Dr. Felice Gersh discusses Menopause with Dr. Ben Weitz.

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Podcast Highlights

1:45  Menopause.  Is menopause a normal part of aging?  It is a normal part of aging, but a very negative one and it can lead to many of the diseases that we associate with aging. But it is also independent of age, since some women go through early menopause such as through surgical removal of their ovaries due to some disease.  “Nature is beautiful and wise, but also can be quite cruel.” The same nature that brings us beautiful sunny days also brings us tornadoes and hurricanes.

5:48  The first stage of menopause is Perimenopause, which is really the stage before menopause.  Menopause is defined as 12 consecutive months without a spontaneous period.  Menopause could also be called ovarian senescence, because it is marked by the ovaries no longer being able to produce estrogen.  Menopause is a natural, gradual process, but we should not ignore it nor embrace it. As humans we have a reproductive destiny and the prime directive of life is to reproduce and have healthy babies multiple times.  Every process in the female body is designed to support fertility.  The hormones, estrogen and progesterone, are the glue that glue all of the different functions in the body involving metabolic, cardiovascular, and immune function that go into pregnancy. When your ovaries can no longer function and ovulate and produce these hormones, all the systems in the body have this profound change.  It’s natural but it is a problem for women and once we understand that, we can create some viable solutions.

13:12  There is no definitive test that a woman is in perimenopause, though you could do a cycle mapping of female hormones, aka menstrual mapping. This test is available through Precision Analytical Lab as part of their DUTCH testing and also though ZRT Labs, where you have a woman measure her hormones daily using dried urine for 28 days or so.  This test is not done by conventional gynecologists, but it allows you to see the various phases of the menstrual cycle and you might see that they start to get a shorter luteal phase and the estrogen spike that proceeds ovulation will tend to be dampened down. Next you will start to see a dampened progesterone response as well.  The progesterone ends up being produced in a lower amount and for a shorter period of time.  This test can help with many conditions, such as fertility problems.

23:27  Phytoestrogens can help to manage some of the symptoms of perimenopause.  Eating organic, whole soy, which contains phytoestrogens, does not increase breast cancer risk.  This can help with hot flashes, night sweats, and sleep problems.  Estradiol has at least 3 different receptors–alpha, beta, and a membrane receptor.  Soy and flax bind to the beta receptors.  Beta receptors are in the cerebrum of the brain and in the cells lining the gut, so phytoestrogens help with brain and gut function, but bone is more alpha, so they don’t benefit the bone as much.  You can eat organic, whole unprocessed soy beans or minimally processed like tofu and include a couple of tablespoons of flax seed. Take Siberian rhubarb supplements, which is another phytoestrogen that is all beta.

37:10  One of the symptoms of perimenopause is mastalgia, for which Dr. Gersh recommends taking 100-200 mcg of iodine.  Also anti-inflammatory supplements like curcumin and fish oil, as well as eating an anti-inflammatory diet.

38:41  If the balance of the estrogen and progesterone tips and the progesterone declines first, chaste tree or chasteberry, aka, vitex can be helpful at a dosage of 200 mg per day.

 

 



Dr. Felice Gersh is a board certified OBGYN and she is also fellowship-trained in Integrative Medicine. Dr. Gersh is the Director of the Integrative Medical Group of Irvine and she specializes in hormonal management. Her website is IntegrativeMGI.com, and she is available to see patients at 949-753-7475.  Dr. Gersh lectures around the world, and she has just written her third book, Menopause: 50 things you need to know: What to expect during the three stages of menopause.  Her other two books are PCOS SOS: A Gynecologist’s Lifeline to Restoring Your Rhythms, Hormones, and Happiness and PCOS Fertility Fast Track and she has also published a very influential paper in the prestigious journal Heart, which is part of the British Medical Journal family of journals: Postmenopausal Hormone Therapy for Cardiovascular Health: the Evolving Data.

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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.



 

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.  Hello, Rational Wellness podcasters.

Today our topic is the three stages of menopause, with Dr. Felice Gersh. Dr. Felice Gersh is a board certified OB/GYN. She’s also fellowship trained in integrative medicine.  Dr. Gersh is a director of the Integrative Medical Group of Irvine. She specializes in hormonal management. Her website is integrativemgi.com. She’s available to see patients at (949) 753-7475. Dr. Gersh lectures around the world. She’s just written her third book, Menopause: 50 Things You Need to Know, What to Expect During the Three Stages of Menopause.  Her other two books are PCOS SOS and PCOS Fertility Fast Track. She’s also published a very influential paper in the prestigious journal, Heart, which is part of the British medical journal family of journals. Post-menopausal Hormone Therapy for Cardiovascular Health, the Evolving Data.  Dr. Gersh, thank you so much for joining me again.

Dr. Gersh:           Well, it’s always a pleasure.

Dr. Weitz:            How should we think about menopause? What is menopause? Is it just a normal part of aging? Is it a disease? What is menopause?

Dr. Gersh:           It is definitely a normal part of aging, but a very negative one. It depends on how you want to look at all the diseases of aging. Menopause is not a disease, but it is a staging event that can lead to many of the diseases that we associate with aging.  In fact, that’s been a very big discussion, which has been very frustrating from me, when I was looking on from the sidelines. So many things that are attributed to just aging, like chronological age, have really been misguided because they’re missing that, I always say the critical ingredient of the hormonal ingredient, like what’s happening to women when ovarian function ceases and they don’t make any more estradiol and progesterone from their ovaries.  That is, of course, related to age, but it is also independent of age in that, for example, if a woman goes into a surgical menopause like, for example, her ovaries are removed for some disease entity, or she is unfortunate one of those women who has premature ovarian insufficiency, where her ovaries stop functioning at a very early age. Then all those conditions start to accelerate in their presence.

So, we definitely don’t want to think of everything that happens to women as just related to their chronological age. That’s why I really want to bring back the picture of menopause as natural, but negative. So I always say, “Nature is beautiful and wise, but also can be quite cruel.” The same nature that brings us beautiful sunny days also brings us tornadoes and hurricanes.  So, we just need to recognize the boundaries that we have in terms of what we can do about menopause and all of its subsequent negative effects, and what we can really take charge of. We can’t avoid menopause. I always said, Benjamin Franklin, who was very wise also, but a guy, he said something. To paraphrase, there are certain things in life that are never going to be done away with, and that was death and taxes.  I said, “Wait a minute. Just one minute here. What about menopause?” We can’t escape menopause. At least at this time, although I hear there are some people working on cloning ovaries, but that’s not happening quite yet for the market.

Dr. Weitz:            Right. It’s interesting, the discussion about whether or not menopause is a disease. There’s also a discussion in the longevity section of medicine, whether aging is a disease. A number of doctors are lobbying for aging to be a disease, so it’s easier to justify treatments for it.

Dr. Gersh:           I would probably draw the line of calling aging and menopause diseases, but I would say that we need to look at what is happening. I’m always into mechanisms. I know you are, too.

Dr. Weitz:            Theoretically, of course, we don’t want to see aging as a disease. But the way our healthcare system is, where we don’t do anything for prevention, you have to call something a disease before you can even justify treatment.

Dr. Gersh:           If we need a CPT or ICD9 code, I guess for menopause and aging so that we can actually get coverage for caring for people, then I’m for that. I have to be pragmatic, as well, so I’ll buy in.

Dr. Weitz:            Let’s go into the stages of menopause. The first stage of menopause is perimenopause, which is really the stage before menopause, but you’re approaching menopause, right?

Dr. Gersh:           I have to work with the existing vocabulary. If it were my choice, I would abolish the word menopause because it has really misguided so many people into viewing this process of ovarian aging, or ovarian senescence, as really about the end of periods. By arbitrary definition, menopause is defined as 12 consecutive months without a spontaneous period. That is completely arbitrary. There’s nothing in nature that points to that as anything other than that it’s part of the process.  Part of the reason I wanted to do three stages, I can’t get rid of the word menopause. That’s stuck. In medicine, we’ve tried to change words. The old word is just added to the new word, and everyone falls back to the old word, because that’s what we feel comfortable with. So I’m not going to abolish the word menopause, so I have to work within that context.  To try to show menopause as what it is, it’s ovarian senescence, and it’s an evolving process. That’s why I, somewhat arbitrarily, created the three stages of menopause, so that people would see that there’s the prelude to this arbitrary definition, and then there’s the first decade. I put the first part of menopause, after the pre-menopause is 10 years because-

Dr. Weitz:            Maybe you should come out with two versions of the book, and call one Ovarian Senescence, and call one Menopause, and see which gets the most attention.

Dr. Gersh:           Okay. You know what? That’s an idea. I’m going to hire you, marketer.  We have to stop thinking of menopause as, you cross a finish line and you’re there. The event has happened and I made it, and I’m still alive!  But to view it as what it is. Of course, aging, people always talk about the minute you’re born, you’re aging. But the bottom line is that there’s certain things that, we’ll say accelerate the negatives of aging, or the process of menopause. We need to understand this if we’re going to actually put into place some pragmatic ways of approaching it. Just because it’s natural, doesn’t mean we ignore it or embrace it. In fact, everything in medicine is about recognizing things that may be natural, but are negatives, and then doing things that are completely unnatural to try to get people back to that state of homeostasis.  Everything that is medicine, even going back to the days of a tribe, where you had the person who was in charge of healthcare in a tribe, they were incorporating natural things. I’ll call it green medicine. They were looking for plants that could reverse a fever, or a pain, or something.  So, everything is about harnessing whatever tools we have to reverse something that’s happening, that we don’t view as a positive, like all the stages of menopause, and all the symptoms I put in there, that people will often experience, and what we can do about it, and recognizing, really. The takeaway that’s so essential from the get-go is that menopause is not a one time event, and that it’s an ongoing process, and that it’s a gradual process involving the declining function of the ovaries, which actually does parallel the declining state of fertility. That’s not an accident.

Dr. Weitz:            Right.

Dr. Gersh:           Once you also, I keep telling people this, and I want it to really come home to roost. Every process in the female body is designed to support fertility. We don’t like to think of, our bodies are designed just to procreate. We just need to recognize that we, as humans, are so unique in that we actually try to determine our reproductive destiny. Whereas, no other creature on this planet says, “This is not a good year to have a baby.” That is just not happening. Or, “I think I’ll go on birth control for the next 20 years.” That doesn’t happen. We do that to our pets when we castrate them, but nothing happens naturally in nature that involves trying to control reproductive function.  Since the prime directive of life is what it is, it’s the most amazing thing of life. Remember, I’ve delivered thousands of babies and it never ceased to astound me that this is actually happening; a baby was coming out of another person. It’s like, “Wow. This is amazing.” That is really the prime directive of life, so every system in the female body is really designed to help to have a successful reproductive status, and have healthy babies, and do it multiple times.

Pregnancy is such a stress test of women. It’s such a challenge, too, with altering the cardiovascular system, and changing the immune system. All these systems in the body are so amazing. I say that the hormones; estrogen, progesterone; they are really the glue that glues all of these different functions in the body involving metabolic functions, cardiovascular, immune functions, everything in the body to the reproductive functions. In fact, all of the different enzymes, pathways, are actually reproduced in the reproductive tissues that are out there in the peripheral tissues.  So, it’s a sink or swim together body. That’s the takeaway. When you lose reproductive functions, when you go through this dynamic change and your ovaries are no longer going to be ovulating, putting out the eggs, you really can’t have babies anymore; all the systems in the body have this profound change that occurs in them because of the loss of this vital force in the female body, which are these beautiful rhythmic hormones.  We need to recognize that, and be honest about it, and then decide, “Okay, what are we going to do about it?” That’s really my mission is really to first educate, because you’ll never solve a problem if you don’t first define the problem. The problem, I call it natural but I call it a problem for women, that menopause is a problem. If you cannot define that problem, I can consider a premature death as a problem, too.  So, if you define a problem, then you can come up with viable solutions to that problem. But if no one even understands what is menopause, what is happening, what are the implications, then clearly, we’ll never have any viable solutions. That’s not going to help women everywhere.

Dr. Weitz:            So how do we know a woman is in perimenopause?

Dr. Gersh:           There is actually no test. It’s a clinical. We do have clinical. I can’t believe this, but I am actually a very old fashioned doctor. I observe. I take a history. I do an exam.  We know, 100%, since 100% of women are going to go through menopause, that at a certain age, it’s going to be a process of ovarian decline and fertility decline. Women will manifest the symptoms quite differently. There’s really a huge range. But every woman, once she hits the age of 40, is definitely going to be having serious fertility changes and serious changes in her hormonal production.  Now, we can do certain tests. I say there aren’t any, but you could do a menstrual mapping. It’s very interesting because I’ve done a lot of those tests. That’s not really mainstream at all. But if you take a woman, and what’s very classic for women as they are in the last decade before the end of cycles, we’ll call it, they will often have changes in their menstrual cycles, but they’re still having them.

So often, the cycle will become shorter. So then you think, “Okay, why is the cycle getting shorter? What’s happening?” If you do a menstrual mapping, then what you will often find is a shorter luteal phase. What happens is, the estrogen spike that proceeds ovulation is dampened down. Then you’ll see a dampened progesterone response.  So, the progesterone should have this nice, rounded little mountain, like a hill. Then instead of being like that, it’ll often be like this. It’ll have a little spike and then it comes down. You’ll actually see that the progesterone is produced in a lower amount, and also in a shorter period of time.  Of course, we know, everyone should know that progesterone is essential for the establishment of a pregnancy. That’s why in IVF clinics, they’re always giving progesterone to everyone for the first three months or so, because progesterone is essential for proper implantation. It works with the endocannabinoid system, so it’s all complex. If you don’t make an adequate amount of progesterone for a long enough period of time, and then allow the placenta to take over and so forth, then you’re going to have a miscarriage. Miscarriages are much higher in their incidents in women who are older, in their 40s and such.  The bottom line is that there’s not a test. You could do things like FSH-

Dr. Weitz:            By the way, on the cycle mapping, just for those listening who don’t know what that is. Can you just explain what cycle mapping is?

Dr. Gersh:           Sure. It’s a wonderful test that can help with many diagnosis, like is a woman having an inadequate spike of estrogen, or LH spike and they’re having fertility problems, they’re having PMS, and so on. What it looks at is through urine, by measuring urine multiple times during a cycle, you actually get a mapping.  So, if you’ve seen a menstrual cycle that’s been graphed out over 28 days, you see the estradiol, and it goes up, and then you have the big spike, and then it comes down, it dips and then it comes up. Then, if you’re not pregnant, it goes down. Then you see the LH, and it will have a big spike right after the estradiol spike, and then you see the progesterone coming up right after ovulation. Then, if you’re not pregnant, it goes down.  All of this gets mapped out on your graph. Then you get to compare it to an ideal one. Then you can see, “Oh, my gosh.” Now, it’s only telling you that one cycle, but hopefully, it’s a classic, typical cycle for that particular woman at that stage of life. What you can see is her estrogen, and the estradiol level is not right. Or you see the LH may be hovering too high because she’s perimenopausal and she has too much LH. Then we also see the progesterone, which often will be inadequate in its quantity and duration.  So, you can really help, a woman has PMS. Then you say, “Oh, yeah. Her progesterone level, or her estradiol level is totally inadequate.” Then we can, instead of just randomly giving people hormones and saying, “Here, I’ll just give you this hormone and see.” No, it’s a much more scientific approach to actually measuring, and then treating, and then seeing, monitoring for the effect.

Dr. Gersh:           So, I love to be evidence based. I hate to just be throwing hormones at people, which is done too often.

Dr. Weitz:            This cycle mapping is available through Precision Analytical. It’s part of their suite of DUTCH Labs, and also through ZRT. This is the kind of test that you might get from a functional medicine practitioner, gynecologist like yourself, which is not, you’re not going to get this from a conventional medical gynecologist, or hormone specialist.

Dr. Gersh:           No. It’s really, actually when you realize what you’re getting, and how valuable this information is, and how completely off the grid it is for the standard OB/GYN, it’s really sad.  So for those of you out there, this is very easy to interpret, and the labs will also help you to interpret them. They give a lot of examples. It’s really fascinating because I have found that so many women who have even regular cycles, when you look at their hormone production, it’s really not optimal at all. It’s very interesting when you see perimenopause and you see where, sometimes, they’ll have an overshoot of estradiol, and you have a really high sustained LH.  So these are really interesting. These are not standard, run of the mill kinds of approaches. Because in the standard, conventional world, they do not do anything for perimenopause. They don’t even really recognize perimenopause. They just mostly, I hate to say this, but they put women, very frequently, on SSRIs. That’s the go-to. Really, it is, because women are having a lot of symptoms and they always say, “Ugh, another crazy woman.” Then, “Why don’t you just go on some Prozac or Lexapro?”  This is standard of care, which is really frightening because that is not addressing, we talk about root cause. That is not the root cause.

Dr. Weitz:            Unfortunately, it’s part of a small bucket of drugs that are used for conditions where they don’t know how else to treat. So, SSRIs are used for perimenopause. They’re used for irritable bowel syndrome. They’re used for, sometimes chronic pain patients. When you don’t know what else to do, try an SSRI, or try a PPI, or try an NSAID.

Dr. Gersh:           Right. When you know that these hormones are very involved in every organ system, including the brain. They’re involved with both cognition and with mood. Now it’s been published that the majority of women, as they are going through the perimenopause, in their 40s, they will have mood swings, sleeping disorder, and also some brain fog.  So, the go-to is traditionally to go on an SSRI. Upwards of 25% of American women in their 40s are now being prescribed an SSRI. That gets back to my, let’s define the problem so we can get a better solution than that. Because SSRIs, I’m not-

Dr. Weitz:            By the way, these drugs are not benign. They’re very difficult to get off of.

Dr. Gersh:           Very.

Dr. Weitz:            We’re manipulating brain chemistry in a very narrow way. We really don’t have much of a clue as to what we’re doing.

Dr. Gersh:           It’s really interesting because during the perimenopause is when bone loss is actually accelerated. It’s not really well recognized because you don’t have the fractures, but you have that accelerated bone loss as the hormones are going down.  SSRIs increase the risk of osteoporosis, so I call these the crazy maker drugs. There’s a ton of them. They actually promote the very problems in this specific demographic that we’re trying to avoid. Then we go on a drug that actually promotes the very condition that we ultimately are trying not to have.

 



Dr. Weitz:            Interesting. I’ve really been enjoying this discussion, but I’d like to take a minute to tell you about a new product that I’m very excited about. I’d like to tell you about a new wearable called the Apollo. This is a device that can be worn on the wrist or the ankle, and it uses vibrations to stimulate your parasympathetic nervous system. This device has amazing benefits in terms of getting you out of that stressed out sympathetic nervous system and stimulating the parasympathetic nervous system. It has a number of different functions, especially helping you to relax, to focus, to concentrate, get into a deeper meditative state, even to help you sleep, and there’s even a mode to help you wake up. This all occurs through the scientific use of subtle vibrations.

                                For those of you who might be interested in getting the Apollo for yourself to help you reset your nervous system, go to apolloneuro.com and use the affiliate code, Weitz10. That’s my last name, WEITZ10. Now, back to the discussion.

 



 

Dr. Weitz:            Let’s talk about some of the lifestyle factors and/or nutritional nutraceuticals that can help manage a woman with perimenopause.

Dr. Gersh:           I love phytoestrogen. Now, poor phytoestrogens have also gotten a bad rap, because people don’t understand them, and they think that somehow they promote all kinds of disease, when they actually are quite the opposite.

Dr. Weitz:            Like breast cancer.

Dr. Gersh:           Yeah. No, they’re actually not. If you eat organic whole soy, you’re not promoting breast cancer. It’s actually, these are actually agonist for the beta.  Now, we recognize plants are not estrogen. It’s a miracle of nature that certain plants can actually bind to our own receptors. We know cannabis binds to our endocannabinoid receptors. So, we have this miracle of nature where plants combine to our own receptors for our own benefit. There are a whole group of different types of plants. We can do plant extracts, as well, and utilize them for helping to maintain gut health.  There was actually a very interesting study that came out, maybe three to four months ago that showed that if you had an organic, soy based diet; a cup of organic soy like tofu or edamame; every day, that by the end of 12 weeks, hot flashes, night sweats, and sleep problems, which are so prevalent in this transitional time. Of course, it can go on for almost 20 more years. It can go on for a very long time, that something like close to 90% resolution of these symptoms, just by including these phytoestrogen foods.  Which is amazing, really, because they bind to the beta receptors. Estradiol has at least three receptors and variants now. There’s offshoot receptors, but the primary receptors are alpha, beta, and a membrane receptor. They have prevalence throughout the body, but in different proportions. They have different effects and they actually up and down regulate each other. They’re very interactive.

It turns out that certain foods like soy and flax seed predominantly bind to beta receptors. Beta receptors are in the cerebrum of the brain. So, it helps with that type of function, and as well, the gut lining cells are mostly beta. So, it helps with gut.  Now, unfortunately, the bone is more alpha, so it hasn’t been shown to improve bone health. It’s not a panacea. It’s not a panacea, and it’s not like having estradiol, but these are ways of harnessing nature’s gifts to us, to help us to feel better, sleep better, and all of those things are going to improve quality of life dramatically.  So, I recommend including organic, of course, if you have a food sensitivity, there are people that can’t eat some of the healthiest foods on the planet because of leaky gut and how their bodies have modified their ability to deal with them. But assuming you don’t have that problem, and you can do elimination diets and check it out, but assuming you don’t have a problem, and you can eat organic, whole, unprocessed soy, or minimally processed, like tofu, and include that on a regular basis, along with a couple of tablespoons of flax seed, that alone can have dramatic effects.  In terms of supplements, you can harness the Siberian rhubarb. The root of that plant is also a phytoestrogen that is all beta. That’s been well tested.

Dr. Weitz:            Let me just clarify for some that don’t understand. Phytoestrogen stands for plant estrogen. So, these foods like flax and soy contain these plant compounds that are very similar to the estrogen that’s in your body, and attach to those estrogen receptor sites.  Then the question is, do they have negative effects? Could they increase the risk of breast cancer, or some of the negative effects that can happen? Or are they more likely to have positive effects?  A lot of the data seems to show that most of their effects are very positive, that in some ways, they block out some of the toxic estrogens that are found from toxins in the environment, like pesticides and all these other chemicals. So, you’d much rather have phytoestrogens attached to your estrogen receptor sites than estrogenic substances coming from petrochemicals, or pesticides, or et cetera.

Dr. Gersh:           Yeah, plastics, right. Absolutely.  These, if you look at the chemical structure, a little bit of the molecule is similar enough that it can actually bind and have a positive effect. Then there are other foods that can also have that people don’t even realize, like pomegranates, which have been called a superfood, and people don’t realize that from pomegranates, you get urolithins. Urolithins are the breakdown from the different polyphenols; the aegisic acid and so on. These actually can also be phytoestrogen effects.  So, many of the foods that are called superfoods, when you actually find out about it, they’re actually phytoestrogens. So many so called superfoods actually do bind to estrogen receptors because, of course, men, I always say, should love estrogen, too. They have tons of estrogen in their body. They just make it locally, on site, in the different organs, from their testosterone. Because all estradiol is derived from testosterone. Men just do it on site. Women make it in their ovaries and then disperse it. Of course, we have different quantities, different ratios.  But in the end, these foods can also be beneficial. Breast cancer, by the way, is virtually always, when it says estrogen receptor positive, it’s working on the alpha receptor. Like soy, flax seed, they’re beta receptor. They’re more like estriol. They actually, we know that when you have a lot of beta receptor stimulation, it actually down regulates alpha. It’s an interesting thing.

So, it’s a little bit like taking raloxifine or tamoxifen, but better. These are drugs that have other interesting but not desirable side effects. It’s nature’s own way of giving these drugs that are actually marketed, like raloxifine, which is also called a SERM. The name SERM is not supposed to be used anymore, but like I said, nobody ever gets rid of the old words.  So, that stands for selective estrogen receptor modulator. But now you’re supposed to say estrogen agonist/antagonist. It means that depending on the location and the receptor, it either acts as a pro or a con. It stimulates or it blocks. So, that’s the new word, but we always say SERM anyway.  So, this is a drug, a pharmaceutical, raloxifene, and the brand name is Evista, that has an FDA approval for bone health, and to help reduce fractures of the vertebra, not of the hip. They haven’t shown hip. But in terms of breast cancer, it’s considered a prophylactic preventative, to help reduce the risk of breast cancer.  Well, duh. You could eat food and then you get all the other benefits of food, but those are natural ways of creating a similar effect to this pharmaceutical. So, I say go for the food.

Dr. Weitz:            What about topping off the benefits of the food by taking, say, genistein or diadzen supplements as well?

Dr. Gersh:           So, in terms of the isoflavone concentrates, I wish that the data was more robust in terms of its benefits. It hasn’t been as good as I would like. I don’t know of any real harm, but for those particular isolates of the isoflavones, you do better by eating the whole food.  So, I don’t actually push for those isolates. In terms of others, there’s been some extracts from what are called lignans, which are also phytoestrogen. Also, as I mentioned, the root of the Siberian rhubarb plant. That seems so arbitrary, but they figured that one out.  You’ve probably heard of black cohosh. Now, black cohosh has also not quite panned out as well as we had hoped. So, they’re just not really nature’s gift to the world as much as we’d hoped. So, I don’t really use a whole lot of black cohosh. I do use some of the others; the lignans, and I do use the Siberian rhubarb root. Then I use food. Of course, as an MD, I do use hormones.  That’s another thing that is not really recognized, that you can give a little bit of bioidentical estrogen, even to women who are cycling. That’s where, if you do the menstrual map, and you see that their estradiol levels are really sub-par, but it’s a crazy time, also mentioning the perimenopause, because there’s a lot of overshoot. That’s the one time when you can have actual estradiol dominance.  People always throw this term around, of estrogen dominance. I’m trying to get rid of it because people think of it as estradiol is evil, and that’s not what estrogen dominance is about. It’s about poor detoxification, endocrine disruptors. It’s not about, the ovaries are making too much estradiol. That’s not what it is about.  Except in one case, and that is when a woman is perimenopause, and she ends up having too little estrogen. The brain, which has a censor says, “Oh, there’s not enough estrogen being produced from the ovaries, so I will tell the pituitary gland to make more of its gonadotropins, LH and FSH, to then trigger the ovary to make more estrogen.”  Well, unfortunately, the ovary is now less responsive because it’s running out of eggs and it doesn’t really make the hormones as well. So, the gonadotropins, LH and FSH, are produced in higher quantities. When you still have some reserve, the ovaries are not completely done for yet, then you have this giant surge of LH and FSH. You can get a giant surge of estradiol, and you can also get multiple eggs coming out.  That’s why women in their 40s have the highest incidents of fraternal twins of any time in a woman’s life because they’re getting hyper stimmed. It’s like what they do when they’re trying to help women get pregnant, like in fertility patients. They give these medications to try to get them to ovulate. Then, sometimes, oops, now we’ve got too many.

Now, in the ancient days, they weren’t so careful and then people had octomoms, they got so many eggs out.  Now sometimes they’ll get twins. They’re very careful. They’ll just abort the cycle if there’s too high of a level. But in nature, nature can do that, and then you get twins. It’s like, “Oh, my gosh. I thought I was not even fertile anymore and now I’m pregnant with twins.”  That happens when someone’s 44. That actually can happen.  But women, because they’re going through this, I call it a roller coaster, where their estrogen is too low. Then they have this giant overshoot of gonadotropins, and suddenly their estrogen level is, I’ve measured sometimes, it’ll come out … A typical level for a woman would be around 100 or so, for picograms of estradiol. Then I’ll get a level of 800. It’s like, “Oh, my God!”  So, this can trigger horrendous migraines, and sleep problems, and mood swings, and breast tenderness. Suddenly they get really, really heavy periods.  You can just imagine how much uterine lining is made by all that estrogen.  Sometimes, if you give a little background, a little bit of estradiol, it’ll keep the brain from creating that giant overshoot of gonadotropins.  So it’s like, if you give a baseline of estradiol, the brain won’t create this roller coaster effect.  Sometimes that can really be a saving grace as women are going through this really challenging time because the conventional world puts them all on birth control pills.  I can tell you that.  But that has its own set of issues, as well.  So, we try to do it and let women still have real hormones, their own natural hormones. But we’re trying to tame the monster here a little bit, during that time when they can have this crazy overshoot.

Dr. Weitz:            Let’s go through some of the symptoms of perimenopause. I want to say, looking at the time, I don’t see how we’re going to get through all three stages because we’re still on stage one, but that’s okay. Let’s do a good job with what we’re doing.

Dr. Gersh:           Oh, they’ll have to read the book!

Dr. Weitz:            Exactly. Exactly.  So, you mentioned breast pain/mastalgia, and that’s often common in perimenopause. Why is that and what can we do about that?

Dr. Gersh:           Well, that’s because of this overshoot, often, of the estrogen. So, the best thing that you can do for that is to have a little bit of patience, and often to take a little bit of, I recommend a little bit of iodine can be helpful. Sometimes that’s a sign. We have massive iodine deficiency, so a little bit of iodine can be helpful. But a lot of patients can be really going-

Dr. Weitz:            When you say a little bit of iodine, you mean 100, 200 micrograms?

Dr. Gersh:           Yes. Yes. Always less than one milligram. So yeah, around 200 micrograms. I am not into massive dosing whatsoever.  Then you can do things that reduce inflammation because remember, pain is always inflammation. You can take some of the anti-inflammatory, herbals is very helpful.

Dr. Weitz:            I take curcumin or fish oil.

Dr. Gersh:           Yes. I love all of those things. Then having the anti inflammatory lifestyle. Really, it’s so important for women to know that this is just a stage, and that it’s not associated with breast cancer. Sometimes reassurance is the best medicine, rather than going on pharmaceuticals for something like that.

Dr. Weitz:            What about if the balance of the estrogen and progesterone is tipping, that the progesterone is starting to go lower, and maybe getting these spikes of estrogen? What about using something like chaste berry to help the body produce more progesterone?

Dr. Gersh:           Yes, absolutely. Chaste tree, also for the Latin name, vitex, is often referred to as the women’s herb. It has actually reasonable data that has been accumulated, showing that it can help with PMS and breast tenderness. Those are really key problems that often go together, actually, because it’s a hormonal imbalance. So yes, chaste tree, vitex is a very, very useful herbal for treating breast tenderness.

Dr. Weitz:            What dosage for that do you like?

Dr. Gersh:           Usually about 200 is a very good dose. For taking it, I always recommend just take the whole dose in the morning, just as a morning dose.

 



Dr. Weitz:                            I’d like to interrupt this fascinating discussion we’re having for another few minutes to tell you about another really exciting product that has changed my life and the life of my family, especially as it pertains to getting good quality sleep. It’s something called the chiliPAD, C-H-I-L-I-P-A-D. It can be found at the website chilisleep.com, which is C-H-I-L-I-S-L-E-E-P dot com.

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If you go to chilisleep.com and you use the affiliate code, Weitz20, that’s my last name, W-E-I-T-Z, 20. You’ll get 20% off a chiliPAD. So, check it out and let’s get back to this discussion.



 

Dr. Weitz:            So, fibromyalgia. That’s a not quite fully understood condition, seems to be fairly prevalent. Patients get pain throughout their body, up and down their spinal cord. How is this related to perimenopause and how frequently is this seen?

Dr. Gersh:           It’s seen all too often and it’s primarily in females. That’s why it’s been swept under the rug quite a bit, and treated a lot with Prozac in the past, and still treated with Cymbalta, which is duloxetine, which is in the SSRI/SNRI family. It’s interesting because some of the same centers in the brain that deal with pain response also deal with mood response.  So, in terms of pharmaceuticals, some of the drugs that are used are gabapentin. But we can do a lot without turning to the pharmaceuticals. So, understanding that there is a strong relationship to hormones. All of the hormones have a lot to do with balancing our endocannabinoid system and our opioids or natural endorphins. It turns out that these hormones are very involved, all of them; progesterone, testosterone, estradiol; in terms of the relationship of these different other systems of the body.  We have all these different interesting systems involving signaling agents. We have the peptides, and we have the fatty acids, which are involved with the endogenous opioid system, and the endorphins. We need to have proper hormones for transporting these molecules into the brain, for having them function properly in the brain, for balancing all of this.  We now know that, although fibromyalgia doesn’t typically have systemic inflammatory markers present, that they can actually be in the spinal cord. It still comes back to pain is inflammation and it’s going on in the central nervous system.

So, we still need a lot of research on fibromyalgia, but a lot of mind/body medicine can be helpful. Trying some balancing hormones, I find is actually very beneficial. Sometimes gentle body work, but not heavy, not pushing too hard. But gentle body work, lymphatic massage, mind/body medicine, and sometimes, short-term, some of the pharmaceuticals, and once again, all of the anti-inflammatory herbals. It’s amazing how we now know that without adequate vitamin D, you’re going to have more pain. Omega 3, you’re going to have more pain. We know that people have, often, very bad diets that are lacking in the antioxidants, the polyphenols.  So, just getting on a diet that is plant based, filled with different colorful vegetables, fruits, and proper fiber, because I’m sure there’s, we’d need more research, but there’s always a relationship to the gut microbiome. So, anything we can do to improve the gut microbiome, have proper short chain fatty acids like butyrate, that’s going to affect the brain.  So, we definitely have to work with lifestyle, mind/body medicine, and gentle exercise like stretching and yoga can be incredibly beneficial.

Dr. Weitz:            Some of the data seems to indicate that fibromyalgia is related to mitochondrial function.

Dr. Gersh:           Estrogen is also the under recognized, because a lot of people talk about aging is related to mitochondrial decline. Estradiol is essential for every single function that is involved with the production of energy in mitochondria.  Also, not just a production of energy. Most people in the functional medicine world know that when you produce energy through [inaudible 00:45:15], you’re also creating oxidative stress, like with superoxide. It turns out that estradiol actually is key to regulation of this very essential enzyme, superoxide dismutase, which helps to detoxify this toxic oxidative stress molecule, the superoxide. So, without that, you then have destruction of the cell and of the mitochondria.  The bottom line is that estradiol comes back to yes, you need estradiol to manage your healthy, functional mitochondria. Absolutely mitochondria, or the energy producing factories. If you don’t make energy, you’re not alive. In fact, everyone knows, if you flat line, that means you’re not alive. You need energy. That’s the spark of life. Estradiol is like the spark of life, by helping mitochondria to make that critical energy.

Dr. Weitz:            Certain minerals, zinc, coper, and manganese are precursors for SOD, so those should probably be included there.

Dr. Gersh:           Right. That’s why so many people have essential deficiencies of these key, I always say you can’t work the machinery of yourselves if you don’t have the right nutrients. That’s why everyone who comes in, and weight gain, we’ll have to come back after, but in terms of the gaining of the weight and the fat redistribution, which is so distressing to women. We know that this can also be very much related to declining estradiol levels, but we can do so much about that. Not just taking hormones, which is part of the equation, but doing proper stress management. There’s nothing that contributes to belly fat more than high phonic levels of cortisol. We’ve got to work on our stress and our sleep. Exercise revs up mitochondrial function. We know that you can have mitogenesis just by having great exercise.

So we have to work with what we have. I say, that’s why I dislike to the bottom of my heart, centers that are just hormone distributing centers. I’m not going to compare it to opioid distributing centers, which exist, where people would come in and get their dose of an opioid every month.  But just giving out hormones is offering false hope because hormones are just a piece of what makes women healthy or men healthy. You can’t just give hormones and expect that’s it. No. You have to do all these other things. You need to have stress reduction, sleep, and so on. Because this belly fat thing is so harmful to women’s self-esteem. Of course, it’s a metabolic poison and creates that chronic state of inflammation, creating that well known term, “inflammaging.”

Dr. Weitz:            Yeah, this whole concept of fat loss, and why different people gain fat in different areas; whether it be more in the abdominal region, more in the hips, more in the back, et cetera; it really hasn’t been studied that much. We know it’s related to these different hormonal balances.  I remember the late Charles Poliquin, who was not a medical doctor, but a very interesting practitioner of exercise and recommendations about nutrition. He would have these categories for, this is an insulin dominant person, this is cortisol, based on where their fat was distributed. That’s something I think really should be given some more attention and study.

Dr. Gersh:           Oh, absolutely. We’re always challenged, as you brought up earlier, with these ubiquitous endocrine disruptors that are really metabolic poisons. Then, when you don’t have your proper production of hormones, then what becomes the dominant hormone, if you can call it [inaudible 00:49:29] information.  So, once you recognize hormones are really the language of the body. There is multiple different languages, but these are the main language. They tell the cell what to do. They’re giving instructions. If you get endocrine disruptors, then you’re going to get the wrong instructions, and the cell will do the wrong thing; make the wrong protein, for example. If you have no information, then the cell goes into a default state, which is pro-inflammatory. The whole body goes into this default state of pro-inflammation.  It’s really interesting when you see estradiol as operating the switch. I think of it as a switch that turns the body from pro- or anti-inflammatory, back and forth. That’s why estradiol is an immune system modulator. That’s why it can be so confusing to people. It’s like, estrogen causes inflammation. Estrogen is anti-inflammation. It’s both because it’s modulating the immune cells.

So, that’s why when you get a pathogen that tries to get into your body, it’s estrogen in the form of estradiol that triggers the [inaudible 00:50:40] to become activated and the mass cells to become activated. So it basically revs up your innate immune system. Then later, it also triggers the production of antibodies, but then it dampens down. It flips the switch so that you go back into the homeostatic state where you have an anti-inflammatory state.  So, estradiol, when you have proper production, it modulates this entire immune system response. Which of course, is also activated if you have damaged tissue. Then, when you don’t have it present, you end up getting into this default system where you end up in a chronic state of pro-inflammation. That leads down the path to all the other things that happen in the other stages of menopause, like hypertension, and heart disease, and then really the fractures, and the disintegration of your joints, and then having the osteoarthritis.  So, all of these things stem from, really, loss of this modulation of the immune system that regulates how you’re either pro- or anti-inflammatory.

Dr. Weitz:            It’s hard to get my head around exactly how it affects immunity because we know that women tend to have stronger immunity prior to menopause. Yet, after menopause, they seem to have increased autoimmunity. So, if the estradiol is so crucial for immunity, and then the estradiol drops after menopause, shouldn’t they have less autoimmunity rather than more?

Dr. Gersh:           It’s interesting because it depends on, there’s different types of cytokines and the different immune cells, but every immune cell in the body has estrogen receptors. The dominant receptor on the cells that make antibodies is the beta receptor. The dominant receptor on the innate immune cells that make the inflammatory cytokines are predominantly alpha.  So, you have this balance between this whole immune system that is then lost. When you don’t have enough estrogen, and this has been shown, the innate immune cells will release their inflammatory cytokines at a lower threshold of stimulus. So, you get altered gut microbiome. This has been now shown. When you lose your estrogen, the microbes in the gut transform into a different set of population. Then you lose your protective mucus coating and you have the impaired gut barrier, or leaky gut.

As these endotoxins, the lipopolysaccharides cross between the lining cells into the gut associated lymphoid tissue where 70%, 80% of the immune system resides around the gut. These innate immune cells are triggered through the toll like receptors that activate them, that the little [inaudible 00:53:42] cells, they put their little fingers into the gut, and they communicate, they all line up.  Then you have this explosion of production of inflammatory cytokines. But as well, you have the connection between these innate immune cells and the lymphocytes that are in the peyer’s patches. These are segregations of lymphocytes that make antibodies that are embedded in the gut associated lymphoid tissue, and they make antibodies, and they communicate through these different types of toll-like receptors. So, they are then triggered into making antibodies.

When you lose estrogen, you actually lose a lot of your control over all these incredibly, critically important and very complex functioning immune cells, so you end up with that situation. We know, for example, when you’re exposed to a lot of endocrine disruptors, and I was trained in environmental medicine under Dr. Walter Crinnion, who I just miss every day. He’s an amazing pioneer in environmental medicine.  Basically, his foundational tenant of life is, most problems are due to pollution, and what is altering the ways our bodies are functioning, because we’re getting all these ridiculous toxic chemicals into our bodies, and that most of the auto-immunity that people are now facing in younger years is because these are endocrine disruptors that are interfering with the normal signaling.  So then, that promotes early onset, like Hashimoto’s, which is epidemic, and also lupus, and multiple sclerosis and such in younger people. Then in older women, rheumatoid arthritis becomes really prevalent. Of course, you can have endocrine disruptors that are contributing, but it’s really the loss of the control of the immune system’s homeostatic mechanisms, by loss of the estrogen.

Then the immune system goes into this crazy state of producing lots of inflammatory cytokines, and then communicating with the lymphocytes to make these antibodies. That’s why we now know that these autoimmune diseases, like rheumatoid arthritis are not just associated with joint damage, and motor disabilities, and pain, but also with cardiovascular risk. That because you have a systemic state of inflammation.  So, it’s affecting the immune system on multiple levels. That’s why you really want to be proactive, because we want to be helping women with both diet, lifestyle, and hormones, so that they don’t get rheumatoid arthritis, which is really incredibly prevalent, and really harmful in a myriad of ways. That tends to show up down in the later phases. But the precursors are happening in the perimenopausal years, when the immune system is starting to get this hit of lack of hormones.  Then of course, the immune system is everywhere, including in the brain. So women who have loss of the hormones have a much higher rate, and this sounds so politically incorrect, but I have to tell the truth. Women have two times the incidents of Alzheimer’s as men. It’s not an accident. It’s because their immune cells in the brain, which are these specialized macrophages called microglea, when they don’t have the proper estradiol to regulate their function, they too, go into this default state, like weapons of mass destruction. They produce enzymes. All these immune cells, these macrophages, produce enzymes that are designed to dissolve pathogens and damaged tissue and then gobble it up.  That’s our cleanup crew, our damage control mechanism. But what happens when they can produce and release these dissolving enzymes for no good reason. Then they dissolve our brain. That’s when the brain tries to have a healing mechanism. Then it produces the beta-amyloid. That’s why getting rid of the beta-amyloid doesn’t prevent Alzheimer’s, as I wished, because it’s a response to these out of control microglea, these immune cells that are producing all of this inflammatory response.  But this is what’s happening elsewhere. That’s what’s happening in our arteries. It’s a similar thing that’s happening in different organ systems. That’s why I love talking to you, to get the word out, because these are not in-solvable problems. Because it sounds so terrible, the future is so grim. But we can actually do so much to work out all of these issues.

Dr. Weitz:            But it’s going to take a lifestyle program. It’s going to take more of an Integrative, Functional Medicine approach, and there’s not going to be one drug that’s going to solve it.

Dr. Gersh:           No, including hormones.

Dr. Weitz:            We’re going to have to wrap here. I was worried about getting through the three stages of menopause, but we didn’t get halfway through the first stage.  Buy Dr. Gersh’s book.

Dr. Gersh:           Well, now really, to give a slight plug, it’s not a book that you have to read from beginning to end. It’s like a little compendium, like a little mini encyclopedia. You can just pick out, one of my favorites because I see women all day long, and they look in the mirror because that’s what we do. We say, “What’s happening to my lips? Why are they getting so thin?”  This way you can say, “I don’t know why my lips are getting thin.” You can look it up in the book. Or, “Why am I getting breast tenderness,” like you said or, “What’s happening to my bones?” You can pick up any topic you want and look up the stage of menopause and what’s happening with that particular symptom, and why it’s happening, and then what you can do about it.  So, you don’t have to sit down and read it cover to cover. It’s a reference book.

Dr. Weitz:           Thank you, Dr. Gersh. How can listeners and viewers get a hold of you? Where can they buy the book?

Dr. Gersh:           It’s on Amazon. I’m actually in one of my exam rooms, so you can find me in my office pretty much every day.

Dr. Weitz:           Is the book available on other booksellers?

Dr. Gersh:           It should be, but right now, as you probably know, there’s a supply chain problem. I think they’re actually having trouble printing books. Isn’t that amazing?  So right now, it’s just on Amazon, because it’s just hard to get printers to print books. So we’re just limiting it to Amazon for right now. That’s what the publisher said anyway. I go with what they tell me.  My office is in Irvine, sunny southern, usually sunny. It’s a little cloudy today. We need some rain anyway. Southern California. I can do some telemedicine. I can do telemedicine throughout all of California. For people in other states, now that things are changing, I do have to see people once a year in person. Unfortunately, that’s the crazy laws that we have. But I can do other stuff remotely and usually we can manage, because it’s a great place to have a vacation to.

Dr. Weitz:            There you go. Thank you, Dr. Gersh.

 


 

Dr. Weitz:            Thank you for making it all the way through this episode of the Rational Wellness podcast. If you enjoyed this podcast, please go to Apple Podcast and give us a five star rating and review. That way, more people will be able to find this Rational Wellness podcast when they’re searching for health podcasts.

I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica Weitz Sports Chiropractic and Nutrition Clinic. So, if you’re interested, please call my office. (310) 395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you and see you next week.

 

Dr. Eric Zielinski discusses Essential Oils 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 my WeitzChiro YouTube page.] 

 

Podcast Highlights

2:43  Essential oils are neither essential, nor are they oils. Essential oils are volatile organic compounds that contain the essence of the flavor and aroma of plants.  They are volatile in the sense that they readily evaporate at ambient room temperature, which is in contrast to chemical air fresheners like Febreze, which you can smell 100 feet away 10 minutes later. 

12:53  Artificial fragrances are killing people every day and they are extremely common.  They are found as fake smells in every public restroom.  They are very strong if walk into a Bed, Bath, and Beyond or a Bath and Bodyworks store or if you go down the cleaning aisle in Walmart.  ((% of us are born in a sterile hospital environment and we go home with all these fake smells from Mama’s perfume to the smells on their clothes and their blanket.  What does that do to our sense of smell, to our brain. You wonder why autism and learning disabilities and dementia and Alzheimer’s are on the rise?  We’re causing brain inflammation.  This is why we should surround ourselves with essential oils instead of with fake smells.

16:52  Essential oils differ from herbal medicines in their much higher concentration.  No herbal supplement can compare to the therapeutic efficacy of essential oils due to their incredible concentration.  One or two drops of cinnamon essential oil are equivalent to two to three teaspoons of cinnamon bark powder at balancing blood sugar.

30:28  Sleep. Lavender is a good essential oil for sleep.  Vetiver and Roman Chamomile are also very effective, though a little pricey.  Geranium and clary sage are both good. You can also use the tree oils like pine, frankincense, sandalwood, and cedarwood. 

34:08  Essential oils for dementia and Alzheimer’s disease.  Dr. Zielinski wrote in his book that hand sanitizer contains chemicals that might damage your microbiome and might increase the risk of brain inflammation and of dementia.  Also, between the VOCs often emitted by your carpets and all the artificial fragrances and aerosols people have in their homes, when they spend so much time in their homes because of working at home and stay at home orders due to the pandemic, we are subjecting ourselves to a huge toxic burden.  Rosemary is an essential oil that is the herb of remembrance, so it can help with memory.  Cinnamaldehyde, which is the primary component of cinnamon bark is a natural acetycholinesterase  inhibitor, so it can help with Alzheimer’s disease.  And of course, cinnamon can help with blood sugar balancing. Basil also has similar activity.  Other essential oils with acetycholinesterase inhibitor activity include sage, thyme, lemon balm, also known as melisma, lavender, and bergamot.  Clove oil is a natural blood thinner as well as some of the highest antioxidant activity.

 



Dr. Eric Zielinski is a Doctor of Chiropractic, a natural health guru, and a best-selling author with his wife, Sabrina Ann Zielinski. Dr. Zielinski is the author of The Healing Power of Essential Oils, which has sold over 200,000 copies and he has a new book, The Essential Oils Apothecary.

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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.



 

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 site, drweitz.com. Thanks for joining me. And let’s jump into the podcast.  Hello, Rational Wellness podcasters.

Today, we’re going to have an interview with Dr. Eric Zielinski on essential oils. And my goals for the podcast episode today are to learn a bit more about what essential oils are and how they can be used in the treatment of specific chronic diseases, like sleep disorders, Alzheimer’s, diabetes, osteoporosis, heart disease and even cancer, among others.  As Dr. Zielinski points out in his new book, The Essential Oils Apothecary, soothing remedies of anxiety, pain, high blood, sugar, hypertension and other chronic conditions, essential oils are neither essential nor oils. They are actually volatile organic compounds and they’re the components of the plant that are released into the air when you smell, say, lavender. But they are oil soluble compounds so they’re used in a carrier oil like olive oil. But we’ll ask Dr. Zielinski to explain more how essential oils are made and work and how they’re different than herbal supplements.

Our guest today is Dr. Eric Zielinski, who is a doctor of chiropractic, a natural health guru and a bestselling author with his wife, Sabrina Ann Zielinski. Dr. Zielinski is the author of The Healing Power of Essential Oils, which has sold over 200,000 copies.  Dr. Zielinski, thank you so much for joining us today.

Dr. Zielinski:                        Well, Dr. Ben, thanks for having me. I got to say I have big shoes to fill. Not many people can boast a hundred five star reviews. You don’t even have a negative review on your podcast here. So I better not screw up. If I screw this thing up, you take it out of my pay, right? How much are you paying me for this? No, no.

Dr. Weitz:                            Yeah. Fortunately, I have a hundred relatives and friends, but-

Dr. Zielinski:                        I love that.

Dr. Weitz:                            … just kidding.

Dr. Zielinski:                        How many wives and kids do you have?

Dr. Weitz:                            So-

Dr. Zielinski:                        That’s funny.

Dr. Weitz:                            … let’s start by explaining: What is an essential oil and how is it made?

Dr. Zielinski:                        Ah, I’m so glad you mentioned that. They’re not essential… funny.

Dr. Weitz:                            Oh, who would’ve thought of that question?

Dr. Zielinski:                        Isn’t that cute? You mentioned something, though, they’re not essential and they’re not oil. I mean, they’re named essential oil because they’re known as the essence of flavor and aroma of plants. So when you put your nose into a rose and those volatile organic compounds are being emitted from the rose, you smell it.  And just to go back to biochemistry for people who might forget, volatile or volatile, meaning readily evaporate at ambient room temperature.  So that means when you spray your Febreze a hundred feet away in a room and you smell it 10 minutes later, it’s because those particles are floating.

Dr. Zielinski:                        Well, organic, again, volatile organic compounds. Organic meaning carbon based and compound meaning [crosstalk 00:03:34].

Dr. Weitz:                            Floating particles. I’ve got to get my mask. No, I’m kidding.

Dr. Zielinski:                        Yes. Again, don’t get me started. And compound meaning there’s a lot of chemicals, meaning there are a lot of components to it. So I’m holding up a bottle that’s used, almost done, of my favorite blends here. And you’re looking at 150 to 200 different plant chemicals. And what do you mean plant chemical, Dr. Z? Well, you’ve heard of menthol, I’m assuming, right? Eucalyptus menthol. What’s in your Vicks Vaporub? What’s in your Bengay? What makes your pain relieving stuff good? Well, people focus on menthol. So they extract the menthol from the peppermint and they create a drug out of it. Same thing with Pinene, Limonene, Eugenol, Carvacrol and one thing, I mean, let’s call it the elephant in the room.  Drugs today, highly, are based off of the chemical constituency that we see in plants. It’s not like a chemist or a pharmacist wakes up in the middle of the night with a vision thinking, “Oh, if we combine carbons and hydrogens and oxygens in a certain way we’ll create this structure.” No. I mean, what we see is what we have in nature and that’s the basis for virtually every drug on the market.  And the best example is Willow. For years, thousands of years, our ancestors have used Willow bark for its analgesic pain relieving property. It is a potent anti-inflammatory. They made pulses and salves and creams and all kinds of stuff out of it. Well, there’s a chemical in it. It’s a salicilin in the salicylate family. If you extract that out, if you manufacture it, synthetically mass produce it, put some preservatives in a white, shiny coating, it’s sold as aspirin. It’s literally aspirin. Same thing with your antibiotics; same thing with your Metformin, your diabetes drug; same thing with your cancer medication.  I want to stress the importance here. I love aromatherapy for the smell and the feel and getting in the mood for me and my wife to enjoy a nice evening together. That’s all great. But what I’m talking about is medicine. Actual, let’s treat disease, let’s prevent chronic conditions. And that’s the basis for this recent book that we published, advanced strategies and protocols for chronic disease and conditions that are robbing people of the abundant life.

Dr. Weitz:                            Yeah. It’s interesting. You talk about all the different compounds. We just recently had a discussion on a podcast with Dr. Pizzorno, and he did a lecture at the IFM’s annual meeting on Unimportant Molecules. And he was talking about the fact that how we analyze foods and he came up with, say 45, different vitamins and minerals, and, basically, said, those are the only important compounds in food.  And now when you go back and you analyze all these phytochemicals, there’s 50,000 chemicals in food and many of them have health promoting properties. We have flavanols and we have carotenoids and on and on and on. And so when you have an essential oil, you have all of these phytochemicals.

Dr. Zielinski:                        They’re actually known as bioactive compounds.

Dr. Weitz:                            Okay.

Dr. Zielinski:                        And so a bioactive compound is a secondary metabolite. So the primary metabolite of photosynthesis and plant biology are your things that you need to live: Your vitamins, your minerals, your carbs. See, here’s the thing. That’s why they’re not essential, right? We should go back to our little … They’re not essential. You don’t need essential oils to live. You technically don’t need fiber to live. You don’t need antioxidants to live. You need carbs, proteins, and vitamins and minerals, or you will die.  Now, that’s the difference. Essential nutrient versus non-essential. But non-essential nutrition, including essential oils, including those  bioactive compounds, are what give you health. So imagine a life without antioxidants. Imagine a life without fiber. Imagine a life without polyphenols and carotenoids and all those thousands of chemicals. That’s where sickness and disease come into play.  So when you’re looking at a nutrition label it’s completely useless. The only thing I look at a label for is to let me know what the ingredients are. Everything else is useless, in my opinion. And so that’s where you start focusing on, okay, what really is important? So that going back to this bioactive compound mentality is this mindset, “Okay. What do I need to live?” I got that. You’re going to get that, basically, … You’re not going to become carb or protein or fat deficient living in America or most industrial countries. You’re going to get that stuff. You’re going to get your basic vitamins and minerals. Very few people are dying of scurvy and vitamin deficiency in our nation.

We could talk about the connection between vitamin deficiency and death, but I’m just talking at a core level. You’re going to get, basically, the stuff that you need, but what’s going to make you healthy? What’s going to make you be able to fight disease? What’s going to give you an immune system? What’s going to help you live an anti-inflammatory lifestyle so that when infection does come in, when you are exposed to XYZ virus or whatever it is that’s out there, how is your body going to respond?  And so, to me, I’m glad you mentioned that because, yes, we’ve majored on the minors and we’ve made ants out of molehills kind of thing. And it’s, okay, how do we get back to the basics? And when you look at plant chemistry, you realize, you know what? There’s a lot out there that we’re taking for granted.  And that … I’ll propose this. This is my big sales pitch in my books, in my blogs, in my classes. Here’s what I’m trying to sell. Again, I’m not a snake oil salesman. By the way, I don’t even sell these oils. That’s my secret. I don’t sell them. I just educate. So now I could be, as I was taught in public high school, an unbiased researcher, and that’s important to me. So I don’t sell them. I’m not going to peddle them. I’m not going to invite you to my multi-level marketing party. Bless their hearts. I love it. Some of my best friends are the top ranked representatives of these companies, making millions of dollars. Good for them.  But I’m just trying to teach you how to look at a lifestyle. And this is my big sales pitch here, to look at a lifestyle a little bit differently. And I want to propose an essential oils lifestyle. I want to propose, when you look at your life, what is your toxic burden? Are you inundating yourself to things airborne, topical, through what you eat that are causing a metabolic burden on your life? Are you poisoning yourself at a microscopic level, not even realizing it?  And once you start to look at your life and once you start to look at the things that you use and buy and consume, here’s something that most people don’t know, is that you are surrounding yourself and are surrounded by essential oils all day long.  For example, what do you think flavors your Coca-Cola?  What do you think flavors any processed food, whether it’s a natural flavoring or an artificial flavoring?  It’s either a synthetic essential oil or an actual essential oil.  What do you think is the aroma in your Febreze or your plugin or your Wallflower or your candle?  What do you think makes your cleaner so effective or your Goo Gone?  What’s in your body care that gives it the aroma?

Essential oils are everywhere.  And it’s, “Wow. I never thought about that.”  And once you start thinking about it, how ubiquitous they are, you start to look at what’s the true danger with synthetically manufacturing these plant chemicals and inundating our bodies with it?  And you start to realize here’s the dangerous thing about the essential oil and the synthetic version of it. Because we talked about them being volatile organic compounds, they’re lipophilic hydrophobic, meaning they’re fat loving, water hating. They will penetrate into your bloodstream within minutes and seep through into your cellular level. They will penetrate your whole life, your whole body. You inhale them, immediately your brain’s impacted. There’s no thalamic relay. What’s that? It’s a fancy way of saying when you smell something, it immediately impacts your brain, the smell, unlike the sensation of pain.  So go back to the last time you might have accidentally hurt yourself, stubbed a toe, cut your finger chopping carrots. Remember that split second of, “Did I really hurt myself? Ooh, I did.” There is no split second when you inhale something. There is no relay center and interpretation center in the thalamus, a part of your brain. So when you inhale something, it sends a direct signal. Your olfactory system sends a direct signal to your brain where your limbic system is, your mood, your memory, your emotions are housed there. Autonomic function is controlled there: Heart rate, breathing rate, which is smart.  When you look at it, as a Christian, it’s awesome. I say, “It’s God’s design. From the evolutionary perspective, it makes sense.” So when you smell smoke, you get in this fight or flight state, this sympathetic state, you get on a high alert immediately. You get out of Dodge. Well, that’s the power of smell.  But essential oils, when you look at that, have such an impact on the body that when you flip it on its head, you start to realize, what does the fake essential oil do to me?  What do the synthetic fragrances do to me?  And that is where I get shaken in my boots because artificial fragrances, Doc, are linked to neurological inflammation, Alzheimer’s, cancer, dementia, autoimmunity.  And, of course, the “minor things” like ADHD, learning disabilities, COPD, asthma. That’s the minor stuff, right? But you say that to someone who suffers with that, it’s debilitating.  Artificial fragrances are killing people all day long.  Artificial flavors are powerful.

Dr. Weitz:                            How common are artificial fragrances?

Dr. Zielinski:                        Everywhere. It’s everywhere.

Dr. Weitz:                            Right.

Dr. Zielinski:                        Everything you smell … And, see, you remember, you’re old enough and I’m old enough, don’t you remember when soap didn’t smell like anything. It was soap, right? People that have been around for a while … You remember when there weren’t all these fake smells everywhere.  And when’s the last time you’ve been to, let’s say, a restroom, a public restroom? And we frequent public gas stations because we travel a lot, right? So we’re traveling, my family and I take road trips up to Michigan, down to Florida. We live in Georgia. And I can’t tell you how many times I’m in the gas station restroom taking a pit stop with the kids and I hear this, “Psst. Psst.” And, “What in the world’s happening?” I look in the corner. “Oh, someone’s spraying me with an artificial fragrance that makes the pooh pooh smell good.”  They’re poisoning us. It’s fumigating in the bathroom. I can’t handle … But gag. You want a cool tip? People are, “Well, it’s okay. It doesn’t bother me.” If you are not bothered by artificial fragrances, if you could walk in the Bed Bath & Beyond or Bath & Bodyworks, if you could go into the cleaning aisle in Walmart and not get sick, not get a headache, if you don’t get a runny nose, if you don’t sneeze, that’s a problem. And that’s synonymous to having diabetic neuropathy where you don’t feel pain and next thing you know, you have a sore in the bottom of your feet that can end up with gangrene and can get amputated because pain is a sensation that tells you there’s something wrong.  If you put your hand into a fire and keep it there, it will burn off. And that’s exactly what’s happened with our sense of smell and we become desensitized to it. From birth, from birth, you’re born in a sterile environment with all these fake chemical smells at birth. 99% of kids born in the hospital and then they go home with all these fake smells. Mama is filled with perfume and all this beautiful stuff that makes her smell good. Wow. What does that do to our sense of smell, the primal sense that we have to protect ourselves? And what does it do to the brain?  And you wonder. You wonder why autism? You wonder why learning disabilities? We wonder why dementia and Alzheimer’s is on the rise? We’re causing brain inflammation. And that is why I’m trying to propose and sell everyone on this idea of this essential oil lifestyle is you are using and being and eating and surrounding yourself with essential oils all day long. You don’t even realize it.  Start to think about it and start to fix it where you’re replacing the fake with the real. And you’ll find your body will respond wonderfully.

 



Dr. Weitz:            Interesting. I’ve really been enjoying this discussion, but I’d like to take a minute to tell you about a new product that I’m very excited about. I’d like to tell you about a new wearable called the Apollo. This is a device that can be worn on the wrist or the ankle, and it uses vibrations to stimulate your parasympathetic nervous system. This device has amazing benefits in terms of getting you out of that stressed out sympathetic nervous system and stimulating the parasympathetic nervous system. It has a number of different functions, especially helping you to relax, to focus, to concentrate, get into a deeper meditative state, even to help you sleep, and there’s even a mode to help you wake up. This all occurs through the scientific use of subtle vibrations.

                                For those of you who might be interested in getting the Apollo for yourself to help you reset your nervous system, go to apolloneuro.com and use the affiliate code, Weitz10. That’s my last name, WEITZ10. Now, back to the discussion.

 



 

Dr. Weitz:                            So how do essential oils differ from herbal medicine?

Dr. Zielinski:                        Simple word is concentration. You can’t find essential oils in nature. I think it’s important to recognize that they are a hundred percent natural, but they’re still manufactured. So, again, picking up my little bottle here. If you’re listening, you can’t see it, but I’m just holding up a bottle of essential oil. You’re looking at roughly three pounds of lavender flowers, steam distilled. Again, where are you going to see a pool of lavender in nature? You’re not. You’re not going to go into a rose garden, “Oh, there’s a beautiful rose essential oil. Let me touch it.” It doesn’t exist.  So I love herbs and I love herbalism. I love spices and we love supplements, all that stuff, but they’re very minor when it comes to the therapeutic efficacy. Essential oils have true pharmaceutical grade effect on the body. Nothing, no herb, no spice, no supplement, no food, can compare to the therapeutic efficacy that essential oils can have simply by virtue of their concentration matter.  And that’s important to realize because one drop will have the effect of, let’s say, your blood sugar. Let’s say, cinnamon. Great example. Cinnamon is highly effective at helping balance blood sugar, help increase insulin sensitivity. But just one or two drops, just drops of cinnamon bark essential oil has the same equivalency of two to three teaspoons of cinnamon bark powder. And how do you compare? So that’s it. It’s true concentration.  Very similar, but also a different chemical constituency because when you steam distill plant matter, you only get the volatile components. Again, those that evaporate. Those heavier components … Well, again, we’re getting deep in the chemistry and plant biology here, but there are chemicals that are too heavy. Those won’t go through the steam distillation process. And a perfect example is frankincense and boswellia, boswellic acids. A lot of people use boswellic acid for its pain relieving, cancer fighting property. A lot of supplements have BAs, boswellic acids in them. Your frankincense oil won’t have boswellic acid in it.  So what does that mean? As a researcher, as a consumer, you’re, “Okay, what essential oil do I want to use, let’s say, for …” Let’s throw out breast cancer? And you see a study that says, “Oh, frankincense has a property that could help with breast cancer and the researchers poll, “Oh, it’s because of the boswellic acid.” Well, that doesn’t apply to my world. And the reason why I’m sharing that is because there’s a lot of mismanaged and misappropriated research out there and very well intentioned bloggers that are saying, “Hey, frankincense is great for XYZ because of the boswellic acids,” but it’s, well, there are no boswellic acids in the essential oil.  So the reason I’m sharing that with you is because when you extract something through steam distillation or solvent extraction, you’re getting a different constituency. The plant is so … It has a myriad of different ways that we could use the plant, whether you use a bark or a leaf, whether it’s steamed distilled or solvent extracted, it’s wonderful. A cannabis oil is not the same as cannabis essential oil or CBD, completely different products, all oily based from marijuana plant, completely different chemical structures.

So that means you just got to learn what’s what and, quite frankly, most people aren’t willing to put the time and the effort, and I don’t expect them to, to dive into this stuff. That’s why I think so many people buy our books because I do the research. I’ve gone to aromatherapy school. I’ve laid it out. I’m, “Okay, this is what you use for this. This is what you consider for that,” and let’s try to make this a little bit simpler.  And I know your audience is, dare I say, a little more advanced or educated than the average so I’m talking in a way that I … Typically, don’t talk a lot because I understand, I’ve seen the previous guests and I know what you offer.  In functional medicine, we need to step up and we need to recognize one size does not fit all and we need to look at essential oils as a key part of this tool belt that we need to treat and help people.

Dr. Weitz:                            So before we get into specific conditions, would you say that, let’s say, we’re treating a patient for a specific chronic condition, would essential oils be something that we would add to our herbal protocol? Would you recommend using them in place of it? Would it be … It seems to me it would make sense to add it as an additional component in the treatment plan.

Dr. Zielinski:                        Yeah, it would be … What I would do is I would look at an essential oil before I would look at a pharmaceutical.

Dr. Weitz:                            Right.

Dr. Zielinski:                        That’s how I want people to look at it.

Dr. Weitz:                            [crosstalk 00:21:36].

Dr. Zielinski:                        So your herbs are always there. But that’s what I mean, your herbs are always there. Your supplements are always there.

Dr. Weitz:                            Right.

Dr. Zielinski:                        It’s just now, when in the protocol do you, “Okay, we need something stronger now.” That’s where the essential oil comes into play. And it’s a first step. If we were going to look at it first for people with minor issues, you could try herbs if you want. Or some people go right to the aspirin. The easiest thing is, my medicine cabinet has no pharmaceuticals in it at all. No over the counter. It’s filled with essential oils. That, to me, is the protocol in my life, is if I need something of that nature.  Otherwise, if I have … There is this compounding effect, going back to frankincense. I do want boswellic acids in my life. I do want herbs. I do want spices. I do want supplements. So you use them in conjunction with essential oils. Only, though, and here’s the thing, only if you want that level of therapeutic efficacy. And I think that’s important because I don’t use essential oils because I have to. I use essential oils because I want to currently because I’m not sick.   And let me clarify. I’m not taking a multivitamin of essential oils. I don’t take a drop of frankincense every day to prevent cancer. I don’t live like that. That’s not my philosophy. I use essential oils going back to my lifestyle approach. It’s in my body care because I don’t use the fake fragrances. It’s in my food because I don’t use the fake flavoring. I like it behind me in my diffuser because I don’t like the fake aerosols, and my body just loves it.

So we use essential oils all day long, but when it comes to actual preventing or treating disease, that’s where it’s, okay, it’s a different mindset. And, again, I don’t take cinnamon oil to balance my blood sugar because I’m not pre-diabetic or diabetic. But, if I were, then that’s when I would look at it in conjunction with herbs and other treatments.  A lot of people, quite frankly, they don’t even bother with … Once they reach a certain stage of their condition, the minimum efficacy that a supplement or a herb can have, they’ll go right to the essential oil because, again, you can’t compare. It’s just, who wants to take 15 pills of a turmeric when you can just have two drops of an essential oil? That’s how concentrated these are. And when you use them in a medicinal dose, then you understand it is that level.  So a lot folks, if they have low grade issues, they don’t even bother with the essential oil because they’re eating habits, they’re stress relieving habits or whatever there is, their supplement habits, protocols will help.  So, I guess, I just want to paint that picture is when it comes to ingesting, that’s the key. Ingesting essential oils. You only ingest essential oil medicinally when you want that true pharmaceutical grade punch.

Dr. Weitz:                            And so I know we’re going to talk about aromatherapy, which is our topic for today. But in terms of ingesting essential oils, are they, typically, put into a capsule or do you put some drops in a glass of water? Or what form are they ingested?

Dr. Zielinski:                        Yeah. And actually, let me … I’m glad you said that. Let me correct you. This is aromatherapy. See, isn’t that interesting? This is the misnomer. I’m so glad you said this. People think aromatherapy, they only think of smelling pretty stuff.  Aromatherapy is the therapeutic use of aromatic compounds. So how you use essential oils, depending on what method, will determine your aromatherapy response.  So aromatherapy is ingesting it. Aromatherapy is topical application. Aromatherapy is inhaling it. So that’s where we’ve got to get out of this mindset of, “Oh, I just go to the store to get something smelly and nice.” That is ancient aromatherapy because, quite frankly, and let’s be real, our ancestors didn’t have essential oils like we have them today. And how do I know that? Well, steam distillation wasn’t invented till the 9th Century A.D. by an Arab alchemist. So, again, my well-intentioned multilevel marketing friends who are Christian saying, “Oh, Jesus used frankincense and myrrh.” It’s Christmas time right now coming up here. Gold, frankincense and myrrh. You how many times I’ve been told people are convinced that Jesus used frankincense oil? No way. It was impossible. Why? There was no way for them to extract it.

So when you think about where we’re at today, traditional aromatherapy used to be burning leaves and incense. Cool. And then they got smart. Our ancestors started to put aromatic plants in oil. Actually coming from the Bible. God told Moses, “Hey, get this big old vat of olive oil, put some myrrh, calamus, cinnamon, cassia and just let that steep and hang out for a while.” A.k.a, he gave them an anointing oil recipe, which was a herbal extract, extracting out some of the essential oil in this wonderfully, beautiful aromatic experience that was aromatherapy.  And why would God do that? Well, I don’t know, but I’ll tell you. They were sacrificing animals, blood sacrifices. There’s a lot of risk for infection. And there’s very few things, by the way, that are antimicrobial like essential oils. This stuff kills MRSA on contact. I mean what kills MRSA? Antibiotic resistant bacteria. What kills anti-fungal resistant fungi? Essential oils. There is no known resistance to them, to anything on the planet.  That’s why researchers today are looking at Carvacrol, which is a primary component of oregano to help with COVID. Hey, this is very cool preliminary research. No one’s making claims that COVID’s going to cure the pandemic. But the researchers, medical researchers are saying, “Look, we know the benefits of using Carvacrol for destroying bacterial cell walls and also to kill viruses. We should look at Carvacrol a.k.a. Oregano oil to help with COVID-19.” The research is being done as we speak.

So this is pretty cool stuff when you look at it. So all that to say, when you ingest essential oils, there’s two primary ways of doing it. Going back to your Coca-Cola, your peppermint patties, your flavored ice cream, that’s what’s known as a culinary dose, very, very minor. One drop of oregano in your spaghetti sauce. That’s enough. But it gives you a nice minor … It’s like herbs. It’s just like using weed. That’s our substitution guide is, if a recipe calls for one to two, let’s say, teaspoons of a herb, a spice or a zest, a lemon or orange zest, just use one drop of oil. That’s a literal substitution in your recipe. But what it does, it has such a powerful antioxidant punch, antiviral punch, that the herb doesn’t have. And that’s the culinary dose.  But if you want a true medicinal dose, yes, you need a gel capsule. You need to have … I recommend a vegan gel capsule. If you’re treating the gut for those people … Excuse me … Who are trying to look at minimizing, managing, or even, hopefully, reversing the symptoms of SIBO, Crohn’s, irritable bowel, leaky gut, you need an enteric coded capsule, which is a fancy way of saying it’s a polymer time release capsule. So when you take the capsule, your body won’t digest it until it gets down to your intestines.

So that’s how you literally treat gut issues because the gut is distal colon. And there’s research sharing, suggesting, proving, three to six drops of peppermint essential oil, going back to peppermint, can help soothe the symptoms and help people with SIBO. And they’ve done actual research up to that level.  So in our book, we take what traditional aromatherapy has taught, we take what we know from the biochemistry, we take what we also know of the metabolic pathways of how drugs are metabolized and we share dosing requirements. And, typically, when you’re dosing internally, you’re looking at three to six drops in a capsule and it’s potent.  Topical, want to point out, topical aromatherapy is think transdermal patch, right? Pain patches now, nicotine patches. We’ve seen this for years. We know that chemicals seep through the skin and get into the bloodstream to have a therapeutic effect. The same thing with essential oils. So what we try to do is teach people the safe way of diluting them and making Sabs. Again, this is huge, different strategy than I want to smell good.  And, don’t get me wrong, our body care is all with essential oils. All of it, because we want to smell good but we also like that nice minor medicinal, just a happy, feely, good thing. But when something goes wrong, I have an infection or we’re trying to treat something or whatever it might be, a headache, a migraine, we know to up the dose to a certain level and now we get that therapeutic effect.

Dr. Weitz:                            Cool. So let’s start with sleep. How can essential oils be helpful in promoting quality sleep?

Dr. Zielinski:                        Yeah. Instantly. Instantly can put you in the parasympathetic state. Instantly.

Dr. Weitz:                            So what would you recommend for sleep?

Dr. Zielinski:                        Yeah. Traditionally lavender is a good start. Doc, one thing I love about essential oils, and, again, there’s a lot of things we do. I mean, we’re the granola, hippie, urbanite, yuppy people that give birth at home. That’s me and my wife and our family. There’s a lot that we do, but when it comes to it, a lot of the things that your other guests are sharing besides forest bathing, by the way, that was a great interview, essential oils are forest bathing, by the way. I mean that’s a whole … What do you think makes forest bathing so potent and so healthy and so helpful? Primarily the volatile organic compounds being made from the plants.

Dr. Weitz:                            Right.

Dr. Zielinski:                        So one thing that’s really important is that when you look at this discussion, you start to realize, “Okay, I need to find something that works for me and maybe lavender is a right approach. Or maybe I should try something else.” But I digress.  The one thing that I want to encourage people with is unlike … And, again, this is my sales pitch. I’ve got to do it. Unlike a lot of the things that we learned and a lot of the wonderful things that your experts and other guests have showed, what is easier, literally easier, and even cost effective than getting a 10 or $15 bottle of lavender putting two or three drops in a diffuser and press “On” right before you go to a bed? There is zero barrier to entry, right? Essential oils are the gateway to natural health, natural living, just like cigarettes are the gateway to drugs, right?  That is … I want to impress everyone how easy this is. So nothing on the planet is as easier or cost effective than getting a couple drops, putting in a diffuser, pressing “On.” Done. So that’s what you do. You get a water diffuser, 15/20 bucks on Amazon. Get a good essential oil. Again, I share with you how to find a good essential oil. That’s a whole another discussion, but there are a lot of fakes out there. There are a lot of counterfeits. You got to find the real deal. Once you get one, a couple drops of lavender. Wonderful.

Now, if you have a little more on your budget, and I want to recognize … We have five kids. I get it. Not everyone has a blank check. Vetiver Roman Chamomile they’re super effective, but they can get a little pricey. So what are other oils you could use? Well, geranium, clary sage, a lot of women like these oils. They’re the traditional women’s health oils. They’re wonderful for calm and peace. Again, when you breathe these in, these volatiles organic compounds and you automatically get in that parasympathetic state, it’s instant. So that would be a good way of starting.  Some of the … Going back to the tree oils and forest bathing, all those oils can help: Pine, frankincense, sandalwood, cedarwood, anything with a “wood” at the end of it. It’s a wonderful, wonderful way. And that’s just aromatic. That’s just through the aromatic compounds being emitted from the diffuser.  But if you really want to get into it and that doesn’t help you enough, that’s where you could use a topical application and giving yourself a neck rub or a foot rub. That’s where taking an actual lavender capsule can give you that. If you’re overdosing on a melatonin supplement just to get through the night, you might need something a little more, I don’t know, dare I say stronger? You might need a stronger approach at first until you’ll get so sensitive to just smelling lavender where it just puts you right there.

Dr. Weitz:                            So I want to ask next about the use of essential oils for dementia and Alzheimer’s. And I wanted to say before you answer that question, in your chapter on that, I noticed that you wrote that, “We should think twice before using hand sanitizer because it might increase the risk of brain inflammation because of damage to our microbiomes.” And all I could think is, “Boy, there very well might be a huge increase in the risk of dementia and Alzheimer’s as a result of the massive use of hand sanitizer in the last two years.”

Dr. Zielinski:                        Yeah, that was tough to get in the book actually. My publisher wanted to cut that part out. And I wrote this book in quarantine. It was the very beginning of lockdown quarantine in COVID 2019. Wait, I’m sorry. 2020. So when I wrote this book, I just … Again, my job’s easy. I’m not a practicing aromatherapist. I’m not a practicing chiropractor. I’m a researcher and I’m an author, I’m a speaker and I share what the researchers say. So this is the easiest thing.  Look, a couple of years ago in Oxford University Journal … Again, this isn’t … I love aromatherapists, but they have a stigma of being hippies that smell like patchouli. So the medical world and a lot of people just marginalize them, “Oh, that’s pseudoscience. We get that as chiropractors. It’s pseudoscience.” Oxford University isn’t pseudo science of any sort. It’s the premier university on the planet next to Harvard and Yale, whatever your ranking is.  There’s a journal called Evolution, Medicine and Public Health that found a strong link between over sanitized wealthier countries and higher rates of Alzheimer’s. They conducted this study over 192 countries, basically, the whole world and they found the more sanitized a country I, the higher the rates of Alzheimer’s like a linear relationship.  Now, no. I didn’t use the word. It’s really important. It’s not a play on words. I’m not trying to be smart here. I didn’t say “clean” I said “sanitary.” All right? Huge difference. Soap and water will get your hands clean. But if you want to quote, “Sanitize your hands,” you need something else. And the problem is we’ve over sanitized our life to the point where we’ve, literally, destroyed …. And the research has concluded. Why? It’s the lack of bacteria on your hands. This is really hard for some people to conceptualize. Please bear with me.

There is a gut microbiome. I know you’ve had a lot of your speakers talk about this in the past. There’s also a skin microbiome and there’s a brain microbiome. What do you think makes us who we are? So when we have a lack of bacteria on our hands because of hand sanitizer, it’s been linked to a poorly developed immune system, which puts your brain at risk for brain and neurological inflammation. I mean, are you serious?  Now, when you compound that with fake chemicals and toxic chemicals, cleaning products and artificial fragrances that directly put the brain in neurological inflammation, it’s no wonder that we’re in the cognitive state that we are. And we’re decreasing rapidly. Why? Because we spend a vast majority of our time indoors.  I mean, even before I wrote this book, the most recent research we had was a couple of years ago when the Environmental Protection Agency was clear and they said, “Look, we spend 93% of our time indoors.” And the reason they’re sharing that is the air inside of our houses are two to five times, some up to a hundred times, more polluted than outside. You’re better off breathing toxic smog in LA than you are in your house if you live in an apartment that you can’t control the airflow. No joke. It’s bad stuff. Bad News Bears in your home.  So why is the EPA talking like this? Well, they recommend having a HEPA purifier. Now HEPA air purifiers are COVID protocol for hospitals and nursing homes and schools and all that stuff. I actually bought air purifiers for our kids’ school. Every room in the school have them. It’s that important. But that research was done a couple years or ago before COVID and that was 93% of our time spent indoors.

What do we know about life since? I mean, we’re looking at 99 to a hundred percent of people’s time. Literally, a hundred percent. Some people haven’t left their home in two years. Is indoor. So what are we breathing all day long? We think about the airborne pathogens. Doc, I’ve been talking this way for quite a while, almost 10 years. And it took COVID to bring word awareness that I’ve been trying to preach for a long time, at least in my life, right? I’m 41 years old. Airborne pathogens. People think COVID. No. Think the VOCs that are being emitted from your carpet, your cleaning material. Think about the aerosols, the fragrances. Think about the stuff that’s constantly just around you. That is public enemy number one. That’s the stuff that puts our brain at risk for inflammation in our immune system, dampening, and puts us at a slew of host of toxic burden that could be linked to chronic disease.

So that, for number one, what’s the solution? Well, don’t use hand sanitizer. I mean, unless … Going back to my road trip lifestyle my wife and I take with our kids a few times a year, unless I’m in the middle of the road with no bathroom nearby changing a poopy diaper, I’m not using hand sanitizer ever, ever. It’s not part of my life. And you know what? I had to break up with hand sanitizer because I used to be an addict. And I’ll admit. I had an OCD years ago. Every time I touched a doorknob, every time I did anything, I had a hand sanitizer. Do you know what’s part of kids’ school supply list? Paper, pencil, erasers, markers, hand sanitizer. You can’t walk into school without a hand sanitizer.  So what we do is we make our own. Basically, an alcohol based with essential oil. Done. No toxic chemicals. And why this is even more important is not only what the research shares about brain inflammation and dampening the immune system, but how many more products does the FDA have to ban? It just happened again last month. Oh, another one. High levels of benzine, a known carcinogen. You better not use this hand sanitizer.  There’s dozens out there in the market that are just poison. And, finally, because so many people are using them getting sick and dying, the FDA is finally saying, “Hey …” But what about all the people that have been hurt? What about all the people that just got diagnosed with cancer? They have no idea why. And maybe it’s because a contributing factor could be the hand sanitizer that just got recalled.

 We need to think twice. And there should be no antibacterial products in your possession, zero. So, yes, this conversation … “Okay. Well, you just overwhelmed me. If they’re in my food, they’re in my air, essential oils, fake essential oils, whatever. What do I do? Where do I start?” Number one, you start with your hand sanitizer. And if you have to use it, if you work at a hospital or if your kids need it, make your own. Just get the highest proof alcohol you can. Whatever moonshine, vodka you could get at the store, get 15/20 drops of essential oil, get a spray bottle, bada boom, bada bing, you’re done. It’s so easy. That’s the best hand sanitizer, effective hand sanitizer. It will kill everything.

But here’s a cool thing. Besides some dehydrating aspect and, by the way, alcohol will dehydrate your skin, essential oils have what’s known as cell selectivity. And, again, I have an easy job as a Christian. When I don’t understand something, I’m, “Hey, it’s just the wisdom of God. It’s how God created it.” Well, the scientists can’t explain why, but essential oils target the pathogenic microorganisms and leave the good stuff alone.

 So we all know about probiotics, good, healthy bacteria. If you ingest essential oils, people are ingesting oregano to help cure and repair leaky gut, they’re ingesting essential oils, they’re putting them on their skin to kill the viruses and bacterial fungi. You don’t have to worry about ruining your microbiome. That’s pretty cool stuff when you think of it. Again, the wisdom of God. Science can’t explain it. So that’s if you need it.  But what else? What’s another good step. Well, think about your body care and think … Because, again, we’re talking Alzheimer’s, we’re talking dementia, we’re talking you’re 41 years old. I’m 41 years old. You’re 30. You’re 25. You could smell pretty. You could smell good. Guys, whatever, handsome, good looking, whatever, you could smell good and you don’t have to hurt yourself at the same time. No perfume, no cologne. Throw it away.

Start making your own. Start experimenting. Because what do you think are the basis for your perfumes and colognes? The perfumers are taking the essential oil and then they’re loading them up with chemicals and preservatives to give you this, ugh, toxic. I can’t even handle going down the perfume aisle like I used to. I used to love those Acqua di Gios and Armani’s expensive stuff. Couple drops of essential oil.

You know what’s funny? I’ll never forget speaking … A mutual friend, a colleague, Dr. Peter Osborne, functional medicine doc invited me to speak at a conference a couple years ago. And I flew into Houston on the way to Dr. Osborne’s office and the Uber driver, again, this big, burly Latino guy, he says, “Man, you smell good. What are you wearing?” And I’m, “Citrus oils.” He’s, “What?” Boom. Had a cool conversation. I get more compliments from dudes than I do how good I smell. It’s you smell good, you smell normal, you smell healthy, you smell like we should smell. You smell like nature. Just pointing out.

But you know when I do it, it moisture … My body care. Why am I saying that? Because it’s our body care. A little bit of coconut oil, a little bit of essential oil. Done. Yeah, you could get fancy. We got all the fun little SháSu [inaudible 00:44:00] recipes, all that cool stuff if you want to do it. But it’s so easy and your body responds so well. Everyone has olive oil or you should, or coconut oil in your kitchen. That’s it. That’s half the battle.

 So how are we treating, how are we preventing Alzheimer’s? It’s this life’s style? And another thing everyone should do, throw away the aerosols. No more pooh pooh sprays and plugins. Throw that trash … Oh, wait … And here’s the thing. If you’re like my wife, I’m sorry. You’ve just got to let go. Throw it away. When I hit my revelation, this was over a decade ago, I’m, “Sabrina, this stuff is bad for us. We can’t use this.” My wife said, “We can’t throw away …” The clean plate club, like my grandma who came from the Great Depression couldn’t throw away anything. She goes, “We can’t throw it away. We can’t. We got to use it and then we’ll transition out.” No. This is poison. We had a little bit … Because she wasn’t there yet, right?

By the way, if you’re a zealot like me, be patient with your spouse. If you’re a zealot like me, be patient, right? That’s the problem that we’re having right now, especially in the context of the pandemic. We have zealots on both sides of the fence. Be patient with your loved ones. Because, for me, it’s, “You know what? It’s not going to kill me. I know it’s harmful, but you know what? Breathing in this thing, isn’t going to kill me today and it’s not worth a divorce.”

I mean, hey, I’m giving marriage advice here, which helped me in a big way because if you’re gluten free and if your husband’s eating pizza and breads sticks all day long, that’s going to cause marital problems. That’s the number one thing we always get. How do I get my family on board? Because I’m there. And women listening are usually the spear headers. Women listening, most are … Just statistically, women are usually the caretakers of the home and they’re the ones who get this. It’s really hard for men, typically, to get this stuff, right? It’s a female dominated industry across the board.

 



Dr. Weitz:                            I’d like to interrupt this fascinating discussion we’re having for another few minutes to tell you about another really exciting product that has changed my life and the life of my family, especially as it pertains to getting good quality sleep. It’s something called the chiliPAD, C-H-I-L-I-P-A-D. It can be found at the website chilisleep.com, which is C-H-I-L-I-S-L-E-E-P dot com.

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Dr. Weitz:                            So give me a couple of essential oils we can use as, let’s say, I have a patient on a functional medicine approach for dementia, what are some essential oils we can add to the protocol?

Dr. Zielinski:                        Yeah. Well, rosemary, the herb of remembrance. And going back to herbalism, a lot of those herbs and spices, rose for love, rosemary for, again, memory, there’s a reason, and our ancestors are very observant, very intuitive. So if you want to help cognitive function, rosemary. You can diffuse it, you can apply it topically, you can even adjust it. It’s safe.  But cinnamon, believe it or not … And I don’t know how much time you even have to get in depth with this, but the primary approach to Alzheimer’s treatment is using a drug known as an acetylcholinesterase inhibitor. So low acetylcholine levels, which is a neurotransmitter in the brain, low levels of acetylcholine is the hallmark sign of Alzheimer’s and dementia. And you need acetylcholine for brain synapses and cognitive function.  So what medicine has done is, okay, we have low levels of this neurotransmitter, so what we should do according to the pharmaceutical mentality, is let stop the natural breakdown of acetylcholine. Well, how do you do that? Well, there’s an enzyme known as acetylcholinesterase. Anything with an “ase” is an enzyme, right? So there’s an enzyme known as acetylcholinesterase that naturally breaks down the acetylcholine.  Well, why would that be? Well, because we’re on a cycle. Just like your skin, literally, regenerates itself every 28 days, everything is being used and built, used and built, used and built. And so what the drug approach is, is to stop the enzyme from breaking down acetylcholine so there’ll be higher levels of acetylcholine. Okay. The problem with that is (a), it doesn’t work. It’s not effective. It can’t cure the disease and the side effects are horrendous. I mean, bad stuff, including dizziness, vomiting, memory loss, which is ironic, and death.  Well, research has shown that cinnamaldehyde, which is the primary component of cinnamon bark, has an 80% efficacy against acetylcholinesterase. Wow. I mean, you’re talking ingesting and inhaling cinnamon bark oil can help my brain function? Wild, isn’t it? And there are other oils.

Dr. Weitz:                            It could also help with blood sugar control because-

Dr. Zielinski:                        Thank you.

Dr. Weitz:                            … a typical protocol for dementia, Alzheimer’s, is going to be a ketogenic diet to try to control blood sugar.

Dr. Zielinski:                        Yes. Yes. And you have basil. I’ll read a list. Other oils that are known for their acetylcholinesterase activity: You have rosemary again, sage, thyme, lemon balm, also known as melisma, lavender, bergamot and basil, and then others.  So, again, this is what I do. I go through the research. I share … Okay, this is preliminary stuff. I mean, we have admittedly, though, let’s be real, we have very little human trials over the course of many, many years to test therapeutic efficacy of oils versus drugs. I get that. So a lot of this is “theoretic,” a lot of this is experimental. But I’m telling you something, if used properly there are zero side effects to using essential oils, other than the rare case of some allergy. And part of that is knowing what drug interaction might occur if you ingest them.

And that’s what we include in the book. It’s actually the only thing that I think exists for the layperson. And even going through aromatherapy school, there is nothing as in depth and simple to look at as a chart. We have this drug interaction chart in the book that says, “A drug for Alzheimer’s, the drugs for diabetes, the drugs for insomnia or whatever,” says, “Look, you can’t ingest these essential oils or you can have an interaction.”  Most people don’t realize that clove oil is a blood thinner. So if you’re on Warfarin, you could cause internal hemorrhaging. And the problem is most multilevel marketing companies and other companies include clove in their “Immunity boosting blend.” Why? Because clove oil has some of the highest antioxidant compound ability than anything on the planet. The ORAC scale of clove is a million.

Dr. Weitz:                            Wow.

Dr. Zielinski:                        I mean, a million compared to wild blueberry’s antioxidant load of ORAC points of what? Five to 7,000. We’re talking a hundred or a thousand times more potent,-

Dr. Weitz:                            [inaudible 00:51:53].

Dr. Zielinski:                        … clove oil. So that’s what we’re dealing with.  Again, going back to your urban spice examples, this is highly concentrated stuff, but you got to be careful, though. If you’re ingesting oils, really make sure you’re working with a properly trained functional medicine practitioner, someone who understands, at the very least who could do a little bit of research and help you because if you’re on a pharmaceutical, again, be really, really careful with any potential interaction.

Dr. Weitz:                            In your chapter on Alzheimer’s you also talk about Anosmia, which is the loss of sense of smell that can happen with Alzheimer’s disease. And we also, as you know, have a virus around, and the infection with that virus can lead to a loss of sense of smell.  Is there an essential oil protocol that can help to return a sense of smell in either Alzheimer’s or in viral infections or both?

Dr. Zielinski:                        There’s no protocol other than the standard of care in this space is to be stimulating your olfactory nerves on a regular basis. That could help. Very similar to stimulating hair follicle growth to help if you’re losing hair. By the way, rosemary is wonderful at stimulating hair follicles, could help regenerate hair growth. So that’s what we try to do is … I hate to use the phrase, fake it till you make it, but the reality is if you have lost your sense of smell, you want to do what you’ve always done. You don’t want to stop. You don’t want to stop diffusing essential oils. You don’t want to stop.  And you might want to even be a little more targeted where you could get an aromatherapy inhaler. And let me pull one up here. You can go online, just type up aromatherapy, personal aromatherapy inhaler. And this looks like a lipstick or a chap stick tube. And it’s just a glass tube with a cotton wick that is saturated with essential oils. And this is concentrated essential oil, but it’s personal. It doesn’t affect the room. You could use this on the airplane, your neighbor next door or right next to you won’t smell this.  But this is a nice way of getting more concentrated, essential oil vapor. And this could help stimulate … You could plug one nostril, breathe in through the other. It’s also a wonderful meditative technique for people that are really trying to focus and relax and calm. Essential oils do wonders with and comes to mental clarity and focus and all that.

But the thing is, though, I’m glad you mentioned the Anosmia because even though you might not … And we didn’t even talk too much about mood or memory or emotions, but essential oils work primarily on the emotional level to stimulate memory. So when you walk into grandma’s house this Thanksgiving and you smell turkey and stuffing and cranberry sauce, that’s going to stimulate, hopefully, happy memories of holidays in the past because the smell triggers a memory in the brain. And you know what happens? You’ll, literally, manifest the same hormone and neurotransmitter production that you did when the memory was made. It’s wonderful. That’s why smelling something can bring you back right there. You’re a five year old kid sitting on Santa’s lap because you smell peppermint. He had peppermint stick smell on him.  Now, you won’t get that. You won’t experience that manifestation, the emotional benefit, of inhaling essential oils if you don’t have your sense of smell, but because essential oils work, regardless if you want them to or not, inhaling certain essential oils like orange, lime, grapefruit, will stimulate a production of dopamine or serotonin in the brain.

So what am I saying? You use essential oils if you can’t smell them because you know that your body’s going to respond, at least on a physiological level. So on a physiological level they will respond if you can’t even smell, you don’t have the sense of smell, but on a psychological level, you won’t have any benefit.  So, okay, okay. I get it. And it was a shame that so many people have been affected by COVID that way. My wife, even now her sense of smell has been dampened since COVID. I mean, at one point she couldn’t smell anything for a few months. Myself included. Mine went back really quick, thank God. Hers, she’s still at 75%. She’s not at a hundred percent yet, but we still do what we do.  And we’ve had wonderful, wonderful feedback from our community members and people that read our books. They follow this, “You know what? I’m not there a hundred percent, but I’m doing a lot better.” Because sense of smell is so important with flavor, with just experience of life, especially at the psychological level of enjoying aroma, it’s so key.

Dr. Weitz:                            So let’s maybe cover one more topic. I was thinking maybe cancer.

Dr. Zielinski:                        Yeah. Yeah. Very respectfully, bleach in a Petri dish will kill cancer cells. I think it’s important to recognize the studies that we have are virtually all in vitro cells in Petri dish or we’re dealing with tumors on animals. We have no studies, no studies on humans, and that’s my disclaimer. But there’s a lot of research, though, a lot. We’re talking about specific cancer cell lines and types.

And I actually have a chart in the book that covers the exhaustive … At a point when we wrote this in 2020, the exhaustive list of all the research done on what specific cancers. And you’d be surprised. You’d be surprised at certain … And maybe it’s just because that’s what the research has done. And that was just what the researchers felt they should try. But there are very specific oils that seem to have pretty potent efficacy on certain cancers.

And so that’s a thought is that I hope if this is something that you are facing … And, again, I don’t have an anti-cancer protocol because I don’t have cancer. I’m not there. But if you do, if you have been diagnosed, working with an integrative oncologist I think is so important. Someone, an oncologist, who recognizes that there are alternatives that could help.

And here’s the thing that I want to stress is that there is zero scientific rationale or zero research to suggest that people should not be using essential oils if they’re undergoing cancer treatments. And that seems to be one of the biggest misnomers in conventional oncology is oncologists by and large will just recommend against anything.

I was privileged and blessed to follow a beautiful young woman in her story overcoming breast cancer and we created a documentary. And one thing the doctor told her at one point was, “Don’t even take vitamin C.” And she’s, “Why?” And she’s, “Well, we don’t want anything to interact with the chemo and make it less effective. We are just going to put you in a state where your immune system is just useless.” It’s, God, what research? It was fear based. It’s all CYA covering their assets. They’re so fearful of malpractice and lawsuits.

And so what this woman did … And if you’re interested and if you want a movie that you’ll cry to tonight, I guarantee a tear, an emotional. This is a documentary. It’s won Film Festival. It was the most inspirational movie of 2020. Go to hopeforbreastcancer.com. Go to hopeforbreastcancer. Watch it for free. It’s my gift for the world. Just watch it. It’s a wonderful film and it’s a wonderful story.

But this woman, Angie, she started doing things without her oncologist knowing about it, “I’m going to use essential oils.” She started making her own capsules. She was telling me the story. Why am I mentioning this? Because this is where essential oils come into play. It’s not all or nothing. You should never look at your life, you should never look at health thinking, “I can only go natural or I can only go conventional.” There’s no balance in that. You have to do what’s right for you.

But here’s the thing, though, regardless of what you choose, you should, and I want to encourage you to have essential oils be part of something, because they should be part of everything, in my opinion. They should be part of it to help you, whether you’re on the all natural route, whether you’re on the conventional route or whether you’re integrative, in the middle.

So, Angie, her name was, from this story, she found herself … And I’ll never forget this … She walked into the chemo room because she took chemo, and she ended up stopping earlier on, she didn’t take the whole system, the whole round and all the … But at one point she walked in on her second or third treatment, and everyone around her, just pale, ash colored skin, they looked like death. I mean, even with her losing her hair, she looked good. Her skin was vibrant, she had the sparkle in her eye, she was not absolutely just annihilated. Yeah, she got sick and she had some side effects, but she just pointed out, it almost felt like she almost felt guilty. She was going through chemo like everyone. Everyone else was barely walking in.

And she accredits that to her natural lifestyle, the food she was eating, the supplements she was taking, the stress, mind, body, prayer, meditation, the essential oils she was using to help.

So that’s what I want to stress. We cover cancer very respectfully in the book. No cure all claims. I’m very much in tune. And I promote … Because here’s a quote. I want to actually quote this from my book, from Biomed Research International: “Essential oils have been reported to improve the quality of life of the cancer patients by lowering their level of their agony. EO [inaudible 01:01:39].” And just that alone. “Essential oils can be used for improving the health of the cancer patient and is a source of a novel anti-cancer compound.”

So why did I include this? Well, I hope some brave cancer patient will show this to their doctor and be, “Look, you can’t recommend me not to take frankincense. This research suggested it could help me.” So you might not want to choose that doctor if you have a doctor that’s just going to say flat out, “No.” We need to work with educated professionals who at least will support you in your decision to do whatever it is that you want to do.

With that said, and we glossed over this, there’s nothing that I know that has such a wonderful effect like essential oils on symptoms, everything: Nausea, headaches. I mean, again, going back to the Alzheimer’s chapter, we have this whole chart of symptoms that Alzheimer’s patients deal with, elderly patients, everything from aggression to bed sores to just stomach issues, you name it, just dry skin. Essential oils are wonderful at symptom based management.

That’s what we focus on in the book is helping people manage the symptoms related to cancer. And there’s a ton of them, and just what to do and how to consider … That way you’re not tempted to maybe go with some pharmaceuticals that will end up destroying your gut lining and making you more immune susceptible to disease and all that stuff.

So I feel it’s a very respectful approach. Again, no cure all claims, but we want to help you. If you’re losing weight, there are essential oils to help you. You want to eat more. I mean, that’s something most people don’t think about. Everyone’s in this, “I want to lose weight,” but if you’re cachexic, if you’re wasting away, if you are struggling to eat, going back to lavender, those oils that puts you in that parasympathetic state will make you want to eat, will help with hunger. So that’s something to think about. Same thing with bruising and swelling. We have a bruise cream. And constipation, all that kind of stuff.

So anyway, I just want to help your lifestyle and that’s it. At the end of the day we’d done … With that documentary, especially walking through and seeing and hearing these stories of these beautiful cancer patients going through what they’ve gone through, it seems to be the quality of life through the journey that really makes or breaks them.

And, yes, everyone wants to cure cancer. Everyone wants to avoid cancer. I get that. But what about the process? What about the day to day? And maybe your chemo or your radiation or your essential oil therapy, maybe it doesn’t save your life, ultimately, but if you could do something to give you an extra three or four or five months, would you not want that? And would you not want three or four or five months of good health and vibrancy and being able to enjoy your family and friends?

It’s a finite way of thinking to only focus on the end result when we lose today because all we are guaranteed is today. I can’t guarantee you to tomorrow. I can’t guarantee myself an hour from now. All I have is this moment. And that’s really the message, not only the documentary, but it’s the message of our whole ministry is to help people do better in the moment so that you have a more abundant life.

Dr. Weitz:                            That’s great. Thank you Dr. Zielinski.  And everybody get The Essential Oils Apothecary. I’m assuming it’s available at all the places books are available?

Dr. Zielinski:                        Yes, sir. Yes.

Dr. Weitz:                            So Amazon, Barnes & Noble, et cetera?

Dr. Zielinski:                        Yeah, everywhere. And for those people who want to take a deep dive, we cover 25 different chronic conditions in depth, everything from fibromyalgia to insomnia, to depression, substance abuse, even libido and erectile dysfunction. These chronic conditions that are robbing people of the abundant life. We go in depth and sharing everything with you that the research suggests on how essential oils can help.  If you pick up a copy, we have a gift. And you go to eoapothecary.com and you just sign up for our book bonus gift and you’ll get about six and a half hours of Masterclass videos for free and my wife and I show you how to make several of these recipes. And we cover these topics more in depth, like heart disease and other things that we just didn’t have enough space in the book to cover. So go there. We got charts, PDFs, downloads, all kinds of fundamental things. Go to eoapothecary.com.

Dr. Weitz:                            Excellent. Thank you so much, Dr. Zielinski.

Dr. Zielinski:                        Thanks for having me, Doc.

Dr. Weitz:                            [crosstalk 01:06:15] podcast.

Dr. Zielinski:                        Appreciate you.

 


 

Dr. Weitz:                            Thank you for making it all the way through this episode of the Rational Wellness Podcast. And if you enjoyed this podcast, please go to Apple Podcast and give us a five star ratings and review. That way more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts.  And I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica Weitz Sports Chiropractic and Nutrition Clinic. So if you’re interested, please call my office (310) 395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz.   Thank you and see you next week.

 

Dr. Joy Kong discusses Regenerative Medicine 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 my WeitzChiro YouTube page.] 

 

Podcast Highlights

 

 



Dr. Joy Kong is a UCLA-trained, triple board-certified physician, anti-aging and stem cell specialist, educator, CEO, and founder of the Thea Center for Regenerative Medicine in California.  Dr. Kong focuses on the prevention of aging, as well as chronic and degenerative conditions that are difficult to treat.  She runs the THEA Center for Regenerative Medicine.

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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.



 

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.

Hello, Rational Wellness podcasters, today, we have an interview with Dr. Joy Kong on regenerative medicine. According to Nature Magazine, regenerative medicine is a branch of medicine that develops methods to regrow, repair or replace damaged or disease cells, organs or tissues. Regenerative medicine includes the generation and use of therapeutic stem cells, tissue engineering, and the production of artificial organs.

These stem cells can be harvested from embryos, from bone marrow or fat cells of adults, from the umbilical cord blood from newborns or from the amniotic fluid. Dr. Joy Kong is a UCLA trained, triple board certified physician and anti-aging and stem cell specialist. She’s also the CEO and founder of the THEA Center for regenerative medicine in California.  Dr. Kong focuses on the prevention of aging as well as chronic and degenerative conditions that no one else has been able to heal. She believes that complete healing can only come from looking at the whole person, mind, body, and soul. Dr. Kong, thank you so much for joining us today.

Dr. Kong:             Thank you so much. It’s a pleasure to be here.

Dr. Weitz:            Absolutely. Perhaps you can start by telling us a little bit about your own personal journey and how you got into this type of work.

Dr. Kong:             Yeah. It’s definitely a unique and fun journey. I grew up on a university campus in Beijing, China. It’s a science and technology university. I spent my first 20 years in China. It was kind of, getting a taste of just how important food is, how your health it’s contributed to by many factors. Exercise was definitely emphasized. Then also, I was always impressed with the… I wasn’t impressed until I came to this country, realizing how Western medicine is dominating everything. Because when I was in China, my mom would have a medicine drawer and it would have Chinese medicine, Western medicine, everything is all jumbled together, and she would just ask me, “Okay, what are you dealing with? What’s the problem?” I’ll give her my symptoms, and then she would just reach into the drawer and she would dig out some, either Western medicine tablets or some Eastern medicine, whatever concoction it was.  Because it depends on the condition, depending on what you’re dealing with. Sometimes Chinese medicine work better, sometimes Western medicine work better. I grew up with the acceptance for this very inclusive approach to medicine. Then when I came here, of course, I love science and I was going to go get a PhD in neuroscience, because I loved the brain, which was probably why later on, I became a psychiatrist and then did some addiction medicine, because, I think the brain is the final frontier. It’s really fascinating.

The psychiatry discipline, as interesting as it is, it’s really be a dichotomy between psychotherapy and drugs. You are either going to the route of talking to people about their childhood experiences and how they’re dealing with life or you’re going into diagnosing somebody to fit them into DMS-5. Once you put them in a category, that makes everything easy. Once you put someone in the box, then you know exactly what medications used in that box.  It’s all about matching the symptoms and the drug. The problem is that you’re omitting a bunch of steps in the middle. Between the symptoms, never mind why you’re having the symptoms, between the symptoms of the drugs, there could be so many opportunities that were missed. The opportunity to check, was there toxicity involved? Was it heavy metal? Was it some organic toxins? If you don’t get rid of toxins, that’s a problem.

If you are not looking at certain hormones like thyroid hormone, male or female hormones, you’re not optimizing the signals your body’s receiving. A simple hormone like thyroid is a master hormone governing so many things and it governs how your mental state is. That was barely checked. The only thing psychiatrists checked is the TSH, which is just not very helpful, because it just shows a very, very little piece of picture and missed majority of people who have thyroid problems.

All these missed opportunities, nutrition. We were not trained in anything that can help prevent or can help optimize a person. We jumped into medication right away. I did psychiatry with the training, altogether, that was 11 years. In the process, I was trying to incorporate Eastern wisdom or a holistic approach to health.  I found it very exhausting when no other psychiatrist was trying to do that, and I was the only one who was trying to understand everything about the patient and I was still given half an hour for follow up visits. I come home exhausted and just… I had to do a lot of self-care to just keep up my spirit.

Dr. Weitz:            Essentially, you were trying to practice Functional Medicine approach, but within an allopathic model.

Dr. Kong:             Right, in the dark and with no assistance, and no language to put it together. When I found the discipline was called anti-aging medicine, which is just an off shoot of functional medicine or integrated medicine, it’s just a different name to the same thing. You’re looking at the body from a diverse, many, many angles and each angle you can address it by very, very detailed, very fine tuned tools, whether nutrition or hormones or detoxification or microbiome, there’s so many ways that you can address it.  All of a sudden there’s a language to what we can do to bridge the gap between symptoms and drugs. There’s so many things we can do. By the time you did all these things, probably drugs would not be necessary at all. We missed the entire, I would say, probably 96%, 97% of psychiatry probably practiced that way, which means you missed so much opportunity to optimize a person’s health, and I think that’s a disservice to people.

Dr. Weitz:            When you’re talking about the brain, what percentage of patients do you think actually have a brain? No, I’m just kidding.

Dr. Kong:             Or how many doctors? Oh my God, where do our brain go? Go catch it. My job is to help more doctors find the part of their brain that actually is open to improvements in their thinking. Because I see so many doctors, probably I’m going to offend a lot of doctors, but probably 95% of doctors, till this day, because I hear from patients of how stuck the doctors’ frame of mind was. That they’re so stuck that they’re not open to see evidence outside.  Whatever they were taught in medical school and whatever they learned during conferences, which are all sponsored by drug companies, by the way. Anything beyond that, they are not open to it. If it’s 95%, then where do people go? Where do patients go? We see that every day. I’m sure, you do functional medicine, you’ve done it for a long time, that’s what you see-

Dr. Weitz:            Absolutely. Here’s a perfect example, I was just talking to a patient who went to see a doctor in Florida at the Cleveland Clinic, and they didn’t run the Cleveland Heart Labs because they have this very narrow, Western focus. Even though they work for the Cleveland Clinic, which has pioneered some of the more detailed, advanced lipid profiles that a lot of functional medicine doctors do, they don’t even do those tests, because they’re too complicated, they’re too long, and they just want to get to the point, here’s your elevated LDL, here’s your stat, et cetera.

Dr. Kong:             Oh my God. Yeah. It’s sad. It’s sad that I started telling people, I said, “Us doctors, us physicians have become very efficient killers. We’re the third leading cause of death. So, be careful when you go see a doctor, just remember, it could be as dangerous as cancer or heart disease, just be aware, fire be aware.”

Dr. Weitz:            I think it’s great that you see regenerative medicine, stem cells as part of a functional medicine approach to a person’s overall health and prevention of chronic diseases, as well as trying to get to the root causes of these conditions and reverse them, and not just treat symptoms.

Dr. Kong:             Yeah. Regenerative medicine, really, that was part of the whole anti-aging medicine, functional medicine, it’s in the framework because it’s really tapping into the body’s own healing capabilities. It’s human cells, and especially when you tap into certain cell types in younger cells, they have tremendous ability to send out signals for your body to heal.  Instead of throwing one drug, that’s targeting that one A to B linear relationship, we’re sending you cells, which contains intelligence that can send you hundreds or thousands of these cell made molecules, and that each molecule can affect 100 different mechanisms and actions. All of a sudden, you have this global healing that’s going on.  That is really exciting. Of course, it’s exciting on paper, and what excited me more was actually hearing stories of how people were healed. Just because something sounds great, doesn’t make it great. But when you actually see it at work, that’s what’s really inspiring. I started seeing that, which was incontrovertible evidence.  Then, I was like, this is just too amazing, and I was learning about the science and looking at the safety, which was incredible safety data, and efficacy. Then I started doing it for my own patients. That’s when it became really fun. When somebody-

Dr. Weitz:            Let’s get into the nitty gritty about stem cells. Teach us about stem cells. What are the best types of stem cells to use in therapy?

Dr. Kong:             I would say there’s no one stem cell that cures everything. Different types of stem cells in our body, they all have their own functions. Otherwise, they wouldn’t be there. Our body is very-

Dr. Weitz:            Maybe you can define what a stem cell is.

Dr. Kong:             A stem cell… All of us started in life as one stem cell. The fertilized egg is one stem cell and that one stem cell has such an incredible potential, it can form any cell in the body. The cell continue to divide and it will retain that kind of potent potential, up to a certain stage. When they use embryonic stem cells, they were actually harvesting the cells at day five to seven of the embryos. Embryo, which is a little ball.  In that ball, those cells are highly potent. Any of those else can form pretty much all organs and tissues of the entire body, except for the sperm and egg. That’s the only difference. They can form just about anything. But they will further differentiate.  The ball will get a bigger and more convoluted and more complex and then they will become other stem cells. All those cells, that’s derived from them are still stem cells, but they lose certain potentials, they become more specialized stem cells, and they can still form, maybe a particular region or a particular tissue type of the human body. So, they keep dividing. It’s almost like a continuum. There’s no, this is first generation staff of cells, second generation, there’s no. There’s a continuum… It’s 1.5, 1.55, it’s continuing as they lose their potential and they earn their specialty, so they start to specialize.

In our human body, we have all kinds of stem cells in our body. For example, the hematopoietic progenitor cells, which can form all the blood cells in the body. That’s a stem cell. We have mesenchymal stem cells. Some people doesn’t believe is a stem cell, but it’s certainly of incredible potential, and in the Petri dish, you can make them into, especially from umbilical source, you can push them into different directions, including bone, fat, muscle and neurons or liver cells. There’s a diverse potential that they can’t become particular cells.  But at certain point, then you become a very specialized cell. You can’t become anything else, but that cell. That’s a progenitor cell that you can sit there and that’s what’s called tissue specific stem cell. For example, in your liver, you have liver stem cells. So, if you liver get damaged, those stem cells who can only become liver cells get activated and they will divide and they will replace the damaged tissue.  There are all these different levels of stem cells. When it comes to therapy, what do we use? One stem cell type that’s really popular, probably the most popular is the mesenchymal stem cells. This is a very, very fascinating type of cells, because they are everywhere in our body. Anywhere we have blood circulation, you have these cells.

The way they are is that, think of a gecko, holding on this tube, which is a blood vessel. They’re holding onto it and they’re sensing what’s going through that tube, all the blood and the signals, and they’re also communicating with the neighboring cells. They’re sensing things and they are also figuring out what’s going on locally and they will either secrete certain molecules based on what they sense or if they’re needed, they’re going to actually going to squeeze themselves into the blood vessels.  They have this very fluid role that they can, what I call like a conductor of the symphony of regeneration. They have this fluidity. They’re everywhere in our body. The benefit of using this type of cells is first of all, these cells are such type of a master cell. A master in the sense that it’s controlling things. It’s able to sense things and then send out appropriate molecules to make changes.  It can send out things into the bloodstream to make overall changes, or it can travel to a specific site and start to secrete different molecules and tell the immune system to bring certain cells to come and clear-

Dr. Weitz:            Where do we get these mesenchymal stem cells from?

Dr. Kong:             There are definitely people who get it from a person’s own. You hear about bone marrow. Unfortunately, bone marrow has 0.1% to 0.01% of mesenchymal stem cells, and has a low percentage of the hematopoietic stem cells, but it has a lot of immature, early immune cells. The bone marrow transplant is one way to get it, even though the amount is minuscule.  A place that has higher percentage is the fat derived stem cells. It sounds counterintuitive, but what’s interesting is they’re not getting it from the fat, they’re getting it from all the blood vessels that are supplying the fat. That’s where the cells are. If you can separate the cells from that tissue, from the blood vessels, that’s where you can get them.

The beauty of these cells is that they work with your immune system. There’s very little potential for rejection. Of course, you don’t have rejection issues with your own cells, but if you are giving transplants, they tend to modulate the immune system, so that immune system is not super amped up. It tends to shift the body from an anti-inflammatory to anti-inflammatory status. Is actually being used for organ transplant. You can transplant an organ, and if you also give the person mesenchymal stem cells, it’s more likely for the organ to survive, instead of being rejected. It has that kind of function.  That makes it very, very, very easy to use, because you’re not going to get different kinds of reactions. The problem is… A person will say, well then of course I want to use my own. Unfortunately, as you grow older, you have less and less of them. Just to give you stats, when you were born, every one in 10,000 cells is a mesenchymal stem cell.  When you reach your teenage years, it becomes one in 100,000, it’s tenfold less, right? Then when you reach your 40s, is one in 400,000. When you reach your 80s, is one in 2 million. You’re running out of the stem cells and the stem cells you do have in your body are a lot less potent. They’re just not working as well, and they lose some of their intelligence.

Dr. Weitz:            We want the stem cells from younger people.

Dr. Kong:             I’m sorry, unfortunately that’s the truth. I was trying to figure out whether or not that’s true. That’s when I delved into all this literature and start to just look at what works better? What works better? People are paying a lot of money for these treatments. I need to give them the best. Apparently, no one has really looked at all the research that’s been out there, because I’ve been presenting this information at different conferences and still, very few doctors really understand the differences.  When you look at all the research that’s been done, for at least 10 years, comparing these different tissue sources. I actually have the lecture online, it’s called Are all MSCs Created Equal? It’s a 40 minute lecture that goes in great detail.  After you watch a lecture, you look at the evidence, none of them was my opinion. All I presented was evidence. Then you can draw your own conclusion. To me, it was very obvious what is a superior source, which is the birth tissue source. We’re not going into the realm of fetal cells or embryonic stem cells, which are not even legal in this country. I think they have their own issues.

Dr. Weitz:            It reminds me of clinics overseas that put the blood of young people into older people as a form of anti-aging.

Dr. Kong:             Yeah, there are a lot of things floating in the blood. We can get those similar elements from the birth tissue.

 



Dr. Weitz:            Interesting. I’ve really been enjoying this discussion, but I’d like to take a minute to tell you about a new product that I’m very excited about. I’d like to tell you about a new wearable called the Apollo. This is a device that can be worn on the wrist or the ankle, and it uses vibrations to stimulate your parasympathetic nervous system. This device has amazing benefits in terms of getting you out of that stressed out sympathetic nervous system and stimulating the parasympathetic nervous system. It has a number of different functions, especially helping you to relax, to focus, to concentrate, get into a deeper meditative state, even to help you sleep, and there’s even a mode to help you wake up. This all occurs through the scientific use of subtle vibrations.

                                For those of you who might be interested in getting the Apollo for yourself to help you reset your nervous system, go to apolloneuro.com and use the affiliate code, Weitz10. That’s my last name, WEITZ10. Now, back to the discussion.

 



 

Dr. Weitz:            Now, is there rejection issues when you’re using stem cells from somebody else?

Dr. Kong:             I wouldn’t call it rejection issues. Depending on what kind of cells you’re using, if you’re using high percentage of mesenchymal stem cells, I have not seen rejection. There are once in a while, I would say maybe one in 200, 300 people, there may be somebody that has a hypersensitivity type of constitution, hyper histamine reaction that they may break out with half the food that you and I can’t eat or half the medications that we can take with no problem. Those are the only people I’m a little bit more cautious about. But the vast majority, I’ve never seen any issue.

Dr. Weitz:            Okay. How do stem cells work to heal tissues?

Dr. Kong:             The stem cells, if we’re talking about mesenchymal stem cells, I’m just going to stick with mesenchymal stem cells, because that’s what we’re looking at these days, for most research. These mesenchymal stem cells, they are attracted to signals. We talked about how they… I always think the image of salmon swimming upstream, because they’re sensing the density, probably of the signals. So, they’re following the signals.  Once they get to the area, then they have all these different actions. It’s really fascinating. First of all, they can send out certain molecules in the vicinity where they can bring in different immune cells. Immune cells, one is that they can clean up the damaged tissue. You need macrophages, you need neutrophil, you need things to get things gobbled up and cleared away, or if there’s infection, kill them off, and you take away what the damage is.  Then the cells also has ability to communicate with the local stem cells. It’s not the mesenchymal stem cells themselves, that becomes to replace a tissue. That was misconception, that’s what people thought a while ago. But really the way it does, is that it talks to your local stem cells and tell the local cells, “Hey, wake up. Stop being dormant. Come out and fill up this tissue, replace it with healthy tissue.”

That’s one part of the function. That’s called paracrine effect. So, sending out signals. But has some other really direct effects. For example, has direct antimicrobial effect. It actually S antimicrobial peptides, and then it also has what’s called anti-apoptotic. It actually saves tissue. Let’s say you have some tissue that’s damaged either, can be by heat, by radiation, by whatever, the damage.  When tissue is damaged, they actually leak out calcium, leak out all these signals that tells neighboring cells to die. Things are not dying just from being damaged, but also from the signals from the damaged cells. What stem cells can do is to prevent the neighboring cells from dying, so they have a protection kind of a mechanism.  Then they also have apoptotic… They can be anti-apoptotic, so preventing programed cell death when necessary, but they can also cause programed cell death when it is old, senescent cells or cancerous, precancer cells, because they can recognize, there’s something wrong with the cells. So, I’m going to tell the cells to die. It also can promote… These mesenchymal stem cells can promote angiogenesis, or promoting blood vessel formation.  It doesn’t do you a whole lot of good to have a lot of cells, but with no blood supply. Also, there’s another thing that they do, that’s really fun, they’ve caught that on electro microscopy, what’s called mitochondria transfer. These new young cells actually can transfer their healthy, vibrant mitochondria into the host cells. In a way, injecting some life force into the host. There are a lot of different mechanism of actions. It’s pretty exciting.

Dr. Weitz:            Okay. What are some of the mesenchymal cell conditions that stem cells can really benefit?

Dr. Kong:             Okay. First of all-

Dr. Weitz:            Can they be a viable alternative for patients who say, are in need of a knee or hip or shoulder replacement?

Dr. Kong:             Yeah. Let me just do a disclaimer, since the FDA, it’s very much watching out for consumers and I’m watching out for consumers as well. We cannot make any claims because so far, with the one exception of blood disorders that stem cells are indicated for, there’s been no other FDA approved indications. Let’s say somebody has blood disorder, they can give them a bone marrow transplant, or even umbilical cord blood transplant, and that can help replace their bone marrow supply and help regenerate their entire hematopoietic system.  That’s good. That I can say, yes, stem cells can treat that. Everything else, I cannot use the word treat. When we talk about conditions, it’s really about the mechanism of why the condition happens and then how stem cells can help assist repair.  I have seen that happen over and over and over in my clinic. Of course, I also founded an academy, which is called American Academy of Integrative Cell Therapy. Our mission is to educate healthcare providers on how stem cell therapy can help with different conditions.  There’s actually course when doctors take the course, they actually take away over 300 published articles, they’re all categorized by organ systems and disease categories. There are research, very active research into many, many disease categories, showing really encouraging results. That’s what I’m trying to show to doctors so they can help their patients.

Dr. Weitz:            Do you have patients who’ve seen you, who had severely degenerative knee who were told they needed a knee replacement, that you treated them with stem cells? Then also, when is it a good idea to use PRP versus stem cells, or when do you use PRP with stem cells?

Dr. Kong:             Okay. What you said, you just described my first stem cell patient. My very first stem cell patient, he was 69 at the time, now he’s 74. He had bilateral arthritis, which he went the two orthopedic surgeons who both told him he absolutely needed bilateral knee replacement. He didn’t really want to do that, he wanted to see if stem cells could help him.  At the time, I did give him an IV treatment because the outer one third of the cartilage of a knee joint is nourished by the blood supply. The inner two thirds is nourished by the synovial fluid. I wanted to attack from both angles. When I give it through IV, it can help nourish the outer one third of the cartilage, and injecting into the knee joint, that helped provide the stem cells to us right there, because it’s very difficult to get the stem cells from blood, into the joint space.  What’s fascinating was that… First of all, this is five years later, he’s walking about four miles every day, his knees are doing fantastic. He doesn’t even think about it very much. What’s really interesting was the next day, he told me, he said, “Hey, I slept through the night. I haven’t slept through the night for decades, because of my shoulder injury.”

When he was late teens, his car rolled over, damaged his shoulder, and it never, I guess, never fully healed. Every time when he turns around, turns in his bed, the sharp pain will wake him up. I never touched his shoulder, I didn’t even know about the problem off his shoulder. I just gave him a simple IV injection, and then one injection into his knee. This is five years later, his shoulder was fixed. I never touched his shoulder. That just shows you the intelligence of the cells that they can find where you need repair. That’s one thing. Then you asked about PRP. The way I do injections-

Dr. Weitz:            Hang on one second, let me just ask you about that patient with the knee. Did you go back and do maybe another imaging, maybe another MRI? If you did, would we see that the cartilage was regrown, do you think?

Dr. Kong:             I didn’t do it on this patient, but there was another patient, which I did not even inject into the knee, I just gave her IV treatment and she did have a pre-injection MRI, and then post, a few months after. It showed her knee cartilage has regrown, which shocked her orthopedic surgeon who had never seen anything like that, because they didn’t know about stem cells. Of course, you don’t see regrowth of the knee.  The body is incredible. If you just give the right signal, it can do amazing things. I want people to feel hopeful, to realize, your body is this incredibly intelligent machine. We can’t even make a single cell. Our human mind can’t even make a cell, let alone this entire body. There’s incredible intelligence that you are walking around with.  Anyhow, as far as the PRP… PRP is obtained from a person’s blood. You take the blood and you spin it out. You get some more growth factors from the platelets, because platelets do secrete a lot of growth factors and help promote healing and all that. It is very helpful. I almost never use PRP alone, I can. But it’s like when you have the best tool in the world, why would you use the second rate?  Yes, maybe because it’s a lot cheaper. But you get much longer lasting results. For example, erectile dysfunction, a lot of people do PRP, inject PRP into the penis. For people who have done it for a long time, specialty clinics. The feedback I got was PRP injections, the effect may last, two to three months. But when you do stem cells, it lasts at least six months, six to 12 months.

There’s a difference in the potential of the cells, because when the cells can keep secreting these beneficial factors and they actually help repair DNA, which I haven’t mentioned because stem cells will secrete exosomes. It will respond to environment and secrete the correct combination of molecules into the exosomes. Exosomes contain micro RNA. These micro RNA can actually get into cell nucleus and help repair DNA.  That’s what causes the long term benefits. I believe that some of the antiaging benefits has a lot to do with that. When you make the DNA younger, when you make it function better, then you are dialing back the clock. The PRP has potential, but it’s shorter lived and it doesn’t nearly have as much potential as the stem cells. But I do like using it because you’re giving extra… I use it with stem cells for all kinds of injections. We can inject into the penis, or any joints and muscle, tendon repairs, or hair, face restoration.  I do use PRP in all those cases, because I like the extra growth factors, and the fact that they do nourish the stem cells and help the stem cells work even better. That’s my philosophy on-

Dr. Weitz:            For regrowing cartilage in joints, or helping patients with degenerative needs to feel better. Do you recommend specific foods or nutritional supplements to help facilitate that? I’m thinking about things like glucose [inaudible 00:35:13]-

Dr. Kong:             Those are great. Those are good.

Dr. Weitz:            Yeah. Collagen supplements, SPM, fish oil, et cetera.

Dr. Kong:             Absolutely. We do advise our patients with all that, and also, I incorporate peptides as well. There are good peptides that help with muscular skeletal healing, like TB-500.

Dr. Weitz:            Which are your favorite peptides?

Dr. Kong:             BPC-157 and TB-500 are two of my favorites. Very-

Dr. Weitz:            What do you think about the oral BPC-157?

Dr. Kong:             I haven’t tried it. It’s supposed to work well, but I don’t… Have you tried it?

Dr. Weitz:            Yeah. We’ve been using it. We find it’s very helpful for leaky gut and it does help with some musculoskeletal injuries as well.

Dr. Kong:             Yeah, right. Great for gut healing, just overall fantastic anti-aging agent.

Dr. Weitz:            Let’s see, let’s talk about degenerative neurological conditions like Alzheimer’s.

Dr. Kong:             Things like Alzheimer’s, I really believe, whether or not it’s Alzheimer’s or Parkinson’s or MS, these are all kinds of different names for the same problem. Like autoimmune disease, whether or not you manifest in the gut or in the brain or in your muscles, it’s really the similar pathophysiology. We still don’t know exactly why yet, although we know there’s rampant inflammation. There are a lot of different theories. But I think, no matter what the cause is, the final funnel is inflammation.  If you can help reduce the inflammation, you can definitely help reverse some of the processes. But as far as helping with these conditions, I’ve definitely helped people with Alzheimer’s, with MS, with Parkinson’s. Definitely, I’ve seen improvements. Improvements, probably no medication has been able to achieve, but did I get them to be 100% back? No. I wish I did. I did get a person 100% back, that he’s on the brink of death, who had liver cirrhosis, which was really shocking to me, because he was already in hospice. That traditional medicine, there’s no remedy. That’s it.

Dr. Weitz:            It’d be interesting to take patients who are going through the Bredesen Protocol, as you probably know, Dr. Dale Bredesen is actually helping to reverse Alzheimer’s in patients. He just published the first study with 25 patients using a full functional medicine approach. It’d be interesting to add stem cells to his protocols.

Dr. Kong:             Absolutely. Absolutely. I remember my first dementia patient, she was very, very late stage. When she came to me, she came with her husband, she was singing and she was asking me if she could marry me. She was completely just not… She’s in her 60s, her mind is very far away from her. She also had not been feeding herself for two months, that she might be hungry, but there’s no volition, there’s no ability to just pick up a knife and fork and just eat.  What’s interesting was the next day, after the stem cell therapy, about 10 o’clock, she had, again, a plate of food in front of her and she just picked up a knife and fork and just ate. Her husband was looking at her in shock. Then she looked at her husband like, what’s your problem? Why are you staring at me? It was really interesting, and I do believe that’s the acute anti-inflammatory action that her brain pathways has been so clogged up, that the communication was stopped, signals could not get across. Once you calm the inflammation, all of a sudden, you got the brain pathways actually are communicating.

 



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Dr. Weitz:            How do you administer stem cells for a patient with a degenerative neurological condition? Are they injected into the brain or are they just put intravenously?

Dr. Kong:             I do it through intravenous. I know there’s some doctors who inject into the brain, which you can do as well, but there’s more, inject into the spinal canal or into the ventricles, which is even more high risk, But even injecting into spinal canal, you’re talking about much higher risk. But one thing I love about doing IV treatment is that, I still believe that all these neurodegenerative conditions, they’re still a systemic issue. They’re just manifesting the brain.  When you can repair your body, all of a sudden your brain can function better. This is all one entity. It’s, blood brain barrier, whatever. It is all one continuum. You want to treat everything. That’s my philosophy.

Dr. Weitz:            What about stem cells for patients with cardiomyopathy for congestive heart failure?

Dr. Kong:             There’s some good research supporting the benefits. Definitely-

Dr. Weitz:            I think in those cases, it’s typically injected directly into the heart.

Dr. Kong:             Not necessarily. Intravenous is fantastic because, if you think about intravenous administration, the first place to go back to is your heart, and then get to come to the lungs and go back to your heart. If your heart has a lot of need, the cells are going to be attracted to those inflammation, those screaming signals.

Dr. Weitz:            How are stem cells beneficial for antiaging?

Dr. Kong:             I actually did a presentation at a few conferences, particularly about this subject, because I realized, because I’m interested in this and I want to help people to live longer and more vibrantly, but what are the evidence? I started looking up, what kind of evidence there has been. It’s really fascinating.  Yes, it has shown beneficial anti-aging effects in humans, but there’s probably more convincing evidence in animal because you can actually observe lifespan. When they did experiments in mice and rats, it’s pretty consistent, the lifespan extension is about 30%, with regular IV infusions of young stem cells. So, young mesenchymal stem cells.  It is really cool. I think one experiment started giving these old mice, young stem cells and these old mice are so old that they’re the human equivalent age of 75 years of age, where half of their peers have died. That’s how they started the treatment point.

They give it to one group, just sham, like a placebo. The other group, they gave them real stem cells. The group that got real stem cells, I think was like monthly infusion, they actually, from the time of the experiment, to the time they died, it was three times as long as the group that got placebo. Not only they live longer, but they’re moving better, they’re fast better, their cognition is better.  Then there’s other studies that were actually looking at acetylcholine levels, growth factor levels of both the muscles and the brain, and it was really incredible because when they gave the older animal younger cells, all these measurements have gone back to the younger level. That’s pretty incredible evidence. What you can measure actually went back to younger level or even better than younger. It was really fascinating. You can imagine how it helps with maintaining physical health, the muscle mass, and then your brain health, just from those things they measured.

Dr. Weitz:            What about patients with diabetes? Can stem cells potentially cause them to be able to regenerate those pancreatic beta cells?

Dr. Kong:             Yeah, absolutely. This is another thing that’s really exciting, because not only type 2 diabetes, it can help reverse, but also type 1 diabetes. We’re seeing of regeneration of beta cells in the pancreas and actually endogenous secretion of insulin.

Dr. Weitz:            Do we have cases of patients who were type 1 who are no longer insulin dependent?

Dr. Kong:             I don’t have those patients, but certainly people have done studies on patients and published results.

Dr. Weitz:            Interesting. Now, what about cancer? First thing, when I think of stem cells and cancer is since stem cells cause cells to grow, you might not want to use them in patients with cancer, because you might cause the cancer cells to grow as well, right?

Dr. Kong:             Yeah. That was my original hesitation. I used to not treat patients who had cancer within the last three years. But what’s interesting was, as I delve deeper into the science and the research, what I saw was yes, if you’re using cells from your own body, from your own fat or bone marrow, boy, you’re taking a risk. Because when they put… For example, this one study, when they put this brain tumor cell, very virulent glioblastoma, when they put the brain cells next to the tumor cells, next to the mesenchymal stem cells, that’s extracted from fat, the tumor actually grew.  But what’s interesting was that when they put mesenchymal stem cells from the umbilical cord next to the tumor cells, the tumor shrunk. They did the same experiment, putting the cancer cells, transplanted it on the animal, put it on the animal body and then put the mesenchymal stem cells either from the fat or from the umbilical cord next to the cancer cells, the same thing happened.  If it’s next to mesenchymal stem cells from the fat, the cancer grew. If it’s next to MSCs from the umbilical cord, the cancer shrunk. We can’t just lump all stem cells together, because when you have young stem cells, they have capabilities that you no longer have when you get older. There’s degeneration. There’s degeneration of life, that’s why we die.

The cells, all the stem cells in your body have lost its capacity, lost its original capacity. It’s not as vital, and that includes the capability to detect cells that shouldn’t be there and have the ability to destroy it. Somehow, as we get older, we lost that ability. I would be very, very, very cautious with somebody that uses their own stem cells. If they have any proclivities for cancer. Of course, the problem with embryonic stem cells is that they can become a tumor themselves. They can just go crazy and wild and start to become all kinds of tissue called teratoma. That is something that doesn’t happen with umbilical cord-derived MSCs.  It’s almost like the umbilical cord-derived MSCs are still very vital, very young, but has lost some of this wildness. So, it’s not going crazy anymore.

Dr. Weitz:            With a cancer patient, if you were considering doing regenerative therapy, you wouldn’t want to take embryonic stem cells, because they might have too much growth potential. If you take cells from your own body, they may already have an oncogenic potential. So, better to take stem cells from a younger person who’s past the embryonic stage and potentially they may have more anti-cancer fighting properties?

Dr. Kong:             Right. The cells from your own body, it’s not so much they have oncogenic potentials, is that they are indiscriminately telling everybody to grow. If you have existing cancers, then these cells are not going to be able to tell the difference, and it’s just going to tell everything to grow, and then that’s going to promote your cancer growth. That’s the part to be very careful with.

Dr. Weitz:            Right. What about the cosmetic stuff, like care growth and skin?

Dr. Kong:             Yeah, that’s the really fun stuff.

Dr. Weitz:            I’ve seen pictures of these vampire facelifts. It’s pretty gross looking.

Dr. Kong:             It’s pretty incredible. I have pictures of my patients just plastic-

Dr. Weitz:            You take this spiny roller and you make little holes in their face.

Dr. Kong:             I inject stem cells into the skin, and then I do micro needling on top, and the results are just incredible. Even with one treatment, drastic, drastic improvements in skin. It’s amazing what these cells can do. Same thing with hair. The hair is going to take a little longer because the hair follicles, the way they come out, every six weeks, they’re not all at once, they’re not active all at once. You can target one group, but then there all these other group are still dormant. So, you have to do it again.  It takes about three sessions. But we’re seeing great results. If you’re completely bald, if it’s shiny, I’m sorry, we can’t do it. But if you’re just thinning, it’s like great, I can help you.

Dr. Weitz:            Cool. Okay. I think those are the questions that I had prepared. Any final thoughts you want to leave our viewers and listeners?

Dr. Kong:             Yeah, sure. I’m all about full health. I really truly believe that one can only achieve a real health and happiness by taking care of yourself physically and mentally, which is understanding why you do the things you do, and what has affected you in the past, and spiritually, all three are very important. That’s probably another reason at clinic, we start doing ketamine treatment.  I find it transformative, and I do think spirituality has a lot to do with it. It lets you out of your own little ego and tap into a whole different realm and capabilities. It’s actually really helpful for chronic pain, but it’s great for depression, anxiety, PTSD, addiction. I want to help people heal fully. That’s something I’m really excited about, what we’re doing in the clinic. Again, that’s Western medicine, that’s an anesthetic, but it happens to be tremendous in what it can do in promoting brain regeneration. That’s another huge tool.

Dr. Weitz:            Ketamine, is that similar to the low dose psilocybin type treatment?

Dr. Kong:             It is not low dose, what we do.

Dr. Weitz:            Okay.

Dr. Kong:             I guess people can do it low dose, but the way we do it is an IV infusion. So, it takes about an hour.

Dr. Weitz:            Ketamine, is it a psychedelic?

Dr. Kong:             Well, it wasn’t developed as a psychedelic, it was developed as an anesthetic, so you can do surgery on people at much higher dose. But what they realized is that at much, much, much lower dose people have a psychedelic experience, but they also get healed of their depression, and the PTSD. A lot of these things go away at the same time. That’s how it got started. It’s a much, much lower dose than anesthetic dose, an extremely safe… It’s actually one of the safest anesthetics in the world. It is one of the essential medications on WHO’s list.  It’s an extraordinary medication, but now we’re using it. Right now is the only FDA approved psychedelic medication.

Dr. Weitz:            Okay. That’s great. How can listeners get a hold of you? What’s your clinic information, your website?

Dr. Kong:             Our clinic is in the greater Los Angeles area. Right now our clinic website is THEA CRM. So, THEA Center for Regenerative Medicine. You can just look up THEA, T-H-E-A-C-R-M.com. They can also look me up on YouTube. I have a lot of interesting videos on YouTube, just my name, Joy Kong MD, that’s the channel. I go into more about different types of stem cell treatments and just a lot of nitty gritties that people don’t talk about.

Dr. Weitz:            Thank you, Joy.

Dr. Kong:             You’re so welcome. It’s fun talking about all this, getting the information out.

Dr. Weitz:            Absolutely. Thank you for sharing some interesting information.

Dr. Kong:             Yeah. Thank you for being willing to learn and join the excitement.

Dr. Weitz:            Always learning. That’s one of the great things about doing a podcast.

Dr. Kong:             Yes. Okay.

Dr. Weitz:            Okay. Thank you.

Dr. Kong:             You’re welcome. Take care. Bye-bye.

 


 

Dr. Weitz:            Thank you for making it all the way through this episode of the Rational Wellness Podcast. If you enjoyed this podcast, please go to Apple Podcasts and give us a five star ratings and review. That way, more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts. I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica, Weitz Sports Chiropractic and Nutrition Clinic. If you’re interested, please call my office 310-395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz.  Thank you and see you next week.

 

Lara Pizzorno and Dr. Joe Pizzorno discuss how to Promote Bone Health and Reverse Osteoporosis 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 my WeitzChiro YouTube page.] 

 

Podcast Highlights

2:31  An acid forming diet like the Standard American Diet (SAD) contributes to bone loss by leaching calcium out of the bones to restore your pH to the right alkaline balance.  This concept of an alkaline diet affecting the pH of the body has been criticized by medical researchers because they measured people’s blood pH before and after an alkaline or acid diet, and they found no difference in blood pH, so they criticized this whole idea. But the body works very hard to maintain the blood pH in a very narrow range but that process may involve the kidneys excreting more acid, which increases risk of kidney stones, and it may involve the body taking calcium out of the bones to help alkalinize the blood. If you want to prevent and reverse osteoporosis, the first thing you need to do is to alkalinize the diet by eating fewer animal products and by reducing salt consumption.  If people consume too much salt, it puts so much load on the kidneys that the kidneys can’t get rid of acid as well. You need to add more vegetables and fruits, which are generally more alkaline.  Even though you may want to reduce animal protein, it is still important to get enough protein, say at least 65-70 grams per day, but you need to balance out this protein with enough calcium, say 1200 mg of calcium per day.  Calcium can come from broccoli, spinach, and dairy other than milk, provided that you can tolerate both the lactose and you don’t form antibodies to milk protein.

12:22  The high sugar and carbohydrate content of the Standard American diet (SAD) cause blood sugar and insulin spikes and this creates inflammation.

12:50:  Unhealthy fats like saturated and trans fats can negatively impact bone health. The healthiest fats are the Omega 3s, which should be in a proper balance of 4:1 with Omega 6 fats.

13:29  But are saturated fats really unhealthy?  If the saturated fat is from grass fed animals, then it is healthier than from animals that are fed corn.  Beef that is pastured will have conjugated linoleic acid, CLA, which is anti-inflammatory and beneficial. Also, if animals are fed corn, then their fat will have high levels of arachidonic acid, which may be causing the problems that are being blamed on saturated fat, according to Dr. Pizzorno.  The other thing to consider is that animals store toxins, like heavy metals in their bones, so bone broth may not be a good idea.

18:05  Flouride.  According to Lara, flouride in small amounts may be beneficial, but in the US excess flouride–flourosis–is very common in younger people, so we are probably best avoiding toothpaste with flouride and avoiding flouride in the water.  Flouride replaces the calcium in the bones and the teeth but it makes for a different bone structure, which is not as well connected. 

20:53  Heavy metals.  Heavy metals can play a negative role in bone health, esp. cadmium, lead, and mercury.  Cadmium causes damage to the bones and the kidneys.  Our kidneys are really good at scavenging cadmium and clearing it out of the blood, but it can get stuck in the kidneys and poisons the kidneys.  The kidneys are responsible for converting  1-hydroxy vitamin D into 2-hydroxy vitamin D, which is the active form. Cadmium also poisons the osteoblasts in the bones, which are responsible for laying down new bone.  Studies done in Seattle show that 20% of the osteoporosis of women was coming from cadmium that came from eating soy products.  If lead is present in the bones, pregnant women’s bones will release the lead to go into the bones of the baby, unless plenty of calcium is included in the diet.

25:32  Lara found out in her early 40s that she had severe osteopenia after taking a DEXA scan at a trade show. She was shocked.  But everybody in her family has had osteoporosis, so she has a genetic tendency. She discovered that her vitamin D level was low and at the time the recommended amount was 400 IU, but she  found that she needed 10,000 IU per day to bring her level up.  She also started taking vitamin K2 MK7, which is required to activate the Gla proteins (Osteocalcin, which pulls calcium into your bones, and Matrix Gla protein, which prevents calcium from depositing in your soft tissues like your blood vessels, your kidneys, your breasts and your brain).  Unfortunately K2 is not present in many foods. It is found in small amounts in certain cheeses but the only good food source is a fermented soybean product called Natto, that smells like dirty socks, so supplementation is necessary.  You should get 100-200 mcg of MK7 and you should have equal amounts of vitamin A and D.  If you have cardiovascular or kidney damage, then take 360 mcg of MK7.  Lara also take B complex. She had a H. pylori infection in her gut, which can decrease hydrochloric acid production and HCL is need for calcium absorption.  She took triple antibiotic therapy, which cured her H. pylori.  Now at age 73 Lara has healthy bones with no osteopenia.

37:21  Drugs that interfere with bone health.  There are a number of prescription drugs that can interfere with bone health, including statins, certain blood pressure medications, and even antidepressants.  Statins, esp. at higher dosages are bad for bone by interfering with cholesterol production and we need cholesterol to make our hormones that are good for bone health.  Cholesterol is used to make vitamin D and to transport vitamin K.  Dr. Pizzorno feels that cholesterol has been overly villified as the use of statin medications has been promoted as the answer for preventing heart disease. Dr. Pizzorno wrote an article, The Vilification of Cholesterol for (Profit ?) about this topic.  Some blood pressure medications interfere with bone health. Thiazide diuretics protect bone, while loop diuretics and calcium channel blockers harm bone.  SSRIs, which are antidepressants, promote bone loss. They increase the production of serotonin and serotonin binds to a receptor on the surface of newly formed osteoblasts and stops them from developing, so your bone building cells don’t develop.

44:44  Calcium.  Some studies that have shown a negative effect on heart health with calcium supplementation did not also give vitamin D and vitamin K. You need all three of these nutrients working together.  And magnesium should be taken with calcium in a Calcium: Magnesium ratio of 2:1.  With respect to types of calcium, despite a lot of claims, calcium hydroxyapatite is not a more effective form of calcium and it contains phosphorus, which is bad for bones, for cardiovascular disease, and for kidneys.  Calcium citrate can be a good choice, since citrate is an alkalinizing agent and it can be absorbed without producing a lot of stomach acid.  Lara recommends consuming about 1,200 mg of calcium per day from both diet and supplements with no more than 500 mg at a time.  It is best to take calcium supplements with a meal since the hydrochloric acid produced for the meal will make it easier to absorb the calcium. She also recommends taking strontium citrate to promote greater bone density.  Strontium has a bad reputation because of a pharmaceutical version of strontium ranelate that was developed that was toxic because of the ranelic acid.  Strontium is a natural bisphosphanate.  It acts through several different mechanisms both to increase osteoblast activity and to increase calcium absorption.  There are also some other trace minerals that are synergistic with calcium, including potassium.

58:11  Boron. Boron is very helpful for bone. It slows down the activation of the 24-hydroxylase enzyme that breaks down estrogen and testosterone. Boron is even used in cancer treatment.  Most people should consume 3 mg boron per day and those with degenerative joint disease like osteoarthritis would benefit from 6 mg per day.  Research shows that 6 mg of boron per day prevents bone loss. Here is a paper that Lara wrote about boron, Nothing Boring About Boron.  

 

 



Lara Pizzorno is the co-author of the newly released book, Healthy Bones, Healthy You!, which she co-wrote with her husband, Dr. Joe Pizzorno.  Lara is the best selling author of a previous book on bone, “Your Bones: How you can prevent Osteoporosis and have strong bones for life-naturally” .  Lara is also the editor of Longevity Medicine Review and the senior medical editor for SaluGenecists and Integrative Medicine Advisors. 

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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.



 

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.

I’m very excited today to be getting the opportunity to speak with Lara and Dr. Joe Pizzorno on bone health. Lara Pizzorno is the bestselling author of a previous book on bone health, Your Bones: How You Can Prevent Osteoporosis and Have Strong Bones for Life Naturally, and she is now the co-author of this newly released book, Healthy Bones, Healthy You, which she co-wrote with her husband, Dr. Joe Pizzorno.  Lara is also the editor of Longevity Medicine Review and the senior medical editor for SaluGenecists and Integrative Medicine Advisors. Dr. Joe Pizzorno is one of the most important naturopathic doctors, educators, researchers, and one of the founding members of the functional medicine movement. Dr. Pizzorno has written or co-authored more than 12 books, including the Encyclopedia of Natural Medicine, which has now sold over two million copies and pretty much everybody who has an interest in natural medicine has a copy on their bookshelf, the Textbook of Natural Medicine, Natural Medicine for the Prevention and Treatment of Cancer, and The Toxic Solution, among others.  Thank you so much for joining us today on the Rational Wellness Podcast.

Dr. Pizzorno:                      Good to be with you. Thanks for the invitation.

Dr. Weitz:                           Before we get into the questions, I wanted to tell you that this new Health Bones book is really a great read and it goes into incredible depth about so many aspects of bone health that are often not discussed, such as, how heavy metals negatively impact bone health, how common chronic diseases such as heart disease, kidney disease, IBS and hypothyroid impact bone health and what to do about it. I think both laypersons and practitioners will learn a lot from reading this book, and not just about bone.

Lara:                                   Thanks.

Dr. Weitz:                           You guys did a great job. Lara, let’s start by talking about some of the factors that cause bone loss in our US culture including the standard American diet? How does a diet that’s high in acid-forming foods contribute to osteopenia and osteoporosis?

Lara:                                   Well, when the overall pH of the body is not in good balance, your body will constantly try to reestablish that healthy balance because many cellular activities can’t happen properly, the enzymes won’t activate, unless they’re at a certain pH level, so when you lose that level, your body instantly tries to reestablish it, and the way that it does that is by making you, typically you’re more acidic and so it tries to withdraw alkaline compounds from your bones, namely calcium, to restore the alkaline balance, and if you’re chronically doing that, you just keep pulling calcium out of your bones and eventually that results in bone loss.

Dr. Weitz:                           Right. Now, I agree with you, but some folks criticize this whole concept of alkaline balance because they say that the blood levels, your pH in your blood, is always going to stay in a very narrow range no matter what, so it’s not really that relevant.

Lara:                                   Okay. I’m going to let Joe do this one because he’s on PubMed with papers on this issue.

Dr. Pizzorno:                      This is my topic.

Lara:                                   Yeah.

Dr. Pizzorno:                      Dr. Weitz, one of the things I enjoy about my life right now is I get to go back and look at age-old natural medicine concepts from the perspective of modern science. I suspect you’ve had this experience, as well. If you look back and read the writers of 100 years ago, they had some great clinical insights but they were limited by the science and technology of the time, their understanding of medicine at the time. They started to notice that people who ate what they thought was an acid-forming diet seemed to be less healthy than people who ate an alkaline-forming diet. They started advising people to eat a more alkaline-forming diet.  What the MDs said was they went through and said, “Oh, well, let’s see what this idea is valid.” They measured people’s blood pH before and after an alkaline or acid diet, and they found no difference in blood pH, so they poo-pooed the whole idea. Okay. Well, there’s two problems with that. Number one, as you well know, since you’re medically trained, the body works really hard to maintain the pH over a very, very, narrow range, because, as Lara said, our enzymes require an exact pH. If you vary on the pH, they don’t work very well, so by making it the very narrow range, so when a person’s eating an acid-forming diet, that means that the foods that are eaten are metabolized to form more acid. Not that the food itself is acid, but it’s how it’s metabolized, the body has to adapt.

The first thing it does is the kidneys start excreting more acid compounds, and which makes you have more kidney stones, by the way, but kidneys adapt. As long as a person has good kidney function and is relatively younger, not too much trouble.  But as people get older, their kidneys don’t function as well. They’re now less able to get rid of excess acid. Now the body has to adapt in other ways. What’s it do? It takes calcium out of the bone to normalize the pH, so it looks like the body’s just fine because the blood pH hasn’t changed, but we look at what’s going on in the bone to adapt to the excess acidity, it’s bad.  And it turns out that, and the research has been, taking older, post-menopausal women, with osteoporosis, don’t give them vitamin D, don’t give them vitamin C, and calcium.  You just alkalize their diet, and they start rebuilding bone. Now, of course, we do way better than just alkalizing, but it’s part of the picture. I think you’ll hear from Lara again and again, you have to deal with the whole picture, not just one piece of it and expect that to fix it.

Dr. Weitz:                           How do we alkalize their diet? What do we take out? What do we put in?

Dr. Pizzorno:                      You want to decrease the acid-forming things and increase the alkaline-forming things, so what causes excess acid?  Sulfur-containing amino acids account for about one half of the excess acidity in the diet. Okay, so, you have to eat less sulfur-containing amino acids which tend to mean less animal products. The other half is really surprising. It sure surprised me, is excess salt consumption, because when people consume too much salt, it puts so much of a load on the kidneys, the kidneys can’t get rid of the acid, as well.  And then in terms of the alkaline side, fruits and vegetables. A plant-based diet is alkaline. Just, once again, a plant-based diet is more alkaline.

Lara:                                   Also calcium. There have been studies done on people with post-menopausal women with bone loss, and the ones who are getting written, because protein is a big issue, and meat is a really good source of protein, and so you don’t want to skimp on your protein, but you have to have the calcium to balance the effects of the protein, and when they looked at people who were consuming at least 1,200 milligrams of calcium daily and 65, 70 grams of protein a day, they did better than the people who were consuming less protein and less calcium, and of course the people who consume a lot of protein and not much calcium really tanked. Not a good outcome.

Dr. Weitz:                           What are the sources of calcium in the diet? Is dairy a good source?

Lara:                                   Well, of course Dairy’s an excellent source and there are many vegetables that are good sources of calcium. In the book, I have a whole table of the common sources and what a serving provides and so forth. There’s dozens of them. If you like broccoli, broccoli’s a good source, spinach.

Dr. Weitz:                           Yeah. Now, dairy’s a controversial one, especially in the natural medicine, functional medicine movement. I think a lot of us have sort of soured on dairy in the sense that the dairy proteins are highly allergenic and difficult to digest, and then most of the dairy products are homogenized and pasteurized and there’s problems for a lot of people in breaking down the lactose in dairy, so I think that dairy is not as popular these days among natural doctors and practitioners.

Lara:                                   I think that’s true. I also think that the key issue with dairy, if someone reacts to casein, to dairy protein, then they need to avoid dairy. It’s going to cause inflammation, and anything that chronically causes inflammation will excessively activate the osteoclasts, which are the cells that break down bone, but if someone is not reactive to dairy, then dairy foods can be very beneficial. The issue with dairy, the one thing that you really have to avoid if you’re going to have dairy is milk. Things that are fermented, the cheeses and so forth, they’re very low lactose content, and even in the quote, unquote, lactose-reduced milk or lactose-free milk, all they do is apply lactase, which is the enzyme that breaks apart lactose, to the milk, so you still have the components of lactose which are glucose and then another sugar called galactose, and galactose is an incredibly inflammatory sugar.  It is used in research to prematurely age animals, and the amount that is used in the research to have this effect is comparable to what you would get if you drank two glasses of milk a day. You can get away with one, but more than that, you do not want to have. Outside of that, milk has whey. It’s a very anabolic protein. If you can tolerate milk, I mean, dairy products, fine, just don’t have a lot of milk.

Dr. Pizzorno:                      Yeah. I think if you can-

Dr. Weitz:                           What do you think about raw milk versus pasteurized milk, and then, a lot of other people in the natural medicine world have moved away from cow’s milk to sheep’s milk or goat’s milk or camel’s milk.

Lara:                                   I’ve never tried camel’s milk.

Dr. Weitz:                           According to Dr. Vojdani, it’s the least allergenic of all the animal milks.

Lara:                                   Yeah. I don’t think it’s readily accessible in the US.

Dr. Weitz:                           There is one company that distributes it.

Lara:                                   Well, if you can get it and you like it, okay, but again, I think it will still have lactose in it. You’d have to check the lactose content of the milk.

Dr. Pizzorno:                      I think also, Doctor, as long as there’s not an analogy, fermented dairy products, we’re okay with, but the raw dairy products in terms of raw lactose, as Lara said, we see problems with it.

Dr. Weitz:                           Right, so, essentially, you’re talking about cheeses and yogurt, right?

Lara:                                   Right, and there are some cheeses that have high content of vitamin K2, which is incredibly protective for bone and the cardiovascular system.

Dr. Weitz:                           Right. Right. Yeah. I definitely want to get into the vitamins in a few minutes. Other aspects of the standard American diet that contribute to bone loss. You talk in your book about a diet that’s high in sugar and refined carbohydrates. Why is this bad?

Lara:                                   Because those cause insulin spikes, and when sugar is in the bloodstream and it’s not absorbed well into the cells, it’s very inflammatory.

Dr. Weitz:                           Okay, and what is the role of unhealthy fats in bone health and which fats are healthy and which fats are unhealthy?

Lara:                                   Well, the healthiest fats are the Omega-3s, properly balanced with Omega-6s which are also helpful when they’re in no more than 4 to 1 Omega-6 to Omega-3 balance. Both types are healthful. The unhealthy fats are the too much saturated fat, and of course the trans fats are extremely unhealthful in any amount, and those are really in processed foods, primarily, so you want to limit trans fats as much as you can.

Dr. Weitz:                            Now, I think the trans fat is uncontroversial, but some in the natural medicine movement have come to see saturated fat, in some cases, as not necessarily unhealthy or maybe a healthier source of fat, and as I’m sure you know, a lot of people recommend grass-fed butter and other sources of saturated fats. What do you think about, or coconut oil which also has a fair amount of saturated fat?

Lara:                                      I think it depends on the life of the animal from which the meat or fat or anything else was derived. Animals, beef, that’s pastured, will have, in the fat, is going to have a compound called conjugated linoleic acid, CLA, which is extremely anti-inflammatory and highly beneficial, and then I don’t think it’s as much of a problem. We need fat. Our bodies need fat. 25 to 30% of the diet, at least, should be fat, but the type of fat that’s consumed is what the issue is, I think.

Dr. Pizzorno:                      I’d like to add a little nuance to this. I wonder if you see this, as well. Whenever a new idea comes out or another new fad comes out, I was try and step back and say, “Okay, now, how does that match up with nature?” Somebody comes out and says, “Well, this food source that people have been eating is a major cause of disease,” well, I look at, first, has something been done to the food to make it bad, or is it a valid concept, and so many of these times, what they’re doing is they’re making a mistake. For example, this whole thing about saturated fat. Now, yes, at high enough dosages, could be a problem, but in most situation, the saturated fat research came from animals fed corn, so that they have high levels of arachidonic acid.  There’s a direct correlation between arachidonic acid and saturated fat. It’s not the saturated fats causing the problem, it’s the arachidonic acid.  And arachidonic acid is only a problem because, rather than feeding cows grass, getting all this better balance of fats, well, we’re giving them corn. Not only giving them corn, but we’re also giving them medicine chemicals that are poisoning them. It gets in their milk, so we’ve actually gone from a relatively healthy food in a natural environment, particularly fermented, at the milk part, or even as the meat, eating the meat when it’s wild, to now this domesticated thing which has all the wrong fats in it, all these toxins in it, and it’s not healthy food.

Lara:                                   Animals store toxins in fat.

Dr. Pizzorno:                      Yes. All these toxins are fat soluble.

Lara:                                   Bones and fat. I’m not a big fan of bone broth because toxins get stored, and heavy metals in particular get stored in bone, then you make a nice, big broth of that and drink it all up. Not a good idea.

Dr. Weitz:                           Right. I guess you’re probably not a fan of liver either, huh?

Lara:                                   Well, if it’s a healthy animal that was pastured and not exposed to a lot of garbage, the liver should be healthful.

Dr. Pizzorno:                      On the other hand-

Lara:                                   Yeah, Joe?

Dr. Pizzorno:                      The liver’s where the toxins are detoxified.

Dr. Weitz:                           Exactly.

Dr. Pizzorno:                      Think about what that means.

Lara:                                   Yeah.

 



Dr. Weitz:            Interesting. I’ve really been enjoying this discussion, but I’d like to take a minute to tell you about a new product that I’m very excited about. I’d like to tell you about a new wearable called the Apollo. This is a device that can be worn on the wrist or the ankle, and it uses vibrations to stimulate your parasympathetic nervous system. This device has amazing benefits in terms of getting you out of that stressed out sympathetic nervous system and stimulating the parasympathetic nervous system. It has a number of different functions, especially helping you to relax, to focus, to concentrate, get into a deeper meditative state, even to help you sleep, and there’s even a mode to help you wake up. This all occurs through the scientific use of subtle vibrations.

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Dr. Weitz:                            You mentioned fluoride in the book, and so is fluoride good or bad for bone? I know most dentists are highly tout fluoride as good for your teeth because they do these studies and they see the fluoride gets incorporated into the teeth. What do you think about fluoride?

Lara:                                  In very small amounts, it’s fine. In larger amounts, it’s an oxidant, and it’s a very, very powerful oxidant, and they’ve now shown that in the United States, fluorosis, you know the brown kind of pitting on the teeth, is extremely common now in younger people who’ve been exposed to it and in the water and everything. I think we’re just getting too much, so it’s like many, many things. In smaller amounts, it’s beneficial and useful, but when the intake is excessive, it can be harmful, and so that’s what I think about fluoride.

Dr. Weitz:                          Yeah. I think the fluoride just replaces the calcium and it’s actually a poorer mineral to be incorporated into the teeth and bones.

Lara:                                  It makes a different bone structure, yes, and it’s not well connected.

Dr. Weitz:                          The fluoride we’re getting in the water is not even some really clean source of fluoride. It’s coming from the fertilizer industry and it’s this toxic byproduct that they’re throwing in our water, and then, as you say, we’re getting excess fluoride from all these other sources, like people who use these Teflon pans and the PFOAs and the PFOSs that have seeped into the water supply all over the country, so those are also toxic sources of fluoride.

Lara:                                  This is Joe’s area, if you want to elaborate.

Dr. Pizzorno:                      Yes, of grave concern. I thought the fluoride was coming from, it was aluminum manufacturing, aluminum production-based products.

Dr. Weitz:                           What kind of manufacturing?

Dr. Pizzorno:                      I thought the fluoride came as a waste product in aluminum manufacturing production.

Dr. Weitz:                           Is that right?

Dr. Pizzorno:                      That’s my understanding.

Dr. Weitz:                           I thought it was coming from fertilizer manufacturers or something.

Dr. Pizzorno:                      You may be correct. I don’t know. I’m aware that-

Dr. Weitz:                           Anyway, we know it’s a toxic form of fluoride that’s being dumped into the water.

Dr. Pizzorno:                      Yeah. This is a great example of a small amount of a naturally occurring element has been negatively associated with cavities, which is great. Doesn’t mean we put in a bunch of a different form of fluoride into our water supply and saturate people with the water supply, with toothpaste, with getting their mouth washed by dentists. Now, we’re way overloading our systems for fluoride, and there’s some pretty worrisome research on fluoride. I don’t want to get into that, because we’re getting beyond the scope of this book, but people need to-

Dr. Weitz:                           That’s one of the great things about this book, is you mentioned some of the concepts like heavy metals that most people don’t think of as being associated with poor bone health, but you got to take all those into consideration if you’re really going to take a functional medicine approach to bone health, and those can be some of the keys, and just taking vitamin D and calcium’s not enough. You mentioned other heavy metals that play a potentially negative role on bone health.  You mentioned, in specific, lead, cadmium, and mercury.

Dr. Pizzorno:                      Right. Well, this is the area of the book that I had the most involvement with, so [inaudible 00:21:33] why I’m missing so much. Let me give you kind of a big statement first, then I’ll get into specifics. As Lara’s writing this book, and the previous one, she would comment to me about what she’s working on or ask me questions with my medical background. Now she’s getting her master’s degree in nutrition, which is exciting, so she won’t have to ask me as many questions, I guess.

Lara:                                   No. He’s teaching me chemistry now. We’re doing organic chemistry together. It’s very entertaining.

Dr. Pizzorno:                      Not that that’s going to be important to bone health, I think, oh, wow, that’s interesting for heart health. Then she’d talk about something else, and I’d say, “Well, that’s important for the kidneys.” Then she’d talk about something else, I said, “That’s important for the brain.” I started to realize that all this physiology she’s trying to normalize in the bones was the same physiology everywhere in the body, so when we’re writing this new book, the people who are helping us try to figure out what name to give it, when they say, “Healthy bones, healthy you,” when they first said that to me, I said, “Wow. What a great idea,” because the things we do to make the bones healthier make everything else in the body work better, as well.

Cadmium is an example.  Cadmium causes a lot of damage, and a lot of that damage is in the bones and the kidneys, so our kidneys are really good at scavenging the cadmium.  It gets all the cadmium out of the blood within a day or two.  It’s really good at it.  The problem is, it gets stuck in the kidneys and it basically poisons the kidneys.  Why is that important for bone health?  Well, the kidneys are responsible for converting 1-hydroxy vitamin D into 2-hydroxy vitamin D, and that 2-hydroxy vitamin D is the most active form. Happens in the kidneys. The kidneys are poisoned by cadmium, the cadmium conversion, and then directly in the bones themselves, well, it turns out the osteoblasts are responsible for laying down new bones after the osteoclasts have taken them out.

Well, cadmium poisons the osteoblasts, so it can’t form new bone as well, so cadmium is really bad on bone. There were studies done here in Seattle where they determined that 20% of osteoporosis in women in Seattle was due to cadmium and the cadmium was coming from eating soy products that were conventionally grown, because conventionally grown soybeans with high phosphate fertilizers, they’re often contaminated with cadmium. Cadmium goes right into the soybeans, you eat the soybeans, it goes right into our bodies, poison the kidneys, poison the bones.

Lara:                                   It’s not just soybeans that are soaking up cadmium from the high phosphate fertilizers. it’s conventionally grown foods. They all have more cadmium in them now. Another thing with cadmium and the other nutrients is that when there’s a heavy metal around and there’s also a nutrient, like a mineral that you want to absorb in the soil, you’re going to absorb more of the heavy metal if you don’t have enough of the nutrient around. They compete, and so, one example is lead and calcium.  They’ve done studies where they’ve given young pregnant women extra calcium because that way they’re releasing less lead from their bones as their pregnant, because, you know, you’re withdrawing calcium from your bones to help form the bones of the baby, and so if you have lead in your body, that lead is coming out, and it can get into the child, so they’ve done studies where they’ve looked at making sure that young pregnant women have plenty of calcium because it will interfere with that release from the bone, so there is a balance.  People take vitamin D, and as you know, vitamin D helps us absorb calcium. If calcium isn’t around, vitamin D is going to help you absorb cadmium and lead and mercury from the food that’s conventionally grown.

Dr. Weitz:                            Well, maybe we should segue into your story, which I know involved finding out that you needed a lot more vitamin D, maybe you can tell us about your story about bone health.

Lara:                                    Sure. Well, I was in my early ’40s. I’m now 73 and I have really great bones, but when I was in my early ’40s, we were at a medical conference and we went to the exhibit hall and they were showing a new piece of equipment that doctors could have in their office that was reasonably inexpensive for clinicians, and it would check your bone mineral density in your ankle. This was, what, like, 30 years ago now, and so, DEXAs were being used, but they weren’t as frequently being used and there was less awareness. The machine for the doctor’s offices were so much less expensive, they were selling it to say, “Get this in your office, and then if someone tests badly on this, then you make sure you get them into the big DEXA X-ray, so we went over, and I got checked, and I just, I’m healthy.

I follow everything that this man tells me to do, and I’ve been very healthy and even though everybody in my family had osteoporosis, I thought, “Oh, no, not me. I eat right. I exercise, et cetera.” I already had severe osteopenia. I was about 45, so this was well before menopause, so that’s what started our little adventure into trying to figure out what on earth was causing this, and for me it turned out to be genetic, which actually isn’t surprising. I mean, if some disease runs in a person’s family, chances are they have a genetic susceptibility that increases their risk for developing that condition.  For me, it turned out to be vitamin D. At that time, I think the recommendation for vitamin D was, like, 400 IU a day. It turned out that for me to get my vitamin D levels up into anywhere resembling normality, I needed over 10,000 IU every day.

Dr. Weitz:                            Yeah. I remember, at the time they would tell us how dangerous the fat-soluble vitamins were and could be really toxic if you take too much vitamin D or vitamin A.

Lara:                                    Yeah. Our friends thought I was going to turn into a pillar of calcium, like Lot’s wife, with a vitamin D genetic susceptibility, but I didn’t and I started to rebuild bone, finally. Also, we live in Seattle, so it rains here all year long. The sun comes out for a couple months a year and you just can’t make a lot of vitamin D here. It’s not easy, so the combination of my genetic susceptibility plus living in Seattle really was causing my bone loss, and that was the start. Then, after we identified that, I started to very slowly regain some bone, and then I was the editor of a medical journal called Longevity Medicine Review, which I think is still up, some of the issues are still up online, and i was asked to write a paper on vitamin K, and so I started reading all the research on vitamin K and I thought, wow, this is really important, especially vitamin K2 which pretty much no one knew about.  I started taking vitamin K2 and that helped. Do you want me to talk about why that helped?

Dr. Weitz:                            Sure.

Lara:                                    Vitamin K2 is required to activate what are called the Gla proteins. I call them the glamorous proteins, because they really make you glamorous in terms of not having cardiovascular disease and not having bone loss, because these proteins, one of them is called osteocalcin and it pulls calcium into your bones, and the other one is called Matrix Gla protein, and it prevents calcium from depositing in your soft tissues like your blood vessels and your kidneys and your breasts and your brain, so vitamin K2 is really important. It’s not present in … Blue cheese has a fair amount of it, but outside of that, in the western diet, there are a few cheeses that supply a little.  It’s very, very tiny amounts of vitamin K2 are available, and you really have to eat a Japanese fermented soybean product called Nattō. Yeah. It’s slimy, gross. Smells like dirty gym socks.

Dr. Weitz:                            [crosstalk 00:30:03]. Yep.

Lara:                                    Yeah. It’s bad, so basically people need to take vitamin K2 to get enough, and I started doing that. That made a big difference. Do you want me to go along the odyssey of some of the other things? There have been a number of them.

Dr. Weitz:                            Absolutely. Yeah. No. [crosstalk 00:30:19].

Lara:                                    I am truly the poster person for osteoporosis.

Dr. Weitz:                            Because, I’ve talked to a number of people who said, “Well, I did all the natural stuff. I took my vitamin D and the calcium and so therefore there’s nothing you can do,” and it’s like …

Lara:                                    No. Vitamin D helps us absorb calcium. That’s it. It does nothing to determine what happens to the calcium once it’s in your bloodstream. That’s the job of vitamin K2, and if you don’t have it around, chances are your calcium’s going to go into your blood vessels.

Dr. Weitz:                            By the way, what about MK4 versus MK7, since we’re on the topic?

Lara:                                    Yeah. MK7 is far more potent and the reason why is that, in your liver, the MK7 is put into cholesterol, and cholesterol travels around the system for three or four days before it’s eliminated, broken down. The MK4 version goes into triglycerides which are cleared within six to eight hours, so when you take MK7 you can take a really small amount. Typically 100 micrograms or between 1 and 200 micrograms is enough for most people because it’s building up in your system, in your cholesterol, and so it’s always available for you to use, whereas the MK4 version, you have to take 15,000 micrograms every six hours to have that stay available for you, so it’s a difference of 45,000 micrograms a day versus about 180 micrograms a day, so I think MK7 is a better choice for most people.  There are a few genetic polymorphisms that make some people very, very effective at using vitamin K, and they’re recycling it more quickly and so on, and so for those people, there are some people who do fine on MK4, but it’s a very small number of the population, and you can have that checked, easily.

Dr. Weitz:                            The dosage of MK7 that you recommend for most people?

Lara:                                    Well, it’s 100 to 200 micrograms is enough for most people but it really depends on, there’s a balance that you want to achieve between vitamin K, vitamin D and vitamin A. They all work together. Your intake of vitamin D and vitamin A should be pretty comparable. They balance each other, and then vitamin D actually increases your production of the proteins osteocalcin and Matrix Gla protein that you need to have vitamin K2 around to activate, and so if you’re taking more vitamin D, you need a little more vitamin K. There’s a chart in the book where I say, “If you need this much of vitamin D, you need this much vitamin A and you need this much vitamin K,” but typically it’s 100 to 180 micrograms for vitamin K2 in the MK form.  If you already have chronic kidney disease or cardiovascular disease, then in the research they’re using dosages of 360 micrograms per day. It’s extremely safe. There’s not even a tolerable upper limit set for vitamin K2. It’s so safe.

Dr. Weitz:                            Good. Yeah, so let’s hear the rest of your story. What were some of the other key factors in helping you overcome your bone issue?

Lara:                                      Okay, so there was K2, and then, I grew up in Florida and I’ve developed lots of pre-cancerous skin problems, basil squamous skin cancers, and I finally realized that I wasn’t getting enough vitamin A. You need the comparable amount of vitamin … The vitamin A and vitamin D balance each other’s activities, and you really need both of them. We don’t eat meat, so that liver you were talking about, we don’t do that. There aren’t a lot of other really good sources of vitamin A, and beta carotene is not vitamin A. About over 80% of people do a lousy job of getting beta carotene into vitamin A, which I also hadn’t known about.

I wrote a couple of review articles on vitamin A and I learned all this stuff, then I started taking vitamin A. That was another thing that I learned. I try to take as much, comparable amount of vitamin A to vitamin D, and because we do not eat meat, I need to take it as a supplement, and then, the vitamin K. You want that to be in balance, as well, so that was kind of the next thing. Then, I discovered that magnesium is a really important mineral for bone, and if you do not activate vitamin B6 into its form of P5P, pyridoxal-5-phosphate, you have a lot of difficulty getting magnesium into yourself, because that’s the job of P5P, so that’s another snip I have.  I don’t do that very well, so I take a little of that. Actually, I take a B complex, because all the B vitamins work together, and just taking one can kind of mess up the pachinko game that goes on among them all. I think those are kind of the biggest ones, the B vitamins, but, yeah.

Dr. Weitz:                            I think you mentioned having a H. pylori infection, as well.

Lara:                                    Oh, yes. Yes. Sometimes, I think that I have experienced many things so that I would know what to do about them. H. pylori was certainly one. For years, I never knew when I would be six. Joe is the president of Bastyr University. We had many formal evenings and dinners and things and I never knew when I would be so six to my stomach I couldn’t stand up from the dining table and leave, so that was an adventure, and I’m old, so this was back when Barry Sears discovered helicobacter pylori. Before this, I had gone to doctors who had told me, “You just need to breathe deeply. You’re not relaxed and that’s what’s causing all of this,” at which point I had control myself from ripping out their throat.  I did refuse to pay for the consult, but, yeah, so, we discovered that.

Dr. Weitz:                            How did you the H. pylori?

Lara:                                    We did triple antibiotic therapy. Oh, yeah.

Dr. Weitz:                            Triple antibiotic therapy.

Lara:                                    Yeah, and I remember, shortly after that, Joe was invited to China to set up reciprocal programs with some Chinese medical schools for students to come here and our students to go there, and here we are in China where conditions aren’t particularly sanitary, and everybody else in our group got sick except for me. I was the only one whose digestion was fine after getting rid of my H. pylori. Many, many older adults have h. pylori. It’s extremely common and it disrupts your ability to digest your food properly because it interferes with stomach acid production, and then you lose bone, and that’s a very, very easy thing to check, and it can make a huge difference for someone.

Dr. Weitz:                            Now, one of the things you mention in your book is how a number of conventional drugs interfere with bone health, and you mentioned high dose statins, certain blood pressure medications and even antidepressants. Perhaps you can talk about those a little bit.

Dr. Pizzorno:                      Wait for a second. Dr. Weitz, thank you for reading our book. I’ve written a lot of books, and so many times I’ll be interviewed very politely by somebody who didn’t bother to read my book, so I appreciate the invitation, but it would be nice if they read it. You clearly read it.

Dr. Weitz:                           Absolutely. I consider that my obligation for having the opportunity to getting to speak with you.

Dr. Pizzorno:                      Okay.

Dr. Weitz:                           Yeah. Let’s start with high dose statins are bad for bone-

Lara:                                   High doses, quite a bit more than, what is it, milligrams a day.

Dr. Weitz:                           Milligrams of Lipitor, or, yeah.

Lara:                                   Yeah, so, at that level, it actually seems to be protective for bone, but when you start going to the higher levels, it can help promote bone loss, and part of the reason why is that statins interfere with cholesterol production, and if you’re really excessively producing cholesterol, that’s a good thing, but if you take so much that you’re significantly suppressing your ability to produce any cholesterol, you know, we use cholesterol. We use it to do things like make hormones like estrogen and testosterone and so forth, and we need those hormones for our bones.

Dr. Weitz:                           They make vitamin D and transport our vitamin K2.

Lara:                                   Exactly. Yeah, so, again, it’s one of those balance things. A little bit might be helpful, but if you have to take a really high dose, you need to make sure you’re getting checked and do everything you can to mitigate against the adverse effects of it.

Dr. Pizzorno:                      This is one of my pet peeves. I wrote a [inaudible 00:39:23] paper about three years ago now, and you can go to PubMed and read it if you want, entitled Vilification of Cholesterol for Profit. You may recall a newscast came out that basically said, “50% of people over the age of 40 should be on a statin drug because they’re so safe and they’re only beneficial,” and they quoted a very large study, 10,000 person double blind, consumer controlled study. Well, that’s pretty impressive, and here’s where there’s a problem when you look at the abstract versus reading the study.  You look at the abstract, wow. That’s pretty impressive. I guess statin drugs are safe and they have benefit, but when we actually look at the data, the way they did it was this 10,000 person trial started with an open label trial. What that means is everybody got the statin drug, then anybody who had an adverse reaction was removed from the trial and then those where left over, half got statin drug, half got placebo, and they found 1% adverse drug reaction to the statin drug. Well, that sounds pretty good, but you need to ask yourself, “Now, how many people did they remove from the study?”  Out of that 10,000, they removed 3,000, so 30,000 of people had a reaction. Now, of course, some of those could be placebo and not real, but then when you do the post-marketing surveillance on what percent of people have an adverse reaction to statin drugs, guess what? It’s 25 to 30%, so they basically, from my perspective, created a study designed to produce the result they wanted, rather than valid information.

Dr. Weitz:                            Those of us in the natural world here seeing patients have known this. We see so many patients who complain about the muscle aches and the brain fog and all the other side effects they get from statins, and meanwhile they’re publishing these results, as you said, showing 2% of the people have these side effects.

Dr. Pizzorno:                      [inaudible 00:41:22] it’s not true, but they make money, so they keep doing it.

Dr. Weitz:                            Absolutely, absolutely, and they even talked about the poly pill which was going to be given to every single person for prevention, and it would contain a low dose statin, as well as, I think it was going to have a blood pressure medication and maybe metformin or something.

Dr. Pizzorno:                       Yes. That was exact. That’s what they were doing. Metformin, statin, and a blood pressure [inaudible 00:41:47].

Dr. Weitz:                            Certain blood pressure medications actually can interfere with bone. Can you talk about which ones?

Lara:                                    If I can remember which ones off the top of my head.

Dr. Weitz:                            Yeah. I took-

Lara:                                    Well, they use [crosstalk 00:42:02] to help lower blood pressure.

Dr. Weitz:                            This is how you can tell that this was such a good book. I’ve got this pad of notes I took while I was reading it, sitting on my back porch drinking a glass of organic red wine. I’m glad that you said small amounts of alcohol are good for bone.

Lara:                                    Small amounts of alcohol are really good for you. Yeah.

Dr. Weitz:                            You said that Thiazide diuretics protect bone, while-

Lara:                                    Right. Loop diuretics cause bone loss.

Dr. Weitz:                            Calcium channel blockers harm bone.

 



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If you go to chilisleep.com and you use the affiliate code, Weitz20, that’s my last name, W-E-I-T-Z, 20. You’ll get 20% off a chiliPAD. So, check it out and let’s get back to this discussion.



 

Dr. Weitz:                            You also mentioned that SSRIs, antidepressants, promote bone loss.

Lara:                                    Yeah. It’s interesting how they do that. That one, I do remember. What happens is they-

Dr. Weitz:                            Those are so commonly prescribed.

Lara:                                    Very commonly prescribed, and they increase the gut production of serotonin and then that serotonin binds to a receptor on the surface of newly forming osteoblasts, and stops them from developing, and so, your bone building cells don’t develop, and that’s a problem.

Dr. Weitz:                            Yeah. I certainly understand. Let’s talk about calcium supplements, and we’ve known for a long time that calcium is beneficial, but of course, when a few of these studies came out showing that calcium increased risks for heart attack, everybody freaked out and now it was like, no, no, you can’t take calcium. Just take vitamin D. If you’re going to take calcium, just take a little bit, because if you take a lot it’s going to calcify your arteries, so what do we know about the truth about calcium? How much should we be taking? How much is it safe? What form?  I noticed you talked about some of the forms that we’ve been told for years, like hydroxyapatite are the best forms of calcium, actually not as beneficial as we thought they were, or maybe not beneficial at all, so tell us about calcium supplements.

Lara:                                   Okay, so, the first thing is the papers that came out, they were primarily written by a group headed by Boland and his team in Australia, and they looked at studies where only calcium was given or calcium and vitamin D were given, and no vitamin K, okay? As I mentioned before, vitamin D helps us absorb calcium. It does nothing to control what happens to that, and if you don’t have vitamin K available, you’re not going to activate the proteins that pull that calcium into your bones where you want it and prevent it from depositing in your arteries where you don’t, so that is essentially the answer to that issue.  You’ve just got to have … The nutrients work together, and you need the team, not just one or two of them.

Dr. Weitz:                           By the way, one of the reasons why they did some of these studies is because earlier studies had shown that people who consumed more calcium had a lower risk of heart problems.

Lara:                                   That’s interesting.

Dr. Pizzorno:                      [inaudible 00:46:36] calcium, magnesium.

Lara:                                   Yeah. Maybe it was magnesium, as well, because those two have to be in balance, too, and that’s another big problem in the modern world.

Dr. Weitz:                           Let’s finish with the calcium first.

Lara:                                   Okay. Okay. On types of calcium, the reason the hydroxyapatite is not more effective, two reasons that I really don’t like hydroxyapatite. One, it’s hyped. It’s really expensive. It’s overpriced calcium, and when you consume it, in your stomach, your body is going to break it apart, okay? The calcium ions, if you produce any stomach acid, the calcium ions are going to be released from whatever their partner is, and then you’ll absorb the calcium ions. You do not absorb it as a blob. You absorb calcium ions and then the apatite is very, very high in phosphate, phosphorous, and high phosphate levels are one of the problems with the American diet, largely because of phosphate additives in all the processed foods.  I wrote a review paper on this, and it’s on PubMed, entitled Canaries in the Phosphate Toxicity Coalmines, which is what we are. The latest research has shown that they’ve known about this for people with kidney disease for a long time, but now they’ve discovered that high phosphate intake is causing cardiovascular disease in everybody, not just people whose kidney function is impaired.

Dr. Pizzorno:                       It increases the rate at which the kidneys degenerate.

Lara:                                   Right, so I don’t think adding more phosphorous phosphate to your, taking that as a supplement, is really a good idea, so I don’t suggest taking that. If you do not produce any stomach acid, then calcium citrate is going to disassociate, even without any stomach acid present, but it has a lot less calcium ion in it than calcium carbonate, and they’ve done many studies showing that people who produce stomach acid, calcium carbonate is fine. In fact, the research that they used to initially show that calcium carbonate was a problem and that calcium citrate was so much better, they took a group of older people who were hypochlorhydric, meaning they did not produce much stomach acid, and they tested them before breakfast, when they were fasting.  They gave them a supplement. They didn’t produce stomach acid in response to the supplement. They didn’t absorb any calcium. They took the same group of people, and they didn’t report this part of the study, and they gave them breakfast, and guess what, they absorbed their calcium just fine. I think there’s a lot of misinformation. Studies have been used to promote various products in a not very truthful way.

Dr. Weitz:                            [inaudible 00:49:30], you know calcium citrate probably has the added benefit of citrate being sort of an alkalizing-

Dr. Pizzorno:                       Alkalizing agent.

Lara:                                    Absolutely.

Dr. Pizzorno:                      [crosstalk 00:49:38]. Yes.

Lara:                                    Yeah.

Dr. Weitz:                            But how much calcium in supplements is it safe to take? At one time we were doing 1,500, even 2,000 milligrams, and then after those studies, everybody pulled way back. Now people say just 500, 800. What do you think is for, if you’re working with a woman with osteoporosis, how much is safe, and then how important is it to take it at certain times of the day, to split it up, et cetera?

Lara:                                    You want to be getting about 1,200 milligrams of calcium per day. In some of the research on post-menopausal women, some people have benefited from as much as 1,500 milligrams per day, but that’s total. It’s not just from a pill that you’re taking. You’re supposed to be eating real food that has calcium in it, and you’re supposed to look at what you’re getting from your diet and then supplement the additional, so the company that I work with, am I allowed to mention a company name or anything?

Dr. Weitz:                            Of course. Yeah. [crosstalk 00:50:41].

Lara:                                    I work with a company called AlgaeCal. In their product, it provides 720 milligrams of calcium. Because the research shows that the majority of people in the US are consuming between 450 to 600 milligrams of calcium daily from their diet, which is way less than you actually need, so if you take the supplement, which is 720 milligrams over the course of the day, you divide it into 2 servings of 350 milligrams each, and the total from your diet and the supplement comes out to between 12 and 1,500 milligrams daily. The fractional calcium absorption, which is how much of the mineral you’re actually going to absorb from what you swallowed, tops out at 500 milligrams.  After you have consumed 500 milligrams of calcium, the transport mechanisms, the compounds in your gut that help you absorb the calcium, will be maxed out. They can’t carry anymore.

Dr. Weitz:                            Don’t consume more than 500 milligrams of calcium-

Lara:                                    … at a time. At one time, yeah, and then you need three or four hours for things to reestablish themselves and for those transporters to be available.

Dr. Weitz:                            Better with a meal? Better in the evening? What do you think?

Lara:                                    Definitely better with a meal. You cannot release the calcium ions from the food matrix or from their stabilizing partners, like calcium bound to carbonate. It won’t release without the presence of stomach acid, and we produce stomach acid in response to a food intake, so definitely with a meal. Whenever you eat.

Dr. Weitz:                            Now, the reason for taking it at night is because some of the studies seem to indicate you lose bone while you sleep.

Lara:                                    Well, that’s why I suggest that people take strontium at night. Bone renewal is a housekeeping function, right? Just like all the repair functions, and those ramp up at night when we’re not busy doing a lot of other things, so it’s best to, I suggest that people, if they take strontium, they should take it at night. They’ll get the most benefit from it at night.

Dr. Weitz:                            Okay, so, calcium with meals, maybe split it up. No more than 500 milligrams at a meal, and then, let’s get into strontium because that’s a controversial compound and I’ve talked to other bone experts who were very negative on strontium and you write in your book that that’s partially because some of the studies of this prescription form of strontium, strontium [inaudible 00:53:24], or strontium ranelate were-

Lara:                                    Ranelate, right.

Dr. Weitz:                            … were potentially harmful.

Lara:                                    Right. When Servier, the company that created strontium ranelate, developed it, they did so because they look at over 100 years of research showing that many, many different natural forms of strontium were beneficial and caused no adverse effects. Then, for some reason that I wish I-

Dr. Pizzorno:                      … to make it [inaudible 00:53:52].

Lara:                                      … to make it … Well, yeah, but why they picked ranelic acid, which is a toxin, to combine it with, God only knows. I so wish they’d put it with something that wasn’t toxic, because it would have been a fabulous drug and a lot of people would’ve benefited, but they combined it with this toxin, and when you consume that, just like for calcium, the strontium ions disassociate from the toxin, and the claim was that ranelic acid wasn’t going to be absorbed and it wasn’t going to do anything. Well, that wasn’t true, and there’s now been research that shows that it’s absorbed and it has adverse effects, and it’s part of the group of aromatic compounds that cause things like rashes, DRESS syndrome, blood clots and all that, all those things that are the adverse effects of strontium ranelate, but in the research on natural forms of strontium, there have never been, in more than 100 years, none of these forms of strontium have caused any of these adverse effects, and strontium is so beneficial for bone.  It acts through so many different mechanisms, both to increase osteoblast activity, increase calcium absorption. There’s even a special calcium receptor that only responds to strontium. It’s activated by strontium and helps you absorb more calcium, and then strontium also helps lessen osteoclast activation, those cells that break down bone, so it’s a really incredible-

Dr. Weitz:                            It’s a natural bisphosphonate.

Lara:                                    Well, bisphosphonates only poison osteoclasts. That’s all they do.

Dr. Weitz:                            Right. Okay.

Dr. Pizzorno:                       That’s a good point. [inaudible 00:55:47].

Dr. Weitz:                            Strontium citrate is the form you like, right?

Lara:                                    Right, and again, the citrate is alkalizing, so that’s helpful-

Dr. Weitz:                            What’s the ideal dosage?

Lara:                                    Well, it depends, just like everything else. If someone has frank osteoporosis, then they would probably benefit from the typical dose, which is 680 milligrams per day, but if someone’s bones are in good shape or they only have osteopenia, they can do a half a dose and they’ll still get benefit from it. There have been studies showing benefits from that. Once my bones were in good shape, I stopped taking strontium. Until I wrote the big review on strontium and I learned all the ways that it supports healthy bone renewal, so I started taking a half a dose, and that’s what I do.  Also, strontium also helps you sleep better. It helps tune down some brain activity that would keep you awake, and I find it really helpful for that.

Dr. Weitz:                            Okay, and now we should have magnesium in a two to one ratio, calcium to magnesium. You recommend that in the book?

Lara:                                    Yes, and that is a big problem because everybody’s taking calcium and vitamin D with nothing else. The standard American diet is really depleted of magnesium because of the way food is grown. You want to talk about that? Then, that balance is off, and when it’s off, it promotes lots of bad things, like cancer as well as bone loss, so it’s really [crosstalk 00:57:26]-

Dr. Weitz:                            I talked to one doctor who’s an expert at bone, and he said that he looked through all the literature and he couldn’t find any literature that substantiated this two to one calcium, magnesium ratio.

Lara:                                    If you send me his email I’ll send him a bunch of papers.

Dr. Weitz:                            Okay.

Lara:                                    I mean, it’s there, for sure.

Dr. Pizzorno:                       Yeah. Actually, I was [inaudible 00:57:48] about that, as Lara’s digging into it, that I’d always heard two to one, but I actually had never saw any research. When Lara actually dug up some research on it, I was quite intrigued. Now, I’m surprised, it was actually two to one.

Dr. Weitz:                            Two to one calcium and magnesium, and then what other nutrients are synergistic?

Lara:                                    Well, a lot of trace minerals. If you skim the book, you saw a whole list of them.

Dr. Weitz:                            You mentioned boron. How important is boron?

Lara:                                    Oh, boron is my favorite trace mineral. I actually wrote a paper on that, too. It’s on PubMed. It’s called Nothing Boring about Boron.

Dr. Pizzorno:                       Mention how many citations, how many research [crosstalk 00:58:25]-

Lara:                                    Yeah. I’m on ResearchGate, and every week they send me, “You had X number of people read this article that you wrote.” Over 3,000 doctors have read boron now.

Dr. Weitz:                            Wow.

Lara:                                    Yeah. A lot.

Dr. Pizzorno:                       Nothing Boring about Boron.

Lara:                                    Yeah. There’s nothing about it.

Dr. Pizzorno:                      [inaudible 00:58:42].

Lara:                                    It’s so helpful in so many ways. After I read all the research on boron, I started on boron. One of the things it does is it slows down the activation of the enzyme called 24-hydroxylase enzyme, that breaks down estrogen, testosterone, so you keep it around longer, but it’s not harmful. It doesn’t make you keep around so much that it would increase cancer risk. In fact, they use boron in cancer treatment, it’s so beneficial, but that’s one of the things it does, and so you get more benefit.

Dr. Weitz:                            What’s the dosage you like of boron?

Lara:                                    You need at least three milligrams, but then there’s a bunch of research showing that six milligrams, particularly for people who have osteoarthritis or degenerative osteo, what?

Dr. Pizzorno:                       Yeah. Degenerative [inaudible 00:59:38].

Lara:                                    Yeah, degenerative joint disease of any kind. They’ve done a number of studies using six milligrams of boron. They’ve had a lot of success with it, and there have been several studies just on bone loss and it helped to prevent bone loss.

Dr. Weitz:                            Now, you also wrote that phytate-rich foods are actually protective of bone.

Dr. Pizzorno:                       Not what we were taught 50 years ago.

Lara:                                    Yeah, well, phytates bind things in the colon that you really want to have leave, and if they don’t leave and they get re-absorbed, they’re inflammatory, and again, anything that promotes-

Dr. Weitz:                            Dr. Gundry’s not going to agree with you on this.

Lara:                                    That’s okay. I’m happy to disagree with him.

Dr. Weitz:                            Let’s hit one final topic, which is exercise. What is the most effective form of exercise to improve bone density? I’ve looked into some of the data on the type of exercise that’s beneficial, and most people recommend some form of resistance training or weight lifting, and yet, a number of the studies really didn’t show much benefit and some of the studies have shown that ballistic or high impact loading is necessary to really turn around bone and stimulate bone building. I know that this is controversial. Do you really want to take somebody who’s older with osteoporosis and have them do ballistic training and suffer compression fractures?  This has also led Dr. John Jaquish, who I interviewed previously, to create his OsteoStrong centers where he has these machines that load your bones to supposedly four times your body weight. I know there’s a lot of controversy. What do you think is the best way for us to exercise to strengthen our bones, and what’s safe for osteoporotic patients?

Lara:                                      Well, I think the most important thing is weight bearing exercise every day for an hour. This stuff of, come into my facility and in 20 minutes once a week, you’re going to rebuild your bones. Uh-uh (negative). Not happening.

Dr. Weitz:                            [crosstalk 01:02:12] 10 minutes.

Lara:                                      Yeah. Bones need stimulation. When the muscles are stressed and the torque is applied to bone, the type of cell and bone, which is actually the most prevalent type of cell and bone, they’re called osteocytes, and they’re machanosensors, and they start the bone renewal process, and they don’t start it until they’re activated, and they’re activated by weight bearing exercise, so exercise is just critical. Really, the best type of exercise is something you’re actually going to do every day for an hour, and there are several types. The having somebody to do the things where they did the pull ups and then people dropped to the floor-

Dr. Weitz:                            That was the LIFTMOR trial.

Lara:                                      I don’t think so. The people survived it and they didn’t get any broken bones, but I wouldn’t want to chance it with patients that I try to help. I think some of these people are very fragile, and you don’t want to do things that is possibly going to cause a fracture, so there are three types of exercise that I really like that people can do in their own home, easily, with very little equipment. Yoga for osteoporosis, I think is an excellent one. It was a protocol created by a doctor, by Dr. Loren Fishman. He’s an MD at Columbia and he teaches a course for, people can be trained to become certified, and I have done his course. People who do a lot of yoga, I know, take the training, so that’s an excellent one.

It’s a series of 12 poses. They can be done at home. You can access the videos for them online for free. There’s books out, and he has proven in peer reviewed, published research, that it is effective, and what happens is you do these poses and they put torque on certain areas and you hold the pose and it’s isometric, and it really puts torque on the muscle and it signals those osteocytes and they build bone. I’m also a Stott Pilates instructor. I love pilates. It’s very safe form of exercise, can easily be adapted so that you don’t do any of the C curve type things that could cause compression, but you can get really good core strength and it helps people stand up more erect and carry their body properly.  It can really work the muscles, and then my favorite is Bar 3, which is a combination of pilates, bar, and yoga. You get all three types of exercises. It’s an hour a day. There are 40 minute classes or 30 minute classes. It’s very accessible online. All you need is a mat, and you can do it in your own home, so I think people need to find something that they enjoy enough that they’ll do it.

Dr. Weitz:                            If they’re willing to do anything, ideally, would it be better to do an hour of weight training?

Lara:                                    Well, if they’re doing it with someone who’s watching them at least until they really understand how to move the weights, and all, I think an hour of weight training will be helpful, but part of it is when you’re, and Dr. Fishman talks about this, say you’re on a machine and you’re doing a leg press and you kind of lie back on the machine and you do the leg press. That’s not functional movement. That’s not how we live in our life, and I think the exercises that allow us to do the type of functional movements that puts stress on the muscles and the ligaments and activate the osteocytes in the bone that we actually do in our life, is probably the best approach.

Dr. Weitz:                            Squats and dead lifts more so than leg press.

Lara:                                    Yeah.

Dr. Pizzorno:                       Exactly.

Lara:                                    Yeah. In Bar 3, I probably did 50 squats today with weights, as part of Bar 3, to music. It was fun, sort of.

Dr. Weitz:                            Great. Thank you for spending some time with us and giving us some great information. Any final thoughts for listeners and viewers?

Lara:                                    You’re a terrific interviewer. I’m astounded at the great questions and how you really looked at the book, and I think you pulled many of the most important things out of it, and I greatly appreciate your help in doing that. I hope it will be helpful for people to hear this interview, and thank you.

Dr. Weitz:                            Get this book. The name of the book again is Healthy Bones, Healthy You, and it’s available, Amazon, Barnes and Noble and everywhere else, right?

Lara:                                    I think so.

 


 

Dr. Weitz:                            Thank you for making it all the way through this episode of the Rational Wellness Podcast, and if you enjoyed this podcast, please go to Apple Podcasts and give us a five star ratings and review. That way more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts, and I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica weight, sports, chiropractic and nutrition clinic, so if you’re interested, please call my office. (310)395-3111, and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you, and see you next week.

 

 

Dr. Peter Bongiorno speaks about an Integrative Approach to Anxiety and Depression with Dr. Ben Weitz at the Functional Medicine Discussion Group meeting on November 18, 2021.

[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 my WeitzChiro YouTube page.] 

 

Podcast Highlights

9:45  Let’s start with what’s going on right now in the world and how the current global pandemic has impacted mental health in the US.  Because of COVID we are seeing incredible increases in both anxiety and depression up to 8 fold.  Drug use has also quadrupled, as have suicide rates.

13:42  The neurotransmitter theory of depression and anxiety.  This is the theory that low serotonin or low dopamine or low norepinephrine is why someone is depressed or anxious or is suffering with other mood disorders and that prescribing medications that increase the levels of one of these neurotransmitters, such as SSRIs like Lexapro or Zoloft or Prozac.  In the case of anxiety, these drugs work maybe 60 or 70% of the time but for the treatment of depression they work maybe 30% of the time, which is only slightly better than placebo.  And such drugs are addictive, tend not to work over time, and they have various side effects, such as sedative effects, gastrointestinal effects, and sexual dysfunction. Why wouldn’t you try a natural approach? 

16:03  And even if it really is a neurotransmitter issue, why are these neurotransmitters low or out of balance?  What stressors does that person have that might be playing a role in their mood?  What is their environment? What are their toxicity levels?  What is the inflammation in their body? How is their gut working?  Are they getting enough sleep?  What’s their hormonal balance?  What foods are they eating? What is their mitochondrial function, and is that a part of why maybe their brain and their mood is suffering? What are their genetic makeup, and is there anything we can learn from that that can help us get a better idea of how we can support their body and the pathways in their body? Are they exercising?  So even if the neurotransmitter theory has some relevance, we still should ask, what is the underlying cause of the neurotransmitters being off?”  And there are clearly a percentage of patients where neurotransmitters are not a major factor and, other than counseling, conventional psychiatry has no other tools to help these patients.  That’s where Functional Medicine can really shine.

23:19  Dietary Factors.  The first dietary factor is blood sugar dysregulation, which can play a role in triggering depression and anxiety.  If patients are insulin resistant, their pancreas will tend to make a lot of insulin and they’ll have wild fluctuations of their blood sugar. This can play a direct role in triggering anxiety and depression and it can also trigger other hormones, such to trigger changing levels of cortisol, which can also stress their bodies and cause anxiety and depression.  Such patients should be eating a good amount of protein, healthy fats and some complex carbs regularly throughout the day.  Such patients may not do well on intermittent fasting. And the Standard American Diet is very pro-inflammatory and that is going to change what is going on in the brain and in the hypothalamic/pituitary/adrenal axis.  What we eat will greatly affect how our brain communicates with the nervous system, the hormonal system and the immune system.  While each individual’s diet should be different, in general, a Mediterranean diet tends to reduce inflammation and this will help with anxiety and depression, as Dr. Sanchez-Villegas showed in the early 2000s. (Sánchez-Villegas A, Delgado-Rodríguez M, Alonso A, et al. Association of the Mediterranean Dietary Pattern With the Incidence of DepressionThe Seguimiento Universidad de Navarra/University of Navarra Follow-up (SUN) CohortArch Gen Psychiatry. 2009;66(10):1090–1098. doi:10.1001/archgenpsychiatry.2009.) Here is another paper that reviews this topic in detail published in 2020:  Mediterranean Diet and its Benefits on Health and Mental Health: A Literature Review.

26:11  Vegans.  Vegans can manage their blood sugar by including beans and nuts and seeds, which contain protein. They can do smoothies with vegan protein powder. And some people do not need as much protein.  When it comes to histamines, some people with high histamines will have more anxiety, so they will do better with a lower protein diet.  Dr. Bongiorno finds that 10-15% of the time histamine is a problem with his patients.  He will include serum histamine in his lab work.  Sometimes patients will mention that they take Benadryl at night and this indicates this person may have high histamine.

28:48  The microbiome and gut health are very important for our moods.  The microbiome plays a strong role in the production of neurotransmitters both in the gut and immune signals that go to the brain to make neurotransmitters.  When there is a lot of inflammation in the gut that modulates neurotransmitter levels, the microbiome can help to modulate that inflammation.  A researcher in the thirties or forties published some studies on how clams can keep their muscles working so continuously to keep their shell closed and they discovered a chemical that they called enteramine, with entero standing for the gut. They learned that enteramine is what helped change motility in the gut and this was later renamed serotonin and then they found that it also happens to be in the brain and plays a role in our mood.

Some say that since the neurotransmitters produced in the gut don’t make their way into the brain, that gut neurotransmitter production has no effect on mood.  But research indicates that the enteric nervous system (the part of the nervous system that surrounds the gut) sends out a lot of signals through vagal nerve stimulation that affect neurotransmitter production in the brain.

32:53  Iron. When Dr. Bongiorno was a student he recalls a patient with depression and the clinician ran an iron panel and found out that both the serum iron and the ferritin were very low. He gave her some iron and within a month she was off her antidepressants after being on them for many years.  Iron is the center of the  hemoglobin molecule that allows you to carry oxygen in your blood. If you don’t have as much iron getting to your cells, your brain will shut you down so you don’t use as much oxygen, which leads to higher rates of depression and anxiety.

34:27  It is very difficult to get off of antidepressants, esp. if you have been on them for some time.  One reason is because if you have been taking antidepressants for a period of time, the receptors become down regulated. The other issue is that you deplete the precursor molecules that you need to make neurotransmitters.  This is also why these drugs tend to have poop out syndrome, which means that they work for while and then they stop working.  It is important to fix the underlying reason why they stop working whether it be low iron or low vitamin D or low B6 or not enough sleep, etc. it is much harder for people to get off these drugs.  You would never want to just take a patient with depression off their medication, because they will likely feel much worse. It is best to work on these underlying issues and get them feeling the best they can on medication before even considering having them slowly wean off their medication, but only with the prescribing physician participating.  Make sure that you work on the underlying issues first. Make sure they are getting good, quality and quantity of sleep. Make sure they are exercising, managing their stress, going to therapy, doing some relaxation work, and eating a healthy diet.  Dr. Bongiorno likes to do a fair amount of testing, including looking at iron levels, red blood cells, B12, vitamin D, B6, inflammatory markers, histamine, hormones, melatonin, glutathione, etc. We may want to do an elimination diet or do food sensitivity testing. We will want to do a good stool test and other gut testing. Dr. Bongiorno has been using the GI Map stool test lately, though he also likes the stool tests offered by Genova Diagnostics and Vibrant America labs.  We want to get the gut as healthy and balanced as possible.  We may want to put patients on amino acids to support some of the neurotransmitters. We may want to put people on blood sugar supportive nutrients to help stabilize blood sugar or whatever the underlying issues are. 

38:39  When it comes to trying to wean off medications, you might not want to do it in the winter, when the days are shorter and darker and serotonin levels are at their lowest.  This is why it can be helpful to use a light box in the winter.  As animals, we’re designed to hibernate and sleep longer in the winter.  It might be better to wean off medications in the spring when the light is longer and the light gets brighter, which stimulates serotonin levels.  This should only be done with your doctor.

40:42  Circadian Rhythm.  Dr. Bongiorno will use either salivary or urine tests to look at cortisol levels throughout the day.  Depressed patients may have very high or very low cortisol levels.  You may have some patients who can’t get out of bed in the morning but are wired at night and can’t sleep. Circadian rhythm is very important to mood disorders and getting people in balance with nature and with the day is a great idea.  You should avoid having a lot of bright lights at night when you should be winding down to go to bed.  You should also avoid eating late, since this also stimulates cortisol.  Most people need 7 1/2 to 8 hours of sleep per night. People who get a lot less or a lot more tend to have more anxiety and depression. 

45:18  Coffee.  People who suffer with anxiety will tend to do better with less coffee. Coffee will usually make them more anxious.  On the other hand, people who drink 2 to 4 cups of coffee a day will have lower depression rates while 7 to 8 cups will increase rates of depression and anxiety.  But it is better to build up their adrenal glands so they have natural energy, rather than overstimulating them with coffee.

51:15  Lab Testing.  While recommended lab testing is different for each patient, some of Dr. Bongiorno’s favorite labs include Hemoglobin A1C, fasting glucose, insulin, RBCs, WBCs, a liver panel incl. GGT, iron panel incl. ferritin,  full thyroid panel, inflammatory markers, including erythrocyte sedimentation rate, C-reactive protein, and Interleukin-6.  Fecal calprotectin on a stool test.  Celiac panel. Amylase and lipase. Vitamin D, zinc, zinc to copper ratio, RBC magnesium, B12, methylmalonic acid, which is marker for B12, and an advanced lipid profile.  Estrogen, testosterone, progesterone, pregnenolone.  While high cholesterol can cause problems, lowering cholesterol too much can be harmful since the body may be unable to make these important hormones that are crucial for the brain and for good mental health.

55:11  Hormones.  Hormones are critical for mental health.  Estrogen plays an important role in the levels of serotonin in the brain and whether serotonin is being made in the areas of the brain that need it.  Higher estrogen levels change the amount of monoamine oxidase to keep serotonin levels high. Progesterone does the opposite.  This is another example of the nice yin and yang balance between estrogen and progesterone.   Men also should have a certain level of estrogen and they have six times the level of estrogen in the brain that women have. Progesterone supplementation for men has not been shown to be helpful.  If Dr. Bongiorno is working with a postmenopausal woman, he will typically work on the basics like sleep, exercise, diet, stress reduction, because those things oftentimes will help. Secondly, we want to support the liver because the liver is what processes the estrogens. And oftentimes when the liver and the microbiome are out of balance, we’re going to see improper levels of estrogen. For example, if there’s beta-glucuronidase levels are out of balance, that’s going to change estrogens and there’s going to be a lot more recirculation of excess estrogens.  If there’s a lot of candida, candida acts as false estrogens, so that’s going to change the balance of estrogens.  So we want to fix all of those things.  So without even touching hormones, we can oftentimes fix the hormones.  After all that, if we want to tweak the hormones it is better to start with a touch of pregnenolone or DHEA, which can feed the rest of the pathways.  If progesterone levels are low in relation with estrogen, then the herb, vitex, (aka Vitex agnus-castus, aka, chasteberry,) does a great jobat a dosabe of 220 mg once or twice per day.  There are studies in premenstrual dysphoric disorder showing it works really well. There’s other studies in perimenopausal depression showing that it worked just as well as SSRIs.  Also, rather than using an SSRI drug if needed after lifestyle hasn’t gotten to where you want to get, it is better to see if tryptophan (500 mg twice per day) or 5-HTP (50-100 mg a day) might be a better way to stimulate serotonin production.

1:02:27  A diet that is too low in carbs can also cause problems with anxiety and depression by lowering serotonin levels.  Also, while gluten can be problematic, since patients with mood disorders are often sensitive to gluten, but if you place them on a gluten free diet too quickly, their symptoms may actually worsen, so they should be weaned off gluten slowly rather than all at once. 

1:04:32  Supplements.  Here are some of the most effective nutritional supplements for anxiety and depression:

1. Essential Fatty Acids.  Fish oil is very powerful and alone can sometimes cure depression or anxiety if people are deficient in them.    

2. SPMs.

3. GLA.  While omega 3s are so important, omega 6s are also beneficial and this is an omega 6 fatty acid that helps the body to make its own prostaglandins and this can help with mood. Patients who use alcohol to feel happier, GLA can often help.  

4. Probiotics.  Probiotics can help to improve gut health and to create a healthier microbiome, along with fiber and fermented foods.  There are studies showing that if you take a fecal microbial transplant from an animal who’s not depressed and give it to an animal that’s depressed and you can lift their mood and depression.  

5. B vitamins.  B vitamins are important for mitochondrial function for producing energy in the body, for methylation, and to break down our neurotransmitters and hormones properly.  Some B vitamins like folic acid may be able to help patients with schizophrenia.

6. Vitamin D.  If vitamin D is a neuro steroid and if it is low, it will be harder for the body to make serotonin and other neurotransmitters. If vitamin D is higher, there will be lower levels of anxiety.  

7.  Magnesium.  Magnesium is very relaxing and important for mental health, including for GABA levels in the brain and it helps with benzodiazopine receptors.  

8. Zinc.  Zinc is a cofactor for so many different reactions in the body as well as for gut health. The zinc to copper ratio is very important.  

9. Nutritional Lithium.  Dr. Bongiorno just wrote a paper about Nutritional Lithium in Natural Medicine Journal. CLINICAL APPLICATIONS OF LOW-DOSE LITHIUM, MENTAL HEALTH, COGNITION, AND MORE.   Nutritional Lithium (Lithium orotate) is great for teens with impulsivity, including for kids age 5 to 10 with anxiety in drop doses. It is very supportive to the brain. Research shows it may be protective for Alzheimer’s disease.  You can start with 5 mg for adults and 1 mg for children and for adults you can go up to 20 mg per day.

10. GABA.  Some say that GABA can only help if you have a leaky gut and leaky brain, because it is very difficult to get it into the brain.  But rather than trying to figure out if you have leaky brain, it is best to just dose it higher, such as 500-1000 mg 2-3 times per day.  You can also give GABA along with theanine and either lithium orotate or CBD oil.  Liposomal GABA seems to work well, but so do chewables.  

11. St. John’s Wort.  St. John’s Wort is very good for mood, esp. for depression.  It has gotten a bad name in recent years, since it affects the cytochrome P450 Liver detoxification pathways involved in the detoxification of certain medications and making them less effective, including Antidepressants, Birth control pills, Cyclosporine, certain heart medications, incl. Digoxin, some HIV drugs, some cancer medications, incl. Irinotecan and Imatinib, Warfarin, and some statins.  While it can decrease the effectiveness of some antidepressants, it can amplify the effects of SSRIs and MAOs and can lead to a dangerous elevation of serotonin called serotonin syndrome that can produce elevated blood pressure, fever, agitation, rapid heart rate, perspiration, diarrhea, and muscle spasms.  Patients who take St. John’s wort while on birth control may find that they are more likely to get pregnant.  But it is also a very good antiviral. It’s an anti-inflammatory and is great for mood.

12. Rhodiola.

13. Lavender. 

14. Saffron.

15. Berberine.  Berberine is an incredible herb that is beneficial for cholesterol, blood sugar, gut health, and it also helps with neurotransmitter production in the brain. Here is a good paper on this: Pharmacological effects of berberine on mood disorders.

16. NAC.

17. Neurologix. This is a product by Integrative that includes saffron, spearmint and a branded citicoline that helps with memory, focus and mood.

 

This is a powerful closing statement from Dr. Bongiorno:

“Yeah. I mean, to the clinicians out there, when you have a patient who, especially if it’s a challenging patient, always double down on the basics. Make sure that those are all taken care of. And just really look for the other underlying factors that maybe you haven’t looked into yet because there’s some reason why a person is feeling the way they’re feeling. And it’s really up to us as clinicians to kind of look at all those factors and really put it together because there’s practically always a way to help to get people to feel better. If not get them off medications, at least get the medication doses lowered which often could be a win, especially in things like bipolar. You’re creating so much less toxicity in the body.  And to any listeners there in the public who are suffering from anxiety, depression, mental health, just know that there’s still a lot of tools out there, and find a practitioner who just really cares and is listening and wants to look into those underlying factors because there’s always something else that can be done. And just don’t give up hope, and don’t give up thinking that you can feel better and feel like your best self.”

 



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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.



 

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.

Thank you for joining our functional medicine discussion group meeting tonight with Dr. Peter Bongiorno on an integrative approach to depression and anxiety, and I hope you’ll consider joining some of our upcoming meetings.  December we are not going to have a meeting, but January 27th, Dr. Aristo Vojdani will be joining us on why we should test the immune system, and I’ve yet to fill out the rest of the schedule for next year, so I’ve got to get going on that.  I encourage everybody to participate in the discussion by typing your question into the chat box, and then I’ll either call on you or simply ask Dr. Bongiorno your question when it’s appropriate.

If you are not aware, we have a closed Facebook page, the Functional Medicine Discussion Group of Santa Monica, that you should join so that we can continue the conversation when this evening is over.  I’m recording this event, and I’ll post it on my YouTube page, and I’ll include it in my weekly Rational Wellness podcast.  If you haven’t listened, please check out the Rational Wellness podcast and subscribe on Apple Podcasts, and if you enjoy it, please go to Apple Podcasts and give me a ratings and review.  I want to thank our sponsor for this evening, Integrative Therapeutics, which is one of the few brands of professional supplements that we use in my office, and so I’d like to welcome Steve Snyder from Integrative Therapeutics to talk to us a little bit about a few products. Steve.

 


Steve Snyder:                    Hi, everyone. Thanks, Dr. Weitz. I’m so excited because finally the topic is something we actually have something that’s pretty unique. Not the only time it’s ever happened, but this is really good. So the Zoom is telling me that you’ve disabled the sharing thing.

Dr. Weitz:                            Oh. Oh. Here. No. Let’s see. Here you go. Okay. You should be able to share now.

Steve Snyder:                    Okay. So just real quick, we actually have a product called Lavela that’s an oral lavender essential oil, and it’s got some really pretty impressive research in anxiety.  What’s unique about this is it was developed by our parent company in Germany, and if you know anything about supplements in Europe, you have to do some pretty significant clinical research to actually sell something over there, and this happens to be a lavender that we grow ourselves.  You can see from the name here, WS 1265. The WS is for Wilbur [Schuaba 00:03:09], and he happens to be one of our owners and also a pretty smart guy.  So he developed this… Lavela is what we call it in The States. Silexan is the trademark name, and it’s got some really, really great research in anxiety.  So it’s significant anxiolytic efficacy comparable to lorazepam and Paxil, so we’ve seen some great benefits associated with anxiety disorders, disturbed sleep, and other somatic complaints, stuff like that. It’s nonaddictive, non-sedative. There really are no side effects other than people tend to burp lavender.

That’s supposed to go away, but it is a thing. There’s a school of thought that maybe that olfactory part is part of the efficacy. Some people like it. Some people don’t, but it tends to go away.  Kind of here’s some of the… These are kind of the two big studies we’ve talked about, and it’s probably hard to see for you guys, but basically the one on the left is comparing Lavela with lorazepam, and this was 77 subjects over six weeks.  You can see we basically had a similar reduction in symptoms, and we had a similar response rate as well. So as you know the benzodiazepines and some of the other pharma stuff doesn’t work for everybody. We see about a 75% response rate with Lavela, so when it does work, it’s awesome, but it doesn’t work for everybody.  The subject on the right is compared to Paxil, and that one was with 539 patients, so a pretty big study at 10 weeks, and we saw the same thing. Similar results. No side effects.  People always asked, “How does it work?” This is one of those things. We’re not 100% sure, but what we believe is that it helps modulate the presynaptic calcium channels, so it’s regulating the release of neurotransmitters, and sort of modulating that response, and lowering anxiety through that mechanism.

We see typically one to two caps per day is all you need. We like to let people try it for about a week if we’re going to do a trial. Some people they say they feel it right away. Like I walk into offices all the time where they say, “Oh. I just took a Lavela. I feel great,” and that’s awesome. I’m not going to argue with them, but it really doesn’t work like that, but if they feel better, that’s good too.

So if people want to sample this product, we do let people try it. We have boxes that have 10 caps in a blister pack, and that’s typically what we have them give a patient, so we want to make sure somebody gets a response before they spend the money on it.

Then there’s a whole bunch of studies on it. It’s about over a thousand patients now, so everything from those studies I just showed you to, again, placebo. There’s also some open-label dose, 80 mg versus 160 mg, so it’s a pretty heavily clinically studied product, and so far it’s one of our flagships.  People ask how much. It wholesales for $35 for 60, so for some people that’s two months. For others, it’s one month, but still relatively inexpensive, and it’s available everywhere.  We love Emerson and Fullscript, but we also sell it direct, and again, if you want to try it, you can email me at steve.snyder@integrativepro.com, and we can send you some trial boxes. [This is for paractitioners only]

So that’s the Lavela, and then the other one I really quickly wanted to mention was Theracurmin, which is our high bioavailable curcumin preparation. It’s essentially a water-dispersible curcumin, so we get really high blood levels very quickly that last for a long time, and the reason I bring it up in this context is there was a recent study done at UCLA where they looked at men with age-associated memory decline, and they weren’t really looking for mood response, but the metric they used to check the memory also had a mood component to it, and they noticed a significant improvement in mood over the course of the study in these guys.  Theracurmin is kind of… There’s a lot of claims being made about curcumin out there. We call it the curcumin wars. We happen to have something that we can back up where a lot of people will say stuff, and then they can’t back it up, so that’s another one we’ll let people try.  There’s all kinds of clinical studies now on it because the pharmacokinetics is pretty well established, so everything from mood, to skin health, to liver function, to cardiac function. We’re trying it everywhere, and we’re putting it in a lot of stuff because with a lower dose, you can get some clinical results. That’s pretty much it. Thank you.

 


 

Dr. Weitz:                            Thanks, Steve. So now I’m going to introduce our speaker. We’re very happy to have Dr. Peter Bongiorno speaking with us this evening, and he’s a naturopathic doctor and acupuncturist in New York City. He also works with clients via phone and Skype.  He’s written a number of books including Healing Depression: Holistic Solutions for Anxiety and Depression in Therapy which is this book here, and this is like an incredible resource, really dense, with tons of information, so I refer to it regularly when I have patients with depression and anxiety.  He’s also written 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. That’s D-R-P-E-T-E-R-B-O-N-G-I-O-R-N-O.com. So Dr. Bongiorno, you have the floor.

Dr. Bongiorno:                   That’s a long name. I started getting bored while you were reading it. Thank you. Thank you so much for having me here. It’s really a pleasure. Thank you.

Dr. Weitz:                          Good. Good. Good. Good. So how do you want to get started?

Dr. Bongiorno:                   Oh, gosh. I mean, we could start with the… Let’s start with what’s going on right now.

Dr. Weitz:                          Okay.

Dr. Bongiorno:                   I’m actually…

Dr. Weitz:                          Is there anything going on right now?

Dr. Bongiorno:                   Well, not really. It’s pretty-

Dr. Weitz:                          Nothing to be worried about?

Dr. Bongiorno:                   No. No. In fact, right now I’m actually preparing a talk for… I don’t know. Do you come to the Integrated Healthcare Symposium in New York City?

Dr. Weitz:                          I haven’t been to that one yet.

Dr. Bongiorno:                   Haven’t been to that one?

Dr. Weitz:                          Yeah.

Dr. Bongiorno:                   So it’s one of the biggest integrated medicine conferences.

Dr. Weitz:                          It’s in February? Is that right?

Dr. Bongiorno:                   Yeah. It’s in February in New York City. Maybe Steve will be there.

Dr. Weitz:                           Okay.

Dr. Bongiorno:                   And Integrative ITI will be there.

Steve Snyder:                    We’ll probably have an army there.

Dr. Bongiorno:                   Great. I’m sure you guys will.

Steve Snyder:                    Yeah. 

Dr. Bongiorno:                   Yeah. You definitely need to be handing out Lavela and some cortisol manager while you’re over there.

Steve Snyder:                    Yep.

Dr. Bongiorno:                   So actually I’m preparing a talk right now for that conference, and it’s going to be about COVID and mental health because it’s just extraordinary what’s been going on in the past couple of years, the incredible increases in both anxiety and depression, like six, seven, eight-fold.  I think it was at its high point in January of last year or up to 42% higher rates of depression and incredibly higher rates of anxiety.  It’s lowered a little bit, but still way, way above …  Oh. That’s okay. So really anxiety, depression has skyrocketed. Drug use has absolutely quadrupled. Suicide rates. There’s so much to be done, and you could say, “Well, it’s the stress of COVID,” and I think that was a part of it, but I also think it was a testament to just the disease in our population, the unhealthy lifestyles and just the general inflammation that’s already been in our bodies, and then something like this comes up and just is sort of the straw that breaks the camel’s back, so for people who are already predisposed, it’s going to really increase these rates.  That’s something, especially in New York, that I’ve been seeing a lot of, practicing in New York City. It’s been phenomenal. It’s been quite an education.

Dr. Weitz:                            Yeah. And I think that’s something a lot of us in the Functional Medicine integrative world have been talking about which is not getting talked about a lot which is the fact that so much of our population is so unhealthy to begin with with poor diet, and lack of exercise, and the incredible high rates of people being overweight, over 70%, and high rates of diabetes or prediabetes and hypertension, and on, and on, and on, and those are the things that can play a role in predisposing us to depression and anxiety and also increase the likelihood we can have a worse case of COVID if we catch it. Low vitamin D levels. Lack of sunlight. Of course, keeping everybody inside, and not exercising, and not getting exposed to the sun, and etc., etc., unfortunately probably makes the situation worse.

Dr. Bongiorno:                   Yeah. Yeah. No question about it, so that’s one of the things that I’ve been working on right now is really putting together the information regarding the factors involved in why we’re seeing these incredible increased rates of anxiety and depression, suicide, drug use, domestic violence, and all of these things.

Dr. Weitz:                            Right. So I’d like you to talk a little bit about the neurotransmitter theory of depression and anxiety, and as we know there’s huge numbers of people on these medications.

Dr. Bongiorno:                   Yeah. So when you work with a conventional psychiatrist, and let’s say you have depression, and you go in there, and maybe you start crying, or you’re emoting some kind of thought, usually a psychiatrist will think to themselves, “Okay. Well, there’s probably low serotonin. Maybe low dopamine. Maybe low norepinephrine, so let’s give a drug, and let’s try to increase those levels of those neurotransmitters.”  In the case of something like anxiety, it works a higher percent of the time, maybe 60%, 70%, possibly 80% of the time when you give drugs like that.  Of course, as Steve had mentioned earlier, those drugs are addictive, and they tend not to work over time, and they can have sedative effects and other problems, which is the reason why if you have something like Lavela, which has been shown to be as beneficial without those kinds of effects, it’s certainly worth trying something like that. Right?

And then you have depression which antidepressants, especially SSRIs which are the mainly prescribed antidepressants, work maybe 30% of the time. Maybe a hair above what placebo’s been shown to use, and then we do have natural remedies, things like St. John’s wort, saffron, curcumin which also Steve mentioned earlier as well, and those have actually been shown in individual studies head-to-head with those medications to work equally as well, at least.  Now, of course equally as well still only means like 30%, maybe 35% at the most, so the question really that I have and what I think about when I work with patients is if it is a neurotransmitter issue, and those drugs work, why are the neurotransmitters off?  And the other question is in the percentages of patients that they don’t work, 30% to 40% are anxiety patients, upwards of 70% for patients who are depressed, what else is going on? That’s really, I think, what I’m interested in and what I work on with my patients.  

So when we want to look at neurotransmitters that’s fine, and if we can work with them and use some natural, less toxic things to help them balance, that’s good, but that’s still not getting to the underlying cause of why they got out of balance to begin with, if that even is the issue, and that’s where I like to think about, “Well, what are the other factors?”  So we want to take into account, of course, a person’s stressors which can certainly play a role, what their environment is, what their toxicity levels are, what the inflammation is in their body. How is their gut working? Are they getting enough sleep? What’s the hormonal balance that’s happening. What foods are they eating? What is their mitochondrial function, and is that a part of why maybe their brain and their mood is suffering? What are their genetic makeup, and is there anything we can learn from that that can help us get a better idea of how we can support their body and the pathways in their body? Are they exercising?

So even when we think about neurotransmitters and the neurotransmitter theory, which I think has some relevance and some credence, we still have to say, “Well, what’s the underlying cause of the neurotransmitters being off, if that’s even it?”  And then for that other percentage of patients where it’s maybe not playing as much of a role, what are the other factors because in conventional psychiatry, if it isn’t a neurotransmitter issue, and the drugs don’t work, there’s no other tools. There’s no other choice, and that’s why I love natural and functional medicine because there are so many other tools because we understand that there are so many other factors involved, and that it’s probably just not one or two factors that are contributing to the mood issue. It’s probably a number of factors that are contributing in small ways that synergistically is creating this syndrome that maybe we’re calling depression or calling anxiety, for example.

Dr. Weitz:                            Exactly. It sort of reminds me with the issues we’re having trying to deal with some of the chronic neurodegenerative problems like Alzheimer’s, and conventional medicine keeps looking for this one pathway and coming up with this one drug that affects that one pathway, and after just hundreds of billions of dollars of research, they’ve come up with nothing, and now we have this new drug that was just approved that does nothing to make anybody better. Best case, patients get worse more slowly, and 30% of the patients get swelling in their brain, and the first patient just died from this drug.  Yet we have a Functional Medicine approach which Dr. Dale Bredesen has finally published his study showing that patients actually improved. They didn’t just get worse at a slower rate, but it’s complicated, but that’s the beauty of a Functional Medicine/integrative approach looking at a number of different factors.  Not only do you end up improving your brain health, but you improve your overall health, and the same thing with a Functional Medicine approach for depression and anxiety.

Dr. Bongiorno:                   Exactly. Yeah, exactly. And Dale Bredesen who did that amazing work with the Alzheimer’s understands that it’s multi, multi-factorial, and that you have to look at a number of factors at the same time and work with as many as we can.  I think what the conventional care model when it comes to drugs doesn’t understand that there’s a lot of… That the body has a lot of redundancy in a sense, so when you give it a drug that works on a single mechanism, the body’s really smart at saying, “Okay. This is foreign. I don’t know what it’s doing, but we’re going to start working around it.” You know?  And so you need to give higher doses than is probably even healthy, so you end up with more side effects and less beneficial effect, and that’s the problem with the medications in general, and then I certainly see that with mental health, and it’s certainly seen in neurology when it comes to Alzheimer’s as well.

Dr. Weitz:                            And apart from all the other factors that we’re going to talk about that affect mental health from sleep, to diet, to exercise, etc., etc., even the neurotransmitter theory is just looking at one neurotransmitter like serotonin. It’s just a huge oversimplification about the way our brain and moods work. There’s a whole plethora of different chemicals that are all interacting in a very complex way.

Dr. Bongiorno:                   Right. Of course. As far as depression goes, if I had to pick a drug that probably did work the best for depression, it was tricyclic antidepressants, and those are the old antidepressants, and what they did was they kind of raised a lot of the neurotransmitters. They raised dopamine, and serotonin, and norepinephrine, and acetylcholine.  The problem with those drugs is that they were very… They were kind of toxic. You can’t give them to seniors because they’re especially toxic to older people, and again, even when they work, they work for a while, and then they kind of stop because like I said, the body figures out that it’s hand is being forced, and it doesn’t like that, so it kind of starts to work around these drugs.  So that’s why we need such a full, integrative, and holistic model that really just looks at the whole person.

Dr. Weitz:                           Now, we’ll get into your testing and theories, types of testing that you think is beneficial, but just on the neurotransmitters, do you think that’s a valuable thing to do to do the urinary neurotransmitter testing?

Dr. Bongiorno:                   Yeah. I mean, urinary neurotransmitters, I think, has some value. Interesting, in New York it’s very hard to get these neurotransmitter tests because of the laws in New York, so I don’t actually use them very much.

Dr. Weitz:                           Oh, really? Wow.

Dr. Bongiorno:                   Yeah. New York is a little toughie when it comes to a lot of these functional medicine tests, so I’ve actually kind of worked around them a bit, but the fact of the matter is is that there are neurotransmitter tests that I think can give you some clues, but you still really need to back it up with clinical relevance, and finding out how is this person feeling to really understand what’s going on. Urinary-to really understand what’s going on. Urinator transmitters, I don’t think give you a full picture of what’s going on in the brain, but they can suggest to you what’s happening in terms of breakdown and metabolites. So yeah, the more information we have the better.

Dr. Weitz:                           So let’s talk about some of the important dietary factors that can play a role in triggering depression and anxiety.

Dr. Bongiorno:                   Well, the first one that I see is just blood sugar dysregulation, especially when people have high insulin levels, insulin will drop your blood sugar. So people whose pancreas tends to make a lot of insulin because they’re insulin resistant, they’ll have these wild fluctuations and blood sugar, and that certainly plays a role in anxiety and in depression. That’ll play a role in triggering other stress hormones, changing levels of cortisol, and that can be very hard on the body and create a lot of stress and cause a lot of anxiety as well as depression. So, that’s the first thing I think about when it comes to it, so I like to make sure people are trying to stay away from simple carbs so that their blood sugar doesn’t go up and then come way down, and then making sure they’re eating a good amount of protein, healthy fat, and some complex carb regularly and throughout the day.

And I know sometimes for weight loss and metabolic health, that sometimes we need to do things like intermittent fasting, where we don’t have people eat for a number of hours of the day. For sometimes for people who have anxiety and depression, that doesn’t work for them, and you need to kind of have them do more of a grazing approach where they’re eating little bits throughout the day to keep their blood sugar stable. Everybody’s different. So what’s appropriate for one person isn’t appropriate for somebody else. And then as far as the foods themselves go, as we know, the standard American diet is really a disaster when it comes to for our health. It’s a very pro-inflammatory diet and inflammation is going to change what’s going on in the brain, change what’s going on in the middle of the brain, which is the hypothalamic pituitary adrenal axis.  So what we eat will greatly affect how our brain communicates with the nervous system, the hormonal system and the immune system. And that’s going to make a lot of changes in what goes on with our mental health as well. So I always recommend people have, if I don’t know a person and I don’t know what their individual needs are, and I had to just make a blanket recommendation, I would probably start with something like the Mediterranean diet. Sanchez-Villegas, in the early 2000s, did a number of studies out of Spain, which showed how the Mediterranean diet can prevent and even treat anxiety and depression as well as lower things like CRP and other inflammatory markers in the blood. So people who eat that kind of diet typically have lower anxiety, lower depression, less inflammation in the body. So, that’s a great place to start.

Dr. Weitz:                          How do you work with vegans or vegetarians given the importance of getting enough good quality protein?

Dr. Bongiorno:                   Well, it depends on the patient, as always.

Dr. Weitz:                          Of course.

Dr. Bongiorno:                   If we’re working with a vegan or a vegetarian, there’s beans, there’s nuts, there’s seeds.  We can also do smoothies with it, so it depends on the person.  Some people don’t have as much need for as much protein, and actually when it comes to things like even histamines, right, if people are very high histamine and they have a lot of anxiety then typically I’ll put them on a lower protein diet to lower levels of histamine. So, that could actually be helpful.

Dr. Weitz:                          Okay.

Dr. Bongiorno:                   So, it just depends. We have to strategize individually where people are going to get their protein from.

Dr. Weitz:                          How often do you find histamine is an issue?

Dr. Bongiorno:                   I would say a good 15% of the time, maybe 10 to 15% of the time.

Dr. Weitz:                          Okay.

Dr. Bongiorno:                   I do run histamine on practically every patient and I’ll do, as part of my intake, ask them a number of questions to find out. Sometimes I’ll have people who’ll come in and I ask them how they’re sleeping and they’ll say, “Oh, I’m sleeping great.” And then I’ll ask them, “What do you take? Do you take anything over the counter?” “Oh, yeah. I take some Benadryl at night. It really helps me sleep.” Great.  That’s kind of a clue that they’re probably high histamine, because Benadryl is an antihistamine.

Dr. Weitz:                           Right.

Dr. Bongiorno:                   If you don’t have really high histamines, it won’t affect your sleep too much, but if you’re high histamine, boy, you get the best sleep with that stuff. So I’m not recommending it as a plan, but I’m just saying it’s a-

Dr. Weitz:                           Right.

Dr. Bongiorno:                   So that could be a kind of a clue to find out as well. Plus if people have a lot of rashes and itching or urticaria, you can write on somebody’s arm and write your name on it with your finger. That’s how you know their histamines are pretty high.

Dr. Weitz:                           And will you use a specific low histamine diet?

Dr. Bongiorno:                   Yes. Yeah. So there’s a number of food that will either release histamine in your body or actually have high histamines in them. So it’s a little handout that I’ll give people and I’ll have them start with the foods that they tend to eat a lot of. And sometimes it’s even healthy foods, it could be even things like avocado, as well as typical ones that people know about are wine and cheese. But even there’s some healthy foods, fish can be high in histamine. So, I love people eating fish. It can be so healthy for you, but if they’re high in histamine, then that might be something we might want to limit.

Dr. Weitz:                          And so we often see patients with histamine problems who come see us with other gut disorders. How important is the microbiome and the gut for overall mental health?

Dr. Bongiorno:                   Yeah, so the microbiome plays such a strong role in the production of neurotransmitters, both in the gut and the signaling through the cytokines, the immune signals that go to the brain and help the brain also make neurotransmitters in different areas of the brain. So when there’s a lot of inflammation in the gut, that’s going to typically change levels of neurotransmitters in the brain as a result. And the microbiome will play a strong role in modulating that inflammation.

Dr. Weitz:                          Now given that the neurotransmitters in the gut don’t make their way into the brain, how important is the neurotransmitter production in the gut?

Dr. Bongiorno:                   Well, neurotransmitter production, that’s actually something that’s being hotly debated right now.

Dr. Weitz:                          Okay.

Dr. Bongiorno:                   And I’m reading the research on that. So there’s some researchers believe that it still does get into the bloodstream, and it also is in the enteric nervous system, right? So the enteric nervous system is that vast amount of nervous system that surrounds your gut and through vagal nerve stimulation, sends a lot of signals that go to the brain and then affect what goes on in the brain in terms of production of neurotransmitters and even inflammation.  So there’s seems to be a relationship between the production in the gut and the production in the brain, even though you’re right, directly… I remember when I first learned about most of your serotonin is produced in your gut and that’s what changes mood. And then as I learned more about it, I did learn, “Oh, no, it actually doesn’t get to your brain though. So how does it affect it?” But we think it’s through those other pathways, that it’s not maybe a direct relationship, but it does have an influence, a pretty strong influence.

Dr. Weitz:                            And it turns out there’s a huge amount of serotonin receptors in the small intestine. And in fact, stimulating those serotonin receptors actually helps improve gut motility. And so interestingly, patients with IBS for years were, because nobody really understood about CBO-

Dr. Bongiorno:                   Right.

Dr. Weitz:                          So IBS was seen as a psychological disorder, so patients were put on antidepressants and it turned out that the antidepressants actually did have some benefit by stimulating the serotonin receptors in the small intestine and helping patients overcome constipation and stimulate motility.

Dr. Bongiorno:                   That’s right. Yeah. I think it was actually in the thirties or the forties, I’m blanking on it. It was a female researcher that had published some studies on how the clam clench down and keep that muscles so strong, day in, day out. And what she found was basically what led researchers to what they called enteramine, which is serotonin. So entero stands for gut, right? And they found that entermine in the gut was what helped change motility in the gut. And they later renamed it serotonin and they found that it also happened to be in the brain and that it was a part of mood, but for a long, long time, the thinking was that serotonin’s main job was working in the gut for motility. Yeah, exactly.

Dr. Weitz:                          What about the importance of iron, for example?

Dr. Bongiorno:                   Yeah, so iron, I remember when I was a student, so this must have been about 24, 25 years ago. One of the very first patients I saw was this woman with depression. And I was talking to her after her visit because she was very, very happy, and I wanted to find out what the clinicians do for her. You know, I was a young, secondary clinician just learning for the first time. And she said, “Oh,” she goes, “Well, I was on antidepressants for many, many years. And the head clinician there had run an iron panel and looked at her serum iron, looked at her Ferritin, which is iron storage, and found her iron storage to be very, very low and her serum iron to be very low. And they gave her some iron, and no one had ever really looked at it, they gave her iron and within a month, she was off her antidepressant after being on them for years.

Dr. Weitz:                            Wow.

Dr. Bongiorno:                   And that was the first time I had ever heard that there’s an association between iron levels and mood. And of course, it may makes perfect sense, right? Cause iron is the center molecule of hemoglobin and hemoglobin is the molecule in your blood that you use to carry oxygen. So of course, if you can’t carry oxygen adequately, your body and your brain is going to kind of shut you down and say, “Okay, well, let’s lower that mood. Let’s shut that person down. So that this way, they’re not going to want to use as much oxygen.” So there’s much higher rates of depression when iron levels are low, and anxiety as well.

Dr. Weitz:                          Now you just mentioned somebody who was on antidepressants for a long period of time and got off. And that’s one of the issues with these drugs, is the difficulty of getting off of them once you’ve been on them.

Dr. Bongiorno:                   Right. Right. And I think that’s twofold, one is because when you’re on the drugs for a long time, the receptors for that particular neurotransmitter, they down regulate because your body knows there’s too much around than it would be doing on its own. So it down regulates some of the effects. So, that’s one issue. The other issue is that it does deplete a lot of the precursor molecules that you need to make the neurotransmitters. And that’s another issue.  And that’s why these drugs, and this is actually a medical term, they call it poop out syndrome. And that’s why these drugs are known to have poop out syndrome, meaning that they work for a while, and then they tend to stop working. And if you don’t fix the underlying reason why the neurotransmitters are off, maybe it’s iron, maybe it’s low vitamin D, low vitamin B6, not enough sleep, all these other issues, it’s very hard for people to get off these drugs because we haven’t fixed the underlying issues. When I have a patient come in and they’re taking medications, especially if they’re not having side effects, then the first thing we don’t want to do is just take them off medication, because they’re probably going to feel even worse than they already do. So what we want to do is, is leave them where they are and start working on the underlying issues and get those as well as we can, get them feeling a hundred percent with the medications they’re taking. And then we can start to have the conversation about how to healthily and slowly wean off the medication.

Dr. Weitz:                          And then what are some of the strategies for that?

Dr. Bongiorno:                   Well, let me preface it by saying, anyone listening should definitely not do this on your own and make sure you work with a practitioner who’s very knowledgeable and certainly don’t just get off any kind of antidepressant or mood stabilizing medications, just blankly get off them because that’s generally not safe. So having said that, like I said, the first step is to really work on all the underlying issues, making sure sleep, exercise, stress, maybe going to therapy, doing some kind of relaxation work, changing the foods, and then doing a fair amount of testing. We want to find out what’s going on with iron, red blood cells, B12, vitamin D, B6, inflammatory markers, histamine. I like to look at hormone levels as well, melatonin levels, glutathione levels.  There’s so many things to look at and what I’ll find is that many of them will be just fine, but that there’s going to be a number of factors that are out of balance. So then we want to start working on those things, and that’s where we can use maybe a different approach with foods, especially if there’s food sensitivities. We want to heal the gut, lower the inflammation, maybe put people on amino acids to start supporting some of the neurotransmitters, put people on a blood sugar supportive nutrients to help stabilize blood sugar, whatever I think the underlying issues are. I do a lot of gut and stool testing, and if the microbiota are really out of whack or if there’s a lot of candida and yeast issues, we may want to work on those things.

Dr. Weitz:                          What are your favorite gut and stool tests?

Dr. Bongiorno:                   I’ve been using GI-MAP tests lately. I think that’s a good test. I think there’s a number of them out there. I think the Genova testing seems to be very good as well. Vibrant America has good testing.

Dr. Weitz:                          Yep.

Dr. Bongiorno:                   Yeah. And so looking at all the testing, trying to adjust the factors that we find that are out of balance, and then once people are on that plan and they’re doing better and better and better, then we can start to have the conversation about how do we wean off the medication? Is this a good time? We’re going into December here in New York, it’s pretty dark. It’s getting pretty dark here in New York and serotonin levels are at their lowest. So maybe right now isn’t the best time to start thinking about getting off SSRIs, if we don’t need to. If there’s a need, then certainly we can. But maybe if we can wait till the spring, that’d be good. So, so seasonality might play a role there too.

Dr. Weitz:                            Maybe you could explain how seasonality affects serotonin and mood?

Dr. Bongiorno:                   Yeah. So generally as the days get shorter and darker, serotonin naturally goes down. I think, as animals, we’re designed to hibernate. We’re designed to go to bed earlier and sleep longer. And that’s the interesting thing about the holidays, right? The holidays put us into needing to be more outgoing and more active than ever at a time when our bodies are looking to be the least outgoing and the least active. So, you combine low serotonin and the stressors of needing to do all those things, and you end up with rates of suicide and depression that are much higher during those times of the year than other times.  And then as the light becomes longer during the day and the light gets brighter and light gets more direct in the summer, that also stimulates higher serotonin levels. So generally people will have much higher serotonin levels in the summer than in the winter. That’s one of the reasons why light boxes can be very helpful in supporting people. And I have many of my patients that I’ll send little reminder calls in August saying, “Hey, make sure your light box works, because we’re going to want to start using that in a couple of weeks.”

Dr. Weitz:                            And so circadian rhythm, it has a lot to do with cortisol and melatonin. And can you talk a little bit about that? And do you ever do the salivary cortisol testing to take a look at that?

Dr. Bongiorno:                   Yes. Yeah, I do either salivary or urine tests to look at cortisol levels throughout the day. And in many patients who are depressed, they might have very high cortisol levels or they might have very low cortisol level, or actually the levels might just be very dysregulated where maybe they’re very low in the morning and very high at night. So you’ll have these people who can’t get out of bed in the morning and then they’re tired and wired at night and they can’t sleep at night.

Dr. Weitz:                            Right.

Dr. Bongiorno:                   And the whole idea of circadian rhythm is very important to mood disorder and getting people in balance with nature and in balance with the day is a great idea. It’s interesting because right now it’s ten after ten here in New York and I have this bright light over here right next to me that’s on. What a disaster for melatonin levels, talking about my circadian rhythm.

Dr. Weitz:                            Absolutely.

Dr. Bongiorno:                   But so that’s not a really great decision on my part, right? To have a bright light in the evening when I should be really winding down and having just maybe these amber lights or orange lights on, telling my body, “This is the time to go to bed.”

Dr. Weitz:                            Right.

Dr. Bongiorno:                   So one night it’s okay to do that. But if you do that many nights-

Dr. Weitz:                            Right.

Dr. Bongiorno:                   …then you start to set a poor circadian pattern and then maybe add eating late, right? Cause eating also stimulates cortisol. So, it’s funny, I got a dog for the first time about three years ago, and I never had a dog before and I brought it to a vet and the vet said, “It’s really important for the dog, that you feed the dog the same time every day. And that you take the dog out to poop the same time every day, because that’s going to make it feel confident. That’s going to make it feel safe. And it’s going to keep its system calm.”

And I thought to myself, “Gosh, that’s exactly the same with us human patients,” right? Us humans need a regular circadian rhythm, when we eat, when we go to the bathroom, when we get up in the morning, when we go to bed at night, when we shut the lights. All of those things, not only are good for general overall health, but they’re really important for our mental health.

Dr. Weitz:                          Now is the quality of sleep equally as important as the amount of sleep?

Dr. Bongiorno:                   Well, both are certainly important. The amount of sleep is going to vary depending on person to person. Generally most people do need, I think a good seven and a half to eight hours. And I think that’s been shown. It’s also been shown that people who get a lot less sleep or people who get a lot more sleep, tend to have more anxiety and depression as well. So there does seem to be a sweet spot, for most people, around seven and a half to eight hours.

Dr. Weitz:                          And somebody asks, what light box do you recommend and how do you suggest they use it?

Dr. Bongiorno:                   Oh gosh. I don’t remember the exact name of the light box. I usually send people links to it. And to tell you the truth, I don’t remember. I could tell you though, in general, I recommend a 10,000 lux light box. So lux is L-U-X. So 10,000 lux, which is the intensity at 30 inches. So if you look for a light box, 10,000 lux at 30 inches, or feel free to send me an email and I could send you the links, my emails is peter@drpeterbongiorno.com. What was the next question?

Dr. Weitz:                          Oh, is coffee- Oh, there’s another question for me. Somebody just ask a question, do you see people who are on antidepressants who are more apt to develop seizures?

Dr. Bongiorno:                   Do I see people on antidepressants who are more apt to develop seizures? Well, people who are on Wellbutrin would be a little more apt to develop seizures. That Wellbutrin has been shown to increase seizure rate and sometimes creates first seizures and people have never had seizures before. I don’t know. I haven’t seen that with the other medications.

Dr. Weitz:                          Is coffee good or bad for mood?

Dr. Bongiorno:                   Well, generally it depends on the person, right? So people who are anxious, for the most part, tend to do better with less coffee. It will make them more anxious. And people who are typically anxious who are affected by coffee, usually have a genetic polymorphism that you can even look at to see how well they break down coffee and how long it probably lasts in their system. But the research on depression is fairly clear that people who drink two to four cups of coffee a day will have lower depression rates than people who drink no coffee to maybe one or two cups a day. So depression-.

There’s no coffee to maybe one or two cups a day. So coffee seems to be protective when it comes to depression rates. Although that effect does start to change around seven to eight cups of coffee and actually increases rates of depression and anxiety. So seven to eight cups, that’s a lot of coffee. I don’t recommend that. One to two cups, I mean two to four cups a day for people who are depressed and the research seems to be good. Now having said that, as a naturopath, as a functional medicine practitioner, I also think about somebody’s adrenal glands, because when you drink coffee, it’s sort of like squeezing those adrenal glands a little bit. So you’ll get more norepinephrine, Ativan, you’ll get the brain to make more dopamine. But if people’s adrenals are very, very weak and already depleted and you keep pouring coffee in them, even for depression, that’s actually I think in the long term, might be more problematic.  So I personally with my patients, if I run the adrenal test and I see the cortisol is very, very low and their no epinephrines really, really on the floor, I don’t want to just give them coffee to kind of boost them up. I want to actually them nutrify them and give them things that’ll actually nutrify their adrenal so that they get the natural boost that we’re looking for. So if they’re not very, very depleted and then I think some coffee can help with the depression. That was a long-winded answer.

Dr. Weitz:                           That’s good. No thoughtful. Why does it seem like young people are just epidemic with anxiety in particular and also depression?

Dr. Bongiorno:                   Young people, what ages are you referring to?

Dr. Weitz:                           I’m referring to teenagers, but even young adults.

Dr. Bongiorno:                   Well, I think there’s a couple of reasons. So one is the sleep schedules, I was reading some research about teens and it seems like teens actually have a different circadian rhythm than the rest of us.

Dr. Weitz:                           Really?

Dr. Bongiorno:                   Teens would do better to wake up later and go to sleep a little later. And unfortunately the schedule is really designed to get up really early. So you have a teen who really naturally wants to get up later and they have to get up earlier and then in the evening they don’t want to go to sleep. Because it actually feels too early for them. So a lot of teens are very sleep deprived as a result.

Dr. Weitz:                           Now why would teens be programmed in that way?

Dr. Bongiorno:                   I don’t have the answer for that, but I’ve been doing more work on circadian rhythms and that’s one of the things that I learned and I can’t tell you why, but it’s something developmentally that when we’re younger, the kids tend to go to bed early and get up early. But then when they get a little older in their teen years, they tend to want to go to bed late and then want to sleep late and it’s not just a habit, it’s actual physiology. And then as we get into adulthood, that starts to shift and we start to want to go to bed a little earlier. So unfortunately these teens at these very critical years of growing are especially sleep deprived in general and then even more sleep deprived for their natural circadian rhythm.  So I think that’s one issue.

I think another issue is deplorable nutrition. There’s a number of studies now that show that the much higher rates of impulsivity, much higher rates of anxiety, depression in teens who eat fast food and eat a lot of poor quality foods versus teens who eat better quality food under the same circumstances.  I have a couple slides and some lectures where I talk about that and the really interesting studies that clearly, clearly show that. I also think in my opinion, the screens that we’re using and social media is also playing a strong role. And there’s a fair amount of research that’s showing that. I mean, look at all the stuff going on in the news right now about Facebook, sort of keeping down some research about the effects it does have on teenagers, especially Instagram, when it comes to self worth and looking at themselves and comparing them to somebody else and what the ideal person should look like and act like, and how many likes should they have.  It’s a lot, a lot of pressure. And plus I think just staring at these screens and the blue light that’s coming from them at night is further exacerbating that sleep issue.

Dr. Weitz:                            Do you think the EMFs might also be playing a factor?

Dr. Bongiorno:                   I’m sure that does play a factor. I mean, more and more research is coming out, showing how strong the electromagnetic frequencies are, especially from iPhones which so many teens have. Very little to no protection on the screen the whole time or having it right on their body somewhere most of the day, if not all the day.

Dr. Weitz:                            Right. So let’s go into lab testing. Let’s talk about in detail a little bit, what you think is a good panel to start with for the average person you’re seeing. And I realize everybody’s different and we’re going to focus on different things depending upon the history and-

Dr. Bongiorno:                   It’s tough. I do in my books, I do have a page where I give the panels that I generally like to see, because it is important. I’ll tell patients, or my readers, if it’s a page you can take out of the book or copy and hand it to your doctor and hopefully he or she will be able to run most of those. It is different for everyone. When I think about running labs, I like to look at blood sugar. So hemoglobin A1C, insulin, fasting insulin I think is very important.  Red blood cells, white blood cells, a liver panel, GGT, which can look at can be a surrogate marker for toxicities as well, and a full iron panel as we with ferritin, as we talked about before. A full thyroid panel, including thyroid antibodies, inflammatory markers. So things like erythrocyte sedimentation rate, C-reactive protein, Interleukin-6, especially if there’s depression. Looking at gut markers. Looking at things like fecal calprotectin. If I suspect there’s colitis, looking at celiac panel as well. Amylase and lipase, if I think there’s pancreatic involvement and then looking at vitamins, vitamin D, zinc, the zinc to copper ratio, red blood cell magnesium, vitamin B12, methylmalonic acid, which also looks at B12 in a different way. So there’s so many vitamins. We could go on and on.

Dr. Weitz:                          With the importance of lipids looking at detailed lipid panel.

Dr. Bongiorno:                   So detailed lipid panel, especially if I think there’s a lot of cardiovascular involvement and lipids. Not only to check to see if cholesterol’s high, but oftentimes to see if cholesterol’s too low, especially if people are on statin medications, because cholesterol is the precursor molecule to pregnenolone, which I also check on labs. And pregnenolone is the precursor molecule to all our important, other important steroid molecules. Cortisol through one pathway and progesterone and then DHEA and testosterone and estrogens through another pathway. And so I do worry for so many patients when the cholesterol’s too low, that they’re not going to have the ability to make all of those other hormones that we really need for good mental health.

Dr. Weitz:                          And there’s a big push in cardiology to get the LDL.

Dr. Bongiorno:                   Lower lower lower. 

Dr. Weitz:                          As low as possible.

Dr. Bongiorno:                   Right, because we look at one pathway and one mechanism and we don’t think about everything else.

Dr. Weitz:                          And yet they say there’s no research to show that statins have any negative effect on brain health.

Dr. Bongiorno:                   It doesn’t make sense. And I think what happens is when ideas are new, kind of the pendulum swings one way and then as more and more research comes aboard and we start to see, maybe this isn’t the right way we’re thinking about it. I mean, how many times have we seen this? We’ve seen this when they demonize fats, we see this with the margarine, when margarine was supposed to be so healthy for us. Things like that. And then we kind of go, it’s not really working out as well as it could have.

Dr. Weitz:                          What about the importance of the hormones?

Dr. Bongiorno:                   So hormones are critical to mental health. For example, estrogen levels really play an important role in the levels of serotonin in the brain and where the serotonin is being made in the brain areas that need it. When estrogen levels are high, it changes the amount of monoamine oxidase to help keep serotonin levels high. Progesterone actually does the exact opposite. So that’s why estrogen and progesterone have a nice yin and yang to them because they kind of balance each other. So looking at not only estrogen levels, but the balance of estrogen and progesterone in a woman is very important. Estrogen levels are actually important in men. Men have six times the level of estrogen in the brain that women do. So sometimes when we think about depression and serotonin and we also want to check on estrogen as well.

Dr. Weitz:                            So let’s talk out estrogen levels in men. Is there a number, do you like to see estrogen above 30 or is there a certain number you like to see? And is there any importance of progesterone levels in men?

Dr. Bongiorno:                   Progesterone levels in men there isn’t a whole lot to research on. It’s something I’ve thought about. And I do know when men are supplementing with progesterone, typically it’s not beneficial. That’s what I’ve seen so far, but it’s an interesting question. And I think it needs a lot more explanation and exploration. As far as estrogen levels, the way I think about it is we want to look at levels of cholesterol, pregnenolone, DHEA, then testosterone and then estrogen. And basically that whole pathway to kind of feed each other very nicely up until the estrogens. And if that pathway looks healthy in general, then I think we’re on the right path with men and women.

Dr. Weitz:                            Right. What about if you have a menopausal woman who’s having a tough time with depression and anxiety, do you ever recommend hormone replacement therapy?

Dr. Bongiorno:                   Possibly. I don’t typically like to start with hormone replacement therapy. So first we want to start with, obviously if someone’s really suffering and the hormones are so out of balance and they need something to help them feel better faster, then I would certainly consider hormone replacement. But in general, first we start with all the basics. Sleep, exercise, diet, stress reduction, because those things oftentimes will help. Secondly, we want to support her liver because the liver is what processes the estrogens. And oftentimes when the liver and the microbiome are out of balance, we’re going to see improper levels of estrogen. For example, if there’s beta-glucuronidase levels are out of balance, that’s going to change estrogens and there’s going to be a lot more recirculation of excess estrogens. If there’s a lot of candida, candida acts as false estrogens, so that’s going to change the balance of estrogens.  So we want to fix all of those things. So without even touching hormones, we can oftentimes fix the hormones.

Dr. Weitz:                            By fixing the gut.

Dr. Bongiorno:                   Right, exactly, by fixing the gut. And then making sure a woman is having bowel movements every day to making sure everything is getting out that needs to get out from the liver. And then if those things aren’t enough, then we can test hormones and see where they are and then make a decision about whether we want to tweak hormones a little bit. If pregnenolone is low and all the other hormones are low, then maybe start with a touch of pregnenolone and that can help feed the rest of the pathways. Or if we see that cortisol levels are actually normal or normal high, but the other side of the pathway DHEA is low, then maybe start with DHEA and see if we could feed the pathway.  So I try to feed the pathway earlier so that the body has more ability to make the decisions it needs to make.

Dr. Weitz:                            Right. So you might start with pregnenolone versus estrogen progesterone.

Dr. Bongiorno:                   Possibly. And I did want to say there’s an herb that I might try before either of those, especially if progesterone levels are low related to estrogen and that’s Vitex, also known as chasteberry, which does a beautiful job. There’s studies in premenstrual dysphoric disorder showing it works really well. There’s other studies in perimenopausal depression showing that it worked just as well as SSRIs. Although it does seem that, that the Vitex seems to work better for the physical symptoms along with the depression. Whereas the SSRI, at least in this one study, showed it was better. The SSRI was a little more helpful when it came to the mood symptoms versus the physical symptoms. So oftentimes when I’m using Vitex, I’ll use Vitex along with tryptophan and I find we can get both the mood and the physical symptoms in balance. So Vitex is a brilliant herb. It’s really wonderful.

Dr. Weitz:                            What kind of dosage do you find effective for Vitex and also for tryptophan?

Dr. Bongiorno:                   Sure. So for Vitex, I think it’ll depend on what kind of, if it’s an extract or what kind of preparation it is. Typically, it’s a capsules around 220 milligrams, so I’ll usually start with one or two of those a day and I’ll do it every day. I won’t dose it with the cycle, but I’ll just dose it every day. And then as far as tryptophan goes, if it’s tryptophan, I’ll usually start with 500 milligrams twice a day, and 5-HTP, maybe start with 50 to a 100 milligrams a day.

Dr. Weitz:                            In which do you find more effective, 5-HTP or tryptophan?

Dr. Bongiorno:                   That’s a great question. And it’s interesting because theoretically 5-HTP should work better. It’s a little further down-

Dr. Weitz:                            It’s a little further down downstream. Right.

Dr. Bongiorno:                   It’s a little further down on the pathway. And especially if there’s inflammation, it should be harder for your body to make serotonin from tryptophan than it should be from 5-HTP. But having said that, I find different patients respond differently. Oftentimes I start with tryptophan because I think I find it does work better, although not in every case. And especially for sleep, for helping people stay asleep, I tend to use more tryptophan. So having said that I’m always open because everyone’s different.

Dr. Weitz:                            Dr. Wasserman asks a question about diet and I think what he’s asking is, you mentioned somebody having too many simple carbs, but can a low carb diet also increase problems with anxiety and depression?

Dr. Bongiorno:                   That’s a great question. That’s absolutely true, because we need carbs to help make serotonin as well and a very, very low carb diet and someone who’s susceptible, can send them into anxiety and depression by lowering their serotonin levels. Some people who aren’t that affected, they can go very low carb, do a keto diet and their brain’s doing wonderfully. But you’re absolutely right that we have to be careful, especially people who teeter on depression and suicide. To put them on a low carb diet can actually lower their serotonin levels more and put them more into that mood disorder than they already are. The other thing I’ve seen in relation to that is gluten can also play a role in mood and people who come in depressed are often sensitive to gluten.

Having said that if you take them off gluten, gluten also creates these kind of morphine like compounds in the body and they affect the brain. And sometimes if you put people on a gluten-free diet very quickly, it’s almost like some taking somebody off of morphine and when they go through withdrawal, their symptoms will actually be even worse. So I do find if people are depressed or they have pretty significant mood disorder and we decide to take them off gluten, I do it slowly. I don’t have them come off of gluten right away all at once. I have them do it slow and I treat it like any other drug that they might be addicted to because I know we’re going to have withdrawal symptoms as well.

Dr. Weitz:                            Interesting. Interesting. That’s a good clinical pearl right there. I’m mean there’s been tons of clinical pearls tonight already. So let’s go into the most effective supplements for depression and anxiety. And I know you’ve mentioned a number of them already, but let’s start with fatty acids.

Dr. Bongiorno:                   So essential fatty acids. I think fish oil by themselves I don’t think can cure depression or anxiety in most cases, unless people are just so genuinely deficient in them, which a lot of us are. There’s a study that came out last August in one of the psychiatry journals showing that patients who are treatment resistant to SSRIs tended to do much better when they took fish oils. And now that also made me think, well maybe you could have just gave them the fish oils and didn’t even need this SSRIs. I mean certainly, essential fats play such a strong role in creating healthy membranes and healthy membranes in the nervous system are going to play such a strong role, an important role in mental health. So to me, fish oil is one of the basics.  When a patient comes in for a first visit, I had a young woman who came in today with anxiety, she doesn’t prefer fish. She doesn’t like to eat fish and we’re going to run some tests and do some of the things that we talked about. But I already put her on fish oil, unless I know a person’s allergic to fish, if they’re not really eating any fish and they’re not taking any fish oil, that’s an easy one to have them start taking some fish oil. Because I know in the long term that’s going to help.

Dr. Weitz:                            What do you think about SPMs, which are those derivatives from fish oil that help to reduce inflammation?

Dr. Bongiorno:                   Oh, those are resolvents? Is that the same as resolvent?

Dr. Weitz:                            Right. Exactly.

Dr. Bongiorno:                   That is a lot of intriguing information about that and my understanding is, and I haven’t used them a lot, so I don’t have firsthand experience with them yet. I just actually started bringing them into the practice. And I’m going to be taking them myself because I like to try everything first. But my understanding is not only does it help with inflammation, it also helps with the healing process as well, which I think is amazing. I’ve been reading the literature on them and I think there’s some substantial information then I could see why a number of companies have been working on bringing those out.

Dr. Weitz:                            GLA?

Dr. Bongiorno:                   GLA. Yes, so I talk about in my books, the importance of GLA, especially in production across the glandins, those are all also feel good molecules that our body naturally makes. And there’s a number of studies in people who are alcoholics. Alcoholics generally drink alcohol because it increases levels of PG2, which helps them temporarily feel happier and giving people GLA can be an important part of helping the body make its own prostaglandins and helping mood as well. So for example, when I see patients who have a strong alcoholic intake and that’s one of their drugs of choice to feel happier temporarily, I will start them on GLA.

Dr. Weitz:                          I think GLA is an interesting example of not throwing the baby out with the bath water. It’s been so much focus on Omega-3’s and the fact that Omega-6’s are too high. So we got to get the Omega-6’s low and I’ve talked to doctors who said why would you ever prescribe an Omega-6? And of course, GLA and evening primrose oil, these are Omega-6’s but they have important benefits too.

Dr. Bongiorno:                   In fact, typically the ratio of Omega-6 to Omega-3 should be three or four or greater something like that. So a healthy diet does have more Omega-6’s in the diet than Omega-3’s. I think so many of us are so deficient in Omega-3.

Dr. Weitz:                          There’s some debate as to what the ideal is. Some labs say under four. I know some people say it should be under two. There’s discussions of the cave men were really one to one.

Dr. Bongiorno:                   It’s funny. I’m scrolling right now. I’m reviewing a book for a friend of mine, who is putting out a book, a medical doctor’s putting out a book on skin health.  Was putting out a book, medical doctor was putting out a book on skin health, and I was just reading the section on omega sixes omega 3 and he put out the latest research. Dr. Mark Tager, I don’t know if you know him, wonderful guy. And he’s got a book coming out on skin health and yeah, I don’t know if I can find it offhand. But I was just reading that on the train coming back, looking, reviewing his book, so.

Dr. Weitz:                          Okay. So what about probiotics?

Dr. Bongiorno:                   So probiotics, it’s again, the first step to a healthy gut is certainly reducing stress, getting enough sleep, exercising, eating the right foods, eating enough fiber. Right? So probiotics by themselves can be helpful, especially when therapeutically if there’s diarrhea, if there’s high levels of a C difficile, for example, using individual probiotics can be useful for balancing things, but overall to really create a healthy microbiome, we want to do all those other basics first.

Dr. Weitz:                           Now you know of course there’s probiotics on the market that are marketed as specifically being beneficial for depression and anxiety.

Dr. Bongiorno:                   Right. Yeah, and there are a couple of studies. And I remember when those first ones came out, there was a company that came out with a line and there was one study. And I tell you, I mean, the research on the microbiome, the microbiota and probiotics have just exploded in the past couple years. So, yeah, I think there’s more and more coming out about that. I mean, and now there’s studies that in animals, if you take an animal who’s depressed and you do a fecal transplant from an animal who’s not depressed, that you can actually lift their mood and their depression.

So there’s definitely something there. There’s no question about it. Whether we can get all the strains into a capsule that we can take in and actually help repopulate, I think that still remains to be seen. But if we can get some of the Keystone strains in there and get the right fibers and again, work on people’s stress and all the other basic factors, I think, yeah, I think it does make a difference. And I certainly use probiotics as part of the regimen when I work with my patients.

Dr. Weitz:                           And some of the keystone species are starting to become available. I interviewed researcher company, Pendulum Therapeutics has, I think it’s the first anaerobic Akkermansia.

Dr. Bongiorno:                   Yeah, I saw that. Yeah. And that’s interesting to me. And again, is giving an individual one like that the most beneficial, maybe. I think of the microbiota as kind of like a garden in there. And so we have tomato plants and we have zucchini and we have peppers and maybe some cucumbers on the bottom. And then, we have the weeds, maybe the ones we don’t want in there too great a level. And some of those we can put in a capsule and give to people, and some of them we just can’t. Right. So we have to do it through fermented foods and we have to do it through just making sure people getting.

Dr. Weitz:                           Fiber and probiotics.

Dr. Bongiorno:                   Yeah. Right. So there’s so much we need to learn, but I think it’s really fascinating. And I’m interested.

Dr. Weitz:                           How about the importance of B vitamins, including folic acid?

Dr. Bongiorno:                   Yeah. So B vitamins, especially for mitochondrial function, for producing energy in the body, for methylation which we nee to make neurotransmitters, which we need to break down neuro transmitters, and break down hormones properly. So we need those B vitamins and in different levels. And they’re certainly worth checking as well. And if I know somebody’s very, very stressed out, it’s usually a safe bet to put them on a low dose B complex at least start because you know they’re burning through those B vitamins.

Dr. Weitz:                           I remember there being some research on folic acid maybe helping patients with schizophrenia. By the way, have you found it effective to use a functional medicine approach for patients with schizophrenia?

Dr. Bongiorno:                   Yeah. I mean, absolutely. Probably even more so because in conventional care, schizophrenia is really about just lowering levels of neurotransmitters. Right. So if we could understand what are the blockages of why maybe people aren’t breaking those things down in their own brain and using that information then yeah, absolutely. So the first step is, again, all of the basics. There’s research now in schizophrenia is also showing a lot of mitochondrial dysfunction. A lot of psychotic mental health disorders may have to do with the mitochondrial dysfunction. So that’s certainly a place I think about when I think about working with patients who have schizophrenia.

Dr. Weitz:                           And what are your first thoughts about trying to improve the mitochondria?

Dr. Bongiorno:                   I guess I want to first think about, well, why is their function impaired? Right. So we think it could be toxicity, it could be heavy metals, could be too much iron in their body. It could be very high insulin levels due to high blood sugar. It could be high adrenaline, high, norepinephrine and epinephrine levels due to stress. There’s a number of reasons why mitochondrial dysfunction can start. Too much inflammation in the body can certainly contribute as well. So we want to look at all of those factors and key in on which one of those are probably most likely for that particular person.

There can be genetic influences too. Although and so when I think about people who have had mental health concerns since they were very, very young, like 3, 4, 5 years old, then I think, well, maybe it’s more of a genetic component in terms of mitochondrial function. Not that we can’t help them, but that it’s probably less environmental and more genetic. But if it’s people who the mental health concerns started happening in their late teens and certainly in adulthood, then I think about it more as a secondary mitochondrial function, based on those other factors.

Dr. Weitz:                           What kind of testing for heavy metals and/or other environmental toxins have you found helpful?

Dr. Bongiorno:                   Well, I mean, the first place to start is a blood test to look for things like mercury and cadmium and arsenic and lead and aluminum and things like that. And the problem with blood tests is that you’re not really seeing what’s going on with body burden. But you are seeing what’s going on acutely. So if you find high levels acutely, then you know you have to start working on that. And then you could do urine tests, provocated urine tests to try to find out what really the body burden is after that.

Dr. Weitz:                           For years, I know we used to use the DMSA and do provocation testing, and now that that’s prescription only, it’s a pain. Is there a workaround? Have you found anything? Can you use glutathione or anything like that?

Dr. Bongiorno:                   I mean, I really, haven’t. Not something I think I know would be really reliable. So I’d be interested if anyone listening has, but I haven’t. Yeah, no, still DMSA, that seems to be the DMPS seems to be the best way to go.

Dr. Weitz:                           Right.

Dr. Bongiorno:                   Yeah, it was nice when the supplement companies had them. Right. We just used it. Check kidney function first. If that’s okay then do a provocated urine.

Dr. Weitz:                           Right.

Dr. Bongiorno:                   Right. They’re making it harder and harder.

Dr. Weitz:                           Importance of vitamin D.

Dr. Bongiorno:                   Yeah. So vitamin D has so many pleiotropic effects in the body. It’s needed for serotonin production, certainly. So when vitamin D levels are lower, it’s going to be harder for the body to make serotonin and other neurotransmitters. And then it’s very important in how we balance inflammation in the body. So that’s another point. It’s a neuro steroid. So the neuro steroids pregnenolone, DHEA, and vitamin D, when any or all of those are low, there’s some really fascinating research that shows the communication between the amygdala, which is the fear center of the brain and the prefrontal cortex change significantly and creates a lot more likelihood of anxiety and depression. So when neuro steroid levels are high enough like vitamin D should be, then there’s going to be a less likelihood of things like anxiety.

Dr. Weitz:                           Minerals, like magnesium, zinc, lithium?

Dr. Bongiorno:                   Yeah. I’m for them. I’m for all of them. So yeah, some magnesium is very relaxing. It’s important. Has so many levels of importance, if I had to pick one in terms of what we’re talking about, GABA levels in the brain. It helps with the benzodiazepine receptors. Zinc, the zinc to copper ratio, looking at zinc levels as a co-factor for so many different reactions in the body, certainly for gut health as well. And then, oh, you mentioned lithium, nutritional lithium.

Dr. Weitz:                           Right.

Dr. Bongiorno:                   Actually I just wrote a paper on nutritional lithium that was published in the Natural Medicine Journal. I’d be happy to send it to anybody.

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

Dr. Bongiorno:                   If anybody would like a copy of it. And also anyone listening, please do join me on Facebook and Twitter and Instagram as well.  And if you want to be on my newsletter, feel free to send me a note. I’m putting out a mental health newsletter, so I’d be happy to send it out. Won’t be selling you anything, just purely research as I read it, things that I’m excited about, I like to send to my friends.

Dr. Weitz:                            That’s great.

Dr. Bongiorno:                   Yeah. So nutritional lithium, I found very, very helpful in my practice. I’ve probably been using it for about eight years now, nine years. And it’s great for teens with impulsivity, even younger kids in the five to 10 age group, it can really be helpful for anxiety in drop doses. Very supportive of the brain. Now there’s even research showing it may be protective for Alzheimer’s later on. So I do use a fair amount of it with patients, and I’m finding good results.

Dr. Weitz:                            So this is the lithium orotate, right?

Dr. Bongiorno:                   Lithium orotate. Yep.

Dr. Weitz:                            And what kind of dosage do you find effective?

Dr. Bongiorno:                   I usually start with five milligrams for an adult, maybe one milligram for child. Yeah. Up to 20 milligrams a day in an adult.

Dr. Weitz:                            What about GABA?

Dr. Bongiorno:                   GABA the supplement?

Dr. Weitz:                            Yeah.

Dr. Bongiorno:                   Yeah. No, GABA can also be helpful. Some people theorize that GABA is only useful if you have a leaky gut and a leaky brain, because it’s very difficult to get into the brain. And, I haven’t seen enough leaky gut patients versus non leaky gut patients that I’ve tested to know for sure whether that’s true. My theory is if you give enough, hopefully some of it will get through. So usually at least 500 to 1000 milligrams, two or three times a day. So if I’m using GABA I tend to dose it high. I find low doses don’t typically do a whole lot by itself. I’ll often give it with theanine and maybe with something like lithium orotate or a CBD oil. So usually I’m using a few things together. But I do find, especially for patients who are very susceptible to the side effects of benzodiazepines, you really want to think about using other gentler things like GABA. And oftentimes you can even find a better result because it’ll help calm people down, but you won’t have the side effects.

Dr. Weitz:                            And there’s a few different forms of GABA on the market. I know there’s GABA chewables. There’s GABA that supposedly is better absorbed.

Dr. Bongiorno:                   Yeah. I’ve been using liposomal GABA, the kind that you can kind of spray.

Dr. Weitz:                            Okay.

Dr. Bongiorno:                   And I’ve been finding good results with that. I’ve heard chewables can be useful too. I haven’t used them but I guess it’d be the same effect, right. Using a chewable, you’re kind of getting it into the oral cavity and getting absorbed through there. So that would make sense to me.

Dr. Weitz:                            I guess, yeah, theoretically, if you kept it under your tongue, and let it dissolve there. What about any of the other herbs? And then I think we’re going to wrap it up in a couple of minutes.

Dr. Bongiorno:                   Okay. Yeah, other herbs, I mean, I know it sounds cliche at this point, but St. John’s Wort is a very good herb for mood, especially for do you know?depression. And it does work for anxiety.

Dr. Weitz:                            Why has it been given an almost a bad name, do you know?

Dr. Bongiorno:                   I think because it’s known to affect the liver and its ability to process other drugs. So I’ve done some formulations for companies, and I have one formulation to support neurotransmitters and for depression. And I purposely didn’t put St John’s Wart in it because I know it won’t be used. So when I use it in my practice, I actually use St. John’s Wort separately with it, because it does affect a lot of drugs more than others. So I think a lot of practitioners tend to stay away from it. I had one patient who came in, she took St John’s Wort while on birth control. And she got pregnant because it stopped. So there is a reason. It turned out she had twins and was very happy about that in the end so it worked out great.

Dr. Weitz:                            So St Johns Wort makes it easy to get pregnant.

Dr. Bongiorno:                   But I like St John’s Wort, especially now in the time of COVID, because also, it’s a good antiviral. It has anti-inflammatory effects plus it’s really great for mood. It’s a beautiful herb.

Dr. Weitz:                            And you mentioned using lavender. You also listed rhodiola saffron in your book.

Dr. Bongiorno:                   Yeah. So saffron, especially when there’s a lot of digestive issues. I have another formulation that I put together, and it has chromium, saffron, turmeric, berberine in it, and a little bit of rhodiola. And the idea of that is to kind of address blood sugar, gut inflammation, hypothalamic pituitary, adrenal access. And the berberine to kind to help promote neurotransmitters in a healthy way as well as helping the gut.

Dr. Weitz:                            So how does berberine promote neurotransmitters?

Dr. Bongiorno:                   So berberine, it’s not something that’s well discussed, but berberine actually binds to Sigma one receptors which help this pathway of chaperone proteins. It’s also helped neurotransmitter production in the brain too. So it is known to help.

Dr. Weitz:                            Berberine is an incredible herb.

Dr. Bongiorno:                   I mean, yeah. Cholesterol, blood sugar. Yeah, gut health.

Dr. Weitz:                            I mean, it’s a natural form of Metformin, so I use it for antiaging purposes as well.

Dr. Bongiorno:                   Yeah. I remember learning about it in school again, 25 years ago. And the only thing I remember learning about it was that it was a good natural antibiotic and kind of helped the gut heal at the same time. Yes. And now it’s just so much more. It’s great.

Dr. Weitz:                            And probably the other wonder nutrient is NAC which you mentioned in your book and seems to be beneficial for almost everything.

Dr. Bongiorno:                   Yeah. And NAC is so good that Amazon has taken it off their website. That’s how good it is.

Dr. Weitz:                            So, well…

Dr. Bongiorno:                   It tells you it’s pushing some buttons. Right?

Dr. Weitz:                            Well, I think the reason they did it is because when it was first approved, it was approved as a drug.

Dr. Bongiorno:                   Right.

Dr. Weitz:                            So hopefully the FDA’s not going to take it off the market. I mean, even though Amazon… To be honest with you, if Amazon said they were going to take all the supplements off of Amazon, I’d be quite happy.

Dr. Bongiorno:                   That’s fine with me. Yeah.

Steve Snyder:                    Can I just pipe in on that for a second on the NAC thing. We think it’s not a thing. We are not stopping making it. We will continue to make it.

Dr. Bongiorno:                   Great.

Steve Snyder:                    There was one study, like in the early sixties that they’re trying to say is the reason that they think it might be a drug. But they haven’t changed any regulations or any classifications or anything like that. It was just a bunch of warning letters last fall. Amazon, because they’re a forward facing, a retail facing company, that’s why they did it. And then Whole Foods Market is owned by Amazon so they did it. And then Thorne is kind of the supplement company that got caught up in it because they pretty much only do Amazon now. So that’s where it kind of the ball got rolling, but it’s another one of those mostly it’s an internet thing. And we are selling it like crazy. We can’t literally can’t make it fast enough, something to the tune of about 5,000 bottles a month.

Dr. Bongiorno:                   Wow.

Steve Snyder:                    So yeah. But it’s not going away. We were not worried about it at all. And we have a great one. It’s super inexpensive, 600 milligrams per cap. Check it out.

Dr. Bongiorno:                   Hmm, great.

Dr. Weitz:                          Maybe come up with a strategy to get Amazon to take more supplements off their website.

Dr. Bongiorno:                   I just wanted to say Steve, I really love the cortisol manager. I find it also works quite, quite well for my patients. And cortisol levels are high and something I’ve been using for a number of years is really good success too.

Steve Snyder:                    Thank you. It’s by far our biggest selling product. It also happens to be natural partners, biggest selling product and probably Emerson too. So it’s definitely our flagship for sure.

Dr. Weitz:                            And you guys also have a brain product that has saffron in it.

Steve Snyder:                    Yeah. So that one’s pretty new. It’s called Neurologix. I don’t know if you’ve seen it yet, but it’s a combination of spearmint, saffron, and and a branded citicoline. So it’s a pretty big anti-inflammatory part. The spearmint and Citicoline part work functionally and structurally, but the saffron is kind of an added thing because we feel like the mood is part of all of that. And individual ingredients have been shown to like it’s working memory, sustained attention, focus, some pretty impressive studies on this stuff. So it’s not cheap, because it’s one of the ones that doesn’t have caffeine in it. So it’s not a stimulant, but i blows people’s doors off. And that’s another one we have seven day trial bottles of, and people will notice it after seven days. And we are happy to let them try it because we know it works so, Neurologix.

Dr. Weitz:                            Okay. Thanks, Steve.

Steve Snyder:                    Yep.

Dr. Weitz:                            So Peter, this has been incredible. You’ve provided us with so much great information. Any closing thoughts?

Dr. Bongiorno:                   Yeah. I mean, to the clinicians out there, when you have a patient who, especially if it’s a challenging patient, always double down on the basics. Make sure that those are all taken care of. And just really look for the other underlying factors that maybe you haven’t looked into yet because there’s some reason why a person is feeling the way they’re feeling. And it’s really up to us as clinicians to kind of look at all those factors and really put it together because there’s practically always a way to help to get people to feel better. If not get them off medications, at least get the medication doses lowered which often could be a win, especially in things like bipolar. You’re creating so much less toxicity in the body.  And to any listeners there in the public who are suffering from anxiety, depression, mental health, just know that there’s still a lot of tools out there, and find a practitioner who just really cares and is listening and wants to look into those underlying factors because there’s always something else that can be done. And just don’t give up hope, and don’t give up thinking that you can feel better and feel like your best self.

Dr. Weitz:                            Thank you.

Dr. Bongiorno:                   Yeah. Thank you. Thank you so much for what you do and bringing these forums to people.

Dr. Weitz:                            Great. Thank you. And we’ll see everybody in the new year.

 


 

Dr. Weitz:  Thank you for making it all the way through this episode of the Rational Wellness podcast. And if you enjoyed this podcast, please go to Apple podcast and give us a five star ratings and review. That way more people will be able to find this Rational Wellness podcast when they’re searching for health podcasts. And I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica Weitz Sports Chiropractic and Nutrition Clinic. So if you’re interested, please call my office 310-395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you and see you next week.