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Reed Davis discusses the Facts and Myths with Adrenal Fatigue with Dr. Ben Weitz.
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Podcast Highlights
0:30 This discussion is about a condition that exists in patients who have been suffering with fatigue and other symptoms related to dealing with chronic levels of stress. This condition has been called Adrenal Fatigue and the concept is that over time, after dealing with high levels of stress and having to respond repeatedly by producing higher levels of adrenaline and cortisol, the adrenal glands become unable to produce optimal levels of cortisol, much like the pancreas becomes unable to produce adequate levels of insulin in diabetics. But this condition was never sufficiently proven in scientific studies and most of the conventional endocrinological medical establishment never accepted this concept and it has become increasingly accepted by the Functional Medicine world that adrenal fatigue, per se, does not exist as we have thought about it. However, we also know that a large number of patients have been successfully treated by Functional Medicine practitioners for fatigue and other conditions believed to be related to adrenal problems with herbs and other very safe nutritional supplements, so something positive must be going on. Check out Ari Whitten’s detailed analysis on adrenal fatigue from his Energy Blueprint podcast: Is Adrenal Fatigue Real?
6:23 The construct of adrenal fatigue has been useful, even though the science has come to show that it may not be exactly what is happening. When we are under stress, out flight or fight sympathetic nervous system takes over and that kicks off an endocrine response from the adrenals and some other organs. Both adrenaline and cortisol are released, both of which are produced by the adrenal glands. Such patients are often stressed out, have extra weight gain, low energy, poor sleep, don’t like to exercise, they might get dizzy when standing, they may have sensitivity to light, irritability, etc. These patients may be self-medicating. They may rely on coffee in the morning and alcohol at night to sleep. We still see the same patients with the same symptoms and they still have low cortisol, it’s just that we can’t place all the blame on the adrenals. The adrenals never lose their ability to produce cortisol, so it is the signalling coming from the brain and the sensitivity of the receptors that are more to blame than the ability of the adrenal glands.
Reed Davis is the Founder of the Functional Diagnostic Nutrition (FDN) Certification Course and the D.R.E.S.S. for Health Success Protocol. He is an Environmental Paralegal, a Certified Nutritional Therapist and Fitness Coach and he served as the Health Director and Case Manager at the Better Health & Wellness Center in Poway, California for over 10 years. One of his specialities, beside training Functional Medicine practitioners, is teaching how to interpret lab tests. Reed teaches a certification course for Functional Medicine practitioners, Functional Diagnostic Nutrition, which you can access by going to FDN.today/drweitz.
Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.
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, our topic for today is facts and myths with adrenal fatigue with Reed Davis. Our topic is about a condition known as adrenal fatigue or as some people refer to it as adrenal dysfunction. And it’s been discussed in functional medicine circles for decades. The concept is that due to too much and chronic levels of stress, at first, your body adapts by your adrenal glands, which react to stress by producing more adrenaline and cortisol. So therefore initially, you may have excess levels of cortisol, and this can result in difficulty sleeping and anxiety and other symptoms related to being in a state of excess stress. After a period of chronically over producing adrenaline and cortisol and these other adrenal hormones, in order to help your body cope with the stress, your adrenal glands become exhausted, much the way your pancreas becomes exhausted in type 2 diabetes after having to produce so much excess insulin in response to sugar surges and at some point is no long able to produce adequate insulin or perhaps any insulin at all, requiring the patient to have to take insulin injections in order to control their blood sugar. So in this stage of exhaustion, which we often refer to as adrenal fatigue, your adrenal glands are unable to produce adequate levels of cortisol for what your body needs. And cortisol levels are often measured in the Functional Medicine world through salivary levels and typically we do a four-part cortisol test, measuring salivary cortisol levels in the morning, midday, afternoon, and evening. On the basis of these measurements, Functional Medicine practitioners often recommend adaptogenic herbs, glandulars and other nutritional supplements. And then medical practitioners may put patients on hydrocortisone. There’s some controversy over whether these salivary cortisol levels are accurate, since salivary cortisol levels measure free, unbound cortisol, and only 3 to 5% of total cortisol is free. So this may not be representative of cortisol levels in the body.
Now, the conventional medical establishment never got on board with this concept of adrenal fatigue. So here’s a typical quote from an endocrinologist from Cedar Sinai, Dr. Anat Ben-Shlomo, quote unquote, “Adrenal fatigue is the notion that our adrenal glands get overworked by stress and stop producing the hormones we need, including cortisol. It’s a medical myth.” This view has also been put forth by the Endocrine Society and other medical groups. And there’ve been a ton of papers published on this concept that adrenal fatigue does not exist. Now, the Functional Medicine world continued to promote this concept about adrenal fatigue, since we do these salivary cortisol levels, we see significant improvement with our patients using our nutritional protocols and adaptogenic herbs, et cetera. However, in the last five to 10 years, it’s become increasingly understood by some, many, certainly not all in the Functional Medicine world that the adrenal glands actually never lose their ability to produce hormones like cortisol. And this view has recently been expressed by a number of prominent functional medicine doctors, including Chris Kresser and Ari Whitten. In fact, Ari did perhaps the most exhaustive detailed analysis of many of the studies and what should be concluded is that while some studies showed a decrease of cortisol levels, some studies showed an increase in cortisol levels, but most patients with symptoms of adrenal burnout or fatigue actually had normal total cortisol levels and Ari reported this incredibly detailed analysis in one of his Energy Blueprint Podcast. So he did a great job with that. On the other hand, we have all these Functional Medicine patients who’ve been successfully treated with adrenal fatigue, so there must be something going on.
So I’ve asked Reed Davis, the founder of the Functional Diagnostic Nutrition Certification Course and D.R.E.S.S. for Health Success Protocol to come on to perhaps give us some information about exactly what’s going on with this so-called adrenal fatigue with these patients who are fatigued and have these other symptoms. Reed Davis is an environmental paralegal, a certified nutritional therapist and fitness coach and he’s also served as the Health Director and Case Manager at the Better Health and Wellness Center in Poway, California for over 10 years. And one of his specialities besides training functional medicine practitioners and health coaches is teaching how to interpret lab tests. Reed, thank you so much for joining me.
Reed Davis: Hey, thank you, Dr. Ben, it’s good to be here and hopefully answer some questions.
Dr. Weitz: Absolutely. So unfortunately, there’s a little bit of delay because Reed’s up there in the mountains without the best internet connection. So Reed, perhaps you can start by explaining, what are the adrenal glands and what are their functions?
Reed Davis: Well, that’s a good place to start, I guess, but I wanted to just back up a bit and say that the construct of adrenal fatigue was very, very useful before the science let us know that it wasn’t ever written in stone that you have adrenal fatigue, but it was never written in stone. It’s just a useful construct because they are considered the stress organ. And you’re absolutely right, when you’re under stress, you go into a fight flight mode, and that has to do with both the nervous system, you basically are going to go into the autonomic, the anxiety mode, the fight flight, that’s basically your sympathetic nervous system. So you get sympathetic dominant, and that actually kicks off an endocrine response. So when you get scared, run off the road, get chased by a bear or whatever the heck, yelled at by your boss or something upsets you, the first thing that happens to your nervous system, you go into that fight flight, the sympathetic kicks in, and it’s so that you can fight or you can run away, it’s a survival mechanism. The adrenals are involved along with some other organs, because they can produce adrenaline, number one, adrenaline is an amazing hormone. It makes you feel good, makes you able to run fast and these kinds of things, or fight hard, whatever it might be. And along with that comes cortisol. They’re both made in the adrenal glands, but they’re made in different parts of the adrenal glands.
So that’s why they’re considered the stress organs. And they’re just some little triangular shaped organs sitting up your kidneys, the kidneys are known as the renal gland and add means above or on top of, basically. So they’re on top of the real or kidneys, very useful little organs. And they’re basically told what to do by the hypothalamus pituitary, and again, the sympathetic nervous system. And again, I thought it was a very useful construct back in the day, 20 years ago, someone would come in feeling stressed out, did some weight gain, maybe some low energy, poor sleep, don’t like to exercise, they might even get dizzy on standing, eyes are very sensitive to light, kind of irritable, things that. The same people often are self-medicating, they need some coffee in the morning, might even need some alcohol to get to bed at night. Another common thing was crashing in the middle of the day and these kinds of things. So since the adrenals are involved in fight flight and they would take a lot of the blame for those types of symptoms. You can go through all the anatomy, physiology, biochemistry, I’m happy to go as deep as you want on this, on the adrenals, but it turns out that they were getting the blame somewhat erroneously. They’re still really involved, but if they’re not producing cortisol mostly and that’s what we used to call adrenal fatigue when you had very low cortisol, there’s other reasons for it. It’s just the signaling, the cell receptorship and interplay and so there’s a lot of moving parts there, so we just can’t call it adrenal fatigue anymore. It doesn’t mean you don’t have the same symptoms, they’re just coming from multiple places and now we know we need to do two things and then I’ll let you chime in here. Now we know we need to do two things. One is to resolve the stressors that got you there in the first place. And frankly, I always took that approach even 20 years ago, the adrenals, well, we don’t want to just treat the paper, there’s supplements you can take to raise cortisol or what have you, we used to do licorice root and all kinds of things and people would feel a little bit better, but the real answer is to reduce the stressors and that could be quite a job, figuring out what they are and those are the real cause of those symptoms.
Dr. Weitz: Okay. So why don’t we talk about what some of the causes of this fatigue that our patients are feeling aren’t?
Reed Davis: Well, when you’re stressed and I don’t mean just getting cut off in traffic or yelled at or some of these mental, emotional things. If it was just that, and it was occasional, you’d be fine. Your cortisol would go up, the adrenals would kick in, you would get some adrenaline and then momentarily later you’d get some cortisol, cortisol sticks around longer. It actually just enhances the fight flight mode, but it doesn’t last more than say an hour, then you’d go back to normal, quote unquote, normal. Well, I picture zebras getting chased by lions and as soon as the lion catches one and starts eating it, the rest of them go back to normal. You see on discovery channel, they’re eating grass in the background because they’re not under stress anymore, not as long as they’re not being looked at as something to eat. So now with us, it’s actually built in, we have this stress response and it’s the adrenaline and the cortisol and some other things, but it’s constant. We’re not under ordinary stress anymore, we’re under daily assault. There are tens of thousands of chemicals in the environment that can invoke the same kind of adaptive response. So your body just knows, it’s really smart. There’s an innate intelligence in every cell tissue, organ and system that says we’re under attack. And so you couple that with watching TV and all the relationships and your relationships with people and with money and with driving through traffic, whatever it might be, and then add on top of that injury and trauma and weakness and imbalances in the body. So I’ve studied stress since about 2001, when I found out it was the reason for 80% of all doctor visits was based on stress and even up to 50% of all diseases were stress related. And so I started studying stress and I just categorized it, all that mental, emotional stuff, your life, things like that and a lot of times we’ll get used to it, we think it’s normal. And the same thing with the chemical salts, a lot of which we don’t even know they’re there, it’s in your food, it’s in your beverages, it’s in your clothing, it’s in your furniture and your draperies and your carpeting, it’s in your household cleaning products, it’s in your personal care products, things that are stressful, things that the body reacts in a similar way to.
Dr. Weitz: You’re talking about environmental toxins?
Reed Davis: Exactly, yeah. So all of that adds up to where it’s just a constant assault and your body, it can get tired of that crap and dysfunctions occur and you end up with all kinds of things upstream from the symptoms, but the symptoms remain the same, that stressed out, crashing in the day, needing coffee, immune system problems, the energy, brain fog, poor memory, all these different things come from assaults from stress, the adrenal glands are one organ involved. And they were getting the blame, all the blame for a long time.
Dr. Weitz: So what other organs are helping us deal with stress?
Reed Davis: Well, the sensory organs in the brain are really important. You have what’s called the limbic system, which is mostly considered the emotional center, also, olfactory–sound comes in through there and it can be loud noises scare you, that’s because the limbic system sends signals almost directly to the adrenals to make adrenaline and you get that feeling. And then again, cortisol would kick in and you have the messages going through the hypothalamus pituitary, so they are another couple of little organs up in the brain and they send the chemical messengers, the stimulating hormones to the adrenals. So that complicates it a bit, well, what’s stimulating the hypothalamus and the pituitary? That again could be in the environment, it could be the circadian rhythm, it could be other hormones, it could be toxins, chemicals, drugs, there’s so many things that can stimulate the sensory organisms or organs in the brain, they’re very sensitive. They’re little tiny things, they can only take so much and they will send out what you might call bad signals. Oh, by the way, it makes it very interesting if you like anatomy or physiology, you’ve got the adrenals aren’t one organ, you have the medulla in the middle that basically stores and releases the adrenaline upon signals from the autonomic nervous system, your sympathetic branch. And then you have signals coming from the hypothalamus/pituitary to three separate layers. If they want to know the names of them, that’s zona fasciculata, zona glomerulosa and zona reticularis, they make different hormones. The cortisol is only made in one. Another one makes your DHEA, which is the parent of sex hormones that is supposed to counter regulate cortisol. And then you have the aldosterone and mineral corticoids that regulate sodium/potassium levels and so on, your blood pressure, blood volume, and hydration…
Dr. Weitz: Hang on one second, Reed. And these three zones are different areas in the adrenal glands, correct?
Reed Davis: Yes.
Dr. Weitz: Okay. What do they call it again? One more time?
Reed Davis: Well, there’s the zona glomerulosa, that is the outer layer of the adrenals, and that makes your aldosterone, it’s the electrolyte and fluid balance in the body, blood pressure, sodium potassium levels. The point was that there are different things affecting the signaling organs in the brain, and then it could send good or bad signals or mixed signals and you have four different areas within the cortex, within the adrenals. There’s the cortex has the zona glomerulosa, it makes the aldosterone, the zona fasciculata makes the cortisol and the zona reticularis makes the DHEA, dehydroepiandrosterone was counter regulates the cortisol. These things by the way, are not just made in the adrenals, so if you want to get even more interesting, some people might say complicated or complex, it is very complex.
Your skin makes cortisol. If you get a little nick or a tiny insect bite, your skin makes its own cortisol, your skin has the same kind of axes as the HPA to adrenals. That’s why… What is cortisol? It’s an anti-inflammatory and it’s a pain killer. So you’d want some extra cortisol if you get a bite in the skin, or if you get punched in the face, same thing. So you’re going to make these things that regulate blood pressure and fluid balance in the body, why? Survival, you’re going to get from the fasciculata, the cortisol, which raises blood sugar, enhances the action of adrenaline, it is very anti-inflammatory and it’s the main signal by the way of catabolism.
Catabolism is what breaks your body down, which you might need to do to maintain the blood sugar levels. And finally, there’s the zona reticularis, it makes the DHEA, that counter regulates the cortisol and it’s the precursor to all your sex hormones, including estrogen and testosterone. So you can start to see why someone under a lot of stress, and you’re messing with the signaling organs, you’re messing with the organs that receive the signals, and you can have quite a lot going on there, that’s why I have one diagnosis for everybody, it’s called metabolic chaos. And that’s a term I use to just describe what’s really going on. I just find it the most interesting, fascinating area, stress and how the body reacts to it.
Dr. Weitz: So you’re giving some complex information about cortisol and it’s interesting because there’s a tendency to see some of these hormones and other substances as good or bad and some people see cortisol as bad, high cortisol is bad. So cortisol has all these important functions and it’s neither bad nor good, in fact, it’s good and bad, depending upon the levels and whether it’s being appropriately secreted at the right times. Now, how is DHEA counterbalancing cortisol?
Reed Davis: Well, DHEA has its own direct benefits on the body, it’s very anabolic. And so when you talk about the adrenals and testing for the adrenals, you’re talking about, maybe not the condition of the adrenals themselves, but just the levels of production, which again, we know we have mixed signals coming to these different layers and these different layers, they don’t swap the substrates. There’s no such thing as the pregnenolone on steal. The cells inside the zona fasciculata cannot steal pregnenolone, the parent hormone, from the other zones. And so that was another big myth that was shattered. And what would I look at because I was trained in a chiropractic office over 20 years ago, to think about balance and resilience. Now, what really defines health could be considered to be balanced, everything’s balanced and cortisol DHEA would be two things you really want balanced in your body. You don’t want cortisone dominance. Remember cortisol dominance over time leads to a catabolic state and the body’s breaking down. Catabolism is the breaking down. You’ve seen people who are completely stressed out like runners who purposefully stress themselves out. They do a very unnatural thing by running 20 or so miles and their bodies are broken down. The cortisol has just pretty much even broken down their meat. Why? To maintain blood sugar levels.
Dr. Weitz: Occasionally, I’ll have a patient who’s maybe been on cortisone for some months and even years for some chronic condition like asthma or some auto immune condition and often they have lost almost all their muscle, you can see that severe catabolism.
Reed Davis: Yeah, exactly. And so you want the cortisol and DHEA to be balanced. They’re both coming from the adrenals for the most part. I said the skin makes cortisol and the brain makes some DHEA, but probably 80% is all coming from the adrenals. And so that would give you balance in a couple of ways. If it’s all about balance, what do we want to balance? We want to balance cortisol and DHEA, and you’re balancing the catabolic with the anabolic, your body breaks down and builds up, breaks down and builds up. You’re also balancing, cortisol is your stress hormone and DHEA could be considered your sex hormone, a main hormone responsible for the sex hormone. So you want stress and sex to be balanced up, that’s for sure. And you want catabolism and anabolism to be balanced out, and that’s for sure. And you can tell, people, doc, you know this, when you explain this to your patient, to your client, and no one else has ever explained it to them, why they feel so crappy? Look, you’re out of balance and this is why, you got all this stress and your body is breaking down and it’s not building up in a way that’s working for you. And so what do you need to do? Reduce the stress, there’s modalities and things. If it’s physical, see a chiropractor. If it’s energetic, you can see an acupuncturist and get some things moving, that we have seen that be helpful. If it’s mental, emotional, there’s lots of help in that area. And if it’s chemical, biochemical, well, you can eat better, get rid of all the toxins and things that are in your food and beverages, as we mentioned, the environment is so full of it, all the other stressors. And I think supplements are very helpful too, to support these systems.
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Dr. Weitz: So what’s the best way to measure adrenal levels and cortisol levels?
Reed Davis: It depends who you’re talking to. When I started, it was just us doing saliva testing only, way back in the days of John Lee, you mentioned [inaudible 00:25:14] he’s been around a long, long time. A lot of other good docs, but they were considered out of the box, kind of like you mentioned, conventional or standard medicine didn’t address this at all, but nowadays, science has grown, it’s expanded. I still think saliva testing is very good, but there’s not much hormone in the saliva. So you’re measuring very small amounts. You have to be very careful. I like the ease of collection, people can take the kits home, you can take it morning and noon and afternoon and nighttime cortisol, you can wake up in the middle of night and take cortisol. You could never do that with blood. Who’s going to go get four or five blood draws in one day? That’s never going to happen.
Dr. Weitz: Right.
Reed Davis: So blood’s not very good for this although there’s other ways to skin the cat and I know people who do a good job with blood work, they just don’t get the circadian rhythm the same way. So then there’s also urine, and there’s a 24 hour collection, which is useless. Total cortisol doesn’t mean much. You really need to look at that circadian rhythm, but now there’s dried urine. So dried urine can be done. It’s still not exactly in the moment as bioavailable saliva, but there’s a lot more hormone in urine and it can be measured that way too.
Dr. Weitz: Do you like the cortisol awakening response. Do you think that’s a significant improvement?
Reed Davis: Yeah, I like that. Lots of saliva testing catches that now. We’ve learned that some people, again, it’s all dependent on whose test results you’re looking at and why would you want cortisol awakening response? Well, some people stay in that sympathetic state all morning. They get up and they’re panicking and they can’t calm down and you can see it in their cortisol levels. Basically, you would take a first waking cortisol, remember it’s rising as you wake up, it’s what helps you wake up and cortisol rising at nighttime with a drop in low blood sugar, whatever it might be, cortisol kicks in to raise blood sugar and it happens in the morning. So when you first wake up, you call it a baseline.
Now, about half an hour to 40 minutes later, it’s going to reach its peak for the day. And then it should come back down in the next half hour or so to within 25, 30% of where it started, you don’t want it staying up that high. What’s very interesting about some people who tend to lean towards high perceived levels of stress, they have, wherever it is when they wake up, baseline, then a half hour, 40 minutes later, it’s quite high. And then the next one, instead of coming down, it stays high or it doesn’t come down very much. So you talk to that person and they perceive life as shitty and it matches perfectly with their test results, it’s so interesting to see that. So you can then coach those people up on lifestyle changes they can make to bring it down. You don’t want to stay in that state generally.
Dr. Weitz: So what kind of lifestyle changes would you recommend to help bring somebody who is in a state of higher cortisol levels?
Reed Davis: There’s so many different stressors and stress reduction is a huge part of our program and it could be coming from mental, emotional, as we said, it could be coming from the environment, including what you eat. So we have people tell us, if you talk to people, you can find out a lot about them and where they think it is and you just begin to get good at making impressions, forming impressions about people. You might say, “Well, this is a mental, emotional thing and you could do some deep breathing, meditation, you could do some pausing to be thankful and say, well, it’s going to be a better day than yesterday.” And lots of positive psychology things are very useful. And again, I think point of view is huge and these people are worried and what have you, so there’s other people who specialize, that’s what they do. They do that type of counseling.
I’ve used emotional freedom technique. And again, I think prayer and gratitude and point of view are more my style and it comes naturally to me, but other people need other modalities or therapies. Other people, we think about, because the same spikes in cortisol could happen throughout the day. You could see it at lunchtime. Wow, why is it so high above range at lunch? Well, it could be that you’re sensitive to something you’re eating, or something else is going on, but you can actually see that stuff. If you have a food sensitivity, that can spike your cortisol because it’s inflammatory and what is cortisol again? It’s an anti-inflammatory. And then if you see spikes in the afternoon or spikes at night before bed, so you can get to know the person and they can get to know themselves. When you have good interpretations and you have good impressions, if you’re good at impression, forming and assessing, you can walk a person through a lot of this, just showing them the facts on paper itself lets them know, you’re not crazy, there really is something going on, let’s take a look at it and you have some objective criteria there plus how they feel and it can work out to be a real good relationship. So there’s other stressors obviously, but [crosstalk 00:31:05].
Dr. Weitz: So you’re saying that anything that creates inflammation in the body is liable to lead to higher cortisol levels. And you mentioned food sensitivities is one, I’m assuming high blood sugar spikes is another?
Reed Davis: Well, low blood sugar would be why your cortisol would go up, so if you don’t eat right, you have to eat in order to maintain steady blood sugar levels and energy and satiation and sense of well being and things. So if you’re eating right, you should also be able to maintain what we call stable cortisol levels or within range, normal circadian rhythm. And there’s no question about it, humans are diurnal, they’re not nocturnal. So we find people with highly disrupted circadian rhythms and they’re not sleeping at night, they’re sleeping in the day, all kinds of things going on. So that matters too then. Sleep becomes important and exercise becomes important and reducing other stressors known, those are the easier ones. The unknown ones are even harder because you’ve got electromagnetic frequencies and you’ve got radiation and you’ve got parasites and bacterias and funguses and viruses and biofilms and Lord knows what else is in there, especially these days, right? So there is a system is the main thing, there’s step-by-step, you can sort out metabolic chaos and that’s what we’ve been known for 20 years, right Doc? Helping people sort it out.
Dr. Weitz: Absolutely. So let’s say you get a patient in your office and they’re complaining about fatigue, you’re going to take their history and then what’s the next thing you’re going to do?
Reed Davis: I would run labs on every person just because I don’t like guessing. And a lot of other people run labs too, but they guess about which labs to run and I really don’t. And it’s because over 20 years, I started recognizing patterns. So the typical practitioner clinician listens to the complaints of the patient and says, “Well, it sounds like this.” They’re forming an impression based on how that person looks and your vital signs and different intake and largely, their complaints and history and say, “Well, it sounds like it could be thyroid.” And then they’ll run a test on thyroid. So they’re guessing about what tests to run, because it sounds like [inaudible 00:33:47]. For other people, it sounds like the adrenals, or it sounds like parasites, or sounds like [inaudible 00:33:53].
Dr. Weitz: Of course, one of the reasons we’re doing that is to try to be efficient and cost effective.
Reed Davis: True, true. Well, it’s also just the heuristic being used. It’s go after the symptoms. The most immediate cause of the symptoms, but that heuristic leaves a lot on the table because it could be any damn thing really far upstream or a combination of things, which is more likely the case. So with me, I just run five labs in every person because I have no clue. I try to avoid it sounding like… I might do it like, “Well, it sounds like [inaudible 00:34:29], but I have no clue if it is. So why don’t we just run… I really run six assessments on every person and there is an investment for that person.
Dr. Weitz: What are those six assessments that you do?
Reed Davis: I look at the hormones, including the adrenal and sex hormones. I look at the immune system, I look at digestion-
Dr. Weitz: Hang on a second. The hormones you measure through urine, saliva or a serum?
Reed Davis: I still like the kits, the saliva kits, because people can take them home and do it. They can also do that with dried urine and they’re both good tests. It just depends on your practice and what your intention is for that person. I’m looking to develop the most holistic protocols possible. Other people are looking more to treat maybe the imbalances in estrogen and progesterone, even cortisol, DHEA, they use a lot of products. So they’re taking the shortest distance between the labs and what products to recommend and I take a more holistic approach with what lifestyle to recommend, which I said could include some supplements. So when I look at the… It’s H-I-D-D-E-N, Doc, if you want to know the magic assessment formula, H-I-D-D-E-N, it spells hidden and [inaudible 00:35:56] things are hidden, but it’s the hormones, immune, digestion, detoxification, energy production, and nervous system balance. It’s really autonomic looking at balance between sympathetic and parasympathetic. We just call it in nervous system or nerve… So it’s hormone, immune, digestion, detoxification, energy-
Dr. Weitz: So how do you measure immune function?
Reed Davis: Well, there are measurable things that have to do with the immune system. For one, the gut, which is about, according to Mark Hyman, it’s 80% of your immune system, but I think we knew that 20 years ago, it was huge. And so you have something called secretory IgA, you have other immunoglobulins, now we have zonulin, that’s some little markers. We can also look at the go to bed flora, if there’s not enough good flora, that would also affect digestion. So some of it is hard with the visuals and the teaching, which could take a while.
Dr. Weitz: So to measure immune and digestive functions, you’re going to do a comprehensive stool test? What’s your favorite stool test?
Reed Davis: Well, I ran one this morning. I haven’t emailed you. I’m always experimenting with new tests, but I like the GI map. I like the Bio-Flora 1, but they went out of business. So I like looking at microscopy and antigen testing and the other test, the culturing. Hardly anyone is doing culturing in these ways where humans are involved in the lab work. Nowadays, it’s all electronic, it’s all high tech and it’s just DNA, PCR type stuff. So there’s a lot of ways to skin that cat. The fact is though, we’re not looking for the disease so much or what’s the bug, “Oh, how do I kill it?” We’re looking at, “Why do you have it again?” It’s the environment. So if you ran those labs, and I would look at an IP, an intestinal permeability test, there’s different ways to do that. There’s the old fashioned challenge, there’s blood, there’s antibody tests you can use, there’s lots of ways to do that, but it’s a preponderance of the evidence, it’s up to the practitioner. You want to be trained in forming these impressions and because you want to give that person things to do, not just things to take, that’s my opinion. And so-
Dr. Weitz: Okay. So you’re going to do a stool test, and so for the intestinal permeability is adding on zonulin, is that sufficient or do you use the lactulose mannitol intestinal permeability?
Reed Davis: I love that test. I like the old fashioned lactulose mannitol. That’s a great test because you’re actually getting a view of the topography inside the gut. If your lactulose is high, you have a leaky gut, you’re letting too much of this large molecule sugar get through and be recovered in urine. So it’s not supposed to be able to pass through very much. If a large amount is passing through, it’s all in a gradient and these things, by the way, are all moving targets, just changing on a regular basis, but you can detect a high recovery of lactulose tells you, you probably will see high zonulin in most of those cases. Leaky gut’s more of an immune problem, but the lactulose mannitol doesn’t look at it that way though, through the immune system, it looks at it through physical topography, it’s a map. It’s almost like a camera when you know how to interpret it right. Now, with the mannitol, that’s a very small molecule. There should be a reasonable amount of that gets through the villi, but villi can be blunted, the brush border can be gone, you can see that on other certain markers. And if they’re blunted, you’d have low mannitol recovery when you should actually be seeing a fair amount. Now, there’s two red zones for the mannitol, because if it’s too high, then you could have extra porous villi, so they’re also beat up, it’s a dysfunctional gut, if you will.
Dr. Weitz: Yeah, it’s interesting, I would say. I would say the lactulose mannitol test is something a lot of us used to do, and we gave up on it because we can almost assume most of our patients have leaky gut.
Reed Davis: Yeah. But here’s the other things, these things are all in a gradient, like I said, and they tend to be moving targets. So it’s nice to know how are they doing now and what direction can we get them to move in? So you can see it’s not real blatant, by the way, the literature says, if the lactulose to mannitol ratio is in a certain range, then they’re fine, I highly dispute that. I’ve looked at thousands of these tests and correlated them with patients. And so I know that you can feel the standard interpretation, and yet there’s a healing opportunity there. Now, that’s the phrase you want to burn in your brain, is healing opportunity. Can this be improved upon? Yeah, I guarantee it can be. And you’ve got to look at the rest of the environment in that gut though, why is it looking beat up here?
Dr. Weitz: Okay. So you’re-
Reed Davis: That’s where the food sensitivities and [inaudible 00:41:42].
Dr. Weitz: So your initial testing, so far you said that you would do hormones, you would do stool tests, intestinal permeability, what are the other components of your testing?
Reed Davis: I like very, very much to look at things like oxidative stress, that’s a healing opportunity. Also, the food sensitivities [crosstalk 00:42:13].
Dr. Weitz: So for oxidative stress, what would you look at? Would you look an 8-deoxyguanosine?
Reed Davis: Yeah, that’s one. There’s also lipid peroxides. The hydroxy-guanosine looks at DNA damage from oxidation, but it might not be that bad yet. You’ll see cellular membrane damage, and you can detect that through lipid peroxides. Genova has oxidative stress 2.0, it measures both. Things like that give you healing opportunities, it’s how can I direct this person’s lifestyle medicine and then of course, it always leads you to another layer, where’s this oxidative stress coming from? I mean, if the person smokes, that’s one reason, but if they don’t, where do you go from there? Overexercise? Probably not. And on and on and on. There’s some other markers that I really missed that have gone off the market. Urinary bile acid sulfates was one, it showed liver congestion, because remember, detoxification is also very critical. So I look for these clues or these healing opportunities, and by a preponderance of those things, can form an impression about a person, how much work they have to do. That’s why that IP test, even if it isn’t so clear, it tells you, “You’ve got all this stuff to improve.” Any adrenals will come back, right? You get rid of all this other crap, that’s the only way to fix those adrenals.
Dr. Weitz: So is-
Reed Davis: So the food sensitivities is large. Some of the bugs are worth treating, but some are just part of a bad environment. And then you can add [inaudible 00:44:08] on that.
Dr. Weitz: Which bugs are worth treating and which bugs are just part of the normal environment?
Reed Davis: Well, if a person’s symptomatic, you’re going to throw some anti-microbials down the pipes for anything listed as a parasite, a pathogenic bacteria, anything from salmonella to blastocystis hominis. You’ve got bugs and you have bigger bugs, but again, I’ve always looked at it-
Dr. Weitz: Hey, you’ve just mentioned blasto, there’s some controversy over blasto and there are some practitioners who feel that it’s not worth treating and it’s actually just a normal part of that.
Reed Davis: I think that it’s definitely a pathogenic species and it’s not unique to humans, you can find it in other animals and when they have it, it can get quite virulent. Humans, maybe it’s not as virulent as some other pathogens, but it contributes to chaos in the gut, it exudes their exudates from it and it doesn’t belong there. So the real question is, is it commensal, can your body get along with it? But to say it’s normal, it’s supposed to be there, I don’t know of any benefit it has. I mean, there’s a lot of verbiage around that thought that they say we need a balance of good to bad flora in the gut. So there’s all this microbiome in there, is it all friendly? No. Well, why would unfriendly stuff be there? Well, it’s to keep your immune system in shape. If you had no bugs, you wouldn’t need an immune system. If there was nothing dangerous around. And then when something did come along, it would kick your ass. And so we have these things hovering to keep us active and ready for the worst, the worstest stuff. And so I don’t think in some people that I would… I wouldn’t treat everyone just because I saw some blasto, it depends how they’re doing. It depends how much is that contributing to all the chaos in their body? And if it’s a particularly bad case, I mean, we call it blastocystis hominis because it’s in humans. In a rat, it’s called blastocystis rati. In a beaver, it’s called blastocystis beaver, whatever those are, you get me? So it’s a parasite. It just may not be real virulent and parasitic, but it’s a bug that don’t belong there using my proper medical phrasiology.
Dr. Weitz: Okay. So is that pretty much all your testing? Are there other tests that go into your initial testing panel?
Reed Davis: The E and the N, so H-I-D-D is real simple, a matter of fact, those I figured out in fairly short order that everyone coming in the office, they’d already seen five or 10 practitioners, they weren’t better yet and I knew there had to be a better way. And I wanted to be the last person they have to see. Now, that was pretty much dreaming at the time, but I did figure out a few things. And if you can find healing opportunities within hormone, immune, digestion, detoxification, help that person to restore a balance and what have you, get those things working better, increases their resilience and last but not least, the EN, the [inaudible 00:48:21] I added on later when I started learning the importance of food with regard to the oxidative rate.
So we burned fuel basically, we all know how energy is produced and it’s produced by eating, it’s made from food, and we process it and we metabolize it the way that produces energy. So that cell is produced on a cellular level so that that cell can do its job. Do you have to teach that cell what it’s job is? No, that’s built in, that’s the intelligence. So you just have to fuel it right and keep interferences out of the way. And so energy production becomes a huge consideration because people are eating the wrong fuel mixture. If you’re a fast oxidizer and that’s inherent, that’s a genetic inborn quality.
And if you are a fast oxidizer, you better eat more slow burning fuel, the proteins and the fats, they burn slower. So if you’re a fast oxidizer, you have just been in a bonfire, you don’t want to put paper on it, you won’t get any energy out of that, it’ll just be gone. So you take a typically and traditionally really fast oxidizer. When they eat carbs, they don’t get energy, they don’t get any satiation, they don’t get a sense of wellbeing, either. They pretty much feel like crap all the time and they end up overeating and that shows a blood sugar off and on and on.
Dr. Weitz: What do you mean by a fast oxidizer?
Reed Davis: So it’s just the rate at which you burn fuel. Some people are genetically faster oxidizers, they burn their fuel faster on a cellular level. We don’t want to go into the Krebs cycle and citric acid cycle.
Dr. Weitz: How do you determine if somebody is a fast oxidizer?
Reed Davis: I use a very simple test. Some people say they can tell through other means more like chemistry. I haven’t learned that and I’m not sure about it, but I use a test called the metabolic typing test. And I discovered this when I met Bill Woolcott, who wrote The Metabolic Typing Diet, about this. Now, he didn’t invent it either, people smarter than all of us figured this stuff up, but there’s definitely the production of energy. Yeah, it’s online, but it’s got a lot of subjective questions, it’s not just objective. There’s questions about psychological traits, there’s questions about dietary habits and physical characteristics as well.
So psychology, physical and dietary habits things, and you can land on a certain place and then you have to dial it in through actually eating that way and dial it in and do a little bit of checking, but once you know what the things are to check, it’s fairly simple. To dial in the oxidative rate, dial in at least your proper ratio approaching fat and carbs. Real quickly, I’ll tell you this quick, my cousin’s a priest up in Canada and he had two Cree Indian villages for his parishes. And I was asking him one day, how’s things going and what do they do for a medicine man? And since he’s a priest, he said, “Well, I’m the medicine man.” And I said, “No, no, I meant when they’re sick, if they get… Then he says, “Oh, Christ, they’re all sick.” He goes, “They all have diabetes. It’s the worst health on the planet, these villages.” Why?
Because they don’t fish anymore, they don’t hunt anymore, they don’t eat wild natural grains in the summertime anywhere, they eat a bunch of crap that’s Tim Horton donuts and fried chicken or something. And so, here you have these extreme, fast oxidizers, and they’re just eating carbs and they don’t get energy and they feel lousy, the biggest cause of death up there is suicide. I think as a priest, he makes his living on weddings, christenings, and death, but anyway, they’re all sick and they just go to the government clinics and get their insulin, it’s a sad thing. But why are they all sick? Genetically, they’re not eating right. Yeah, it’s so obvious. It’s just so obvious.
Dr. Weitz: Okay. So I think we’re probably ready to wrap. So how can folks find out about your functional training programs?
Reed Davis: Yeah. Well, thanks for that. We set up a URL that everyone could go to and you could put it in your show notes, it’s FDN, that stands for Functional Diagnostic Nutrition, that’s the course and program I teach, Functional Diagnostic Nutrition. So it’s FDN.today/drweitz.
Dr. Weitz: Okay.
Reed Davis: Fdn.today/drweitz. It’s D-R-W-E-I-T-Z. And that way we could see [inaudible 00:53:44].
Dr. Weitz: And who takes this course? Is this for doctors, is it for any functional medicine practitioner, is it somebody who’s new to functional medicine?
Reed Davis: Well, all the above. We have a lot of allied practitioners and we teach health coaches and again, any kind of allied practitioner. I’ve had people take the course just for their own edification and that alone is worth the price of admission. It’s a very reasonably priced program for what we deliver, which is a ton, a heck to of training.
Dr. Weitz: How long a course is it?
Reed Davis: It’s going to take the average person who has a life, six to eight months. I’ve had people do it in three months, but I know they just plow through it. Again, I would call this the perfect compliment to a functional medicine practice and the practitioner, him or herself, should actually take the course, and maybe have some staff go through it with you. And we also have people for hire who practice this, who are otherwise not physicians, health coaches, the sort of the upper echelon elite health coaches. Again, I started this back in the 90s, myself training and my pursuit of trying to be the last person someone needs to see, I ran thousands and thousands of labs on thousands of people. I was told by the labs, “How many doctors have you got working there? I said, it’s just me. And there was doctors working there, but I was the only one running labs and was told some very complimentary things, especially by the clients and patients coming in. I mean, I got miracle stories just from, forget the diagnosis and treatment of the paper, it’s the person, it’s what are the healing opportunities? It’s staying true to those and giving the person things to do at home. From your own practice, I’ll finish up Doc, from your own practice, coming in your office is great, but what they do in between visits is what makes it all come together.
Dr. Weitz: Thank you, Reed for spending some time with us and giving us some information. Check out his Functional Diagnostic Nutrition Certification Course.
