need really accurate testing. We need ventilators. There are projections….

Dr. Weitz:                       How can we know where the curve is to decide upon strategies?  Like how long are we going to do social distancing and quarantining or whatever you want to call it unless we really know what the numbers are, and do we even know to what extent the numbers are going up?  Or just the fact that we’re testing all these people who maybe were already positive and …

Dr. Lyons-Weiler:           I’ll take that question as a serious one. There are two countries that we could have followed the model of. One is South Korea. We cannot follow the South Korea model. It’s too late. We already reached the exponential point. They did expert contact tracing with online information systems that were really exquisite. They did testing, testing, testing. They had it in place in time.  It’s too late for us to have a serious impact in terms of slowing down the spread of this because we have… For every case that you see right now, that person was also… Four to five people five days ago were also infected along with that one person. So, we’re looking at, of the number of cases that we have, we maybe may know 20% of what we have.

Dr. Weitz:                       Wow.

Dr. Lyons-Weiler:           So, because we don’t have the contact tracing combined in parity with the clinical testing and the test that people are being shipped is not accurate, that is …

Dr. Weitz:                       How did that happen? Why is there such a massive screw-up on the testing? Why were we so late with the testing? Why didn’t we take the World Health Organization test, and what’s the screw-up at the CDC?

Dr. Lyons-Weiler:           Unfortunately, CDC is more like a business corporation than it is a regulatory agency. They have a not for profit that pharmaceutical companies donate over $27 million to every year in the name of doing good for humanity. However, the World Health Organization offered the CDC the German’s test, the test from Germany, and they declined and that cost us a valuable, incredibly valuable, two weeks. And I was hammering on, “No, we need to get the testing now. We need to get the testing now.”  The other country whose model that we… Where do we know where we are in the curve?  Well, we know we’re exponential. We know we’re only seeing maybe 20% of the cases that are actually residents in the country. We don’t know where they are. We don’t know who they are. They include medical staff right now. They include nurses. They include the doctors and so on. They include taxi cab drivers. They could be anyone.  And the point is, not to scare people, but China did not wait for a vaccine. China used social distancing. They put the people at home and if you broke quarantine, you were arrested. That’s why you saw people arrested. People say, “Oh, my God. That can’t ever happen here.” Believe me, every governor in every state will prosecute you if you’re under mandatory quarantine and you’re found to violate the quarantine. You will be arrested. You will be tried. You could be fined and put in prison, absolutely. Okay? So-

Dr. Weitz:                       But to this point, we’ve never had mandatory quarantine, right?

Dr. Lyons-Weiler:           I think San Francisco is now pretty close to that. Pretty close to where everybody is supposed to stay at home, right?

Dr. Weitz:                       Well, my son’s in San Francisco right now going to college. So, they’re basically told they’re supposed to stay at home except for important things like going to the grocery store.

Dr. Lyons-Weiler:           Okay, right. So, we’ll get to that. Right. So, a quarantine does mean that you have to have three months of food in your house, right?  It means it’s a good idea to have a week or two, but here’s the deal. China shut this down.

Dr. Weitz:                       And we’re not going to… The water supply is not going to be jeopardized.

Dr. Lyons-Weiler:           The roof of your house is not going to blow off. It’s not a hurricane. You’re going to have electricity.  Okay?  The wastewater treatments are still going to work. Okay? So, the utilities will all be there but in China, they shut this…

Dr. Weitz:                       So, stop stocking up on water bottles.

Dr. Lyons-Weiler:           If it makes you feel better, there’s that aspect of it. If you like to see 20 cans of sardines in your pantry, go for it if it makes you feel better. You’re not hurting anybody by doing that. So, you’re actually driving the economy a little bit. That’s an actually very serious point. There’s kind of a silver lining here.

Dr. Weitz:                       No, I know. The supermarkets are booming right now.

Dr. Lyons-Weiler:           So, in China, they shut this down through a combination of therapeutics and social distancing. They didn’t just use social distancing, and there’s no vaccine in China. They shut it down. And let me show you a curve. Okay?  China was doing this. And we’re now talking about extending the curve out, flattening the curve out so that the medical community has time to be able to prepare to handle it. China’s curve went just like this. They ended it.

Dr. Weitz:                       I know. I just looked at it on the map. Can we trust those statistics?

Dr. Lyons-Weiler:           Yes. Yes, we can. The doctors were taking their… Yes, we can. The doctors were taking, the nurses were taking their masks off. People are showing up in the streets. You’re going to see a video over the next few days or next week of Wuhan itself returning to normalcy. And that’s what we want because we cannot afford an extended social distancing. It will destroy our economy to maintain social distancing.  And there’s no promise that the vaccine that’s being tried right now in Seattle is going to show the safety profile that it needs to. I’m very, very skeptical that the animal studies… They skipped the animal studies and they went right to human trials.  The problem with that is that the animal studies in every other SARS-like, MERS-like vaccine that used the spike protein, the animals getting the vaccine when they were challenged with the virus after the vaccine had worst clinical outcomes, higher morbidity, higher mortality. They had immunopathology in their lungs. They had hepatitis. They had serious issues and I think it’s an autoimmune reaction, that you get sensitized to it by the vaccine, and then you get challenged by the virus.

So, I did a deep dive into the epitopes that are in the virus in SARS-COV2. And the deep dive that I did showed that out of the 37 proteins that I studied, all of them except for six had immunogenic peptides. So, there’s six of them that won’t be useful in a vaccine. Out of all of those that had immunogenic peptides, all of them except for one had a match to a human protein, and a third of those matches were two immune system proteins.  So, that’s probably why these animals had a worse outcome because their own immune system was being attacked by their own immune system after they were challenged by the second virus. It’s a two-hit hypothesis. People are calling it immune enhancement, which it’s a misnomer. It’s a gross misnomer. We’re changing the terminology to pathologic priming where the first exposure to the virus sets you up for worse outcomes whether it’s through clinical exposure. You get a double infection and you get the SARS virus this year. You get another SARS coronavirus next year, whatever the second exposure is.  And I think that probably explains why the mortality was so, so, so high initially in the Hubei Province and in Wuhan because the people there had been exposed to coronaviruses for years. And yet, the national vaccine program that was mandatory, a widespread vaccine program, only got started on December 1st.  So, you’ve got people that are exposed to this virus while their bodies still has adjuvants from the vaccines in them. In many cases, multiple adjuvants and so…

Dr. Weitz:                       Wait a minute. So, starting in December, they were vaccinated with which vaccine?

Dr. Lyons-Weiler:           They just started a national mandatory vaccine program. It was to do…

Dr. Weitz:                       For this novel coronavirus?

Dr. Lyons-Weiler:           No, no, no, no, no. No, just for vaccination programs for the pathogens.

Dr. Weitz:                       So, did they get immunized against SARS?

Dr. Lyons-Weiler:           No, they don’t have the SARS. Not to my knowledge. That was my initial concern. So China, a company called Sinovac, actually in the 2000s did a vaccine safety phase one trial on humans. They did a vaccine trial on humans. I think they had 45 participants. I’ve never seen a phase two or a phase three, but my initial suspicion, because the mortality was so high, I couldn’t believe that a super coronavirus could possibly lead to such high mortality and morbidity.  And people are saying we can’t trust from China what’s going on. No, it’s real and if it’s that high, what possibly could have caused it. And I suspect that perhaps the Chinese had on December 1st started a secret phase two or three clinical trial in Hubei Province with a SARS coronavirus, setting people up unbeknownst to them, for this pathogenic priming a.k.a. immune enhancement.

Dr. Weitz:                       Wow.

Dr. Lyons-Weiler:           I’m not sure if that’s real or not, but I know they didn’t do that in Italy. So, Italy has high morbidity. If you want to talk about the risk factors, about who’s most likely to get truly sick and die here, there’s a linear relationship between your age and your risk of serious illness, critical illness, and death. If you’re above the age…

Dr. Weitz:                       Is that mainly because older people a) are more likely to have cardiovascular or respiratory problems, and because they’re more likely to have immune issues?

Dr. Lyons-Weiler:           I think that’s probably a big part of it because if you have a cardiovascular issue, you have like a 10% chance of mortality.  If you have diabetes, you have a 6% chance of mortality. What are we doing here in the United States with such a high rate of what we call metabolic syndrome?  We’re sitting ducks for this virus.  So, we absolutely have to shut it down or we’re going to see mass mortality… Like 6% of people, people who even have…

Dr. Weitz:                       Well, if you don’t believe in exercise and you’re just going to sit around and eat Big Macs and tweet all day, then there you are.

Dr. Lyons-Weiler:           Absolutely. Think of all the people that you know with diabetes and imagine 6% of them getting this virus and dying. That’s a serious amount of morbidity and mortality. There are other underlying conditions. People that get the virus one time can get infected again, and it appears that they can suffer from myocarditis and die, some of them.  And we don’t know if that’s due to direct effect…

Dr. Weitz:                       So, you’re saying you can get it again the second time?

Dr. Lyons-Weiler:           Unfortunately, some people appear to. Yeah, there’s multiple reports from multiple countries….

Dr. Weitz:                       Because, theoretically, once you get a virus, then your body builds antibodies to it, right?

Dr. Lyons-Weiler:           Correct. And remember, I just talked about how there’s this pathogenic priming.

Dr. Weitz:                       Cross-reactivity to your own immune cells.

Dr. Lyons-Weiler:           Right, so the patients in the ward next to you actually… If you had checked me with the SARS-coronavirus-2 and then I’m sick for a live one, and then I’m sick for a week or so, and then you isolate the virus after I’ve been sick for a week or so, you’re going to see a different virus. There’s huge amount of selection to adapt to my immune system.  Plus, this corona virus is always recombined. If there’s more than two types of coronavirus in the same animal or the same body of a human, the very nature of their transcriptional process means if you had one cell infected with two types, they recombine. You get a new virus.  So, we don’t really know what’s going on, but we know that there’s probably a huge autoimmune component. So, if you have cellular myocarditis because you’ve got cellular infiltrates like eosinophils in other aspects of the immune system, you could end up with a very serious death rate of people who get a secondary infection.  And that’s why I am proposing very, very strongly, and we’re about to go huge with this, that everyone should contact their congressional representatives. I’m talking federal, not state, and everyone should contact their senators and say that we need the CDC, the NIH and the FDA to get behind convalescent plasma therapy now. There’s going to be so many people that survive from this. They’re walking around with antibodies …

Dr. Weitz:                       Okay. Can you explain what convalescent plasma therapy is?

Dr. Lyons-Weiler:           Absolutely. So, let’s say that I had the sickness and I get well again. I have the antibodies. So, I donate a liter of my blood and then you isolate the antibodies, and then those antibodies become a biological product. That biological product is screened for other viruses to make sure that I’m not carrying HIV or something.  And then if you’re a front liner, or if you’re in the military, or if you’re an EMT or a medical staff, you’re given a dose of those antibodies.  It gives you a form a passive resistance and it works.  There’s great… Ten out of 10 patients in a recent study on this came out great.  Ian Lipkin, who’s a world renowned virologist, has announced that John Hopkins University is entering into a clinical trial.  I think we need everybody to ask for 50 clinical trials now in all 50 states.  Most of the money that’s afforded to the CDC, the $8 billion is allegedly, I guess, going towards distribution of tests and vaccines.  And the problem is, if we wait for two months, people are losing their houses.  People are losing their jobs.  People… We’ve only been under partial… kind of like a hint of social distancing for two days and the world’s falling apart.  How are we supposed to do this for two months or let alone 18 months?  We cannot.  It will destroy our economy to wait for a vaccine. Absolutely.

Dr. Weitz:                       And by the way, I believe that that phase one trial that’s going on is going to continue for like a year or something, right?

Dr. Lyons-Weiler:           Yeah, it’s absolutely ludicrous and it’s unbelievable. I’m not going to be too critical, but it’s unbelievable that knowing the plasma convalescent therapy is an option, that the bulk of the money is going towards things like testing when we need to shut down…  Let me make the following prediction. The way that this epidemic, this outbreak in the United States, this pandemic will end, it will not involve a vaccine. It will end through a combination of social distancing and therapeutics. There are antivirals that pharma will be asked to start mass-producing, like remdesivir and chloroquine phosphate which is an anti-malaria drug, and others. There are supplements that are very important that people have, like selenium. If you’re selenium-deficient, the virus can enter your cells more easily.

High-dose vitamin C, the Chinese used that as well. They used vitamin C and it appears to have a protective effect by reducing viremia, the number of viruses in your body, so you can’t transmit it. It’s very, very important that we understand that this epidemic, this outbreak, will end through a combination of social distancing and therapeutics.  Social distancing alone will just destroy our economy, and we’re not going to let 20% of our elderly people die. We’re not going to let 6% to 45% of Americans with diabetes die. And we’re not going to let 10% of people on ACE2 inhibitors with cardiovascular disease die.  So, the way that this is going to end, I’m predicting right here and now, is that people are going to say, “No, I can’t do this anymore. I’m going to lose everything that I’ve built. I’m going to lose everything I’ve saved up 20 years of my effort for. Please give us therapeutics, and we don’t have time for a vaccine. We don’t have time to wait for it.”

Dr. Weitz:                       Right. It’s interesting the big variance in fatality rates. I looked at the Worldometer.info website and the fatality rate in Italy is 7.7%, whereas the fatality rate in Germany is 0.23%. That’s a freaking amazing contrast.

Dr. Lyons-Weiler:           It is. So, look at factors like smoking in Germany compared to smoking in Italy. Look at the age distributions. There’s a lot of older Italians because of their Mediterranean lifestyle, the diet. That mysterious thing that keeps Italians alive older, right? There’s these factors that play into it.

Also, look at the nutrients in the soil. So, how much selenium is in Italian soil and how much selenium is in the vegetables that they eat compared to that in Germany? I don’t know. I know Germany was glaciated and then deglaciated during the last… 16 or 18 times through the Pleistocene. I don’t think they made it past the Alps. I think Italy was always… What you have in Italy was there throughout. They’ve probably been flooded and reflooded. So, they might have a very different soil in Italy. They might benefit from selenium. There might be a genetic component too.

So, there’s a genetic component in the virus. We think that there’s two types of the virus. There’s the slow and the fast. There’s S and the L. The one that’s more deadly apparently is the one that was clustered in Hubei, the ones in Hubei Province in China. The story goes from the Chinese that once it got out into the rest of China, there was another virus that came about with a mutation and that it’s less lethal. That’s exactly what we expect to happen. Okay?  So, they should type the virus in Italy and see if it’s the more dangerous type. If that’s true, then we know, “Okay, we’re dealing with a more dangerous type.” So, you need to type the virus. And then there’s also genetics in people. So, the human genetics plays a role here too in terms of susceptibility to these factors.

Smoking, I mentioned smoking.  Right now, all Americans everywhere, quit smoking everything.  Don’t let your smoking habits or your pleasure that you get from smoking outweigh the fact that this virus is more likely to enter your cells if you smoke because smoking causes increased production of availability of ACE2.  If you’re on ACE2 inhibitors, ACE receptors I should say.  So, there’s receptors on the cell and if you’re on an ACE inhibitor for blood pressure, then you’re inhibiting the ACE2 molecules that usually go into the receptor and by doing that then, you’re freeing up all the receptors to be available for the virus to enter cells.  So, you’re going to get more rapid viral growth and more viremia, more…

Dr. Weitz:                       So, ACE inhibitors increase your risk. I also just read that one of the officials in France today came out and said that taking nonsteroidal anti-inflammatories also increases the ACE receptors.

Dr. Lyons-Weiler:           Right, and the fact that steroidal treatments seem to help really points to an autoimmune component to the base, the root cause, of this disease.  We see a cytokine storm.  That, to me, is an outcome of an autoimmune. It’s in a vicious cycle, cytokine storm.  But to me, if you start to see cytokines released, that’s a signal that you have an autoimmune attack going on for the most part.  Or a really extensive, rapid viral attack.  But the autoimmune component, because if you use steroids, that tends to actually modulate the immune system, so you might be seeing the fact that the steroidal anti-inflammatories were safer, but the other thing… Unfortunately, the French also recommended paracetamol. They recommended what we call “Tylenol.” And I think that’s a big problem, because you need your glutathione to be able to fight off infections, you need your glutathione to…  Because when you get an infection, your body starts producing cellular toxins. The cellular toxins are strange-formed, misformed, misfolded proteins that your body doesn’t… They see it as foreign and so, your body doesn’t know to attack with the immune system or what.  So, if you have glutathione, it gets tagged. It goes to the liver and it gets removed. That’s a much better route and if you have…  Of course, if you have a very serious fever of 104.5 or so, you’ve got to get that fever under control because the fever itself can start denaturing critical proteins.  But the medical community in France did a service by saying, “Watch out for ibuprofen. Go for steroidal if you can.” I think they don’t what they’re looking at is autoimmune.

Dr. Weitz:                       Right, yeah. Well, it’s one of the reasons why we’ve been recommending a nutrient known as N-acetyl cysteine because it’s a precursor of glutathione and it’s been shown to have some activity against viruses.

Dr. Lyons-Weiler:           Yeah, absolutely. So, I’m taking NAC. I’ll tell people what I’m taking. I’m taking N-acetyl cysteine. I’m taking selenium.

Dr. Weitz:                       How much NAC are you taking?

Dr. Lyons-Weiler:           I don’t talk doses because I’m not a medical doctor. Right? Then it becomes like, “Okay, wait a minute.” But people can look at the package and they could figure out for themselves.

Dr. Weitz:                       Well, you don’t have to recommend it. You can just tell us what you’re taking. I can tell you that I take 900 milligrams of NAC twice a day.

Dr. Lyons-Weiler:           That’s fantastic. Yeah, so how’s your selenium?

Dr. Weitz:                       I also take 200 to 300 micrograms of selenium and I take 45 to 60 milligrams of zinc partially because I have a…

Dr. Lyons-Weiler:           Zinc is important.

Dr. Weitz:                       gene that makes it more difficult to absorb zinc and…

Dr. Lyons-Weiler:           Yeah, so I also take glycyrrhizin which is a licorice extract.

Dr. Weitz:                       Licorice. Correct, yup.

Dr. Lyons-Weiler:           Right? And these are supposed to be helpful in some way although I’m pretty…

Dr. Weitz:                       Licorice is also really good for adrenal support and any signs of stress and anxiety. That’s not a bad idea either.

Dr. Lyons-Weiler:           Absolutely. So, what we’re talking about is licorice root extract. Don’t go out and buy Twizzlers and think you’re going to save the world. It’s not going to do it for you.

Dr. Weitz:                       And also don’t DGL, which is deglycyrrhizinated licorice. The one thing you have to look out for with glycyrrhizinic acid is it can raise your blood pressure. So, monitor your blood pressure.

Dr. Lyons-Weiler:           There you go. Yeah, so when we’re looking at the clinical, the epidemiology of this thing, this is a fascinating moment in the history of epidemiology in the United States as well, because I’m seeing kind of an inversion. I’m seeing the people who are skeptical of allopathy looking at it more like, “Okay, this is a pattern at the population level.” And I’m seeing now epidemiologists really super focused on the molecular level.  It’s a really strange kind of inversion; whereas in other aspects of medicine, I see the people that are concerned about toxins in vaccines or that kind of thing really more focused on the molecular end and doctors are saying, “No, the epidemiology shows there’s nothing there at the population level.” What about the individual, right?  So, we don’t have to rehash that whole thing, but it’s really interesting because I think there’s a teachable moment here, a really big learning opportunity here where we argue a lot about causality when it comes to like vaccine adverse events. We argue about, “Well, it’s just a correlation.”  Here, we really don’t have the luxury of a randomized prospective clinical trial with infecting people with the virus and then saying, “Okay, so therefore, we know because it was a saline controlled, placebo-controlled, double-blinded randomized placebo clinical trial of virus infection.” And yet, we know so much about how this virus is affecting people by observational data.  So, it’s kind of a fascinating moment in time where we can see people struggling to understand mechanisms of disease, the mechanisms of pathophysiology from a virus using the tools that we’re restricted to use in terms of a vaccine injury. Yet, they’re somehow able to sort it out and come out with pretty strong statements like you probably shouldn’t use ibuprofen, this kind of thing. Right?

Dr. Weitz:                       Right. Are any of the antiviral medications like the one from Gilead liable to play a role in this?

Dr. Lyons-Weiler:           Absolutely. So, in addition to the plasma therapy, we absolutely have to… You said earlier if you were this omniscient or powerful, mighty person. If I was president of the United States right now, I would do a press conference, sit in the Oval Office, and I would ask on television for pharmaceutical companies to ramp productions of antivirals for the US Military, for front line defenders, the first responders, and for families and coworkers that have it.  So, we’re talking about remdesivir.  We’re talking about chloroquine phosphate. There’s actually an expert opinion piece, a consensus panel out of China that said, “These are the treatments that we use that worked.” So, we know what works. If we don’t do antivirals and if we don’t do the plasma therapy, we’re going to see the curve extend out for months and months and months, and it’ll destroy our economy.

Dr. Weitz:                       Yeah, there’s no way we can survive months and months and months.  So, what’s your prediction?  How long are we going to be involved in the social isolation thing we’re doing?

Dr. Lyons-Weiler:           Great question. If after you watch this podcast, you find your senator’s email and you find your congressional representative’s email, and you find their phone number, both the Washington office and the local office, and you email both of them, both types of people. You’ve got two senators and a certain number of congressional reps. Email all of them, I should say, and call both offices and say that you want therapeutics added to the agenda. Tell them you want plasma convalescent therapy and antivirals added to the agenda as the first step of defense to shutting down social distancing.  That’s what we need. We need to promote that this is a… It’s readily available. We can do this now and like I said, China took their curve which was going up like this, they did social distancing, added antivirals and had convalescent, and it dropped to zero. The number of new cases remarkably went from like thousands to 46. Right? Because they…

Dr. Weitz:                       It sounds like probably adding some IV vitamin C and maybe some IV glutathione wouldn’t be a bad idea as part of the mix as well.

Dr. Lyons-Weiler:           So, for treatment, IV therapy would be great. If you have access to an IV system, you could do IV vitamin C. That probably would have the same kind of antiviral effect, right? The glutathione, absolutely. Look up on the internet how to enhance your glutathione.  In America, we are so proud of our independent. We don’t want to turn to the government to do the right thing, but take care of yourself. Increase your glutathione intake, take everything out of your lifestyle that’s depleting your glutathione, and be as healthy as you can. Get sunshine when you can. Get out in the sunshine every day if you can. Get the exercise you’re talking about.  But we’re not turning to the government for support. We’re turning to the government to tell them, “Don’t make a mistake. Don’t do the wrong thing.” And this is why I think we need to bring civics back into the classroom, because one thing that I hope that my sons learn from me other than the science that they know and the love… They fell in love with science. They’re both on route to be scientists.  The one thing that I hope that they got from me, and I know that they did because I can see what they’re doing, is that you don’t just have the right to participate in your own government in the United States. You have a moral obligation and responsibility to be part of your own governments. You can’t just sit back on your couch and wait for somebody else to make the decisions. Right?  So, even if you know nothing about coronavirus, the more you learn… This week, read everything that you can. Read all my blog articles at jameslyonsweiler.com and watch all of the videos at WWDNYK Studios on YouTube about coronavirus.

There’s another guy I would say… You guys need to watch this John Campbell out of the UK. This man is doing a saint’s job since the beginning. He’s been tracking the numbers, and he’s calm and he’s not excitable like me. I’m excitable and agitate-able, but he’s calm, grandfatherly. He will make you feel like the world is not ending, but he also from time to time gets…  When he gets emotional, he’s such a gentleman. He turns the camera off. That’s how he does. When he starts getting upset and angry at the World Health Organization for not declaring a pandemic, he stops talking and turns off the camera. And I have no idea what he does once the camera is off. But John Campbell, this guy is great.  And I believe he should be nominated for some serious Nobel Peace Prize or something like that, because he’s a PhD nurse that’s been teaching the public what coronavirus is as well as he can. There’s sometimes when he speaks that I’m like, “That’s not exactly right,” but he’s excellent. John Campbell, he’s a hero of mine, for sure.

Dr. Weitz:                       So, we’re going to have to continue with the social isolation until we see that curve start to go down? Or are we just going to say, “We’re getting tired of this and…”

Dr. Lyons-Weiler:           There’s no way that they’re going to let, like I said, 20% of everybody over the age of 60 get this virus. So, it’s not going to happen, and they’re not going to let 6% of diabetics die. They’re not going to let 10% of people with cardiovascular disease die.

So, the only option that we have one way or the other, whether it’s because I say it, or you say it, or because the rest of society wakes up that we need therapies. We need therapeutics, and until we clamor and really… If you want to go back to work, you want to go make some money, call your congressman and your senator. And tell them that you think therapeutics are 100% necessary to shutting this down now.

Dr. Weitz:                       I, personally, think that there’s huge numbers of small businesses, there’s no way they can hold out more than four weeks.

Dr. Lyons-Weiler:           Yeah. Well, some are folding right now.

Dr. Weitz:                       No, I know that.

Dr. Lyons-Weiler:           So, be a decent citizen. People that are stockpiling food, that’s fine. But I hope that you bought non-perishables because if you’ve got three months’ worth of food and they are successful in shutting this down next month, you’re good for the rest of the year, but be a good citizen. The restaurants that you used to frequent, they still will deliver. They still allow carryout. So, use the restaurants and keep the money flowing.

And by the way, if you’re in quarantine, there’s some psychological advice too. Do things that… Look at it as a staycation. Don’t look at it as the end of the world. We’re such type A Americans. We don’t know how to relax, “Oh, my God, I’ve got to be home with my wife and kids for so long.” Or if you’re a wife, “I’ve got to be home with my husband and kids for so long.” Or if you’re a kid, “Oh, my God, I’ve got to be with my parents for so long.”  Take a moment and reconnect as a family. Get out the board games that you always wish that you taught your kids how to play. Monopoly, it’s fun. The Game of Life, it’s fun. Okay, have fun. If you’re kind of isolated and alone, take that moment, take the next eight weeks or whatever it’s going to be to learn a new language.  I use Duolingo and I’ve learned German using Duolingo. I have no financial relationships or financials to disclose, but you can learn a new language, learn a new musical instrument, learn some new life skill. If you always wanted to master that one recipe that your grandmother used, it doesn’t matter. Take up gardening. Do something that’s healthy and productive. How about those projects around the house that you’ve been delaying and you don’t want to get to?  So, there’s a lot that you can do and take advantage of this time and still feel like, “Okay, I…”

Dr. Weitz:                       Read a book. Read one of Dr. Lyons-Weiler’s books.

Dr. Lyons-Weiler:           Oh, thanks for bringing that up, Ben. I appreciate that.

Dr. Weitz:                       You can always gang watch the Rational Wellness Podcast.

Dr. Lyons-Weiler:           That’s right. Here’s The Environmental and Genetic Causes of Autism, which I hear is a sleeper. There’s 1,000 studies on autism. Cures vs. Profits for you, you want to learn some things about. Yeah, there’s 16 or 18 different topics, I think, in here on biomedical research and what makes legitimate biomedical objective research and what makes it not legitimate.  It’s got things like why do we know that the hormone receptors on breast cancers will help us determine which chemotherapy is likely to be effective? How did that come about? It tells the history of the things that we take for granted, but it goes also into some controversial areas, which I’m proud to say I didn’t shy away from.

ADHD, for instance. While the pharmaceutical companies were saying, “It’s genetic, there’s nothing you can do,” I was writing a chapter, It’s Their Brain, Not Yours. And I go right deep into science about what’s right and wrong with the studies, about the things that we think that we know from biomedical research.  And yeah, the podcasts, what we do not yet know. Studios, it’s called Unbreaking Science, and we get into a lot topics that I think people find really interesting. And also, if you’ve always wanted to create your own outlet… People need outlets. They want to be heard. Do what Ben here is doing. Dr. Weitz is doing this. Get out there and do your own podcast if you always wanted to do it. We need to hear from people that have creative and good ideas.

Dr. Weitz:                       Awesome. I think that’s a good way to wrap this podcast interview.

Dr. Lyons-Weiler:           Right on, thank you.

Dr. Weitz:                       Okay. Thank you, Dr. Lyons-Weiler. I think this is super timely. I’m going to definitely get this up tonight.

Dr. Lyons-Weiler:           All right, thank you. Also, please stop by ipaknowledge.org if you could and check out what IPAK is doing. That’s the Institute for Pure and Applied Knowledge. We’ve been up and running since 2015, doing research in the public interest without profit motive. No connection to the government except for regulatory, and no connection to any corporate finances. So, take it easy, you guys.

Dr. Weitz:                       Are you guys looking for donations?

Dr. Lyons-Weiler:           Oh, absolutely. We’re 100% funded by the public and we’re almost done with our 501(c)(3) application. So, we’re not yet a charity, but we’re not for profit in Pennsylvania.

Dr. Weitz:                       Cool and your books are available through?

Dr. Lyons-Weiler:           I would recommend people go to independent booksellers near you and if they don’t have it on the shelf, ask for it because they look my name, James Lyons-Weiler. Because when they order one, then they tend to order multiple ones. But also, we want to keep local businesses in business. Amazon’s got enough money.

Dr. Weitz:                       I’m with you on that.

Dr. Lyons-Weiler:           Right on. All right. Well, thanks. Thanks for having me.

Dr. Weitz:                       Okay. Thank you, James.

 

 

Guest blog written by Dr. Howard Elkin M.D.

 

HEADLINES:

 Wednesday 3/11/2020

  • World Health Organization (WHO) announces that COVID-19 is officially a pandemic.
  • The NBA announces suspension of their regular season indefinitely.
  • The 2020 NCAA men’s basketball tournament is canceled (first time since its inception in 1939).
  • Santa Clara County, California passes an order imposing mandatory countywide moratorium on gatherings of more than 100 persons.

Sunday 3/15/2020

       Los Angeles bars and nightclubs will close and restaurants must halt dine-in service and limit their business to takeout until March 31 as part of the city’s attempt to slow the   spread of the virus, announced Major Eric Garcetti. Movie theaters, gyms and fitness centers will also be closed.

 

These headlines essentially changed how many of us felt with the rapid spread of coronavirus COVID-19. Suddenly panic and pandemonium reached a new height. Italy and most recently Spain announced total lockdown.

Amid the outbreak and the mounting public response, Disneyland is closing. Broadway has shut its doors. Schools are closing and large gatherings are being banned.

President Trump declared a national emergency and in the early morning hours on 3/14, and the House passed a bill to provide Americans relief.

By 3/15/20 the number of confirmed cases worldwide topped 170,000, according to a report from Johns Hopkins University. More than 6,500 people have died. Latest counts here in the Unites States have totaled more than 3,700 infections and 60 deaths.

SO THE PROBLEM IS REAL, AND WHAT REMAINS IS A LOT OF UNKNOWN.

Those at greatest risk are the elderly, those with cardiovascular disease, diabetes and lung disease. As a cardiologist, such people constitute a large proportion of my patient base.

A few facts:

  • Overall case fatality rate remains low at 2.3%
  • Morbidity and mortality increase significantly with age, rising to 8.0% among patients 70-79 and 14.8% in patients over 80 in large scale Chinese case reporting.
  • Case fatality rates for those with comorbid conditions are higher than the average population

           Cancer: 5%

           Hypertension: 6.0%

           Chromic lung disease: 6.3%

            Diabetes: 7.3%

            Cardiovascular disease: 10.5%

Despite the fact that many of the patients whom I see are indeed high risk, that doesn’t necessarily connote a negative outcome. That’s when it clearly pays to be your own medical advocate while staying in the driver’s seat when it comes to your health.

Firstly, despite the need for universal concern, there is no need for panic. Panic leads to intense anxiety which clearly weakens the immune system. This is the exact antithesis of what is needed at this time.

I don’t understand the hoarding of water and paper products. This is a health emergency, not a natural disaster. Furthermore, we need not deprive others of much needed supplies. It’s not about “everyman for himself.” Such thinking is panic.

Most of the commonly mentioned precautions have been aptly stated by the CDC and others:

  • Washing of hands. The average person spends about 6 seconds on this menial task. It’s time to adopt a new strategy; extend this to 22-30 seconds. When soap and water are not available, alcohol-based hand sanitizers will do.
  • Sneeze and cough into the crook of your arm, and not your hand. Remember the virus spreads by nasal droplets.
  • Avoid close contact with anyone who is acutely ill.
  • Avoid shaking hands and hand holding. Instead opt for an elbow bump.
  • Avoid touching your face. This is a tough one. The average person touches their face over 160 times a day!
  • Stay hydrated. Keep the blood pumping and the kidneys working.
  • Stay home if you feel ill, as to avoid inoculating others. If you have to leave your house, make sure to wear a mask.
  • Facemasks should be reserved for those showing symptoms to prevent spread of disease. They are not recommended for the general

Some of my recommendations:

  • Watch your sugar and carb intake. You may consider it comfort food, but it can cripple your immune system. It can deplete your body from critical immune –supporting nutrients, such as zinc, vitamin C and glutathione. There is a sugar- vitamin C link. Through the pancreatic hormone insulin, sugar and vitamin C compete for the same spot in your immune system. Don’t allow sugar to win! Doing so could impair your immune system, making you more vulnerable to illness and disease.
  • Prioritize sleep. Sleep is one of the most important activities when it comes to combating the ill effects of aging and disease. Sleep equates to rest, repair and rejuvenate. The contrary, sleep deprivation leads to heightened stress response, reduced immune function and increased inflammatory processes. The end result is enhanced vulnerability to infections and illness.
  • Get outdoors. Unlike our ancestors, we spend the majority of our time indoors, up to 90%. Although staying indoors protects us from adverse weather conditions, it also increases our exposure to indoor pollutants. Spending too much time indoors disallows us from the protective factors we receive while outdoors, including vitamin D from the sun, and electrons from the earth while being barefoot (grounding). Additionally, most of us become destressed while in nature.
  • Avoid large gatherings whenever possible. It just makes sense.

Various foods can support immune health

  • Lemons and limes. These are great sources of vitamin C and antioxidants.
  • This age old remedy may reduce inflammation, support your immune system and help fight infections.
  • Apple cider vinegar. Provides great disinfectant support
  • Olive oil
  • Ginger
  • Mushrooms

What about supplements? There are numerous supplements that can help support the immune system during stressful times such as what we are currently experiencing. I tend to keep it simple and stick to the basics. Remember diet and lifestyle are key to maintaining immune health while avoiding disease. Supplements are next in line.

Some of my favorites:

  • Vitamin C
  • Vitamin A
  • Vitamin D
  • Selenium
  • Zinc
  • Astragalus (used for centuries in traditional Chinese medicine).
  • Fish oil
  • Turmeric
  • Probiotic (80% of our immune system emanates in the gut)

The above list is not nearly complete, though they constitute my personal preferences.

There is no question that our country and the world at large are dealing with a true health crisis, call it a pandemic or national emergency. We all need to do our part and respond appropriately, replacing fear and panic with action. We need to “keep the calm”.

Regardless of whether or not you are in a high risk group, we can all do our part and shake off the ill effects of coronavirus COVID-19. That’s what medical advocates do. We stay in the driver’s seat when it comes to our health.

 

Wishing all of you optimal health and wellness; now and for always.

 

Howard Elkin , MD

By Dr. Ben Weitz

If you’re watching the news reports all day while you are home from work, you can get completely panicked.  You may be thinking that the coronavirus will kill all of us, so you have to avoid contact with everyone and everything by staying in your house and dousing yourself and your pets and your house with bleach and alcohol.  In fact, you should bathe in bleach or alcohol.  You need to stockpile toilet paper and water and rice, beans, canned and frozen foods because there will be no food to eat or water to drink.  Or alternatively, you may think that the coronavirus is just a hoax from the fake news media to get President Trump out of office or it is just a mild flu that you should completely ignore. I have read up on some of the scientific reports about the coronavirus and would like to present a reasonable perspective on what the coronavirus is and how to keep yourself and your family safe without panic and fear.  Fear and anxiety will only weaken your immune system.

 

First we will start with some of the basic facts. 

 

  1. What is the Coronavirus and what is Covid-19?  

 

    • A virus is a tiny infectious organism that replicates inside of the cells of living organisms, including animals and plants and even bacteria.
    • The coronavirus that is the cause of the current pandemic is a type of virus similar to the SARS (Severe Acute Respiratory Syndrome) virus that also started in China in November 2002 and spread around the world. These are both coronaviruses that originated from bats.
    • COVID-19 (Coronavirus disease 2019) is the disease caused by this current coronavirus. Once the virus has infected you, it gets into your cells and starts reproducing unless your immune system can fight it off.  Because our immune system does not have antibodies to fight against this particular coronavirus it is referred to as a “Novel” virus, which is one of the reasons why it may be more dangerous than the seasonal flu.
    • COVID-19 is rapidly spreading and the rate in the US is likely to accelerate over the next few weeks, partially because we have just ramped up testing. The social isolation measures we are taking are designed to slow down the spread and it is likely that the measures we are taking will lead to a leveling off and a slowing of new cases, though this might take several weeks or months.  But no matter how long it takes, we will get over this and 6 months or a year from now, things will be much better.

 

  1. COVID-19 symptoms and incubation period.
    • After being infected, there is an incubation period of up to 14 days, which means that you may not have symptoms and still be infectious for up to 14 days. This long incubation period is one reason why it is more likely to spread throughout society.
    • One reason why you should not worry is that for 80% of those infected, they will have mild to moderate symptoms similar to the seasonal flu.
    • Here are the most common symptoms in order of frequency:
      • Fever
      • Cough
      • Sore throat
      • Runny or stuffy nose
      • Body aches
      • Headache
      • Chills
      • Fatigue
      • Sometimes vomiting and diarrhea

 

  1. How deadly is COVID-19?

While most (~80%) who contract the coronavirus will have mild symptoms, it appears to be more deadly than the seasonal flu by an order of at least 10 to 1.  The numbers out of China look like the fatality rate is between 3 and 4, while the rate in the US right now is between 1 and 2, but that is with many people with minor symptoms who have not gotten tested.   The more people who have had it will make the percentage who have died go down due to the math.   And we are only just rolling out our testing now, so there are many Americans who have been sick with COVID-19 and were sent home and have recovered and those numbers we don’t know now.  When the antibody tests are available, we will be able to get a sense of how many people previously had COVID-19 and recovered.

Those at biggest risk of severe symptoms like pneumonia are those with a weak or compromised immune system or who have existing heart or lung diseases, esp. those over the age of 70.

 

  1. How is the coronavirus spread?

While this virus is not airborne, it is spread through respiratory droplets, often produced while coughing or sneezing, which can then land on your face or hands or a nearby surface that you might touch, followed by touching your eyes, nose or mouth or some food or drink.  Once this virus lands on a surface, such as a countertop or a door handle it can live there for a few hours and possibly as long as 9 days, according to one study.   This is still being debated by the experts.

 

  1. What is the best way to protect ourselves from getting Covid-19?
    1. Wash your hands for at least 20 seconds with soap and water. The soap makes the fatty layer that surrounds the coronavirus fall apart.  Singing Happy Birthday twice is about 20 seconds.  Make sure to wash both the palm side and the back side of your hands and fingers. Wash under your fingernails and wash both thumbs.
    2. Wash your hands multiple times per day, including after you blow your nose, cough, or sneeze. Also make sure to wash your hands after you have had close contact with others, after the bathroom, and before and after you eat. You should also wash your hands before, during, and after preparing food, after you touch or feed your pet, and after visiting public spaces, such as stores.
    3. After washing your hands, drying them with a hand towel or paper towels is important, since you can remove germs with the friction.
    4. If there is no soap and water, hand sanitizer or gel that contains at least 60% alcohol is your best bet.
    5. Clean and disinfect frequently touched surfaces, including doorknobs, light switches, desks, phone, keyboards, toilet seats, sinks, etc.
    6. Avoid shaking hands and instead use the elbow or forearm bump. and close contact with others except when necessary, such as going shopping, getting your hair cut, or going to your dentist or doctor.
    7. Avoid touching your face, rubbing your eyes, biting your nails, etc.
    8. If you have to cough or sneeze, do it into the crook of your elbow.
    9. Get chiropractic adjustments, which increase the likelihood that your nerves that start in your spinal cord and exit your spine in between vertebrae can flow freely. Several scientific studies have shown increases in various measures of immune function with chiropractic adjustments.

 

  1. What not to do.
    1. There is no need to stock up on toilet paper or water. There is not going to be a lack of water. It is a viral infection, not a natural disaster. There is no lack of toilet paper, except that too many people are hording it.  Calm down and stop worrying about stuff like this.
    2. There is no need to horde food. There is plenty of food. Give the grocery stores a few days to stock their shelves and you will be able to get the food you need. While some stores might be temporarily out of rice and beans and pasta and frozen foods, there is plenty of fresh fruits and vegetables, which is what much of your diet should consist of anyway.  Even if you must be isolated, you will still be allowed to go to the grocery store.
    3. Don’t watch the news before you go to bed or you may have trouble sleeping. Read a book instead.
    4. Don’t stop exercising, even if gyms are closed, as they are in Los Angeles. Do pushups and bodyweight exercises, use bands and dumbbells, and go out for a walk. Walk up a hill at a rapid pace.
    5. Did I mention not to spend too much time watching or reading the news?

 

  1. Ways to strengthen your immune system to help you fight off the coronavirus if you come into contact with it. Since there is currently no effective treatment for COVID-19 and a vaccine is not available and it could be a year away or longer, the best way to protect yourself is by keeping your immune system strong.
    1. Make sure you get good sleep, since getting sufficient, quality sleep strengthens the immune system.
    2. Continue to exercise regularly, since moderate levels of vigorous exercise improve immune function, including enhanced activity of macrophages, immunoglobulins, and anti-inflammatory cytokines. If you are somebody who exercises by going to the gym like myself and your gym gets cancelled, you should find a way to exercise, such as by
    3. Avoid sugar, processed foods, and junk food
    4. Eat foods that have immune boosting properties, like garlic, ginger, turmeric, onions, broccoli, mushrooms, citrus fruits, red peppers, and green tea.
    5. Drink plenty of clean, fresh water and don’t trust your tap water. Your best bet is to get a water purification system, since plastic water bottles are problematic since chemicals from the plastic can leach into the water.
    6. Meditate
    7. Listen to my Rational Wellness podcast (just kidding).
    8. There are a number of nutritional supplements and nutraceuticals that can benefit your immune system to help you fight off viruses, including the following favorites of mine:
      1. Vitamin C—take 500-1000 mg at least twice per day. If you are sick take 1000 mg every couple of hours. Reduce it if you get diarrhea.  Intravenous vitamin C may be beneficial in getting very high dosages into your system and there are several clinical studies using 12,000 to 24,000 mg/day IV vitamin C for patients with COVID-19
      2. Vitamin D is super important for your immune system and while it is best to get it from the sun, I have found that even in Southern California many patients have serum levels that are either low or less than the optimal level of 50-70 ng/mL. I have found 5000 IU per day to be a beneficial dosage for many patients, and ideally it should also contain vitamin K.
      3. N Acetyl-Cysteine is an antioxidant has been shown to help with acute respiratory diseases like COVID-19. I recommend 500-1000 mg twice per day.
      4. Resveratrol and quercetin have both been shown to inhibit other types of coronavirus infections, so consider taking both of these. Quercetin helps to trasnport zinc into the cell, which has potent virus killing potential.  There is currently a clinical trial using quercetin and zinc in Wuhan for the treatment of COVID-19.
      5. Selenium is a mineral that boosts the immune system. You can either eat 2-3 Brazil nuts or take a supplement of 200 mcg of selenium per day.
      6. Zinc has been shown to have potent antiviral effects, including against coronavirus.  I recommend taking 15-20 mg twice per day for several months. If you do this for more than a few months, you should add 1-2 mg of copper.
      7. Reishi, shitaki, and other mushroom supplements contain beta glucans and are extremely potent immune strengtheners. Check out episode 103 of my Rational Wellness podcast with mushroom expert Jeff Chilton.
      8. Probiotics are very important for immune function and there are even specific ones that are more potent for immune strengthening.
      9. Andrographis, echinacea, elderberry, garlic, oregano, and astragalus are some of my favorite immune strengthening herbs that have activity against viruses.

 

 

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Integrative Approach to Heart Disease with Dr. Howard Elkin: Rational Wellness Podcast 147
Loading
/

Dr. Howard Elkin discusses an Integrative Approach to Heart Disease with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]

 

Podcast Highlights

3:42   What is coronary artery disease and why are so many patients dying of heart attacks?  There are close to a million heart attacks per year in the US and heart disease is still the number one killer of both men and women.  Heart disease is a disease of excess–excess blood pressure, excess cholesterol, excess sugar, excess stress, excess smoking, however there is a lack of one thing and that’s exercise.

4:35  Why does cholesterol build up in the walls of the arteries, given that our bodies are designed to protect us and promote our survival?  It is because of inflammation in the endothelium, which is in the lining of the artery walls.  We now know that the simple theory that heart disease was caused by eating cholesterol and saturated fats is not correct.  Cholesterol is actually very important for many functions in the body, including the absorption of fat, vitamin D, sex hormones, acids, myelin sheath in the brain also with new nerve cell formation, it’s essential. We cannot live without it.  When it comes to cholesterol, it’s not as simple as just thinking of LDL as bad and HDL as good.  Particle size matters and larger particles of both LDL and HDL are better, while small dense LDL is more likely to cause arterial plaque.

7:05  Cholesterol in our diet does not equate with cholesterol in our blood.  Saturated fat can be an important factor and there were several often cited studies published in the 60s and 70s that appeared to show that saturated fat was associated with an increase in cholesterol. Since then, these studies have not quite stood the test of time and saturated fat is not as bad as we thought it was.  But then we learned that we need to look not just at cholesterol as a risk factor, but we broke it down into (bad) LDL and (good) HDL.  In recent years we have learned that the size of the cholesterol particles is potentially even more important and generally speaking bigger is better.  Oxidation leads to inflammation and because of inflammation, the LDL particles can burrow into the wall of the artery, which is coronary artery disease.  Eating fruits and vegetables can supply antioxidants that can reduce the oxidation.

8:35  There are a number of factors that can result in inflammation, including toxins, stress, food sensitivities, and inflammatory foods like sugar and refined carbohydrate foodsChronic infections can play a role in inflammation, including periodontal disease caused by P. gingivalis infection in the gums. Inflammation can be monitored with HsCRP serum levels. Additionally, gut health and uncorrected sleep apnea are also both causes of inflammation. 

10:40  The Functional Medicine approach gives you such a different perspective on heart disease. The average person finds out they have high cholesterol and they see a cardiologist and they get put on medications like statins, end of the story. But this doesn’t consider what are the root causes of the inflammation that results in the cholesterol building up in the arteries.  Functional Medicine model helps us to look for the periodontal disease, the gut dysbiosis,food sensitivities, toxins and heavy metals that may be some of the underlying reasons for the inflammation that results in heart disease.  If you see a traditional cardiologist, you will get a prescription for a statin and probably an aspirin or blood pressure medication, if the problem is blood pressure.  Dr. Elkin’s approach if a patient has high blood pressure, he prefers not to place them on medication and instead would rather give them a few supplements and talk to them about lifestyle. 

12:56  The recommendations for aspirin have been updated recently.  Doctors have been recommending that patients take aspirin to prevent heart disease to prevent heart attacks and strokes, since aspirin thins the blood out a bit.  It turns out that there is more risk of a major bleeding event from taking aspirin, like an intracranial hemorrhage.  This was shown in the ARRIVE trial (Aspirin to Reduce Risk of Initial Vascular Events) published in Lancet in September 2018: The use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomized, double-blind, placebo-controlled trial  and the ASCEND trial (A Study of Cardiovascular Events in Diabetes) published in NEJM in October 2018:  Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus.   

14:36  A plaque in a coronary artery can be stable or unstable and that plays a big role in whether or not it leads to a heart attack or a stroke.  If plaque has a larger lipid pool and thinner margins, it is more likely to rupture and form a blood clot and this can lead to a heart attack or a stroke. Dr. Elkin recommends that a lot of his patients get a coronary calcium scan, which tells you the degree of calcium in the three major arteries to the heart. It helps to stratify your risk, but it only shows calcified plaque and it doesn’t tell you if you have soft plaque and it also doesn’t tell you if the plaque you have is stable or unstable.  A calcified plaque, because it tends to be more stable, is less risky than an unstable plaque that is more likely to rupture.

19:07  There is a new lab test called a PULS (PULStest.com) that Dr. Elkin is running that utilizes biomarkers to determine the likelihood that a plaque is stable or unstable.  Once you identify a patient with an unstable plaque, you need to be very aggressive with treatment and this is where the full Functional Medicine workup can be very beneficial.

20:57  The standard lab panel that your primary doctor orders is usually governed by what the insurance company will pay for, so it is usually very limited and usually only involves total cholesterol, estimated LDL, HDL, and triglycerides.  It is much more accurate to run an advanced lipid profile looks at LDL particle number (instead of estimating it), LDL and HDL particle size, Lp(a), oxidized LDL, homocysteine, HsCRP, and other tests. But this does not fit into the standard cardiology or primary care practice model and it takes more time and insurance companies do not reimburse doctors for time spent with patients. So doctors are forced into a short (5-10 min) office visit and they need a quick, cookie cutter approach, such as your LDL is above 100, so take this statin.  End of story.

 



Dr. Howard Elkin is an Integrative Cardiologist and he is the director of HeartWise Fitness and Longevity Center with offices in both Whittier and Santa Monica, California. He has been in practice since 1986. While Dr. Elkin does utilize medications and he performs angioplasty and stent placement and other surgical procedures, his focus in his practice is employing natural strategies for helping patients, including recommendations for exercise, diet, and lifestyle changes to improve their condition. He also utilizes non-invasive procedures like External Enhanced Counter Pulsation (EECP) as an alternative to angioplasty and by-pass surgery for the treatment of heart disease.  Dr. Elkin has written a book, From Both Sides of the Table: When Doctor Becomes Patient, that will soon be published. He can be contacted at 562-945-3753 or through his website, HeartWise.com.

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



 

Podcast Transcript

Dr. Weitz:            Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts, and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates and to learn more, check out my website, drweitz.com. Thanks for joining me and let’s jump into the podcast.  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 Apple Podcasts and give us a ratings and review, or wherever you listen to your podcasts. Also, if you would like to see a video version, please go to my YouTube page, Weitzchiro. If you go to my website, drweitz.com, you can find detailed show notes and a complete transcript.

Our topic for today is Natural Approaches to Preventing and Managing Cardiovascular Disease with integrative cardiologist, Dr. Howard Elkin. Heart disease continues to be the number one cause of death in the US and around the world. This is an incredibly important topic. However, despite many improved treatments, especially heroic lifesaving procedures, we often fail to identify ahead of time who is going to have a heart attack. More than 50% of heart attack patients have normal cholesterol based on a standard lipid profile, but deaths from heart attacks are potentially preventable.

For this discussion, we are going to try to split our time between coronary artery disease and arrhythmia, and I know it’s going to be difficult because coronary artery disease could probably take up three hours, but we’re going to see what we can do. Coronary artery disease is all about cholesterol and lipids, and the prevention of heart attacks and strokes.  For the rest of the discussion, we are going to talk about arrhythmia which is a condition not often discussed, especially in functional medicine quarters. An arrhythmia refers to problems with the rhythm of your heart that occurs when the electrical impulses that coordinate your heartbeats don’t work properly.  This results in the heart beating too fast, too slow, or irregularly. There are a number of forms of arrhythmia. As with arterial disease, we will focus on a functional medicine natural approach to arhythmia.

Dr. Howard Elkin is an integrative cardiologist with offices in Whittier and Santa Monica, California, and he’s been in practice since 1986.  While Dr. Elkin does utilize medications, and he performs angioplasty and stent placement, and other surgical procedures, his focus in his practice is employing natural strategies for helping patients, including recommendations for exercise, diet, and lifestyle changes to improve their condition. He also utilizes noninvasive procedures like external enhanced counterpulsation as a noninvasive alternative to angioplasty and bypass surgery for the treatment of heart disease. Dr Elkin has written a book from both sides of the table, When Doctor Becomes Patient, that will soon be published. Dr Elkin, thank you so much for joining me today.

Dr. Elkin:              Thanks. I’m delighted to be here, Dr. Weitz.

Dr. Weitz:            Excellent. Let’s start by having you explain, what do we mean by coronary artery disease and why are so many patients still ending up with heart attacks?

Dr. Elkin:              Well, here’s the thing, coronary artery disease, there’s close to a million heart attacks in this country every year, and I believe every 39 seconds, there’s a person that dies of heart disease. So it’s really prevalent, it’s your number-one killer of both men and women, so it’s very common. It’s a disease of excess. We’re talking about excess blood pressure, excess cholesterol, excess sugar, excess stress, excess smoking, it’s really a disease of excess, however there is a lack of one thing and that’s exercise.

Dr. Weitz:            Can you explain why would cholesterol, which is a fat in the body, why does it start to build up in the walls of the arteries?

Dr. Elkin:              It’s really funny, this whole cholesterol hypothesis started way back, it’s been for several years now, in the ’50s. The ’60s and ’70s, there were studies that were going on saying that, “Okay, well cholesterol and saturated fat are really the culprit when it comes to causing heart disease.” And it’s not that simple. We’ve learned other things in the last few years. So-

Dr. Weitz:            Well, I just wanted to also add in here, when I ask why would cholesterol build up? I just want to make sure everybody has in their minds the fact that our body is basically designed for us to work properly, to protect us. It’s a normal part of the life cycle for us to eat, for us eat animals. We’ve been doing it for thousands of years, and animals are going to contain fat, there’s going to be cholesterol, saturated fat. So what’s going wrong that there’s cholesterol starting to build up in the arteries?

Dr. Elkin:              It’s just one term called inflammation, and when I was a fellow studying cardiology several years back, we didn’t know anything about inflammation, we didn’t know anything about endothelial injury.  We just thought that there was a blockage in the artery that got worse and worse, it was probably related to cholesterol. Around that time when I was finishing my fellowship, the first statin came out, so that was what we thought, but we really-

Dr. Weitz:            By the way, for those who don’t know, you mentioned endothelial and that’s related to the arteries, the inside of the arteries is the endothelium, and a statin is a medication used to lower cholesterol.

Dr. Elkin:              Correct. Thank you. So let’s face it, cholesterol is essential for life, we wouldn’t be here if it wasn’t. It does everything from help with the adsorption of fat, vitamins, vitamin D, sex hormones, bile acids, the myelin sheath in the brain, also with new nerve cell formation, it’s essential. We cannot live without it. But it got a bad rap because of this whole thing, this assumption that it really caused coronary disease.  Now a couple of things you need to know, as far our audiences are concerned, we now know that cholesterol in our diet does not equate to cholesterol in the blood. So if anyone is still eating egg white omelettes, is just like totally out now. We know that doesn’t exist. Now the whole thing about saturated fat, that’s an important thing. That came out in the ’60s and ’70s and these were like small, short studies based on… They were short term studies first of all and they showed that saturated fat was associated with an increase in cholesterol.  As we learned to classify cholesterol, most specifically LDL. Just think of LDL is lousy and HDL as healthy, it’s not quite that simple.  So what we’ve learned in recent years is that it’s about the size of the particle and all your audience really needs to know, is that bigger is better. Whether it’s HDL healthy or LDL lousy, the bigger the particle size, the less likely it is to get oxidized. Oxidation is what leads to inflammation, which is really a long answer to your question. Because once we have inflammation, okay, that LDL particle can burrow into the wall of the artery and that’s where we really develop coronary artery disease and also progressive coronary artery disease.

Dr. Weitz:            So obviously oxidation if we’re consuming lots of fruits and vegetables, those are going to contain antioxidants. But other than consuming fruits and vegetables, what other factors result in inflammation in the walls of the arteries?

Dr. Elkin:              Lot of things. First of all, the environment, air pollution, we know that’s effective. Toxins in the environment.  Stress is a big one. Stress affects everything. Also eating foods.

Dr. Weitz:            Food sensitivities.

Dr. Elkin:              Inflammatory foods that add inflammation, I tell people all the time. Sugar is our biggest villian, it’s not cholesterol, it’s sugar. Eating sugar and carbohydrates and grains that break down to sugar, it’s like pouring gasoline over fire. These are major culprits that lead to inflammation in our arteries and source coronary artery disease and heart attacks.

Dr. Weitz:            Also chronic infections, and I know you like to look at the gums.

Dr. Elkin:             Right.

Dr. Weitz:            as one of the sources of that.

Dr. Elkin:              I think I mentioned when we talked earlier is that when I have a person, a patient that’s persistently demonstrating inflammation, just a systemic  inflammation, which is a simple lab test, I have to ask why.

Dr. Weitz:            Which is high sensitivity CRP.

Dr. Elkin:              Right. Let’s say it’s three or four, it remains that way for like several months. Then I say, can we have to look further? What’s happening? One of the major causes of inflammation is the oral cavity or Periodontal disease. A lot of people say, oh, well my dentist says that everything’s fine. But not every dentist really knows how to evaluate periodontal disease. You often have to go, I send people to periodontists all the time because a pocket of 4 is not o.k., it’s like not good. It’s not okay. That’s a nidus of infection and inflammation based on that infection. The other one is the gut.  That’s probably the second most common cause that’s very important.  Also uncorrected sleep apnea. These are all things that lead to systemic inflammation and whether it’s heart disease, cancer, autoimmune disorders or Alzheimer’s. All four of those big causes, the pillars of aging, have to do with inflammation. It’s like the common denominator.

Dr. Weitz:            Yes. I think the average person out there when they’re worried about heart disease, they’re thinking, okay, I just need to go to cardiologist and I need to get put on some medications. But if you really utilize the full functional medicine model, that’s really the only way you can start to consider some of these underlying causes rather than, okay, you have high cholesterol, you have high blood pressure, you take this medication, end of story.  You’re talking about looking at the underlying factors that create the inflammation and it is possible, but you need to cast a wider net. You need to consider P. gingivalis infection in the mouth, gut dysbiosis, food sensitivities, toxins, heavy metals.  All these things are possibilities when you clear some of those underlying causes of inflammation that can cause the underlying reason why you have cholesterol buildup in the first place and that’s truly getting to the root cause. It’s one of the reasons why I think the Functional Medicine model can be so effective for heart disease prevention.

Dr. Elkin:              You’re absolutely right. The model that we use in Functional Medicine, it’s really the only way because if you go to traditional medicine, and in my case traditional cardiology, if you have high cholesterol they’re probably going to give you a statin.  They’re going to probably tell you to maybe take an aspirin or there maybe… Or if you have high blood pressure, they’re not going to wait and see whether you can get it down on your own.  They’re going to put you on a blood pressure medication. We’re masking things by giving people medications.  Not that there’s not a role for medications, there is.  But it’s like we jumped to medications.  I have a patient yesterday came to me, she was a registered nurse and she’s telling me she’s struggling with her blood pressure’s bad.  I said, it looks like you will probably need medication, but let’s not jump to that right now.  It’s not so high that I need to worry about it.  So let’s track it, let’s go on a couple of supplements, let’s talk about lifestyle and where we evaluate. The average doctor or cardiologist would not do that.

Dr. Weitz:            Right. Absolutely. By the way, you mentioned aspirin, I guess the recommendations for aspirin have been taken back a bit, huh?

Dr. Elkin:              Yes, thank goodness. I really never believed that everybody over 50 for prevention should be on aspirin. But for years it was given as primary prevention. So let me just segue away for a minute. So primary prevention is to prevent a heart attack or a stroke and someone who has no known coronary disease whatsoever. But now secondary prevention is someone that’s had a heart attack or a stroke, they’ve had a stent, they’ve had bypass.  This is a higher risk population and we still think that these patients should be on aspirin for the duration of their life.  But at the study that came out whose name I can’t remember right now, came about actually about a year or so ago,  that it’s overkill and actually there’s more bleeding from aspirin, then saving heart attacks and strokes. So that was changed.

Dr. Weitz:            So essentially the reason why aspirin was being given was because aspirin and all nonsteroidal anti-inflammatories tend to thin the blood out a little bit. So if the blood is a little thinner, it’s likely to clot and form strokes. Form clots, lead to strokes and heart attacks. What they found was that while it thins the blood out, the risk of having a bleed somewhere’s counteracts the potential risk of a clot, unless you really know the person’s at higher risk of a clot, it’s not worth it.

Dr. Elkin:              That’s right. I should mention, just to understand this thing about blood clot. So you have a plaque in the coronary artery and it could be there for years and it often is there for years. We still don’t know in 2020 what makes a stable plaque become an unstable plaque. We don’t know that.

Dr. Weitz:            Okay. Can you explain what a stable plaque is.

Dr. Elkin:              A stable plaque is just, mostly, it’s going to be more… It’s a cholesterol smooth muscle plaque. But the composition, it actually, it has more fibrous tissue in it, more scar tissue in it. So the lipid pool, the fat pool is actually less and these can stay. There’s certain way to look at an artery, tell that from a scan, but we know by looking at them at autopsy and so forth if this is a stable plaque.  I think with plaque has a larger lipid or fat pool and thinner margins, the thinners fibrous tissue, and those can rupture at any time without warning. Once that plaque ruptures, and it can be a 40% blockage, once that plaque ruptures, then a blood clot forms and that’s where aspirin can help.  So it’s a plaque rupture that leads to a blood clot or thrombosis and then you have a heart attack or a stroke depending on the location.

Dr. Weitz:            So you have this plaque that’s blocking, say 20, 30% of the artery and it becomes, it can lead to a heart attack if either A, it blocks the entire artery, continues to grow and grow, or a piece of it breaks off, and that’s what we mean by this unstable plaque. Then you get this inflammatory reaction and you get this clot formation, and that then blocks the artery, right?

Dr. Elkin:              Right. You remember there’s still almost a million heart attacks a year in this country. That’s a lot and probably 50% of these people have normal cholesterol levels.

Dr. Weitz:            So a lot of doctors that have been having patients get a test called a Coronary Artery Scan and that’s to look for these plaques. But what does that really show?

Dr. Elkin:              It’s a good test, I use it a lot. It helps me to prepare my patients for their treatment protocol.  I’ll tell you how.  So you get this test done and it tells you the degree of calcium in their three major arteries. It tells you the degree of calcium…

Dr. Weitz:            The three major arteries that go to the heart.

Dr. Elkin:              Yes. So you get what’s called a coronary artery calcium score. A perfect score is zero. You don’t have any calcium in your arteries but it’s unlikely as you get older. But then what happens… I happen to like Harbor-UCLA because they have a very large database and they have a wonderful doctor who’s been researching this scan for over 25 years. Anyway so they have a database of 30,000 patients who I say, okay, this is how you compare to other 60-year-old males. You’re in the 30th percentile. Not too bad. You’re in the 40th, 50th. Well, that’s a little worrisome. You’re in the 80th, 90th, that’s high risk. So it does help stratify your risk, but it doesn’t tell you who has a stable plaque or an unstable plaque.

Dr. Weitz:            It also doesn’t tell you… It only shows calcified plaque, not soft plaque.

Dr. Elkin:             Really if you look at a plaque, if you could microscopically, about a third is calcium and the two thirds is like soft tissue that you do not detect with that scan.

Dr. Weitz:            So you get a coronary calcium scan. It can be helpful if you have a calcified plaque.  But even if you have a score of zero, it does not mean you don’t have any plaque.

Dr. Elkin:             I was one of those people.

Dr. Weitz:            Exactly. It just means you don’t have any calcified plaque. Noncalcified plaque tends to be less stable, right?

Dr. Elkin:             Right. 

Dr. Weitz:            Less stable means that it might break off, in which case it could form a blockage.

Dr. Elkin:             Right. The end result is always going to be a thrombosis or a blood clot and that’s where the aspirin does come in. But yeah, so that’s what it’s really based on knowing different calcified plaque actually could be considered protective. It’s less likely to rupture.

Dr. Weitz:            Is there a way to test if you have a calcified plaque or not?

Dr. Elkin:             Well, calcified plaque is very well done with the coronary artery scan, it’s how can we detect…

Dr. Weitz:            Unstable plaque?

Dr. Elkin:              So as we were starting, I told you there’s a new laboratory test. It’s relatively new, it’s not been used much in this country. It’s called a P-U-L-S, PULS. It started off, it actually, I forgot what it stands for, but it was started off in Canada and now it’s being adopted in the United States. What they’ve done, they’ve set a number, like over 100 biomarkers to detect an unstable plaque and they tested three different centers and they all came down with nine biomarkers, I’ll explain that in a minute, and then taking those biomarkers into consideration, if you take someone’s blood sample, it can give you a score.  So the higher the score, the worse off you are. So you wouldn’t have a score less than 10. Although it’s new thinking and it’s a new test, what a great novel idea because it can take someone who’s got risk factors, who’s totally asymptomatic, but who has a high score. That means there’s endothelial damage in that vessel and there’s ongoing inflammation that we cannot see and that can presage a heart attack. So it’s very exciting to be able to do this and I think we’ll be getting more of this the next couple of years. It’s a simple blood test.

Dr. Weitz:            So therefore, once you find a patient who has an unstable plaque, this is a person you need to really focus on and be very aggressive with treatment.

Dr. Elkin:              Right. This is when what we do in functional medicine really makes a difference. It’s more than a statin, it’s more than a beta blocker or an aspirin, it’s involves lifestyle and that’s what we do.

Dr. Weitz:            Now, when you go to your standard, get your standard physical exam from your primary care doctor, they do what’s called the lipid profile as part of the blood screen if you’re lucky. Because insurance companies are so strict these days, they hardly want to cover any lab testing and it’s only gotten worse and worse over time. So if they do this standard lipid profile, it looks at total cholesterol, it looks at estimated LDL, it looks at HDL and triglycerides. But that’s not really an adequate way to screen for heart disease, is it Dr. Elkin?

Dr. Elkin:              Not at all. But I will tell you that most cardiologists do that simple lipid profile that you can get from a family practice or general interest. It just tells you what’s normal and what’s abnormal. But it doesn’t tell you anything else because once I get a LDL, let’s say it’s 110, which is barely above normal. As soon as it tells what’s going on, and so I want to know more so we can order what you and I know about is called advanced cardiac testing or advanced lipid testing. That tells us about the particle number and even more helpful, the particles’ size. Remember like I said, bigger is better. You won’t know that unless you do a more advanced test. 

Dr. Weitz:            Why is it that the average cardiologist is not taking advantage of this available testing?

Dr. Elkin:              I think to be perfectly frank with you, I think there’s a lack of time and effort because the way medicine is practiced today, it’s so robotic. It’s like, “Oh, do you have this? You want a statin and you have this, you got it…” That’s why I practice on my own so I can do the type of medicine that appeals to me and I think really helps people and saves lives.  I think it’s, the doctors are burnt out as standard medical doctors and I think they said that they still have all the surveys I’ve read the major one complaint that patients have about their doctors, they do not feel heard. They say, oh, he got one foot on the door, one foot out the door. Or they’re sitting there typing while the patients… I don’t bring my laptop in the room with me, I can’t do that. I can’t focus on the patient. So it’s time-intensive. I have to do a lot of education and I have a nutritionist that’s in my office two days a week that does a lot of… As far as chips a lot. But when it comes to limits, I’m the guy and lifestyle because I have to walk my talk.

Dr. Weitz:            Yeah. [inaudible 00:23:39] is unfortunately and I’m not sure if all the patients are aware of this, but the healthcare system today is essentially controlled by the insurance companies and doctors unfortunately do not get reimbursed by insurance companies for the amount of time they spent. So therefore based on the way the insurance controls stands and the reimbursement, medical doctors, primary care doctors and cardiologists are basically limited to a five or 10-minute office visit. Unfortunately, you can’t go into having time to explain this kind of detailed testing and lifestyle recommendations and diet in a five or 10-minute office visit.

Dr. Elkin:              You really can’t. Let’s just take whether it’s Cleveland HeartLab or Boston HeartLab, and they’re both very good [inaudible 00:24:33].

Dr. Weitz:            Those are examples of advanced lipid profiles.

Dr. Elkin:              But when I get the test packet, after much over the liquid virus and I’m just saying, “Okay, this is your inflammatory profile. You have inflammation, this is your metabolic profile. You’ve got diabetes or prediabetes or you’re at risk of diabetes.” There’s so much to explain. You cannot do it in five or 10 minutes.

Dr. Weitz:            Right. So these advanced lipid profiles, they vary. But typically besides the things you mentioned, like LDL particle number and particle size, and also look at the size of the HCL. They also look at a particle known as LP(a). They look at homocysteine, they look at so many inflammatory factors like, high sensitivity CRP. They look at whether the LDL is oxidized.

Dr. Elkin:              Yes. Really useful information.

 



 

Dr. Weitz:                            I’ve really been enjoying this discussion, but now, I’d like to pause to tell you about the sponsor for this episode of the Rational Wellness Podcast. This episode is sponsored by Pure Encapsulations, which is one of the few lines of professional nutritional supplements that I use in my office. Pure Encapsulations manufactures a complete line of hypoallergenic research-based dietary supplements. Pure products are meticulously formulated using pure scientifically-tested and validated ingredients. They are free from magnesium stearate, gluten, GMOs, hydrogenated fats, artificial colors, sweeteners and preservatives.

Among other things, one of the great things about Pure Encapsulations is not just the quality products but the fact that they often provide a range of different dosages and sizes, which makes it easy to find the right product for the right patient, especially since we do a lot of testing and we figure out exactly what the patients need. For example, with DHEA, they offer five, 10 and 25-milligram dosages in both 60 and 180 capsules per bottle size, which is extremely convenient.

                                                Now, back to our discussion.

 



 

 

Dr. Weitz:             So let’s go over some of the particular things that are found on advanced lipid profile and some of the recommendations we can make from a natural approach for helping these patients. So let’s say we have a patient with an elevated LDL particle number and/or an increase in small dense LDL.

Dr. Elkin:              Okay. Remember, bigger is better. So if you have a small dense particle size versus a large buoyant, it’s not in your favor because it’s about 30% more likely to get oxidized, which we know leads to inflammation and clot. So what can we do? First of all-

Dr. Weitz:            What type of diet to start with is beneficial for these patients?

Dr. Elkin:              Absolutely a lower carbohydrate diet. That definitely does better when it comes to, if you want to decrease the size…, if you want to increase the size of the LDL particle.

Dr. Weitz:            Why are you mentioning carbohydrates?  Most cardiologists would say, hey, you got to lower the fat.

Dr. Elkin:              Right. I know it goes against what everybody’s been taught. If you look in the ’90s, everything was low fat and high carbs and what happened? The country got fatter and we have more diabetes than ever before. But definitely I put them on a low carb diet and you have to explain to them, because a lot of their standard cardiologists are still telling me to go low fat. Why? I don’t know.  When we have signs that tell us otherwise. Then I use niacin, which is actually a vitamin, vitamin B3. I’m using it in a larger dose and I would if I was giving it as a vitamin, but niacin can do what statins can’t. Statins are very good at one thing, lowering your LDL but it will not lower… It will not make a small particle into a large. It won’t effect [inaudible 00:28:53], it won’t effect HDL, it won’t affect Lp(a), whereas niacin has the potential to do all those things. It’s pretty well tolerated and guess what? It’s been around a lot longer than statins have and it’s a supplement. So I do use that quite a lot of my [crosstalk 00:29:10].

Dr. Weitz:            I will say that if you ask the average standard primary care doctor, they will tell you that niacin, that the study show that niacin doesn’t work.

Dr. Elkin:              It’s based on one crummy study that really wasn’t well… It was a flawed study about just a few years ago. It really…

Dr. Weitz:            Yeah. There were a couple of studies and they were both terrible. One of them actually didn’t use niacin. It used niacin in combination with a drug that prevented the flushing. There’s all sorts of side effects that come with that drug and they reported the study as being a study on niacin.

Dr. Elkin:              Here’s another problem that a little off the record here is that, see when you’re in medical school, you go through your training, you are taught how to evaluate studies. We learn about statistics, we learn about meta-analysis, Beysian analysis, all that stuff. But when you’re in practice, you forget all that stuff. There’s no time to think. Oh, so this drug rep comes and tells you what this is and you just buy it. That’s another thing about the current medicals and that really gets to me. But niacin can be very useful. I’m using it for years and again, it does things that statins don’t.

Dr. Weitz:            What about using Red yeast rice?

Dr. Elkin:              Red yeast rice is also, so actually if you look at the original statin that came out, when I was a fellow in the early mid ’80s, it was red yeast rice, which actually is a supplement that came from a plant in China.  There’s certain patients that refuse to take a statin, just refuse and I don’t try to fight it even if they have coronary artery disease. I always believe in patient’s match and what they feel comfortable doing. But I’ve had some success with red yeast rice supplement and I believe Dr. Mark Houston uses a much larger dose, but he’s got success. But I have found to be useful. What else?

Dr. Weitz:            Adding tocotrienols.

Dr. Elkin:              Yeah. So tocotrienols it’s like a form of vitamin E, it’s got tocopherols and tocotrienols and there’s various subclasses with each. But the tocotrienols are an interesting class, which actually lower cholesterol and do it quite nicely. So that’s another thing. Another thing that can be helpful is bergamot. Bergamot is a supplement that you can get and it actually works two ways. It works by decreasing cholesterol production by the liver and also by decreasing cholesterol absorption in the gut, which is kind of unusual.  But I’ve had some success with that. Is it as good as a statin? No, probably not. But it depends on what I’m after and I also get, I listen to what a patient’s preferences are.

Dr. Weitz:            So besides statins, what other medications are there for lowering LDL levels?

Dr. Elkin:              One say we talked about Red yeast rice, we talked about niacin, we talked about bergamot, there’s also berberine. Berberine is another herb that we use a lot. We use it, well, we use it in for functional gut disease, also we use it in diabetes and prediabetes. But it also has an interesting effect, and I didn’t want to go into all this detail, but there’s a new class of drugs that are very expensive that you take twice a month subcutaneously called a PCSK9 inhibitor and I don’t mean to bore the audience here.  If there are receptors, PCSK9’s receptor is in the liver. We know that that’s where cholesterol is produced. But basically berberine is a natural PCSK9 inhibitor. So the supplements can be very additive. I don’t necessarily think that one would do the entire trick, but it depends on what you’re after and how low do you have to lower cholesterol anyway, unless you are at high risk.

Dr. Weitz:            Right. By the way, one of the reasons why sugar and carbohydrates are such a problem is when you look at the mechanism by which these drugs work, like statins and PCSK9 inhibitors, they’re not binding with cholesterol and taking it out of the system. They’re reducing the body’s production of cholesterol. That’s right. Most of the cholesterol that’s in the bloodstream is being produced by the liver, and the liver makes cholesterol from glucose. So that’s how the statins and these other drugs work. Now there’s a new cholesterol lowering medication that works by a different mechanism.

Dr. Elkin:              Yeah, I forgot the name of it. It was just a…

Dr. Weitz:            Bempedoic acid.

Dr. Elkin:              It just was approved by the FDA I think it was a couple of weeks ago. It’s not a statin, I think it does work in the liver. It’s a different, I don’t know where in the chain of events, but it will have a modest effect on decreasing out our costs. So I think if you look at Statins can decrease at 30% or more and then [inaudible 00:34:14] which works on decreasing cholesterol [inaudible 00:34:17] and got maybe 10%.  This is like in between my 20, 25%. So it’s another tool to use are certain people that are statin intolerant or who won’t take statins. But again, I would probably want to use this more in my higher risk patients versus just anyone with an elevated cholesterol level, but I’m sure it will be misused. [inaudible 00:34:39]

Dr. Weitz:            So now let’s say we have a patient who’s has low HDL. Now HDL is the potentially protective lipid that HDL if it’s effective, if it’s functional will produce reverse cholesterol transport meaning it takes the bad cholesterol, the LDL out of the system. So ideally you want to have a higher HDL level.

Dr. Elkin:              So where did we see low… I’m talking levels like 20, 30, really low level. First of all, it tends to be genetic. I’ve got enough families that it’s in my career to see that. It tends to be low with obese individuals. So weight loss can be important and actually improving the HDL. Omothyroid is one other condition. I want to check the thyroid status. Smoking. Smoking is known to be a factor in decreasing HDL.  But again, there’s also a genetic component. Also, there’s a metabolic situation. If you look at your diabetics, your prediabetics or your metabolic syndromes, they tend to have kind of like low HDL, high triglycerides and moderate LDL. So there’s a pattern we look for. They tend to have a very low HDL as well. Now, so what did we do about it?

Dr. Weitz:            Then we have bodybuilders on steroids who are on very low HDL.

Dr. Elkin:              I have seen in my practice, women, who seek competitors that take both of those, they still called safe steroids. I don’t know what safe means anymore and I’ve seen single digit HDLs, really scary, like levels of eight, nine. Very scary. So yes, certain drugs can certainly cause that.

Dr. Weitz:            So how do we elevate HDL?

Dr. Elkin:              Weight loss, smoking cessation, you have to just quit. Note, it’s not an exercise. Probably more cardio [inaudible 00:36:42] activity. So that’s going to be important. So a lot of lifestyle can improve HDL and I haven’t seen gone like 10, 15 points. Would that really employ those methods. I will tell you that in the last 25 years it’s been at least three different trials based on different medications that we thought would improve HDL or augmented.  What happened, all these trials they were halted midway because they actually found more depths from those taking this medication. That was before we knew about particle size and functionality. Like we’ve learned that some HDL was functional and some isn’t and it’s more than about what’s the number is.

Dr. Weitz:            [crosstalk 00:37:21] there are patients who have very high HDL that tends to be nonfunctional, right?

Dr. Elkin:              Right, exactly.

Dr. Weitz:            They have HDL of 90 or 100 or…

Dr. Elkin:              It’s got great, but it’s not necessarily good at all. So drugs have not been helpful in that regard. Now diet is very interesting. So although saturated fat has been maligned or vilified, like beyond, yeah, I believe saturated fat has a few advantages. It can actually increase your HDL level. It can actually decrease LP little a which we haven’t really talked about and can also increase the size of the LDL particle, which is really interesting. So even though it’s been maligned, it does have some potential benefits when it comes to this cholesterol thing.

Dr. Weitz:            Yeah, I’ve used coconut oil with some patients and seen a rise in the HDL. What about fish oil for improving HDL?

Dr. Elkin:              I haven’t seen it do… But basically anybody with age of 40 it’s going to benefit. I use it as my right hand supplement.

Dr. Weitz:            Very cardioprotective, reduces inflammation…

Dr. Elkin:              It can also help with blood thinning and in a protective way as opposed to causing bleeding that you would get from aspirin. It also can help prevent, but we’ve talked about [inaudible 00:38:48] prevent sudden death. It’s been shown to be useful there. So as far as HDL, it may have an additive effect.

Dr. Weitz:            I think it can help somewhat with HDL, right?

Dr. Elkin:              Definitely. I’ve had niacin and I’ve had people increase like 15 points with taking [inaudible 00:39:07] to be dose dependent when they can tolerate and I usually go up to like max two gram today. I don’t feel comfortable going beyond that.

Dr. Weitz:            Yeah. I think there’s some other nutraceuticals like Copine some other…

Dr. Elkin:              I’m kind of basic. I stick to the ones that I know work that I’ve had good experience with. But I’m always open to new ideas and suggestions.

Dr. Weitz:            Right. Another factor on advanced lipid tests is homocysteine, which is another protein found in the blood that increase the risk of heart disease.

Dr. Elkin:              Right. So homocysteine is really a big thing now. It’s really an amino acid and your body normally wants to break it down to something called [inaudible 00:39:48] but some of us aren’t able to do that and so the homocysteine is built up in the arteries and they could also cause plaque of the arteries especially in the heart and in the brain, so it’s not a good thing.

Now that we’ve done a lot of genetic testing, which [inaudible 00:40:02] there to talk about now, there tends to be a propensity of people that have this thing called MTHFR. They have a variant, it’s that which is basically a typo in your genetic makeup. But these people, and I’m one of them, but I’ve [inaudible 00:40:20] my genes not being expressed.

But 60% of us have this and that can lead to high homocysteine levels. So it’s easy to decrease homocysteine levels and I have my own kind of product that put together and it’s B vitamins. But it’s higher dose B vitamins [inaudible 00:40:35]. So it’s always worth to try that because again, if you’re high risk, you want to be able to decrease that risk easily and you don’t need a medication. It’s simply a combination of B vitamins.

Dr. Weitz:            Yeah. One other nutrient is trimethylglycine and also can be very effective for homocysteine.

Dr. Elkin:              Naturally I include that in my supplement. So [inaudible 00:40:56].

Dr. Weitz:            What about LP little a? Now LP little a is the particle that the trainer Bob Harper from The Biggest Loser who had a massive heart attack, he had an otherwise great clusteral profile except he had elevated LP little a.

Dr. Elkin:              Lp(a) is the biggest bugaboo I know and it’s part of the advance of the profile. So you’re going to get the value. In my younger patients that have heart attacks and I have quite a few, invariably you’re going to see oftentimes I should say, at least elevated LP little a. It’s a fragment of LDL, it’s very sticky, very inflammatory, and it’s like not a good thing to have. Unfortunately diet and exercise won’t touch it.   So it doesn’t have much role there other than perhaps saturated fat might help. There’s no medication that has been really useful. Again, I’ve had some good success with niacin. It doesn’t always work, but I have had someone drop their [inaudible 00:42:07] as much as 100 points with high dose niacin. So I have had success. There is something in the pipeline I [crosstalk 00:42:15].

Dr. Weitz:            I think there’s a drug that is in the final stages of testing and we’re close to getting improved…

Dr. Elkin:              [inaudible 00:42:23] and we’re talking about a 70% reduction in like less than six weeks, which is amazing. However, it’s a drug. It’s going to be a biologic, which means it’s going to be, have to be injected probably a couple of times a month.

Dr. Weitz:            It’s probably thousands of dollars per month.

Dr. Elkin:              But in those that are really high risk, it could be a life saving [inaudible 00:42:47]. So it’s a beautiful thing.

Dr. Weitz:            Right. Let’s bring up one more particle and then we’ll move on. Arrhythmia is T-M-A-O, which is very controversial and I know that you’ve been starting to test it as part of the Boston HeartLab. TMAO is another protein in the blind that was developed by Stanley Hazen from Cleveland HeartLab that’s been shown to correlate with higher rates of heart disease.  But it’s very controversial and I’m skeptical of this concept because when you consume fruits like fish or eggs that have choline or L-carnitine or fuss with title choline that increases the levels of TMAO and we know that those foods are hard healthy and yet we’re being told that these nutrients like choline and L carnitine, which we know are super helpful for patients with cardiovascular problems are, we’re being told that they’re harmful.

Dr. Elkin:              Also brain-healthy for that matter.

Dr. Weitz:            Choline, crucial for brain health.

Dr. Elkin:              I look at it because I do a lot of [inaudible 00:44:06] HeartLab testing and it’s kind of standard. I will tell you, most of the patients that I test don’t have a, I wonder whether it’s over emphasized because I see a lot more abnormalities when I study, when I look at profile. But with some are elevated. But I would say the majority of those that I’ve tested really aren’t. So what do I do? Right now I’m just observing because it’s like, okay, what do I know that can help a patient [inaudible 00:44:33]? Particle size, LP little a, homocysteine, working on their diet.

I totally agree with you, choline is lacking in so many people and their diets as it is and it’s so useful and as far as [inaudible 00:44:48] but it’s like very important in cardiovascular health. Because it helps you bring nutrients to the mitochondria if it reduce. So I just don’t see at this point, I’m not changing people’s diet because of it. Also, is it really the food or it’s because the gut isn’t healthy? Is there a microbiome problem?

Dr. Weitz:            Right. Yeah, absolutely. So that’s something to continue to discuss over time. So let’s move on to Arrhythmia. This is a topic not often discussed but is increasingly common, especially among us aging baby boomers. Perhaps you can tell us what is Arrhythmia.

Dr. Elkin:              Okay. Arrhythmia is really a rhythm disturbance. So you have this thing called normal sinus rhythm or sinus rhythm which is your standard rhythm that most of us have. Even if you have a disruption in that, it’s an Arrhythmia. So it’s kind of a wastebasket term for a lot of different things. Let me break it down to what type of Arrhythmia is it, are they isolated atrial beat or premature beat, or it’s something that’s sustained. [crosstalk 00:46:00]

Dr. Weitz:            Or somebody who just can’t dance.

Dr. Elkin:              It’s interesting. So a very common complaint in the cardiologist office is palpitations. Now I for one, have never had a palpitation [inaudible 00:46:23]. So I have to really delve into, I have to really ask people, what does it mean? Is it skipping, is it fast, is it slow because I can’t relate. But fortunately there are two ways we can monitor patients.

Now, mostly with me is [inaudible 00:46:37]. So what I’m treating are symptoms and [inaudible 00:46:42] out. But some are malignant like ventricular tachycardia, atrial fibrillation that leads to sudden death. So part of my job is to figure out what’s really important and what’s not and if it’s not important, what can I do to assuage the patients feel, they’re uncomfortable with feelings because it can really run you.

Some patients are very debilitated by the presence of palpitations and arrhythmias. What I’ll talk about briefly is that what I’m seeing more and more of is atrial fibrillation, which used to be the most common Arrhythmia that we saw in people over the age of 70. But I will tell you, I’m seeing the younger, younger people with it now. Two of my closest friends had to have ablations in their early 50s because if such refractory [crosstalk 00:47:30].

Dr. Weitz:            What’s an ablation? Can you explain what that is?

Dr. Elkin:              So ablation is done by a cardiologist like me but they specialize in electrophysiology. So they specialize really in Arrhythmias and trying to study with me as, and if they find something that… Because Medicaid patients are really suboptimal. Tons of side effects that can actually make arrhythmias worse. So with ablation, it’s a procedure in which you go through the heart, into map out where the Arrhythmia emanates from and then you can sap it with either radio frequency waves or cryotherapy, which is cold. You can potentially cure an arrhythmia problem with ablation. So it’s evasion…

Dr. Weitz:            So basically damaging, either burning or freezing a part of the nerve that is leading to that contraction of the heart.

Dr. Elkin:              Sometimes part of the heart muscle but we don’t want to do that. But it’s pretty actually in the proper hands, the side effects are pretty low. So [inaudible 00:48:38] I’m a solo practitioner. I probably get three or four new cases of atrial fibrillation every month in my office. It’s so common. That’s probably the most significant thing because we used to think that, okay, well it’s important to treat because the kinds of hearts beating irregularly, irregular is [inaudible 00:49:05] for blood clots to form in the heart and to break off and cause a stroke which is devastating or could be potentially devastating. But also what we’ve learned in recent years, it can be a cause of heart failure, progressive heart failure. But here’s the new one that we have found is that it also can lead to early dementia. Maybe there could be a little microemboli go into the brain that we don’t really recognize as strokes. So it’s not a good thing.

Dr. Weitz:            So which dietary factors are important for helping to manage a patient with Arrhythmia?

Dr. Elkin:              It’s a good point. Well, first of all, magnesium is always important. Actually if you look at the sodium, potassium, magnesium, they all or your basic minerals and they deal with… They’re essential for proper nerve and muscle and nerve function. Well, sodium regulates body fluids. So you want to…

Dr. Weitz:            Do you want to add salt or you want to remove salt?

Dr. Elkin:              I don’t usually deal with removing salt unless I’m dealing with a patient with heart failure, liver failure or kidney failure. I think this whole thing about salt, we pretty much have discounted the importance of it. I know that the heart association is still saying low salt diet or less than 2.5 grams a day. I don’t. If you’re active person, that’s nothing. It’s nothing. So I don’t think salt affects your heart rhythm at all. So what affects it? Stress is a big one. I think fatigue, another big thing is sleep apnea, uncorrected sleep apnea. So there are things that we have to look…

Dr. Weitz:            Caffeine, energy drinks.

Dr. Elkin:              Yeah. Energy drinks are the worst because they not only can be [inaudible 00:50:59], they can also is an EKG abnormality called a long QT interval, which doesn’t mean much, but it’s an EKG diagnosis and that itself can lead to life threatening with news as in sudden death. It’s been reported in the young people like not good things to have.

Dr. Weitz:            One of your articles I read said that celery, garlic and onions can play a role. Have you heard that?

Dr. Elkin:              I haven’t heard that. I’m a big user of magnesium and hydration in general. I also use an amino acid called taurine, useful. Magnesium tends to quiet the heart and it can be very important, especially people that have bothersome palpitations. Another thing in women that are going through menopause is hormone replacement therapy. It’s not the only reason they need to go it, but low progesterone is a very important factor and causing irregular heart rhythms which I didn’t learn, I didn’t know that until I did my anti-aging medical township. I didn’t learn it at all in cardiology.

Dr. Weitz:            Now what about hawthorn extract?

Dr. Elkin:              Hawthorn berry is good for the heart. It’s not my go-to, but it’s something that it’s additive and a lot of patients take it and they’ve heard about it. They see it on the Internet and they’ve heard the utility of it. So it can be useful for heart rhythm. Yes.

Dr. Weitz:            What about CoQ10?

Dr. Elkin:              Definitely CoQ10. Yeah, that’s…

Dr. Weitz:            I’ve also seen some articles mentioning vitamin C and of course vitamin C there’s actually a protocol for using vitamin C for LP little a, right?

Dr. Elkin:              Yes. So definitely, so vitamin C, magnesium for sure. Taurine it’s for sure and also looking at the lifestyle. Smoking is bad, fatigue or poor sleep habits are not good. Lifestyle today, we’re living very stressful times along with political scene, but we all know what’s happening. People are stressed. I think when they come into my office but I can’t say it over the air. But they say, you know why my blood pressure is high? [inaudible 00:53:12].

Dr. Weitz:            I hear you Howard. Well, we’re going to try to stay away from politics. Can maneuvers that stimulate the vagus nerve be helpful?

Dr. Elkin:              Okay. That’s interesting. I do this diagnostically. If someone has an arrhythmia in my office and I’m trying to… Yeah, you can actually do vagus maneuvers like it’s called a carotid massage. A carotid massage will activate the Vegas nerve cause you’ve got a sinus in there. I’ve had it actually break Arrhythmia, it can be very useful. So I use that. I don’t use drugs per se for that because they can have some nasty side effects. But I do use it. I tell my patients if they’re having what’s called SVT or supraventricular tachycardia, which is very common. I say, okay bear down, cough a lot.

Dr. Weitz:            Coughing [inaudible 00:54:09] flax.

Dr. Elkin:              I put your head in a bowl of ice water. If you have a partner or someone, it’s hard to do your own carotid massage because people are turning to the extreme. You have to get on top of the carotid artery and go up and down kind of firmly and it’s not real comfortable so every person want to do it on their own. But if they have a partner or a friend or bystander, they can do that.

Dr. Weitz:            Then what about natural procedures that reduce stress like yoga, meditation, and I know you were involved in a study on grounding as well.

Dr. Elkin:              Yes. So grounding, I did a study with Dr. Sinatra. We did it mostly looking to see the effects of blood pressure and it can really reduce blood pressure. It’s really cool. But it’s also anti-inflammatory and it’s also an actual blood thinner. It also helps us sleep. I love it because it’s free. You’re just using the electrons or surface but…

Dr. Weitz:            I should consider seeing if it has a positive effect on Arrhythmia, I would think it probably would.

Dr. Elkin:              Yes. We didn’t study that per se because we were looking at one component and blood pressure is such a big target. But these are all additive things. I think a lot is on lifestyle and hormonal and environmental and we live in a very toxic world. Pesticides, there’s formaldehyde in everything. I didn’t even know that until recently. I got scared when I started seeing all the things in our household that could potentially contain formaldehyde. Do you believe that? Like our carpets. That’s why I got rid of all the carpets.

Dr. Weitz:            Yeah. They have those flame retardant chemicals and yeah, a lot of furniture. You got to really try to go nontoxic as much as you can. Well, this has been a great discussion, Dr. Elkin. Any final thoughts for our viewers and listeners?

Dr. Elkin:              Well, here’s my final thought is that I believe in patient smart and I tell patients you need to become your own medical advocate. Yes, you want excellence in doctors and nurses and health care. You don’t depend on your doctor, the hospital, your insurance plan or the federal government to take care of you. So do your research, try to find functional medicine people.  If you have a doctor that’s traditional, you can develop your own dream team because you need to look at those lifestyle factors, nutrition on stuff that we talked about. That’s really what I like to leave people with is that stay in the driver’s seat when it comes to your health. That’s a very important message that I always try to get across. I’m your second and you’re your first.

Dr. Weitz:            Exactly. I think that’s also very important. A lot of times people will see different doctors as, is this doctor, is it better to go to a conventional doctor or should you go to an alternative doctor? Really they both have their place and you’re suggesting for ideal health, for optimal health it’s best to have a team and there’s some great benefits to having a conventional primary care doctor and there’s all kinds of routine testing and it’s great to see them for infections and things like that.  But on the other hand, it’s also good to have a functional medicine doctor as part of the team to look at some of those underlying causes of some of these chronic diseases so you can look at things from different approaches and really get to the root causes.

Dr. Elkin:              [inaudible 00:58:02]

Dr. Weitz:            So how can listeners and viewers get hold of you, Dr. Elkin?

Dr. Elkin:              Okay. Well, if you go to my website, it’s www.heartwise.com, you learn about me and I try to put things there on a regular basis. On Facebook is HeartWise Fitness and Longevity Center and on Instagram, it’s Doc HElkin and I always try to post some things couple times a week. So I try to keep current and I try to inform people what’s happening. So it’s kind of a, I like to be contribute in that matter.

Dr. Weitz:            Thank you, Howard.

Dr. Elkin:              Alright, great. Thanks, Ben. I loved it. Very good. Thanks.

Dr. Weitz:            Me too.

 

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Natural Solutions for Anxiety and Depression with Dr. Peter Bongiorno: Rational Wellness Podcast 146
Loading
/

Dr. Peter Bongiorno discusses Natural Solutions for Mood Disorders like Anxiety and Depression with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]

 

Podcast Highlights

4:45  Rates of anxiety and depression are rising today, esp. among teens.  When depression becomes severe, you wonder about suicide, but suicide rates that been soared, despite the use of all of these antidepressant drugs being prescribed.  In fact, some of the SSRI (serotonin reuptake inhibitor) drugs are known to increase suicide rates.  These drugs do have benefit, esp. in urgent care situations, where they can be life saving.  SSRIs are commonly used for depression and anxiety, but for mild to moderate depression, they work about 30-35% of the time, which is a hair more than placebo.  Usually after 2-5 years these drugs tend not to work as well. And these drugs are not getting to the underlying problem, even if that is a serotonin imbalance. You still want to ask, why did your serotonin get out of balance?  If we can treat the underlying causes, then that is a better solution, which is why the Functional Medicine approach can be so helpful.

7:52  The neurotransmitter imbalance theory of depression is questionable, since brain chemistry appears to be much more complicated than some think, since we have drugs that increase serotonin levels, drugs that increase norepinephrine, dopamine, GABA, and reduce glutamate levels that all seem to have some efficacy. In fact, there is even an anti-depressant that decreases serotonin levels that seems to have equal efficacy to drugs that decrease serotonin levels. Dr. Bongiorno points out that the older tricyclic antidepressants are actually more effective for depression. For anxiety, while anti-depressants are not very effective, the benzodiazepines, like Xanax and Ativan, are fairly effective. But the problem with these drugs is that you can’t take these drugs long term because they have a lot of side effects, they are very addictive, and they stop working after a while. If the Ativan stops working, they may get put on Xanax and eventually other, stronger drugs.

10:25  Natural Treatments for Anxiety and Depression. Diet, sleeping, and exercise are all important factors that affect the risk of depression and anxiety.  The digestive tract is super important, since most of the neurotransmitters are produced in the digestive tract, and diet directly affects digestive health.  While dietary recommendations are best individualized, in general, the Mediterranean style diet is probably best and it has been shown to raise GABA levels, which is the calming neurotransmitter.

12:32  Balancing blood sugar is very important for patients with mood disorders.  If blood sugar is not balanced, insulin will be elevated and this can drive inflammation.  While it is popular in the Functional Medicine world to do intermittent fasting and skip breakfast, Dr. Bongiorno finds that “for mood, it’s really helpful to have a good breakfast, to have a good lunch and have a smaller dinner.”  It is best to have meals based on healthy proteins with healthy fats, in addition to some healthy carbs, like whole grains and beans.  Dr. Bongiorno pointed out that if you look at the diets where people live the longest in the Blue Zones, they include some healthy carbs like whole grains, beans, and legumes.  For patients with mood disorders, getting some of those carbs are really helpful to keep the serotonin levels up.

18:12  Lab testing can help us to sort out some of the underlying imbalances that might lead to anxiety and depression.  A full lipid/cholesterol panel is important since if cholesterol is too low, this can lead to hormone deficiencies.  If the HDL goes below 35, LDL goes much below 90 or total cholesterol goes below 190, that can be negative for the brain. In our drive to lower our cholesterol levels to lower heart disease, we are pushing cholesterol levels too low for optimal brain function and cognitive function and this can be playing a role in mood disorders. Labs should also include a good iron panel, a full thyroid panel, vitamin D, Red Blood Cell Magnesium, Carnitine, B12, salivary cortisol test, and sex hormones like estrogen, progesterone, and testosterone. Melatonin levels are helpful when there are sleep problems. We might also want to look at histamine levels and mold toxins, depending upon the history.  CoQ10 levels can help us with mitochondrial status.  

24:29  Sleep.  Dr. Bongiorno mentioned that he emphasizes the importance of sleep in all of his books and makes it the first chapter. If people aren’t sleeping, it’s very hard to make them feel better. The first thing that needs to happen is that your patients need to be sleeping and pooping every day before you can fix any other problems. It is important to go to bed no later than 10 or 11, since most of our melatonin gets released somewhere between 8:30 and 10:30, which is needed to get into a deep sleep state.  If you stay up late playing video games that cause the elevation of our dopamine and our norepinephrine, which are neuroexcitatory, you will much more likely have mood disorders. We need to respect our normal circadian rhythm if we want to have a good sleep pattern. Wearing blue light blocking glasses at night can be helpful, esp. if they are looking at their phones, computers or TV.

29:00  There is a therapeutic benefit to spending time in nature, which the Japanese call shinrin yoku.  Molecules known as phytoncides are emitted in a forest and we breath them in and they get into our bloodstream and they help our immune system to work better and balance our neurotransmitters. Just standing on the earth, grounding, changes our electromagnetic field and has therapeutic benefit.

30:25  Exercise has been shown to be as effective as the leading antidepressant medications.  Exercise as a treatment modality for depression: A narrative review.   

34:17  The Gut and the Microbiome in Mood Disorders.  The bacteria in our microbiome can send signals to our brain that help our brain to create the right neurotransmitter balance.  Our gut also affects inflammation levels in the body. It can be helpful to take a probiotic and also include plenty of fiber as well as fermented foods in our diet. 

37:07  Nutritional Supplements for mood disorders that Dr. Bongiorno recommends include a multivitamin, a good B complex, fish oil, and a probiotic are the basics for most patients.  Fish oil has quite a few studies showing its benefit for brain health and for mood disorders and patients should take 1-2,000 mg of EPA and DHA per day.  If patients are vegetarian he may recommend AHI flower oil, which has a fair amount of EPA.

42:57  Other fatty acids like GLA can also be helpful for mood disorders and they can help with hormonal balancing, like evening primrose oil. GLA has also been shown to be useful in alcoholism because it can help with production of prostaglandins. 

45:00  There are other important minerals like magnesium, zinc, and copper.  Magnesium if very calming for anxiety, esp. magnesium glycinate or magnesium threonate, which sometimes is even more calming. He might recommend something like 250 mg in the evening before bed. It can also help with sleep issues and it can benefit blood sugar balance.

 

 



Dr. Peter Bongiorno is a Naturopathic Doctor and Acupuncturist and he is the co-director of InnerSource Natural Health and Acupuncture, with offices in New York City and on Long Island. He also works with clients via phone and Skype. He’s written a number of books, including Healing Depression in 2010 and Holistic Solutions for Anxiety and Depression in Therapy in 2015, targeted for physicians, and How Come They’re Happy and I’m Not, and Put Anxiety Behind You: The Complete Drug Free Program, both for patients. His website is DrPeterBongiorno.com.

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



 

Podcast Transcript

Dr. Weitz:                            Hey, this is Dr. Ben Weitz, host of the Rational Wellness podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness podcast for weekly updates. To learn more, check out my website, drweitz.com. Thanks for joining me and let’s jump into the podcast.  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 Apple podcasts and give us a ratings and review. That way more people will be able to discover the Rational Wellness podcast. If you’d like to see a video version, please go to my YouTube page. If you go to my website drweitz.com, You can find a complete transcript and detailed show notes.

Today our topic is in integrative approach to mood disorders like depression and anxiety with Dr. Peter Bongiorno. Depression is a mood disorder characterized by a persistent feeling of sadness and loss of interest. According to the journal, the American Medical Association, in 2013 16.7% of adults filled one or more prescriptions for psychiatric drugs with most being anti depressants. This prevalence is higher among women than men.  An estimated 3.2 million adolescents aged 12 to 17 in the US had at least one major depressive episode representing 13.3% of adolescents. Anxiety is characterized by feelings of worry, nervousness or fear that are strong enough to interfere with one’s daily activities. Anxiety is even more common than depression with 19.1% of US adults having experienced an anxiety disorder in the last year and 31.1%, having experienced an anxiety disorder sometime in their lives.

These numbers for rates of anxiety have been rising in the US. Depression and anxiety are typically treated within conventional medicine with medications like antidepressants such as Prozac, Zoloft, and Lexapro. These are among the most commonly prescribed medications in the US. The number of people taking these medications has been rising rapidly. Recent statistics show 64% increase in the number of people taking antidepressants in the last 15 years. 12.7% of the US population took antidepressants in the last month and older adults took them in even higher numbers.  Most of these antidepressants were originally approved by the FDA for short term usage, and there are only a few studies that lasted longer than a few years. But yet many patients are being placed on these drugs indefinitely. It’s very difficult to get off these drugs. A large percentage of patients who take them report severe withdrawal symptoms when trying to wean themselves off or are unable to wean themselves off.  One of the focuses of our conversation today will be whether these drugs are actually effectively treating the causes of depression and anxiety and what alternative treatments might be available, taking a holistic or functional medicine approach. Either as alternatives for patients who do not want to take these medications, or perhaps to make these medications more effective.

Dr. Peter Bongiorno is a Naturopathic Doctor and acupuncturist and he’s the co founder, co director of Inner Source Natural Health and Acupuncture with offices in New York City and on Long Island. He was a researcher at the National Institutes of Health in the department of Neuroimmunology. Then he went to Bastyr University to study naturopathic medicine and acupuncture. He’s written a number of books, including Healing Depression, in 2010, and Holistic Solutions for Anxiety Depression, as well as How Come They’re Happy, and I’m Not and Put Anxiety Behind You The Complete Drug Free Program.  Dr. Peter is a sought after speaker and he spoke at the A4M conference in Las Vegas in 2018 where I saw him speak. Dr. Bongiorno, thank you so much for joining me today.

Dr. Bongiorno:                   Oh, gosh, it’s my pleasure.

Dr. Weitz:                          Why do you think rates of depression and anxiety are so prevalent today and especially anxiety seems to be rising among teenagers?

Dr. Bongiorno:                   I mean, there’s no question that anxiety and depression rates are just soaring. It’s really interesting because as you alluded to at the statistics, we’re using more and more of these drugs for depression and anxiety every year. Yet, more and more people are getting anxiety and depression every year. If you look at, for example, depression, one of the things you worry about the most, of course, is suicide.  Suicide rates have soared. There’s a few studies that look at rates from between 2007 and now. We’re seeing these incredible jumps and even in just the past few years. Despite the fact that all of these drugs are being used and more and more are coming out on the market, the endpoint, which we’re most concerned about is only becoming more and more of a problem.

Dr. Weitz:                          In fact, the side effect of some of these drugs is that they actually increase suicide rates, right?

Dr. Bongiorno:                   Yes. So now they’re putting black box warnings on things like SSRIs which are serotonin reuptake inhibitors, which are commonly used for depression and anxiety. But now they’re showing that in younger people, they may actually increase suicide rates. In fact, it started out with very young people like teens and adolescents, and now they’re bringing it up to young adults that they’re seeing this concern with.  It’s not to say that medications don’t have their place. Sometimes when someone is in a real urgent care situation, and there’s really no other choice, then sometimes a drug can be life saving. It’s not that they’re completely not useful and always a bad idea, but they’re certainly being far overused. They’re not getting to the underlying problem. For many people, they might numb the symptoms when they do work.  For example, depression, in mild to moderate depression, which is when SSRIs are used the most, they work about 30 to 35% of the time, which is maybe a hair more than a placebo would work. Even in those cases, at some point, it’s usually within two to five years, those medications tend to not work as well anymore anyway. At some point, you still have to say, okay, we have to figure out what’s going on. Even for people when they work in the case of depression, you still want to sit down with these person and say, well, what’s the reason things went awry.  If an SSRI fixes serotonin, and that helps, you still want to ask, but why did the serotonin get out of balance to begin with? These are the questions that aren’t being asked. Instead, people are just being put on medication and sent on their way. Then once it stops working, it becomes a crisis.

Dr. Weitz:                            You wonder if this whole concept of these mood disorders actually being caused by neurotransmitter imbalance is really valid. If you think about the fact that we have drugs that increase serotonin, you talking about SSRIs. Then we have drugs that increase Norepinephrine. Now we have drugs that increase dopamine. We have drugs that affect GABA, glutamate. We even have drugs that decrease serotonin and seem to be equally effective. You just have to wonder what do we really know about the complexity of brain chemistry? It certainly doesn’t seem to be as easy as just increasing serotonin production.

Dr. Bongiorno:                   No, absolutely right. It’s interesting because the drugs that seem to work the best, not great, but certainly the best of what are called tricyclic antidepressants, which are the old ones. They just seem to basically raise everything. So it’s just pull everything up and hopefully it will help somebody feel better. The problem with those drugs is that they do have a lot of side effects, which is why they are considered first generation not really used so much anymore.  Like I said, in mild to moderate depression, which is the vast majority of use of these prescription drugs, it only works maybe 30, 35% of the time tops. Anxiety, on the other hand, benzodiazepines, drugs like Xanax and Ativan, they do work. If somebody takes one of those, they get calmer. But the problem with those drugs are, is you can’t keep taking them. You get addicted to them, they stop working and need more and more, and I can’t tell you all the patients I see on the same path trajectory.  They’re young, they get anxious, they get put on an Ativan. The Ativan doesn’t work, they get put on Xanax. Now they get withdrawal at night, they have trouble sleeping, so they get put on Klonopin, and then the Klonopin stops working so they get put on Tramadol or something even stronger. Trazodone and just… We keep upping the ante and these gets stronger and stronger to the point where people, they can’t get off them but they’re not working anymore either.  I can’t say how many patients I’ve seen in that situation as well. It’s just a testament to the fact that the body is not being treated to heal. It’s just being treated for symptoms. That doesn’t work.

Dr. Weitz:                            Right. Let’s get into some of the natural approaches. What role does diet play in depression and anxiety? What’s best type of diet to control it?

Dr. Bongiorno:                   The first thing I want to say is that there’s a lot of factors that play a role. You just touched on a major one. Diet, if people are sleeping, whether they’re exercising or not. Certainly what’s going on with their thoughts, play a role, environmental toxicities, inflammation in the body, digestion, hormonal balance, nutrient deficiency. When I look at a patient, I try to assess all of these different things at the same time and figure out for them, what are the factors that are contributing to what we’re calling anxiety or what we’re calling depression.

Diet is clearly one of them. Our digestive tract is such an important place in terms of making the neurotransmitters. If neurotransmitters are off, we really want to start thinking about the digestive tract. What we eat and what we put in our mouth, of course, is going to play a huge role and how well that digestive tract functions. To answer your question, if I don’t know a patient and someone asked me well, what is the best diet? I would start with something probably like a Mediterranean style diet.  Mediterranean style diets are shown to be very beneficial to help raise GABA which is the calming neurotransmitter. It helps lower inflammation. We know that inflammation that goes to the brain can play a really strong role in all kinds of mood disorders. The Mediterranean diet really provides a lot of nutrients, a lot of good fiber for the microbiota in our body, which is clearly an important part of how we can balance neurotransmitters in our brain. Without knowing a person, if I had to pick a diet and didn’t understand their sensitivities, I’d probably start with some version of the Mediterranean style diet.

Dr. Weitz:                            Good. What are some of the dietary factors that play a role here? I know in your book you talked about the importance of balancing blood sugar.

Dr. Bongiorno:                   Yes, blood sugar is very vital because what I find is a lot of people who have both anxiety and depression, their blood sugar tends to bounce around a lot or sometimes their insulin, which is the hormone that takes the sugar out of the blood and puts it into the cells, can get very high for some people and that can also drive a lot of inflammation. Eating in a balanced way can be very useful.  Now everybody’s different, of course one size doesn’t fit all. But usually I find if patients are very susceptible to mood changes when they don’t eat, then the first step is really to make sure you’re eating throughout the day at least three good meals and definitely a good breakfast. I tell a lot of patients: eat like a king for breakfast, a queen for lunch, and a pauper for dinner. It does work because I find when people eat a good breakfast… I know right now, with intermittent fasting, sometimes it’s become desirable to not eat and have a breakfast later so that you lessen your hours.

Dr. Weitz:                            Yes, very popular, especially in the holistic Functional Medicine circles. We skip breakfast so we have a longer period of time between dinner the night before and lunch without eating.

Dr. Bongiorno:                   That could be fine for some people therapeutically if they want to lose weight. But I always like to check in because if they have mood issues, and especially if they have mood issues associated with not eating, then we might want to modify that for them. Again, everybody is different and there’s no one size fits all and that might be great for some people, and not so good for other people. But I find for mood, it’s really helpful to have a good breakfast, to have a good lunch and have a smaller dinner.  Make those meals very healthy protein based, whole foods, good healthy fats, and also some healthy carbs. If you look at the diets really where people live the longest in the Blue Zones, they don’t really get rid of all the carbs. They tend to eat good whole grains, beans, legumes and things like that. I find for my patients with mood, getting some of those carbs are really helpful to even keep the serotonin levels up. Everybody’s different, but I think for mood that’s a good general rule.

Dr. Weitz:                            I think it’s important that you’re emphasizing the benefits of carbohydrates because especially in the last five 10 years, carbs have been demonized as some of these low carb diets have become more and more popular like the paleo diet and the ketogenic diet. People are really seeing carbs as just completely evil. I think we need to rethink that and realize that carbohydrates can play an important role, especially healthy carbs or low glycemic ones that have a lot of nutrients and fiber and can be part of a healthy diet.

Dr. Bongiorno:                   Yes, absolutely. When I was a student over 20 years ago, I had the opportunity to spend time with Dr. Atkins in his center in New York.

Dr. Weitz:                          Okay, Mr. Low Carb himself.

Dr. Bongiorno:                   Yes, the guy who really figured out that not eating fat and eating all of these bagels was a bad idea. Nobody was talking about it. He was a very nice man. The thing that I learned in his clinic is that therapeutically, using very low carb can be really helpful and get people out of crises when there’s a lot of inflammation, when there’s heart disease, things like that, but for the long term, it’s not always a good idea. I think even Dr. Atkins himself started people on a pretty strict diet and then eventually put them on a more modified diet.

Dr. Weitz:                          That’s not information that you hear a lot.

Dr. Bongiorno:                   Yes. Now you hear about eating a lot of bacon and stuff but I don’t think that’s what it was really about there.

Dr. Weitz:                          Right.

Dr. Bongiorno:                   I think that’s interesting. All of these tools can be used therapeutically for the right person, but we really have to say, as a practitioner, do I want everyone not eating breakfast? Maybe some people that works, some people that’s a disaster. We really have to tailor.

Dr. Weitz:                          I’ve been in the healthcare field for 30 years. When I first got into it, the big thing was, everybody said because they skip breakfast, they don’t have time, they rush off to work. One of the big keys was you have to eat within that first hour of eating, you have to have small meals or snacks and now skipping breakfast, which was a bad thing is now supposedly the good thing. It’s funny how these things go in cycles.

Dr. Bongiorno:                   Yes, as info comes out, the pendulum keeps swinging. The truth is, it’s all can be useful and it’s all could be not appropriate. It all depends on the patient. Everyone is different. That’s really what’s in a sense, I think what’s fun about our job. We get to sit with the person. It’s really an honor to spend a lot of time with this patient, learn about their life and their history. Then, based on our knowledge, help them figure out what really works for them.

Dr. Weitz:                          Exactly.

Dr. Bongiorno:                   That’s what’s exciting to me about the job.

Dr. Weitz:                          That’s great. We have all these different complicated factors, and you just touched on a bunch of them. One of the ways to sort this out, besides taking a detailed history is to do some lab testing. What do you think are some of the most beneficial lab tests that help sort out patients with anxiety and mood disorders?

Dr. Bongiorno:                   Well with blood work I definitely like to do a good cholesterol panel. Believe it or not just to find out to make sure it’s not too low. Because cholesterol is the major molecule your body uses to make your other steroid hormones. Sometimes I worry it’s too low. I know regular doc’s worry about it’s too high. In fact, HDL levels, when they’re low, that’s actually considered a marker of depression. You want to have good lipid levels.

 



 

Dr. Weitz:                            We’ve been having a great discussion, but I’d like to take a minute to tell you about the sponsor for this episode. I’m thrilled that we are being sponsored for this episode of the Rational Wellness Podcast 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 patients prevent chronic diseases and feel better naturally.

                                                Integrative Therapeutics is also the founding sponsor of Tap Integrated, a dynamic resource of practitioners to learn with and from leading experts and fellow clinicians. I am a subscriber and if you include the discount code Weitz, W-E-I-T-Z, you’ll be able to subscribe for only $99, instead of $149 for the year. And now, back to our discussion.

 



 

Dr. Weitz:                          What level of HDL is considered a marker for depression?

Dr. Bongiorno:                 Under 35.

Dr. Weitz:                         Okay.

Dr. Bongiorno:                  It depends on the lab tests but around there, around under 35.

Dr. Weitz:                         Interesting. It’s interesting because today you hear the latest drug, the PCSK9 inhibitors, which when combined with the statin we get your LDL below 40.

Dr. Bongiorno:                  Low low low.

Dr. Weitz:                         Exactly and there’s problems with getting your LDL level too low.

Dr. Bongiorno:                  What are we doing to the brain, right?

Dr. Weitz:                          Right.

Dr. Bongiorno:                   It’s just not a great scenario for the brain.

Dr. Weitz:                          Is there a level of LDL or total cholesterol that you like to keep the body from getting too low on? Is there a cut off?

Dr. Bongiorno:                   I like to see the total cholesterol at least around 180. I think is a good place to be in and maybe LDLs around 90.

Dr. Weitz:                          Oh, wow. Okay.

Dr. Bongiorno:                   Maybe 100. It just really depends. Because we’ve been lowering them and lowering them and lowering them. I’m not sure we’re seeing the benefit of that. But we are seeing the detriment to the brain and cognition and cognitive function. It’s… I mean, I think there’s still a lot to be learned there so I’m still open but-

Dr. Weitz:                            Probably plays a role in the rise in neurodegenerative diseases like Alzheimer’s and Parkinson’s.

Dr. Bongiorno:                   That’s what it seems to be. It’s-

Dr. Weitz:                            Okay. So besides lipids, what other…

Dr. Bongiorno:                   Good iron panel and iron storage. Of course, vitamin D. Then I like to look at thyroid, a full thyroid profile, not that thyroid is perfect in terms of lab testing, but I think it’s good to see where it is in terms of labs and then correlated with how people are feeling clinically.  Certainly look at things like red blood cell magnesium.  Carnitine is another amino acid that I like to look at. B12 certainly. Then I like to do a full hormonal panel. I like to look at the four or five point cortisol test, see how people’s stress hormones are doing throughout the day and see what their circadian rhythm looks like. Especially for women looking at the estrogen levels. But even in men seeing what the estrogen level is is important too, because that’s important for serotonin and serotonin receptors.

Progesterone in women as well is really important for the calming GABA neurotransmitter, testosterone for both men and women can be very important for the brain. Melatonin levels are useful especially when there’s sleep issues to see what’s going on there. Pretty full profile and then depending on the patient, there could be other things they might want to look at like histamine levels, mitochondrial function, mold toxicity.  Everyone’s history is a little different. Then that might give me clues. Unfortunately, there’s so many tests you can do. You can’t run them all on everybody. You need to listen to the history and then start looking down those roads first.

Dr. Weitz:                          How do you assess mitochondrial function?

Dr. Bongiorno:                   I mean, you could start with things like lactic acid, which is an easy test. Pyruvic acid, which you can do with blood work. Certainly looking at CoQ10 levels. CoQ10 levels, believe it or not, if they’re low, that can suggest mitochondrial issues or if they’re too high. Because if a patient starts taking CoQ10 but their levels are high, that usually means the mitochondria is in some sort of distress.

Dr. Weitz:                          Interesting.

Dr. Bongiorno:                  Things like that. Then now there’s more specific mitochondrial profiles and genetic profiles that look at mitochondria as well. I’m starting to learn more about those two. It’s pretty exciting stuff.

Dr. Weitz:                          Right, there’s that Mitoswab test that’s available now.

Dr. Bongiorno:                   Have you used that test?

Dr. Weitz:                          I haven’t yet but I interviewed the doctor who came up with it, Doctor Ganeshan.

Dr. Bongiorno:                   Oh it’s terrific. Things like that I think are really fascinating. For a lot of patients too, I see especially when they have a lot of sensitivity to noise and light, as well as being very fatigued, looking at mitochondrial function, I think is a really great idea.

Dr. Weitz:                          Yes good. You mentioned sleep, how important is getting good quality sleep for us?

Dr. Bongiorno:                   If anyone’s ever looked at any of my books, sleep is the first chapter. That tells you how important it is. Sleep is… If people aren’t sleeping, it’s very hard to get them to feel better.  Sleep is absolutely imperative. The two things that I look at for patients is if they’re not sleeping, and if they’re not pooping every day, that has to be worked on first.  No matter what they’re coming in for, because I find is really hard to fix anything.  If those things aren’t happening.  Sleep is really… It’s where our brain detoxes and where it de-inflames and fixes things.  That’s where our mitochondria fix themselves and rebuild. It’s critical.

Dr. Weitz:                          Do you use devices to help assess sleep?

Dr. Bongiorno:                   You mean like wrist devices..

Dr. Weitz:                          Yes.

Dr. Bongiorno:                   There are a few different ones. I haven’t found anything that has been especially useful yet. I don’t think they’re quite there yet. I mean, it’s interesting. But to tell you the truth. Usually just by getting a good story from the patient, you’d like to figure out what’s happening with the sleep.

Dr. Weitz:                          Check out the Oura Ring.

Dr. Bongiorno:                   Oura Ring?

Dr. Weitz:                          Yes.

Dr. Bongiorno:                   Okay. I’ll give that a try.

Dr. Weitz:                          Does it matter what time we go to sleep?

Dr. Bongiorno:                   I think it does. I mean, in Chinese medicine, they’ll say an hour before midnight is worth two after midnight. Our melatonin gets released somewhere between probably 8:30 and 10:30. If we go to bed too far after that, we start to lose the beneficial effects of melatonin to get into a deep sleep earlier. We end up staying in more surface sleep that lasts the whole night. Even if we’re sleeping, the sleep isn’t going to be deep. Getting to bed earlier is definitely advantageous because we’ll get into a deeper sleep.

Dr. Weitz:                           This refers to our natural circadian rhythm, right?

Dr. Bongiorno:                   Mm-hmm (affirmative).

Dr. Weitz:                           That’s why the body secretes the melatonin when light comes down.

Dr. Bongiorno:                   Yes, but our eyes recognize when it’s evening and when it’s nighttime, and that starts that whole process of melatonin. Melatonin really is a master hormone that tells our body it’s time to go to sleep. Then Once it does that, then it starts all those processes I mentioned before about detoxing, getting rid of inflammation and fixing the brain and all that.  It’s one of the reasons why these computers that we’re on and all this blue light, and TV watching and games. I had a patient I was working with yesterday, who had pretty… He was in his early 20s, had pretty significant depression the first time I’d seen him. For the last couple of years, he’s up every night just playing games till late. Of course, his sleep is completely disrupted. That seems to predate a lot of this mood.  I know it sounds simple, but that routine has got to get changed, and it’s hard because those games they raise our dopamine. They raise their norepinephrine and we get addicted to them. Between the addiction of those neuro chemicals and the excitement of the game and then that changes of our circadian rhythm, then we get into these patterns then we wonder why we don’t feel good. Very disruptive.

Dr. Weitz:                           Do you recommend blue light blocking glasses or using red light bulbs or things like that?

Dr. Bongiorno:                   Yes, absolutely. In fact, with the patient I spoke about yesterday, that’s one of the things we talked about is looking into blue light glasses. Because when people are in a certain pattern, it’s usually hard just to ask them to completely stop something. They’re not ready and frankly, they’re addicted to it. We do it in steps, right?  Something like lessening the amount of time, using blue light glasses is a good place to start.  If possible, I’d like to get people to shut all the screens and blue lights an hour before bed, and if they want to read they could read by an orange light or an orange red light. Just enough light so that they could see but not a color in the spectrum that’ll suppress our natural melatonin. Right.

Dr. Weitz:                           Let’s see, in your book you talk about therapeutic benefit of being in nature like taking a hike.

Dr. Bongiorno:                   Yes, the Japanese have a term for it, it’s called shinrin yoku. What they recognize through studies in Japan and elsewhere is that the forest and nature emits these molecules they called phytoncides. We actually breath them in, they get into our bloodstream, and they interact with our immune system and help our immune system work better and interact with our nervous system and balance our neurotransmitters.  There’s clear benefits from a research and scientific standpoint of getting into nature. We all know that it just makes us feel good. There’s no question about it, but there’s real reason for it. I know. Dr. Sinatra, I don’t know if you’ve talked to him at all. He’s a big proponent now of grounding. Taking your shoes, your socks off, going to the sea putting you’re feet in the sand.

Dr. Weitz:                           Yes, one of the doctors in my office, Dr. Howard Elkin, he worked with him on that grounding study.

Dr. Bongiorno:                   I love it. It’s great stuff. That’s getting into nature and just changing your whole electromagnetic field and getting together with the earth. Our bodies respond very positive with it.

Dr. Weitz:                           What about the role of exercise for depression and anxiety?

Dr. Bongiorno:                   Exercise alone has been proven to be as effective as any of the medications by itself. We know the medications for depression don’t work so great and for anxiety, they do work well and so does exercise. Exercise is just… It’s an interesting thing. As I’m learning more about depression, I’m learning how there’s something… You know that mTOR, mammalian target of rapamycin?

Dr. Weitz:                           Yes.

Dr. Bongiorno:                   There’s a molecule in our body that’s mTOR that shuffles between building us up and breaking us down. We need this balance of both. Exercise has really been shown to create that balance for that. It helps us clean out when we need to clean out, and then build back up when we need to build up. That has very beneficial effects on the nervous system. For anxiety and depression, exercise is just such a key, especially in the way that it burns our stress hormones.  Let’s say you’re anxious, in the wild, if we’re anxious, I feel my heart beating and I get very stressed and upset and I see a bear behind me. That would be the reason why I’d feel that way and I’d run. I burn off those stress hormones, burn off that norepinephrine. Get away from it, and then feel calm.

Well, in today’s society, we have those feelings, and we get very stressed and anxious, but we’re not burning it off. We’re not doing anything to release it. So It does build up in our body, and then it comes out as panic attacks, and anxiety attacks. In most cases, in my opinion, depression is really just anxiety and overwhelm that gets to the point where a body can’t take it anymore.  We start to almost decompensate for all that overwhelm and then we get depressed. Anxiety and depression are almost two sides of the same coin in most cases. Exercise is just a brilliant way to help remedy that.

Dr. Weitz:                            I think exercise is overlooked as a solution for so many problems. Everybody’s into fasting these days. One of the benefits is something called autophagy, which is where you break down yourselves to rebuild yourself. Exercise is the original stimulator of autophagy. You don’t necessarily have to starve yourself.

Dr. Bongiorno:                   The only thing I would say for my patients is if you’re not getting enough sleep, don’t trade sleep or exercise. Make sure you’re sleeping first, and then get up and go exercise.

Dr. Weitz:                          Right, what type of exercise? Do you think it matters?

Dr. Bongiorno:                   From the studies I read, all exercise is good. Certainly up to what a person can do. I generally recommend doing something you enjoy, because if you do something you enjoy, you’ll continue to do it. What seems to be the most beneficial is actually having a mix where people are doing strength training, and are doing cardiovascular. In the mitochondrial studies I’ve seen, to build optimal mitochondrial function doing both seems to be optimal.  

Dr. Weitz:                          We were talking about testing. I wanted to ask you, what do you think about the urinary neurotransmitter test to get a sense of what’s happening with neurotransmitters?

Dr. Bongiorno:                   Yes absolutely. I think tests all have their value and have their limits, but I do think looking at neurotransmitter testing through urine can be very helpful.

Dr. Weitz:                           Okay. Then what about the role of the gut and the microbiome in mood disorders?

Dr. Bongiorno:                    What we’re learning now and every day I see new papers on the microbiome and the microbiota. There’s little bacteria in our digestive tract we’re finding, plays such an important role in keeping the environment of our digestion proper. That environment is really key to how sending signals to our brain that helps our brain create the right neurotransmitter balance. Also that environment in our gut also plays a really strong role in how inflammation happens in our body or doesn’t happen.

As we were saying before, the foods we eat are certainly the first key towards that. But then, there’s other things that we can do as well. There’s specific foods that help raise the microbiome in different ways. Then there’s certain fibers specifically that can help that process. I think there’s so much that we still have to learn about it. But the way I think about it is the microbiota in there, is like this garden.  When you have a garden that has certain plants that are too many and other plants that aren’t enough then it creates a lot of imbalance and it’s not a very productive garden.  But when you have a very balanced garden, with all different plants and species, that’s usually when you get the most productive use out of it.

Dr. Weitz:                            There are supplements on the market like probiotics that claim to specifically improve mood. What do you think? You think it’s early for those?

Dr. Bongiorno:                   I think a lot more studies have to be done. I think the most compelling studies… There’s some small clinical studies that are showing things like lactobacillus and bifidus can increase GABA levels in the brain. Even though those studies aren’t large, there’s a number of them now that are pointing in the same direction. I think using basic keystones like that seem to make sense.  Now there’s some other studies coming out with a few other strains, which I think still need to be replicated I’m very interested in. It certainly does make sense. One thing we do know though is that the strains… A lot of the strains of interest, we’re not actually capable making into a supplement, at least at this point. My general idea, my general tact is to give patients the probiotics that we know can be helpful, that are basic Keystone strains, and then make sure we’re filling in with all the proper fibers and vegetable matter and fermented foods that can help add all those other and help our body make all those other strains that we probably can’t supplement on our own.

Dr. Weitz:                          Outside of probiotics, let’s go over some of the most beneficial nutritional supplements for mood disorders.

Dr. Bongiorno:                   Okay, well, I mean certainly the basics, having a patient take a multiple vitamin, a good B complex with a [inaudible 00:37:26] is a great idea. Then certainly a fish oil as well as the probiotic. Those to me are the basics probably for most patients to at least get started.

Dr. Weitz:                          Fish oil has quite a bit of studies showing benefits for brain health as well as for mood disorders.

Dr. Bongiorno:                   Yes, in fact, the newest studies right now coming out of the psychiatric journals are showing that in patients who are treatment resistant, meaning that they’re on a drug, but the drug isn’t working, when you give them fish oil, then the drug seems to start working. Which makes me think, well, maybe if you just gave them the fish oil and without the drug, you probably get them feeling better too.

Dr. Weitz:                          Right.

Dr. Bongiorno:                   So I’m not sure… Anyway.

Dr. Weitz:                          What about the best… What’s the most effective dosage for fish oil and also, do you think it matters? As far as, I keep seeing studies showing well, EPA is really better. No, DHA is better.

Dr. Bongiorno:                   No.

Dr. Weitz:                          Do you think we know if it’s better to have just a balanced EPA, DHA or if it’s better to have more of a concentrated EPA or DHA?

Dr. Bongiorno:                   It’s a good question. I think the studies are fairly clear that EPA levels of around 1000 to 2000 milligrams are a good idea with the associated DHA that would normally come with that in a regular fish oil. Maybe like a 1000 milligrams of EPA, around 300 milligrams of DHA. I usually shoot for that ratio, and then depending on the patient, starting with either 1000 milligrams or 2000 milligrams of the EPA.  It seems pretty clear to me that for anxiety and depression, looking at those levels of EPA seem to be the best. I know in children, sometimes giving higher levels of DHA can be useful for certain cognitive reasons and attention deficit. For those specific sometimes I think, a higher DHA might have some benefit. But I think in general for anxiety and depression looking for those higher EPA levels, which frankly, are what comes naturally in fish oil seems to be the way to go.

Dr. Weitz:                          Can you get those levels of EPA/DHA from vegetarian sources?

Dr. Bongiorno:                   I find it pretty difficult to do so. It’s not that easy. My strong preference when possible is to use fish oil. If I have a patient for ethical reasons or other religious reasons, or for allergies, they can’t take fish oil, then we’ll use other vegan oils and try to make up the difference. I’ll give patients things like ahi oil which has a reasonable amount of EPA for a vegetarian source.

Dr. Weitz:                          What’s it called?

Dr. Bongiorno:                   Ahi flower.

Dr. Weitz:                          Never heard of that one.

Dr. Bongiorno:                   A-H-I flower oil.

Dr. Weitz:                          Okay.

Dr. Bongiorno:                   There are few vegan vegetarian version that are out there that are a little higher. A lot of people are cognizant that they need to get those essential fats. Unfortunately, and I discussed this in my books, a lot of patients who have mood disorder, they’re not very good at converting the vegan oils into the EPA. So because they have the delta desaturate enzyme, genetically maybe isn’t working as well.  For those patients, unfortunately, it’s really important to try to get the EPA indirectly as possible.

Dr. Weitz:                            You mentioned B vitamins, you monitor some of those genes like the MTHFR and the COMT, and so many others?

Dr. Bongiorno:                   I do. For a lot of patients, I do run the genetic snips to take a look at that. Again, I think a lot of that is in its infancy, I think to look at one gene snip and say, okay, you need this vitamin [inaudible 00:41:36] another, I think it’s very premature because there’s so many gene interactions that we don’t understand. But I think it’s helpful. In other words, if you see a patient who has a snip of the COMT, and a snip of the DRD and a snip of the Chip the fan hydroxylase enzyme. You see they’re testing… all their neurotransmitter there low. They’re depressed. It starts to add up. [inaudible 00:42:04] the gene cell that they’re probably not keeping them up and certainly their testing shows it’s low and clinically they’re low. Then we know we have to work on that. I like using it to just basically inform.

Dr. Weitz:                          Quite a clinical picture, but don’t place too much importance on just any one particular gene.

Dr. Bongiorno:                   Yes, absolutely. I mean, what I’ve learned in this job is not to be religious about anything I’ve learned. Because as soon as I get a little religious and they go, this is what people need. Then it turns out not to be correct. I find you have to always be flexible and look at the patient first and then look at all this testing as part of information to help make the best choices.

Dr. Weitz:                          What about-

Dr. Bongiorno:                   Another thing about genetics, I think in the future, it’s going to be more and more useful.

Dr. Weitz:                          Yes, I totally agree. What about other fatty acids like GLA?

Dr. Bongiorno:                   GLA actually has been shown to be very useful in alcoholism, to help patients… A lot of people who are alcoholics, one of the reasons why they drink alcohol is because it artificially raises prostaglandins, these feel good molecules as well in our body and in our brain. What’s been shown is that when we take things like GLA and certain oils in that realm, that we can actually help ourselves make those natural prostaglandins. I’ve seen patients with alcoholic tendencies and things like that do really well with those oils.  They’re also very good for hormonal balancing like a primrose oil. When you see women who have mood issues, and they also have menstrual cycle disorders and things like that, I like using those. So yes, they’re definitely helpful.

Dr. Weitz:                          What about vitamin D?

Dr. Bongiorno:                   Vitamin D, it’s the sunshine vitamin. It’s the sunshine… I remember Alan Gabby. You know, Alan Gabby?

Dr. Weitz:                          Yes.

Dr. Bongiorno:                   He used to give us… He used to tell us that John Denver said sunshine on my shoulder made him happy. That was the best study on vitamin D there was. I mean, vitamin D it’s a neuro steroids. It’s important for so many factors in our brain, and in our body. I think, by itself, it doesn’t cure depression if it’s low, and you bring it up or anxiety, but I think it is a major factor that needs to be looked at. I remember when I was in school, 23 years ago, naturopathic school, they talked a lot about vitamin D. When I got out to New York, nobody was running vitamin D 16, 17 years ago. Then I was just so amazed after all the things I’d learned about how wonderful it is. Now it’s nice to see that people are running it. That it’s a common thing to look at now even in conventional medicine.

Dr. Weitz:                          Right, absolutely. What about some of the most important minerals like zinc and magnesium?

Dr. Bongiorno:                   Magnesium is I think a must for most people with anxiety. It plays a role in helping relax the muscles, and it plays a role in helping the brain form GABA.  There’s just so many effects all over the body with magnesium. I typically use magnesium glycinate which is a very calming form. Sometimes I’ll use magnesium threonate which does seem to have an even more calming effect.  I know when I take it’s very relaxing, the magnesium threonate.  I’ll use that with some patients, especially if they’re really anxious.

Dr. Weitz:                          What dosage of magnesium do you like?

Dr. Bongiorno:                   Depending on the patient, I’ll usually start with 250 milligrams maybe in the evening before bed. Especially if there’s sleeping issues. I am careful though sometimes magnesium can cause loose stools.  Different forms of magnesium might be better for that than others.  But other than that, magnesium is usually a really nice choice for patients for both anxiety and depression.  It’s good for blood sugar balance. Lot of benefits.

Dr. Weitz:                          Yes, I think the glycinate has less bowel issues.

Dr. Bongiorno:                   Yes, absolutely. What was the other mineral? Oh yea, zinc.

Dr. Weitz:                          What about so many other minerals?

Dr. Bongiorno:                   Zinc is such an important co-factor in so many places. Zinc is really important to the digestive system as well. I do like to look at that zinc to copper ratio. I do find with most patients with mood issues, you’ll see a very low zinc to copper. Sometimes you’ll even see patients with high copper and high copper can be a problem in terms of estrogen balance and that can throw off serotonin as well.  Zinc itself is a co-factor for making the neurotransmitters too. For all those reasons I like To check Zinc when it’s low or low normal, I typically will supplement with Zinc.  I don’t supplement too high.  Usually just 15 to 30 milligrams. I’m careful to avoid overdosing.

Dr. Weitz:                          What is the zinc to copper ratio you like to see?

Dr. Bongiorno:                   At least one to one and preferably I think a little bit higher.

Dr. Weitz:                          What if the copper is too high? Do you ever use things like molybdenum or other things to lower the copper?

Dr. Bongiorno:                   Usually I’ll start with zinc. Then if that doesn’t work, then bring in things like molybdenum or just a good minerals formula, obviously, copper.

Dr. Weitz:                          What about lithium orotate?

Dr. Bongiorno:                   Lithium is one of my favorites for anxiety. It seems to be quite safe and it’s not… Just for everyone listening, when we talk about lithium, we’re talking about lithium orotate which is a mineral, which is used in very low doses. Maybe 15… I’m sorry. Five to 20 milligrams in adults.

Dr. Weitz:                          And you’re saying which is different than the prescription lithium?

Dr. Bongiorno:                   Right. Prescription lithium is lithium carbonate, which is a much higher dose of lithium, maybe 900,000 milligrams plus carbonate which is a separate drug on town. Lithium orotate it’s been used for a long time. It’s quite safe, it’s even safe in children. What they saw many years ago in the early part of the 19th century is that places that had high levels of lithium in the water-

Dr. Weitz:                          There’s a crackling coming from your microphone somehow.

Dr. Bongiorno:                   Oh really? Okay. Is that any better now?

Dr. Weitz:                          I think it’s better if you hold it.

Dr. Bongiorno:                   I might have been moving it around there. Thank you. What they noticed is that areas in the United States and even around the world that had higher levels of lithium typically had… Still doing it?

Dr. Weitz:                            Yes.

Dr. Bongiorno:                   Let me see if I can adjust it. I don’t hear it from here.

Dr. Weitz:                            Okay. We’ll keep going.

Dr. Bongiorno:                   Any better?

Dr. Weitz:                            Yes right now I don’t hear it.

Dr. Bongiorno:                   Okay. I’ll stay still. Lithium was… In places where lithium levels-

Dr. Weitz:                          Need some lithium pill.

Dr. Bongiorno:                   Yes, I do. That’s why I play the drums. It helps me get some of that.

Dr. Weitz:                          Okay.

Dr. Bongiorno:                   So yes, lithium is just one of those things that in higher levels seem to lower… There’s less rates of suicide. People are generally happier, less anxiety, less depression, in fact, Seven Up the beverage was originally lithiated water.

Dr. Weitz:                            Really?

Dr. Bongiorno:                   Yes. Then when I think they decided to take the cocaine out of Coca Cola, lithium they said, okay, we’re not putting anything in these beverages anymore. We don’t know what this stuff is. They took it out but actually lithiated water was around for a long time as something to just help people generally feel happier.

Dr. Weitz:                            Wow. Interesting.

Dr. Bongiorno:                   Sometimes for the young children, I’ll have parents soak thyme, the herb thyme which has high level of lithium in it. You can soak it in olive oil for a month or so and then you could spoon out, maybe a teaspoon and put it on food once a day and you’ll get a couple of micrograms of lithium out of it.

Dr. Weitz:                            Really? Interesting.

Dr. Bongiorno:                   Is there any downside to using lithium orotate? I mean, in those levels, it doesn’t seem to be. I know early on I always was interested in checking kidney function and thyroid because we know the drug can cause problems with those but lithium orotate those levels. I haven’t seen anything. The literature that suggests a problem and I certainly haven’t seen it in patients.

Dr. Weitz:                            Cool. What about use of amino acids as precursors for neurotransmitters.

Dr. Bongiorno:                   Amino acids, to me thinking about using amino acids is similar to thinking about using drugs, right? Because we use drugs to stop the breakdown of a lot of those neurotransmitters. We want to use amino acids to more naturally bring up the levels of the neurotransmitters which makes sense if you give the body the precursor, it will help to make its own.  I think that makes sense to me. I think it’s safer and more gentle on the body than drugs. Certainly not as strong as drugs are but I think if you’re using it in combination with all the therapies we just talked about, it can be very supportive. I find tryptophan is… I have a patient who did well on an SSRI, but for some reasons, they don’t want to stay on it or they’re having side effects. Transitioning to tryptophan can be really helpful.  Instead of just taking everything away from them and removing the drug, you can bring in the tryptophan and slowly lower the drug and raise the tryptophan. If we get all the basics right, the sleep, the diet, the exercise, it’ll work.

Dr. Weitz:                          And use tryptophan or 5-HTP.

Dr. Bongiorno:                   It depends. Theoretically 5-HTP should be better because it’s closer already in the pathway to serotonin. But I do find a lot of patients seem for whatever reason to do well with tryptophan. I tend to use maybe equal amounts. At night if people have sleeping issues, I tend towards more of the tryptophan. I can’t explain why that’s better.  I know, there’s some studies that suggest that there’s a lot of inflammation in the body, you might be better off using 5-HTP. Because the certain pathways, one pathway that’s called the [inaudible 00:52:45] pathway suggests that if you use tryptophan it could actually create more inflammation. But I have to say clinically, I find tryptophan generally seems to work better. I’m open to either.

Dr. Weitz:                          Interesting. What about some of the other neuro transmitters. Any of them you find particularly helpful? Any other amino acids?

Dr. Bongiorno:                   Yes, I like using tyrosine sometimes. I created a formula that uses tyrosine in combination with mucuna. I find that can be really useful… Let’s say you have a patient who did really well on wellbutrin, then dopamine’s low. Their genetics show they’re probably low. The neurotransmitter test shows they are low, using things like tyrosine and mucuna can be very helpful for that purpose.

Dr. Weitz:                          What about GABA?

Dr. Bongiorno:                   GABA, I find for some people it works well, for other people it doesn’t. Theoretically, I’ve read if you have a leaky gut, then GABA can work well because it gets to the brain. You need both the leaky gut and a leaky brain barrier. Both of those it works.

Dr. Weitz:                          That’s what Dr. Kharrazian says. Right?

Dr. Bongiorno:                   Yes, but GABA I think can be very helpful. A lot of times they’ll use GABA and lithium orotate together, or sometimes I’ll even use GABA with [inaudible 00:54:04] seem to work really well together.

Dr. Weitz:                          What about some of the herbs like St. John’s-wort?

Dr. Bongiorno:                   St. John’s wort is the most studied herb of all time, and it’s very solid evident. It’s interesting. I just read an article in the Washington post which I wrote a letter to the editor about. Basically it was this woman who’s a nutritionist who is basically saying how supplements don’t work. One of the experts that she quoted was saying how St. John’s-wort really has no studies suggesting it works.

I read that and I was just amazed. I’m like well, apparently that person isn’t looking at PubMed at all. There are scores of analysis and scores of meta analysis. Then there’s a bunch of a meta analysis of the meta analysis all Showing that St. John’s-wort head to head to the SSRI’s most commonly used antidepressants work just as well in mild to moderate depression with much less side effects.  It’s amazing to me that a major paper like that could have this kind of information, it just shows you the bias that these people have going in. Again, if you want to challenge me on that, you could say, well, you just told me the drugs themselves don’t work much better than placebo. That’s true. What I’m saying is, St. John’s-wort, I think, has an effective rate at least as well as the drugs, but it doesn’t mean it’s the whole story.

That’s why I don’t want people to get the idea of oh, I don’t feel I have anxiety, I have depression. I’m just going to take St. John’s-wort and go along my way. No, we still need to work on sleep and exercise and our thoughts and going to therapy and the right foods. Then with St. John’s-wort, I think it’s a slam dunk. It works great.

Dr. Weitz:                          Right, and you’re really bringing up the importance of employing the entire functional medicine model and not thinking you can reduce it to just simply taking a particular supplement. If all you do is take a particular supplement like St. John’s-wort instead of taking an antidepressant, you just practicing an inaugural form of the same type of limited medicine.

Dr. Bongiorno:                   Right, exactly. That’s exactly right. It might work and that’s great, but I still encourage everyone listening to still dive into all of those basics and make sure those are right because that’s why things probably got out to begin with.

Dr. Weitz:                          Right, great. I think we’re done here. Any final thoughts-

Dr. Bongiorno:                   No, I mean-

Dr. Weitz:                            … listeners and then how can those listening contact you, find out about your books, your programs and how to consult with you?

Dr. Bongiorno:                   Okay. Well, first of all, I want to thank you for doing the work that you’re doing and getting out all this great information to people. For anyone listening, anxiety and depression, it’s not easy. I think these are the toughest conditions because when you’ve had it, and you’ve gone through it, it feels very insurmountable sometimes. For those people, I want to say a couple things. One is, if you’re taking drugs, don’t just stop taking them. Because that’s never a good idea. That can be dangerous.  You always want to continue, but I want to let you know that there are practitioners, there’s naturopathic doctors, functional medicine doctors, and they have answers that I think are more holistic and can really help. So that it is really worth pursuing this thinking. I do see daily how it can help people. Don’t give up and please do keep working on this because it’s absolutely worth it and you’re absolutely worth it. As far as contact information. My clinic website is www.innersourcehealth.com. That’s I-N-N-E-R S-O-U-R-C-E health.com. Our phone number is 631-421-1848. It’s really been such a pleasure to be here. Thank you so much.

Dr. Weitz:                          You’re welcome. Thank you, Dr. Bongiorno.

Dr. Bongiorno:                   Okay. Have a great day.