Dr. John Lewis discusses The Benefits of Polysaccharides with Dr. Ben Weitz.

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Podcast Highlights

13:26  Polysaccharides.  Polysaccharides are complex sugars and some of them have unique health promoting properties, including those that come from aloe vera and from rice bran.  Aloe vera is 99% water, so you have to extract the polysaccharides out of the aloe vera plant and this acetylated polymannose has amazing properties.

20:25  Polymannose.  Dr. Lewis met Dr. Reg McDaniel who had been working on the aloe plant since the 1980s at the Texas A & M vet school, who is still doing research at 87 years of age.  Dr. McDaniel shared studies that these aloe derived polysaccharides were anti-inflammatory, antioxidant, antiproliferative, and have wound healing benefits.  He found that in addition to the wound healing and stem cell production boosting function of aloe vera, this polymannose is a key sugar when the endoplasmic reticulum and the Golgi of the cell are communicating with each other and making other bioactive compounds that you need.  This polymannose is similar to d-mannose, which is often recommended as part of a protocol along with L-carnitine and CoQ10 for supporting the heart muscle in patients with congestive heart failure, though Dr. Lewis’s research was more focused on brain health.

25:51  Aloe polymannose multinutrient complex.  In their study on the polysaccharides for Alzheimer’s patients, Dr. Lewis and colleagues used an aloe polymannose multinutrient complex, including aloe polymannose, rice bran, larch tree, cysteine, lecithin, tart cherry, inositol hexaphosphate, yam, flax seed, citric acid, and glucosamine.  They gave the patients this nutritional supplement four times per day in a powdered form that put into a liquid to drink. For the Alzheimer’s study, they took patients with moderate to severe disease, which means the sickest of the sick and this group is the hardest to see improvements with.  The neuropsychological testing showed a significant improvement at nine and twelve months.

35:06  Alzheimer’s study lab results. The lab results showed statistically significant reductions in VEGF and TNF alpha.  There was an improvement in CD4 to CD8 ratio, which obviously is very important for all of us.  They also showed an improvement of just under 300% in CD14 cells, which is a marker of adult stem cells.  And the average age of these patients were 79.9 years of age.  They theorized that these adult stem cells migrated to the brain and created new neurons, new synapses, and repaired damage to neurons.  Also BDNF levels went up by 11%, though this was not considered to be statistically significant.  They did not ask these Alzheimer’s patients to change their diet or to exercise or do anything else to improve their lifestyles.  We can only imagine how much more benefit might have been derived if this nutritional intervention were used as part of a Functional Medicine approach that also put them on a healthy diet and had them perform vigorous exercise and do brain stimulating exercises as well, such as the approach used by Dr. Dale Bredesen. [The Effect of an Aloe Polymannose Multinutrient Complex on Cognitive and Immune Functioning in Alzheimer’s Disease.]

44:45  MS study. These patients with relapsing remitting MS were placed on a similar aloe polymannose multinutrient complex four times per day for 12 months.  The FAMS (Functional Assessment for MS) questionaire was used for functional assessment and results showed very significant improvements in every scale.  MS patients frequently get infections and these patients who took the nutritional intervention had much fewer infections.  Serum biomarkers, quality of life, symptom severity, and functioning also improved. [The Effect of a Polysaccharide-Based Multinutrient Dietary Supplementation Regimen on Infections and Immune Functioning in Multiple Sclerosis]  and  [The Effect of Broad-Spectrum Dietary Supplementation on Quality of Life, Symptom Severity, and Functioning in Multiple Sclerosis]                            



Dr. John Lewis is the founder and President of Dr. Lewis Nutrition and the website is DrLewisNutrition.com. Dr. Lewis was a professor of Psychiatry and Behavioral Sciences at the University of Miami School of Medicine and he was the principal investigator of over 30 different studies in his research career.  Much of his research has focused on the effects of nutrition, dietary supplementation, exercise, and medical devices on various aspects of human health and disease.  One study that he was involved with that we will discuss is The Effect of an Aloe Polymannose Multinutrient Complex on Cognitive and Immune Functioning in Alzheimer’s Disease.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their 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. Our topic for today is the benefits of polysaccharides with Dr. John Lewis. We have discussed many topics in nutrition, especially as related to brain health. And typically, part of the discussion is usually about reducing carbohydrate intake to improve insulin resistance, getting the brain to work off of ketones, et cetera. We’ve recently had discussions with Dr. Dale Bredesen, Dr. Heather Sandison, and Dr. Kabran Chapek, all of whom advocated for some version of a low-carb or ketogenic diet for most patients with cognitive challenges like Alzheimer’s disease or after concussions. Now we have Dr. Lewis to advocate for polysaccharides or carbohydrates for brain health, the lowly carbohydrate, the much maligned carbohydrate in the world of nutrition.

                                Dr. John Lewis is the Founder and President of Dr. Lewis Nutrition. He was a professor of psychiatry and behavioral sciences at the University of Miami School of Medicine. He was a principal investigator of over 30 different studies in his research career. Much of his research has focused on the effects of nutrition, dietary supplementation, exercise, and medical devices on various aspects of human health and disease. One study that he was involved with that we will look at is the effect of an aloe polymannose multi nutrient complex on cognitive and immune functioning in Alzheimer’s disease. Dr. Lewis, thanks for joining us.

Dr. Lewis:            Thank you for having me. It’s a pleasure to be here, and I’m happy to follow such distinguished guests that you recently had.

Dr. Weitz:            So how did you become interested in health, nutrition, and dietary nutritional supplementation?

Dr. Lewis:            Well, like a lot of people, I think I was lucky. I started out at a very early age, my grandfather pitching baseball to me out in the backyard and getting me on a track of playing sports most of my youth. And then after high school, getting into drug-free competitive bodybuilding. It was kind of just a natural progression for me, continuing to be active, obviously in a much different fashion as opposed to playing team sports. But then, at that point, I kind of got, I would say, very interested in how nutrition, exercise, stress, how all of that affects the body, affects everything from our individual cells all the way up to who we are as a human. And so I sort of went from there. It’s been a long evolution, a long progression, but excuse me, in my twenties, I shifted out of more of an interest in performance and sports, there’s nothing wrong with that, of course, but into more of a health orientation.

                                And I felt like for people who are gifted with the opportunity to play competitive sports at a very high level, obviously that’s a very, very tiny percentage of our population, but everyone’s affected by health regardless if you have any sports acumen. So I thought it was much more important to go down that road in my professional career of looking at, as you said, the way nutrition, supplements, different types of exercise, affect health and really many different parameters around health as opposed to performance. I mean, I still lift every day. I’m still very active in my own personal exercise routine, obviously, I’d be a hypocrite if I was not. But as far as all of my interests go, I’m going to continue the rest of my life looking for ways really mostly through nutrition and supplementation to help people be healthy, because I feel like, I don’t know about your opinion, but I believe as far as the science goes, nutrition is up here. To me, it’s the absolute number one behavior. Exercise is a pretty far number two below it, and then obviously everything else sort of falls into place.

                                To me, nutrition encompasses so many different things just simply because every time we put something into our mouths, we’re giving coded information to ourselves, guided by our genes, to either express or suppress or do things genetically. But all those other downstream effects of metabolism, there’s nothing else that you, well, other than of course, drugs and smoking. I mean, those are different topics, but nutrition, everything we put in our mouth, what we eat and drink, just gives our… It really is true. You are what you eat. And so all that is very important to me in terms of what I’ll do the rest of my life continuing to look for answers for health.

Dr. Weitz:            I’m on the same page with you. Nutrition is information, learned that from Jeffrey Bland 30 years ago, and I think that’s a big basis of functional medicine, which is a big part of my practice. So what led you to, by the way, I also was a competitive bodybuilder back in the eighties, and so we have a similar start, except I didn’t go into academics, I went into becoming a chiropractor. What led you to a research career in academics?

Dr. Lewis:            Well, that’s an interesting part of my life as well. I got into undergrad and I’m trying to, like many people in college and university, you’re trying to figure out what you want to do with your life. And I just sort of fell into it actually. I decided once I really, as I mentioned previously, got into this idea of getting really focused and really understanding why the body works, as you know as a former competitive bodybuilder as well, it’s so important to be very dialed-in and very specific in what you do, because otherwise you really are going to struggle with achieving anything if you’re not very focused on your effort and making the best use of your time. And so as I continued wanting to develop really my knowledge, which actually there are obviously many aspects of that too. I learned a lot of things just in my own discovery through reading the literature.  But I just, as I continued going from my undergrad to my master’s degree to my PhD, it seemed like I enjoyed the academic lifestyle at that point in my life. And I felt like conducting research was something very valuable. I guess I was a bit naive at that point in terms of all the funding and how you have to be such a dog-eat-dog kind of personality to really bring in funding to be able to do your research. And then, oh, by the way, here, a guy like me, as you mentioned, I’ve had this long career at the University of Miami, which is a very conventional pharma-focused institution. So here a guy like me, a physiologist, doing nutrition and supplementation and exercise research in a very, very conventional environment where the majority, not the majority, almost everyone is doing, if you’re not doing pharmacology or genetics or some combination, you’re pretty much a black sheep.  And so I was very much a black sheep most of my academic career, and ultimately that was a big reason that I actually left academics. Don’t get me wrong, I’m not bitter because I did end up making what I feel like are for some very important and cool discoveries. But I just, to answer your question, I really enjoyed the academic lifestyle at that point in my life, but eventually I got to a point where I was so burned out on spending so much of my time trying to raise money and trying to break into this clique, if you will, in NIH and other large foundations where they really only want to fund, again, drug research or genetics research. Nutrition, they may talk a good game publicly, but they’re not interested in nutrition. They don’t view it as a way of making money eventually.

Dr. Weitz:            Exactly. This is unfortunately one of the issues I talk about quite a bit is that while the capitalist free market economic system is a great system for spurring innovation and creativity and has led to a great economy, I don’t think it’s a great way to run the healthcare system. And most of the money and research is coming from drug companies. I talked to Dr. Terry Wahls. I mean, she has the most incredible story, is helping thousands of people to turn around this horrible condition, MS, and her data’s incredible, and all her research is being funded by private, wealthy donors who she happens to know because there just isn’t a lot of money around. As you said, the NIH, most of the people on the NIH, have worked or have closely worked with big pharma and big pharma controls all the money. So if there’s not a lot of money to be made, unfortunately the research is not going to get done, which is too bad.

Dr. Lewis:            That’s right. And just to extend that point, so I left academics full-time about six years ago, and I still have a voluntary appointment. But when we published, which I’m maybe jumping ahead a little bit, but the results of the Alzheimer’s study that for me was so profound and still is so profound in terms of my own career. We published the first article from that study in 2013, and I was so excited at that point. I really had a high, what we had shown, and we’ll talk about that hopefully in a minute.

Dr. Weitz:            Yeah, you would’ve thought that the people from NIH would’ve been begging to give you more money.

Dr. Lewis:            Exactly. I tried twice with NIH, twice with the Alzheimer’s Association, to get funding to extend our work. I got crickets in response, nothing.

Dr. Weitz:            But they’re spending tens of billions of dollars researching these drugs that have had zero benefit for patients with Alzheimer’s. And they’ve been approving a series of these drugs recently. And the only benefit is to slow down the worsening of the disease. None of them make any of the patients better.

Dr. Lewis:            I know. It is so sad. And I guess that’s where my naivety or my gullibility of how academic research works pretty much came to a conclusion at that point. When I know for a fact, I mean, I’ve had friends who worked for NIH, I’ve had friends who’ve spent a lot of time sitting on review committees, and they all have told me that the typical NIH mentality is, they don’t want to fund something that they think will not work. So in other words, when they get reviewed, when these reviewing people, when these board members get reviewed, their boss wants to be able to say, “Well, yeah, so-and-so funded all this research that showed this many benefits to society or health or whatever.” And so they have this bias where if you submit an application that if they ultimately decide, well, there’s no snowballs chance in hell of this thing working, we’re not giving this guy any money.

                                Well, in my case, we were submitting a proposal with data, like we actually said, “Hey, look at what we’ve done. We have already demonstrated some success here. Give us more money to help us extend this line of research.” And for 10 years, that has not happened, which is like a hole in my heart. I mean, thankfully for Dr. Wahls, she’s had people supporting her work in MS. Well, that was the same in our case. The only reason we even ran this Alzheimer’s study was due to the generosity of a family who had lost four of their family members to Alzheimer’s, and they gave us money to run a study. So you’re absolutely right. I mean, if you don’t have some network of really wealthy people that have more money than common sense, then if you’re trying to do something in our world in nutrition, I don’t know where it comes from.  So my goal, part of my business goal as an entrepreneur, is to make my company successful enough where I’m going to fund my own research eventually. I’m not begging people. You know what? I’m over the begging game. I begged the government, I’ve begged foundations, I’ve begged people. I’m done with all that. I’m just going to make enough money in my own business that I’m going to fund the research myself.

Dr. Weitz:            Well, the problem is you’re trying to promote health and our so-called healthcare system is only designed to treat disease. There’s no promotion of health at all.

Dr. Lewis:            Zero. It’s not a healthcare system.

Dr. Weitz:            It’s not. It’s a sick care system.

Dr. Lewis:            That’s right. It’s a travesty.

Dr. Weitz:            Let’s get into the topic at hand. What are polysaccharides and why should we be excited about them? Aren’t carbohydrates bad?

Dr. Lewis:            I love it. I love that question. For me, it’s just such a neat little thing to do when I talk about sugar. So yes, to your point, I mean-

Dr. Weitz:            Well, why don’t you start by defining what is a polysaccharide.

Dr. Lewis:            Exactly. So it’s a complex sugar. I can imagine some of the other folks you’ve had before that talk about keto and this and that. I mean, it is fine. I’m not here to be an enemy to people like that or to try to be some maelstrom type person. But these polysaccharides are so unique in their function and they’ve been shown, just time and time again, not just through the work in our lab, but people all around the world that these complex sugars. And if I said, “Well, sugar is good for you.” Again, most of your listeners will probably laugh me off the screen here, but a sugar is not a sugar. And so for me, when you say the word sugar, you have to be very careful because you’re using a very generic term that if you’re talking about high fructose corn syrup, well sure, that’s not good for you, don’t eat it. Look on your label, and if anything says high fructose corn syrup on it, put it back on the shelf, don’t buy it.

                                But these complex sugars, and again, a sugar is not a sugar. It depends on the molecules, it depends on the chain in the molecules, and it also depends on the source. It’s not just a matter of whether something is a mono or a di or a polysaccharide. It also, in my view of the world, it depends on the source of these things. So what we’ve shown in our work now, going back close to 20 years, is that these two particular polysaccharides that we’ve focused on a lot come from aloe vera and rice bran. Well, obviously humans have been using aloe vera since recorded history. I mean, that’s pretty much a no-brainer, but unfortunately, most people think of aloe vera as something for a topical purpose, which is fine. If you have a sunburn or a cut or a wound or something, I don’t knock you for putting a little aloe vera gel on there, that’s fine. But an aloe vera gel is 99% water, and so to get the polysaccharide out of that gel to have a very therapeutic benefit is going to be unlikely.

                                You really need it in a concentrated form where all that water has been taken away and the polysaccharides have been extracted out of there. So mannose, acetylated polymannose, aloe polysaccharide, there are a lot of synonyms for the same thing. But basically this particular polysaccharide coming to us from the aloe vera plant is just so dynamic and so amazing. And then the rice bran, not the same, but similar to, the same story. Obviously, humans have been eating rice since recorded history, but unfortunately, most of the world prefers to eat white rice. Well, when the rice is milled from when it comes from the field into the processing center, when the kernel is stripped off, which is mostly the bran, and the bran is actually packaged up and fed to animals, the animals are actually getting the best part of the rice. If you’re only eating white rice, you’re eating just basically simple carbohydrate, and you’re not getting all the dynamic polysaccharides that are contained in that rice bran.

                                So the interesting thing for me, when I think about this whole keto, even the carnivore craze that seems to be growing, which I completely don’t understand, that’s another topic, but you don’t have to be like, we’re talking just a couple of grams of carbohydrate per day. To me, that’s what’s interesting about people typically talking about carb, carb, carb and carb, carb is bad, but we’re only talking about, from our research, and again, people in other labs around the world, you only need a couple of grams at the most of these polysaccharides per day. I mean, really, is somebody going to be offended by taking 500 milligrams, a gram, a couple of grams of these polysaccharides per day when you’re so focused on protein and fat? I mean, to me, that just doesn’t… You know what I’m saying? That’s irrelevant.   When somebody’s eating 500, 600, even a thousand grams of carbohydrates per day of mostly processed garbage, sure you’ve got a big problem. But if you’re going to talk about being keto or carnivore or whatever, and then adding a couple of grams per day of these polysaccharides into your diet, and you have a problem with that, I’m sorry, you’re lost. You are totally missing out on some incredible benefits from these polysaccharides.

Dr. Weitz:            You might be better for marketing purposes describing it as a phytonutrient.

Dr. Lewis:            Sure, absolutely. But you know what? I had a lady call me up the other day ripping my butt over the fact that I had flaxseed in our formula, and she’s telling me about all the problem with phytoestrogens and this and that. I had to endure this lady because I’m subject to being left some horrible review on Google or something. This lady’s completely talking out of her butt. She didn’t have any idea what she’s talking about making all these wild accusations about, she’s going to call the FDA and tell the FDA that anything that’s got flaxseed in it should have a label warning that says, “Oh, it contains phytoestrogens.” I’m like, “Lady, you don’t even know what you’re talking about. Lignins are some of the most anticarcinogenic phytonutrients known to humanity, and you’re telling me that a few hundred milligrams of flaxseed in my formula is a health problem. Are you nuts?”

Dr. Weitz:            Yeah. You just have to ignore that.

Dr. Lewis:            Are you nuts?

Dr. Weitz:            There’s a lot of opinion. When you talk about rice bran, it’s interesting. I’ve had Dr. Barrie Tan on talking about tocotrienols, and I know rice bran is one of the sources for tocotrienols.

Dr. Lewis:            Yes. Well, again, rice bran, I mean, I think, again, in my view of the world, I’m going to put rice bran, if I have to make a hierarchy, I’m going to put the aloe polysaccharide at number one. I’m going to put the rice bran polysaccharide at number two. But I mean, there have been thousands of different amino acids, fatty acids, in addition to the polysaccharides, vitamins, minerals, elements, co-factors, metabolites, all found within rice bran. I mean, what a dynamic food source this is. And so anybody that says, “Oh-“

Dr. Weitz:            Of course, a source of fiber as well.

Dr. Lewis:            Fiber as well, exactly. So anybody that says, “Oh, I can’t, can’t have a little bit of rice bran in my diet, I’m too strict.” Well, okay, fine, but you’re losing out on some amazing nutritional benefit to your cells.

Dr. Weitz:            Tell us about how the aloe polysaccharide, how does it have these health benefits, and about the studies you’ve done?

Dr. Lewis:            Well, again, we ran these trials. Actually, we also ran a trial in MS as well, in addition to the Alzheimer’s study. But I was very fortunate to meet a couple of people back nearly 20 years ago. One gentleman, Dr. Reg McDaniel, who had been working on the aloe polysaccharide for, gosh, he started back in the eighties, and this man is still going to his office every day, 87 years old, still fighting the good fight. I mean, what a warrior for health Dr. McDaniel is. I don’t know about you, but in school, I thought maybe, if I recollect, it’s very many years ago that I was in school, but I may have had a half a lecture in biochemistry at one point about polysaccharides or saccharides in general. And all I knew about them at that point was that they were an energy source.

                                I didn’t really know much about anything else related to their function. But when I met Dr. McDaniel, and he started sharing with me all of the work that he and his colleagues had done, primarily at Texas A&M at the vet school, it was just an amazing enlightening experience. And just, as you do, once you go down a path and you start building your knowledge base and you discover all these different things that these polysaccharides can do, and again, mostly focused on aloe vera at that time. But to answer your question, what’s ultimately been shown, and I’ll talk a little bit about our findings as well, but before even running our study, if you just look into the literature, go to PubMed and type in acemannan, mannose, acetylated polysaccharides, you’ll find many studies that have shown that it’s anti-inflammatory, it’s anti-oxidative, it’s antiproliferative, of course, all the wound healing benefits.

                                In fact, I think FDA actually has some sort of, I don’t know, I’m not too familiar with the FDA world in terms of approvals, but FDA has granted some sort of a wound healing benefit to aloe vera that people can use, I guess, for labeling and claims purposes. But in addition to that, boosting stem cell production, there are just lots of different mechanistic functions that this polymannose has. And so what has been shown by other people around the world, again, not in our lab, but just in general, people looking into the glycomics field, is that this particular mannose, this one key sugar that comes from aloe vera is needed when the endoplasmic reticulum and the Golgi are communicating with each other, and they’re making other bioactive compounds that you need so many molecules of mannose in that process.

                                So obviously oxygen is our number one nutrient. And then beyond that, we have vitamins and minerals, amino acids, fatty acids, but mannose is very important in that chain where, again, when you’re talking about that activity in the organelles and all that coded information, again, going back to what Dr. Bland said, all that coded information from mannose, from these polysaccharides, is actually way, way more than what you get from amino acids, fatty acids, even vitamins and minerals. So it’s so much coded information in there, in that mannose, to be able to then guide the cells to do their job. And so whether it’s again, creating another bioactive compound, phosphorylating, glycosylating, communicating with another cell, I mean on and on and on, that mannose is so crucial to that.

                                And so what we’ve showed really in our research kind of at a helicopter view level is that, I like to use the analogy of an old car. If your car has water in the gas tank, you get the gas cleaned up, you get the water removed, and you start giving it high test gasoline, your car may function better, it may start driving like it’s a newer car again. Same thing with our cells. It’s really true. Again, we are what we eat. And so these polysaccharides, it’s just like pouring gasoline on the fire. Once you give the cells the proper nutrients, the raw materials that they need to function properly, they will do that. And so it’s basically going back to a very key component of the bioengineering of life.

Dr. Weitz:            So I’m familiar with the use of d-mannose as part of a protocol for supporting the mitochondria in the heart along with l-carnitine and CoQ10, is this polymannose similar to d-mannose?

Dr. Lewis:            Absolutely. It’s the same chemical structure.

Dr. Weitz:            Oh, okay. Exactly. So there’s a ton of data showing the benefits of that for patients with congestive heart failure. So potentially your product could have benefits there as well.

Dr. Lewis:            That’s right. Well, and again, our only limitation in terms of answering research questions is just simply money. I mean, if we had an unlimited source of funds, we’d be running other clinical trials. It’s just we’ve been very focused on the brain due to this family’s generosity and wanting us to stick with Alzheimer’s. We did run a sister study in MS as well, but if you want me to, I’m happy to share with you the results of our clinical trials in both of those studies.

Dr. Weitz:            Sure. But by the way, I was looking at the paper, it looks like it’s a combination of products. It looks like a combination of different nutrients in that product that you use, correct?

Dr. Lewis:            That is correct. So we were not interested in trying to create or fall under the pharmacological model of one synthetic or one chemical for one mechanism of action for one disease or symptom of disease. We really, due to the severity, and I don’t know if you’ve had any family members with Alzheimer’s, I personally have not, but just due to the severity of the disease, the lack of anything from a conventional treatment perspective to even help people, and just really the desperation, the sheer desperation. I mean, when I got into running the study and hearing from these caregivers that are just the most desperate people on the planet to find something, we believed that just looking at say, aloe by itself, while it could have been very effective, was probably a limited view and not really a nutritional view.  So as you well know, nutrition is more like a shotgun where you’re providing hundreds if not thousands of things all at once to the cells compared to the pharmacological paradigm where again, it’s just one chemical or one synthetic compound for one mechanism of action. So we were trying to help people the best we could, and combining with some of these other things like the rice bran, the flaxseed, the tart cherry, the sunflower lecithin, the [inaudible 00:27:30], the citric acid. Again, we were trying to really give these folks something to help them. 

Dr. Weitz:            I’m kind of interested in all these compounds. Maybe just real briefly, you could give us a thought as to why you included some of these other compounds. I see, besides the polymannose from the aloe and the rice bran, there’s large tree fiber, large tree soluble extract, cystine, soy lecithin, ultra terra calcium, aluminosilicate, tart cherry, inositol, yam powder, omega-3, citric acid, and glucosamine.

Dr. Lewis:            Yeah, and actually we had a change in the formulation midway through the study. We actually had to swap out some of the larch due to supply concerns that we increased the amount of aloe in that second iteration of the formulation. But to answer your question, so for example, the flaxseed, obviously being a very rich source of omega-3 and lignins, and fiber as you mentioned. I mean, that was-

Dr. Weitz:            So the flaxseed, is that the omega-3?

Dr. Lewis:            Yes, exactly that, yes. And then we actually switched from soy lecithin to sunflower lecithin. Again, because some people are very touchy about soy. So we decided to switch to sunflower, which obviously is a good source of choline. So choline has been shown in many different studies to be very beneficial for the brain.

Dr. Weitz:            Precursor for acetylcholine.

Dr. Lewis:            Yes, exactly. The IP-6, that’s a very interesting compound that actually also comes from rice bran and much more so than say for brain health effects, but it’s actually been shown to be very anticarcinogenic. So we felt like anything like that that could help to lower inflammation. And obviously, the people that we ran in these clinical trials, they didn’t just have Alzheimer’s or MS. I mean, they had other comorbid conditions as well.  The tart cherry is very interesting. I mean, it’s just got a plethora of different nutrients in it. It’s actually a good source of melatonin as well.  So we felt like for overall, again, this strategy of giving an overall compliment to different metabolic pathways, it was a good selection.  The diaspora, the wild yam, is a very nice endocrine modulator.  It’s got these saponins in it that are not completely understood why they affect or modulate the endocrine system, but they’re very beneficial from that.  What else am I missing?   The ultra terra clay has some very interesting properties. It comes from a very deep water lake in the state of Mississippi, and it has very potent chelating properties to it. So one of the nice things that this formula does is, while it’s giving you all these different nutrients, we’ve got the clay in there to help strip out different things that build up over time, whether it’s heavy metals, arsenic, PCBs, PFAs, all these different things. So it’s got a very nice detoxifying effect as well. So while you’re feeding the body on the one hand, you’re also helping to clean it up on the other with the clay. So we love that particular ingredient in the formula. Of course, citric acid, it’s obviously a very well-known antioxidant part of the Krebs cycle, being very important to help produce all the different cellular metabolism. Oh, I’m forgetting NAC, n-acetylcysteine, obviously is a precursor to glutathione.    So prior to some of these more recent technologies using liposomes or micelle or other nanotechnology, obviously there’s been a big problem for many years of trying to deliver glutathione orally. So if you can put in NAC where it’s obviously the precursor to glutathione, now you’re helping to boost the body’s own production of glutathione. So again, we were looking at multiple metabolic or mechanistic components to this formula in terms of lowering inflammation, lowering oxidation, boosting overall immune function. And then we ultimately, to our surprise, to our pleasure, or to our excitement actually, we showed an increase in adult stem cell production. So all these things ended up happening in our Alzheimer’s study on the one hand.

Dr. Weitz:            So you gave this nutritional product once a day, twice a day?

Dr. Lewis:            Four times per day.

Dr. Weitz:            Four times per day, okay.

Dr. Lewis:            Yes. About two and a half grams per serving.

Dr. Weitz:            So is that like a scoop or something that they put in liquid?

Dr. Lewis:            Yes.

Dr. Weitz:            Okay. And they took this for a year?

Dr. Lewis:            Yes. So for the Alzheimer’s study and the MS studies, actually, they were both one-year interventions. For the Alzheimer’s folks, as I mentioned, we did a powder that, we felt like for a lot of people with dementia or Alzheimer’s, they have issues with swallowing. So a powder would be preferable, and it turned out to be true as opposed to taking a capsule or a tablet. So that was a good choice for that study. For the MS study, it didn’t matter quite as much. They didn’t really report having swallowing difficulties per se. But for the Alzheimer’s study, we chose people with moderate to severe disease. We felt like we wanted to choose the sickest group of people. And as I’m sure you know, those folks are not typically ever selected for studies with big pharma. Big pharma looks at those folks as lost causes basically.

Dr. Weitz:            Just so we have a context, what would be the range of MoCA scores?

Dr. Lewis:            Oh, gosh. On the MoCA, we didn’t use the MoCA. We used the ADAS-Cog. So the ADAS-Cog is really the gold standard for assessing cognition in dementia studies. The ADAS-Cog goes from a 70 where you’re basically like a piece of furniture, you have zero cognitive ability all the way to a zero, which is basically perfect cognition.

Dr. Weitz:            Oh, the opposite of some of the other tests.

Dr. Lewis:            Yeah, exactly. So it goes down. Going down means a good thing. And for the ADAS-Cog, I believe I don’t have the data in front of me. I think at baseline, it started out in the forties and it got down to, well, it was a four point change, which according to what the ADAS-cog people say, anything four or greater is clinically significant. And we were just beyond four points at both nine and 12 months. So we did the neuropsych testing at baseline 3, 6, 9, and 12 months, and then we drew blood at baseline and at 12 months. Unfortunately, our budget was limited. We didn’t have enough money to draw blood at three, six, and nine, but the neuropsych testing was done every quarter. And again, we got clinically and statistically significant improvements in cognitive function at nine and 12 months. So at that point, I mean, we were just beyond thrilled, and that’s where I was still in sort of my naive thinking that NIH or Alzheimer’s Association or somebody was going to jump on this and help us out, which never happened.

Dr. Weitz:            What were some of the results of the labs?

Dr. Lewis:            So the most exciting things in terms of the labs were we showed statistically significant reductions in VEGF and TNF alpha. So those were probably, I think, probably the first time that had ever been shown in people with Alzheimer’s. I don’t think anybody else had shown that, at least not with moderate to severe. And of course, those two markers typically have mostly been looked at in either cancer or heart disease. So again, I think we were the first group to actually publish that in Alzheimer’s. So that was really interesting.

                                The second interesting finding was the improvement in CD4 to CD8 ratio, which obviously is very important for all of us. It’s not just for people with dementia or even people with HIV, for example, but for all of us. As we age, we want our helper cells to be as high as possible in relation to our cytotoxic cells. So that was a really nice finding. And then third, we showed an improvement of just under 300% in CD14 cells, which is a marker of adult stem cells. We couldn’t believe how much those dramatically improved. And oh, by the way, I didn’t mention that the average age of our subjects was 79.9 years of age. So we’re talking a relatively old group of people that not only had this tragic Alzheimer’s disease, but also had other comorbid issues as well. So we were just blown away with those findings.

Dr. Weitz:            What about adult stem cells correlated with Alzheimer’s? I’m not really aware of how that’s directly correlated.

Dr. Lewis:            One of the things that we theorized in the discussion section of that first paper is that when you look at the triumvirate here of results that we have, so on the clinical side, we have this improvement in cognition, which again just blew us away. We were so happy with that result, but also lowering inflammation and improving this adult stem cell production process. The only thing that made sense to us, mechanistically speaking, is that the stem cells migrated to the brain and either created new neurons, created new synapses, repaired damage, all the above. I mean, obviously it’s speculative and it’s theoretical. We can’t prove that per se. We didn’t have money, and I don’t even know back almost 15 years ago if the imaging at that time was even not that good.  But today, if we had a new study to be able to actually do images of the brain, PET, CT, whatever, SPECT, whatever technology, that we could actually show changes morphologically in the brain. But again, we’re speculating that because we had such a dramatic increase in adult stem cell production, the only thing that made sense to us is why these people were coming back from the ether is that their brains were getting repaired. I mean, to us, that was the only thing that made sense to us.

Dr. Weitz:            Sure. And then in terms of the MS study, what did you find?

Dr. Lewis:            Well let me, if I may, just share one other little quick thing.

Dr. Weitz:            Yeah, go ahead.

Dr. Lewis:            On the Alzheimer’s study. So we did two other papers, not as exciting to me, but to your point, of still trying to figure out, okay, well what really happened here, mechanistically? We did a secondary analysis. We looked at brain derived neurotropic factors. So from the point of publishing the first article in 13 to then publishing these two subsequent articles, we looked at BDNF because there had been other articles coming out showing BDNF’S, link to hippocampal function, memories, all sorts of neuroplasticity, all sorts of different things that we thought might help to explain it. Unfortunately, we didn’t show a statistically significant improvement in BDNF, it only went up by about 11%. But it was linked to different cognitive improvements and different changes on the immune system as well. We actually had done another study with HIV positive people many years before that where we discovered that if you had a BDNF level of 5,000 units or higher, you actually had worse, I’m sorry, you had better cognitive function than people that had less than 5,000 units. I can’t really tell you why that’s true. It’s just one of those artifacts of nature, basically.

                                But we decided to split our group of people with Alzheimer’s at that 5,000 point level as well. And it turned out to show basically the same thing, that if you had a BDNF level higher than 5,000, you had better cognitive function and you also had better immune function. So that seemed to be interesting to us. And we got two more papers out of that. And then we actually have a fourth paper that’s currently under review for another thing. I don’t know if I should really talk about it too much. I usually don’t typically talk about articles that haven’t been published yet. But briefly, what I’ll tell you is, we are looking at some, again, very unique, and I think for the first time published data in people with Alzheimer’s where we looked at the Th1 to Th2 components of the immune system, which had never been characterized.

                                I spent hours looking in PubMed. One of our other co-authors looked at it as well. We couldn’t find anything else that had ever been published before in people with Alzheimer’s looking at the balance between the Th1 and Th2 components in the immune system. And so we’re going to characterize that for the first time. We’re going to show that our formula actually helps to balance it. We’ve also compared the folks with Alzheimer’s to people with normal or healthy levels. And the differences are just so wildly different that you’ll say, “Well, no wonder these folks are so sick.” And then sort of the cherry on top of the cake is that the rebalancing of the Th1 and Th2 levels is correlated with an improvement in cognitive function. So it’s a really exciting new paper that hopefully will be published in the very near future.

Dr. Weitz:            Now, these patients in your study, were they also put on a healthy diet or told to exercise?

Dr. Lewis:            Oh, I’m glad you asked me that. Thank you for asking me that. I totally forgot to mention, that’s the beauty of our study. We didn’t change anything else. We didn’t change their diet, exercise, socialization, medication, nothing. They stayed completely static in terms of their daily routine, their medication regimen. Of course, in the event of an emergency, they had to be intervened, but everything else was static. So that-

Dr. Weitz:            So imagine if this supplement was used in the context of a functional medicine approach that would’ve put them on a healthy diet, had them doing vigorous exercise, had them doing brain stimulation, controlling for other factors, taking a functional medicine approach like Dr. Bredesen does with his Alzheimer’s patients.

Dr. Lewis:            That’s exactly right. And that’s what Dr. McDaniel and I have been saying for years. Gosh, if we just had the money to run subsequent studies, and to your point of making it a more holistic functional medicine approach, my goodness, what could we show demonstrating that adding this supplement into all these other things can be so potent and really benefiting people because ultimately that is what this is all about. And before I talk about the MS study, I just want to make a point real quick to your listeners that it’s wonderful to do science, especially when you’re doing science like I did for most of my career where I wasn’t beholden to a drug company or something like that where I felt like, oh my gosh, what am I doing here? But to be able to actually run good science is wonderful, but when you can actually run good science and then show that you can help people on top of it, man, to me, that’s like the pinnacle of science.  With all due respect to my basic science colleagues who run experiments on cells or tissues or animals. A rat never was late for a study, or a mouse never didn’t just show up and not call you and left you hanging there wondering when you were going to do your assessment. So for basic scientists who do all these very controlled experiments and show interesting things, a lot of times unfortunately for them, their discoveries never end up translating to how it helps people. They may be interesting discoveries scientifically, but do they actually ever end up helping people? No. But in our case, the stuff that we were running with nutrition, we knew immediately, yes, this stuff can help people. And so I had caregivers, I didn’t even mention. I had caregivers calling me in the middle of the study and tears of joy telling me that their loved one was talking about things or doing things that he or she in some cases hadn’t done in years.

                                We even had a very skeptical staff. The center where we ran the study, the psychiatrist especially, he was very skeptical. He said, “Well, we don’t really do nutrition here. We do pharmacology. You guys have some money, we’ve got plenty of patients, we’ll help you. But we don’t really think this is going to do anything.” I mean, that was the kind of response that we had going into the study. So I just love to point out that we actually did stuff that made a difference in people’s lives. And to me, that’s beyond just being a good scientist that’s actually doing things to help people.

Dr. Weitz:            Yeah, that’s great. So go ahead and give us a little information about your MS study.

Dr. Lewis:            So with the MS study, it was a very similar design in terms of a 12-month intervention. It was the same assessment schedule, obviously different assessments for people with MS, but these were people with relapse remitting MS. People that had been, I think the average time of diagnosis was like 15 years. So again, these were people that were very sick, had been sick for a long time, and were looking for alternatives to try to improve their lives. So we put them on a very similar, basically the same formula. Again, we tweaked it a little bit over the years, but we looked at pretty much the same group of biomarkers in terms of the blood work at baseline and 12 months. The clinical assessments were obviously much different again with people, as you know, people with MS don’t typically have the same level of cognitive impairment as folks with dementia, but we were really much more focused on functionality and quality of life.

                                So the FAMS, much like the ADAS-Cog is considered the gold standard for dementia, our cognition assessment and dementia. The FAMS is considered the gold standard for functional assessment for people with MS. And we had just wildly significant improvements in almost every scale. I think one scale was not significant, even though it was borderline close, but every other scale was statistically significant. And so that was very impressive. We had the BD&I, the Beck’s Depression Inventory. Obviously, mood is a very big issue for people with MS. That’s statistically significantly improved. We looked at three different quality of life measures. They all statistically significantly improved. We had a homemade, I say homemade, it’s an assessment the clinic uses, a homemade assessment of symptoms. That thing wildly, statistically, significantly improved.

                                We had just all sorts of really nice anecdotal responses from the subjects as they’re talking about their improvements and how they can function every day, how they can move, how they can get around, how they’re better able to take care of themselves, not being reliant on a caregiver or having other people to help them. So all that clinical stuff, just again, wildly, significantly improved. And then on the biomarker side, one thing that I had no clue about when I got into running these two trials was that the leading killer of people with MS is actually infections. I had no idea. And so we went from having, I think at the baseline, these folks had eight infections at baseline, typically eight different types of infections. At 12 months, they were down to two and a half. So that was just-

Dr. Weitz:            I wonder if those infections are because they’re taking immune suppressing drugs as part of their treatment.

Dr. Lewis:            Exactly. I’m sure it is. That’s at least part of that process. But to get that many infections under control where again, these poor people are just dealing with all sorts of infections. I mean, that was a huge discovery. I don’t think anything else has remotely come close to that. And that goes back to one of the things that I mentioned about the aloe polysaccharides is initially we were talking, their potency against pathogens is just remarkable. Whether it’s virus or bacteria or fungi or whatever it is, not fungi, protozoans, their ability to counteract these infections is just really, really remarkable. But so we had that really nice discovery in infections.

                                And then also in a different way, it is kind of a mouthful to go into in terms of explaining all the different effects, looking at the cytokines and growth factors, and then of course the overall immune function as well. But essentially what happened was very similar, or very parallel to the Alzheimer’s study, in the sense of lowering inflammation and then improving overall immune function. So again, it is a very nice story when you look at the clinical improvements combined with lowering infections, combined with changing the immune function and lowering inflammation at the same time. So I think both of those studies really just were kind of beyond anything that we expected. Certainly we were optimistic and we were hopeful, but to be able to make such discoveries and again, be able to help people at the same time, we just were so pleased with our work.

                                We’re going to actually look at the same, this Th1, Th2 phenomenon in the MS dataset as well. As soon as we get this Alzheimer’s paper published, hopefully in the next couple of months, I’m going to move on to doing that MS analysis as well. So we currently have three papers we published from the Alzheimer’s study, two from the MS study, and then hopefully if things go well, we’ll have two more totals. We’ve got a really nice base of knowledge and information from running these two clinical trials. Again, it’s only due to the lack of funding. People ask me all the time, “Well, what are you going to do next?” I’m like, “Well, write me a check.” If I had an unlimited amount of money, if I had more money than common sense, I’d already be running more clinical trials. It’s just, clinical trials are very expensive to run, and I haven’t been able to do that. But that is definitely a goal of mine for the rest of my life, as I mentioned, to continue the research, obviously running it, of course, we will have a relationship with someone else to actually run it.

                                I feel like spending 20 years in the trenches was enough of my life, but if I have the money to be able to pay another group or even a contract research organization, I really don’t care who ultimately runs the studies. As long as they do a good job and they do it the way that they’re supposed to, then again, that’s my goal, to continue running these trials and answering these questions about why these polysaccharides are so beneficial and kind of taking it, one more thing that I’d like to point out about these polysaccharides is, again, the body, it’s intelligent enough to recreate or recomposition simpler sugars into mannose or galactose or xylose. Some of these very unique polysaccharides, the body is smart enough to be able to do that. When you just feed it junk, it can still do that. But there’s something very special about these polysaccharides that again, come from aloe vera and rice bran.  I think it may be something beyond biochemistry. I think there may be actually something on the physics level at play here. And so to me, that’s something that I want to spend, again, when I have the funding to do it, to answer the question of what it is-

Dr. Weitz:            What would that mean, something on the physics level?

Dr. Lewis:            Well, so what I’m saying is we think of biochemistry or nutrition as being biochemical. Everything about nutrition is on the biochemical level, but to me, there’s something about, we are frequency beings, right?

Dr. Weitz:            Right.

Dr. Lewis:            We resonate at a frequency. All of our cells resonated a frequency, and so there’s got to be something special or dynamic about the resonant frequency of these particular polysaccharides compared to others. Because to me, I’m just continuing to ask myself, why is it that these things are so damn special? What is it that gives them this quality to heal us? I don’t know. My theory could be completely proven wrong ultimately, but I think there’s something beyond biochemistry that has an explanation here.

Dr. Weitz:            I wonder if it could have anything to do with possibly deuterium levels. You familiar with that concept?

Dr. Lewis:            A little bit. I’m not too knowledgeable about it, but that’s-

Dr. Weitz:            So having lower levels of deuterium, meaning for every million water molecules, you’ll have, I think the average is, in seawater, 150 molecules of deuterium. So it’s basically heavy hydrogen, hydrogen with two neutrons instead of one neutron. And so if your polymannose product had lower deuterium levels, there’s a bunch of sort of interesting, not super fleshed out, but research showing that lower levels of deuterium have all these health benefits.

Dr. Lewis:            Interesting.

Dr. Weitz:            So it might be something to look into. Have you tried to reach out to Terry Wahls or talk to her at all?

Dr. Lewis:            I have not.

Dr. Weitz:            Yeah.

Dr. Lewis:            I saw her on an IFM lecture one time, but other than just hearing her lecture, I haven’t tried to contact her.

Dr. Weitz:            Yeah, she’s got a bunch of ongoing research and she’s very big into using a wide range of different plants and phytonutrients as part of her program. She doesn’t follow a vegan program, but she’s very big on having a huge number of different phytonutrients as part of her program. She was in a tilt-up wheelchair, not able to walk or anything, and she’s totally reversed it and walks and teaches and rides a bike. It’s incredible.

Dr. Lewis:            That’s awesome. Well, I have a customer, client who also had MS or has had MS for I think 35, 36 years. She heard me lecture last year. She started using our formula. She had been in a wheelchair, I think she said for the previous two, three years prior to that, was just getting really progressively weak. Got on our formula, and within less than 60 days she was walking again.

Dr. Weitz:            Wow, that’s a great story. In fact, probably a good story to end on.

Dr. Lewis:            Right.

Dr. Weitz:            I think we’re hitting the top of the hour. So tell our listeners and viewers how they can find out about your product.

Dr. Lewis:            Well, I’d be happy if anyone goes to drlewisnutrition.com to read more information about all the work that we’ve done describing the formulation, product reviews, testimonial videos, that would be the best source of information about all of our work. Of course, I don’t publish the full articles of our studies there. I don’t want to violate any copyright, but anybody could go to PubMed and search my name and you’ll pull up all of those articles as well. But I have, again, very good summaries of all the research. So just go to drlewisnutrition.com is the best source of information. That’s D-R with no period, L-E-W-I-S nutrition.com.

Dr. Weitz:            That’s great. Any other final thoughts you want to leave us with?

Dr. Lewis:            Well, again, I’d just like to say that for those of you who think sugars are bad, just don’t throw out the baby with the bath water. We’re talking about, if you can add a couple of grams per day of these polysaccharides to your life, man, you’re going to make a huge difference for yourself. And so just don’t prescribe to this notion that a sugar is a sugar because they’re not, they’re very different. And these sugars are very beneficial for us. And I’ve really kind of become a specialist in this. Of course, I still, general nutrition, supplementation of other things, obviously is important, daily activity. I mean, I’m about all that stuff and that’s what I do every day. But you can only, I don’t know about you, and I don’t pretend to know everything there is to know about nutrition. I think anybody who does comes across as a fraud because to me, the field is so massive, there’s just no possible way.

                                I don’t care if you’re the smartest person on the planet, you can’t possibly know everything there is to know about nutrition. So I try to stay in my lane of polysaccharides and maybe a couple of other things here and there. But really I think for me, just again, opening, if you’re so opposed to carbohydrate, just read our research and do your own research of other people around the world looking at these two particular polysaccharides about how much benefit they provide and how much of a loss it would be to you, your family, your friends, whoever, to not be open-minded to say, “Hey, maybe these things could help me too.”

Dr. Weitz:            We’ll just talk about polysaccharides. Don’t mention that they’re sugars.

Dr. Lewis:            Yes, exactly. Just polysaccharides, forget that sugar word.

Dr. Weitz:            Exactly. Thank you, Dr. Lewis.

 


 

Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review. That way more people will discover the Rational Wellness Podcast.  And I wanted to let everybody know that I do have some openings for new patients so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardiometabolic conditions, or for an executive health screen, and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way. And that usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective. So if you’re interested, please call my Santa Monica, Weitz Sports Chiropractic and Nutrition office at 310 395 3111, and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.

 

Michael Hobson and Karen Weitz discusses The Science and Energetics of Water 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

6:16  Primary water.  This Aquene Springs water is a primary water.  It does not come from rain that forms underground aquifers and accumulates in lakes and rivers. Oxygen is actually the most common element in the earth’s crust, followed by silica as the second most prevalent element.  Oxygen combines with hydrogen to form water and they form steam because of the heat in the earth’s crust and it comes to the surface and roars out of the ground at 140 degrees Fahrenheit. So that’s an example of primary water that is made in the Earth’s crust on a continuous and ongoing basis.

12:14  Silica.  The Aquene Springs water is high in silica dioxide, which is a silicon atom with two oxygens, which is the most common form of silicon found in nature.  And silica, which is a trace mineral, has lots of benefits for our health.  Silica is the basis for bones, hair, teeth, skin, it helps with blood flow, is beneficial for cardiac health, and is also helpful for gut issues.  It also binds with aluminum, a heavy metal, and pulls this out of the body.  As we age we tend to lose water and aging is a process of dehydration and losing silica also contributes to a loss of health.  Michael also recommends a plant based diet partially because this will also result in getting more silica in your diet.   

20:05  Hydration.  There are a few ways to improve out hydration. One is to drink water. Another is to eat foods that contain water, like fruits and vegetables. Taking a shower or a bath also helps to hydrate you, since we absorb water through your skin. An additional way that we get hydrated is through the electron transport chain.

 

Michael:               Well, there’s that. Okay, I’m with you on that. Chlorine’s, not necessarily a good thing for our bodies, for skin, but there’s a third way that Ben, I think will appeal to you from the scientific standpoint. And that is the well-known process of the electron transfer chain, which was discovered by Albert St. Georgi, won Nobel Prize in 1937 as a result of some of this work.  So it turns out that particularly at night, but even during the day in the human body, we take carbohydrates or fats, which store what? Hydrogen. But hydrogen in a very interesting form, not in H2 like it is when it’s bound to oxygen for water, it’s atonic hydrogen, it’s H. If you look at those molecules, it’s H bound up with other molecules. So hydrogen bonds to those in a way that when this electron transfer process happens, hydrogen atoms are released, they find each other, and when hydrogen atoms combine , two Hs find each other and form H2, they release energy in the form of heat. And at the same time they bind to oxygen because what do we have in our body? We have oxygen, which is a crucial element. So what I’m saying to you is that the output of the electron transfer mechanism is heat, to warm our bodies to keep them stable at 98.6 degrees and water. So we actually make primary water in our bodies.



Michael Hobson is the founder of Aquene Springs, which is a source of pristine primary water that comes out of the ground at 80 gallons/minute and it is a silica-rich, deuterium depleted water with a low surface tension.  Michael is a mathematician, an econometrics professor and a corporate business consultant.  He had several businesses in the music industry and his interest in frequencies eventually brought him to water.  His website is AqueneSprings.com and using the discount code Rational10 will get you 10% off an order of this special water.

Karen Weitz is a Reiki energy master, Akashic Reader, Reiki Master, and Sound Alchemist.  Her website is AllInDevineTime.com.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their 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, DrWeitzs.com. Thanks for joining me, and let’s jump into the podcast. Hello, Rational Wellness Podcasters.

                                Our topic for today is the Science and Energetics of Water with Michael Hobson. When I was considering having Michael on the podcast, I read about what he’s about and I read where he talks about the energetics of water. And I talked to my wife, Karen, and I said, I’m not sure if this topic really resonates with me because I’m really more focused on the science. And so Karen said, “That’s totally my topic because I’m totally into the energetics.” So this is the first time I’m having my wife, Karen Weitz join us on the Rational Wellness Podcast. And Karen is a Reiki energy master and she’s also a Sound Bowl healer, and you can find her at her website at allindivinetime.com. And she also posts a lot to Instagram under her name at @KarenWeitz.

                                So Michael Hobson is the founder of Aquene Springs, which is a source of pristine primary water that comes out of the ground at 80 gallons per minute. It’s a silica rich, deuterium depleted, low surface tension water. Michael is a mathematician, an econometrics professor, and a corporate business consultant. He had several businesses in the music industry and his interest in frequencies eventually led him to water. Michael, thank you so much for joining us.

Michael:               It is such a pleasure to be on this podcast with you and honored that it’s the first podcast that you’ve had that includes your wife.

Karen:                  How fun is this?

Michael:               I’m thrilled.

Dr. Weitz:            That’s great. So Michael, how did you get involved with water and did any of your prior business experiences help lay the groundwork or the groundwater?

Michael:               Such a great question, Ben. I thank you for the introduction. I won’t spend a lot of time talking about my past. It turns out that all the things that you mentioned are things that led me to where I’m at right now. So my training actually is as a mathematical economist and econometrician, but that’s another lifetime that I was in academia, and then I spent some time in corporate life. And then in the last 33 years, I’ve started 11 businesses, Aquene Springs. That’s how it’s spelled… it’s pronounced, I should say. Sorry about that.

Karen:                   No, no worries.

Michael:               Yeah, and just gives me the opportunity to say that that’s a native word that means peace, tranquility, and clarity. So that’s why we chose it, because the place where it comes from is very special, and I’ll talk a little bit more about that. So anyway, the answer to your question is that along the way, it’s interesting. At any given point in time, if somebody had stopped me and said, guess what, you’re going to be involved in water at 10, 15, 20, 30 years from now, I would’ve said, you got to be crazy. In fact, I admit sheepishly that probably up until about 10 or 12 years ago, I wouldn’t call myself a big water drinker or consumer.

                                So I can’t look back and say, oh yeah, I’ve always cared about water. I’ve always been passionate about it and so forth. It’s only when it came up as part of what my path was, what I’m here for, that I got involved in water. And it started, and I’ll just give you a short little story. It started when someone… I was involved in a business that I started called Classic Records and Reissue vinyl company of all things that I started in the mid-90s, and somebody about somewhere in the early 2000s was interviewing me and they said, oh yeah, Hobson, you’re a serial entrepreneur, blah, blah, blah, what are you going to do next?

                                And I hadn’t really thought about it because I was being interviewed about this current business and without hesitation, and it’s a true story, I said, I don’t know, but it has something to do with water. So that was the first time I knew where I was going. I didn’t know why I was going there or where I was going. And then as time went on, you could say that there was this series of fortuitous or coincidental occurrences. But of course when you look back, you say, well, that’s part of the path. And so everything that I’ve done as I look back, all makes sense now based on where I’m at. Okay, so that’s a long answer to your short question. But yes, the trajectory was there and it really does have to do with what Nikola Tesla said. “If you want to understand the universe, think in terms of energy, frequency and vibration.”

Dr. Weitz:            So this water is a primary water, what is that and why does that matter?

Michael:               Well, okay, so most people understand that the bulk of the water that is consumed worldwide is part of what’s involved in the hydrologic cycle, right? So it’s evaporative in nature, be it from lakes and rivers and streams or the ocean, which form clouds and then clouds under circumstances that are still mysterious, let that water fall back to earth and it replenishes, and we draw it out of mainly aquifers, lakes and streams and so forth. And for municipal purposes, we put that in pipes and that’s what we consume. And then there’s the whole other bottled water industry that comes from aquifers of some description or another.

Dr. Weitz:            Or somebody’s tap.

Michael:               Well, yeah, that’s part of the municipal supply. And here in California, we know that in Southern California, we get most of our water from Northern California as a result of that nice Mulholland ditch some people call it, that brings water down from Northern California, and then we process it. And that’s what most people drink. So little known but true is that there’s another source of water. And I’m going to tell you there’s an anecdote here. I know people are aware of the as above, so below comment, and I’ll explain in a minute how actually what happens in the earth happens in our bodies as well. So the above and below is appropriate. So in the Earth’s crust, the number one element, and this is true, you can look it up, is oxygen. So the Earth’s crust contains primarily oxygen followed by silica in terms of the second most prevalent element, actually silicon. But there’s a technical thing-

Dr. Weitz:            I would’ve thought it would’ve been carbon.

Michael:               Nope, not. Again, all verifiable third, and this is one that I didn’t know and I was a little surprised. The third is aluminum. And we can talk a little bit about silicon and aluminum.

Dr. Weitz:            Once again, I would’ve thought steel would’ve been much higher. Iron would’ve been much higher than aluminum.

Michael:               I know but again, all verifiable scientifically, have a look. If you were a geologist, you would know this. And I’m not either. So anyway, so in the earth’s crust, you have oxygen also, we have hydrocarbons, right? Back to your point, and most often hydrogen’s bound up with carbon because hydrogen doesn’t like to be on its own, right? It’s one of those elements that is an unhappy bachelor, I like to say.  And so when you have a circumstance where hydrocarbons are in the presence of heat, geothermal areas, what happens is when you apply heat to a molecule, in this case a hydrocarbon, the heat breaks the bond, and hydrogen is freed up as well as carbon. But hydrogen’s freed up. Well, remember, it doesn’t like to be on its own. So it’s looking around for a partner. And guess what it finds? Oxygen, and when those two combine in that circumstance, they form steam because there’s heat around. And that steam in this case and in other cases, makes its way through the Earth’s crust, picking up trace minerals. In our case, we think the most important of which is silica. And then it comes to the surface and roars out of the ground at 140 degrees Fahrenheit. So that’s an example of primary water that is made in the Earth’s crust on a continuous and ongoing basis.

Karen:                   So I was listening to someone talk about where we have a water shortage, that there’s no water shortage of primary water. Can you speak to that?

Michael:               Well, I would say that that’s true, that it’s really about finding those sources. And there are actually sources of primary water in California, and I just don’t think that there’s enough attention paid to that because people aren’t really aware. But I think geologists do know about it, but it’s not very common. And so maybe there’s a future where we can tap into the primary water that Mother Earth makes. And one of the great things about primary water is that when you think on this level of purity, it really doesn’t get any pure than that because of course, the water that’s part of the hydrologic cycle is subject to all of the stuff that we already know about, the pollutants in the atmosphere. It’s also subject to all the runoff and pollutants that are in the ground and that make their way into groundwater and aquifers and so forth increasingly. So, yeah, in terms of purity, it’s about as good as it gets.

Dr. Weitz:            Now, when people hear about silica, that’s essentially silicon, right?

Michael:               Yeah, so it turns out silicon, if you look in the periodic table is the element. But again, you’ve got another one of those elements that does not like to be on its own. So the common form of silicon is bound with oxygen, and so it’s referred to as silica dioxide, which is a silicon atom with two oxygens, silicon dioxide. And that’s the most common form in nature.

Dr. Weitz:            And so one of the benefits of this water is that it’s very high in silica. Can you talk more about why silica is good? And then some people are afraid of silicon because they heard about silicon breast implants and silicon getting in the body, right?

Michael:               Yeah, a very different thing than silicon implants and so forth. Silica is what we call referred to as a trace mineral. In fact, it’s widely regarded in the scientific community as one of the very most important trace minerals. So what happens is that it is the basis for bones, hair, teeth, skin, it helps with blood flow. It embeds into the capillaries and arteries and veins in our body to help with blood flow. It’s known to be beneficial for cardiac health. It also binds to aluminum. And so-

Dr. Weitz:            How does it help with cardiac health?

Michael:               Again, with the binding to the walls inside of the heart and so forth to allow the blood to flow more readily.

Dr. Weitz:            So is it keeping the arteries more flexible?

Michael:               That’s one of its purposes. Yes, exactly.

Dr. Weitz:            Interesting.

Michael:               Now, interesting sidebar is that… And there’s two comments here, one about water specifically, and that is that when we’re born, we’re about 85% water by volume, and by the time we reach the elderly state, or let’s say close to death, we’re about 70 or 65% water. So you could say, and I think rightfully so, that the process, the aging process is a process of dehydration. Now, I’m not saying that dehydration causes the aging process, but they are hand in hand. And so the argument for staying hydrated, not just during your life, but as you reach the elder years is important. And again, well-known that that’s the case. What’s not well-known but is also true is that over that same course that I just described, that period, we lose silica. So is it any surprise that elderly people have issues with their skin, teeth, hair bones, gut health, silica is good for gut health as well, have gut issues, blood flow,

Dr. Weitz:            Really, do you have any idea how silica can help with gut issues? Is there a mechanism that you know of?

Michael:               I don’t know specifically about what the thought is, but there are studies that suggest that silica is important for the digestive process. But with blood flow is something that the elderly suffer and struggle with. And then there’s the issue of silica binding to aluminum. So what I was going to say a little earlier is, and again, there are books written one by a guy called Steven Exley I believe, The Aluminum Age, that talk about silicas role in detoxifying the body of aluminum and aluminum’s everywhere.  It’s in the air, it’s in food stuff, it’s in things that we drink. We live in the aluminum age, and it’s the third most prevalent element in the Earth’s crust, but it’s highly toxic to plants, animals, and human beings. In the case of animals and human beings, silica binds to the aluminum in our bodies, and we excrete it by sweating or urination. Plants actually, because they absorb aluminum from the soil, the silica that they also uptake encases the aluminum and renders it unable to inflame the plant. And that’s what happens effectively with aluminum is it causes inflammation. In the case of Alzheimer’s and some of the chronic inflammatory diseases that a lot of the elderly suffer from, it’s an inflammatory situation, at least in part the result of aluminum toxicity. So-

Dr. Weitz:            I think that silica is a bit of a natural binder.

Michael:               It is and sadly we lose it over time. And so if there’s a message here for me to share with people, it’s that certainly as we age, we should be doing things that, or eating things or supplementing silica intake.

Dr. Weitz:            Either eat some sand or drink some high silica water.

Michael:               Well, so I’m going to say I don’t endorse people eating sand. I know that might it’s-

Dr. Weitz:            It’s not particularly good for the teeth.

Michael:               Well, it might drive a few mothers crazy because they’re worried about their kids playing in the sand and so forth, which is a whole nother subject I won’t get into. But yeah, so it turns out silica, even though it is the basis for sand is digestible in this particular case and the case of plants and vegetables and fruits, which is the main way that you get silica in your diet, another good reason to have a healthy plant-based diet. I’m not suggesting people become vegetarians or vegans, but it is good from a silica standpoint. It turns out that the best way to get silica into your system is through water. It’s the most bioavailable method of doing that.

Karen:                  I think it’s interesting that you said that we are 75% water because the earth is also 75% water.

Michael:               Shocking, isn’t it?

Karen:                  Yeah, isn’t that amazing?

Michael:               Shocking, isn’t it? Another thing I wanted to share that I mentioned before, the as above, so below, so it turns out that when people think about hydration and they want to have their body fully hydrated, there’s a couple of ways to do that, right? A few ways to do that. One is to drink water. You could drink other fluids as well that contain water or eating, obviously a lot of food stuff, fruits and vegetables particularly have a high water content. So those are different ways, but interestingly, people don’t realize that taking a shower or a bath or swimming is also a way to hydrate yourself because it turns out that our pores are a two-way street. So we can actually absorb water as a result of that.

Karen:                  The filter, the water that we shower in.

Michael:               Well, there’s that. Okay, I’m with you on that. Chlorine’s, not necessarily a good thing for our bodies, for skin, but there’s a third way that Ben, I think will appeal to you from the scientific standpoint. And that is the well-known process of the electron transfer chain, which was discovered by Albert St. Georgi, won Nobel Prize in 1937 as a result of some of this work.  So it turns out that particularly at night, but even during the day in the human body, we take carbohydrates or fats, which store what? Hydrogen. But hydrogen in a very interesting form, not in H2 like it is when it’s bound to oxygen for water, it’s atonic hydrogen, it’s H. If you look at those molecules, it’s H bound up with other molecules. So hydrogen bonds to those in a way that when this electron transfer process happens, hydrogen atoms are released, they find each other, and when hydrogen atoms combine , two Hs find each other and form H2, they release energy in the form of heat. And at the same time they bind to oxygen because what do we have in our body? We have oxygen, which is a crucial element. So what I’m saying to you is that the output of the electron transfer mechanism is heat, to warm our bodies to keep them stable at 98.6 degrees and water. So we actually make primary water in our bodies.

Dr. Weitz:            Interesting.

Michael:               Yeah.

Karen:                  I have a question. I go to Mount Shasta a lot and we drink well water in the hedge waters, silica in the hedge waters, or is that different water than-

Michael:               Well, that’s a great question. I can’t speak intelligently to that. I don’t know if they report whether it’s silica rich or not, or what the silica content… If you check out most waters, the silica content is either non-existent or it’s actually very low. So there are supplements, right? There are supplements that you can buy, silica dioxide, and you can make a cocktail, which I think it’s pretty expensive to do, but that’s another way to do it.

Dr. Weitz:            I want to say horsetail, I think is a-

Michael:               Good source of silica.

Dr. Weitz:            Yeah, you’ve seen that as part of a supplement.

Michael:               Yes, yes. I would agree wholeheartedly. So that at least is a dive into primary water from the standpoint of purity. And an interesting sidebar about us actually making water inside of our bodies.

Dr. Weitz:            So what is structured water?

Michael:               So there’s a lot of controversy around this concept of structured water, and this idea is from most scientists, even some people involved in water, the idea is that water molecules form in clusters, but then soon, very quickly break up. And so the argument is by most physicists and chemists, and even biologists quite frankly, is that there is no basis to structured water, that it’s really not possible. There is a subset of people that are working in biochemistry and some physicists as well, and some medical doctors that understand this concept of what are called coherent domains. And that’s a situation where water molecules as a result of some type of stimulus, some type of energy input, be it from the cosmos, which we’re being bathed with, maybe even from cell towers that we use, we’re caught up in that as well. And maybe even the wiring in our walls, the 60 hertz in our walls, all of that affects us and it affects water and so forth. So what I’m really saying is some type of electromagnetic or vibratory input causes the water to form into different shapes that can contain patterns and-

Dr. Weitz:            So my understanding of structured water, and Correct me if I’m wrong, is that we normally think of water as having one of three states. It’s either liquid, it’s frozen, and it’s solid, or it’s evaporating. And this is sort of a fourth state, like a gel-like state. Is that correct?

Michael:               That is correct. In fact, a dear friend of mine is a professor at the University of Washington, an esteemed professor called Gerald, and he’s written a book that you may have heard about called the Fourth Phase of Water. And it’s becoming more and more widely accepted. It has been pretty controversial, but I think it’s quite frankly, irrefutable. And I think there’s a lot of application of that activity in our bodies and in particular, think about this, right? This is what we call bulk water, this is some of the spring water, but it’s just liquid water. And we drink that, and of course we sweat some of it out and we urinate and so on. But the water that we uptake into our cells and tissues and so forth is not in that state. It’s actually in a very structured crystalline state. So it turns out that the water around different organelles inside of our bodies and inside of our cells is actually in a crystal in state, and that is well known.

                                So it’s not bulk water. And by the way, it is becoming more and more well understood. I’ve got a book here that I think people should take a look at. It’s called We Are Electric by an English Woman, Sally Ade, and it talks about the electrical nature of our bodies and how the cells communicate with each other, tissues, how there’s communication between the brain, the heart, different tissues. And all of these systems are communicating, using light, using photons, and using electromagnetic impulses.

                                And it turns out that the water in our bodies with the minerals, and that’s one of the reasons why the minerals are critical, is conductive. And so we need enough water, it needs to have the right minerals in it, in order for those neurons and those conductive pathways to be able to communicate effectively. Again, back to the elderly. What happens there? They’re dehydrated and as a result, unable to communicate in a way that keeps them in a state of health.

Dr. Weitz:            Now, I can’t recall the name, but I did interview this doctor who talked about the fact that in order to get this structured water, it was better to get your water from eating fruits and vegetables than from drinking water because by doing that, you’re getting this structured water in this water in this crystalline state.

Michael:               Absolutely, in fact, I would not necessarily agree that that’s the only way to do it. But from the standpoint of consuming food, absolutely. Yet another argument for consuming fruits and vegetables, because it turns out that the water that is there is in a structured state. And so I believe that that is an accurate statement. However, from the standpoint of drinking water that’s structured, it turns out that most spring waters across Europe, across the United States and so forth are naturally structured, right? That they have some structure to them. And I’ll zero in on this in a minute. I really haven’t answered your question about what-

Dr. Weitz:            It’s hard for me to understand that because what’s in my head is if this is a crystalline state and now you’re drinking a liquid, how does that square?

Michael:               Well, think about how water is uptaken into our tissues through the blood. So that’s one way that it gets into our… So if you have water that has structure to it, then it can make it into the blood. It also is absorbed into tissues through the gut, through those little cilia that absorb nutrients, that also absorbs water. That’s how water gets into tissues as well. So that would be a way to… And I think that’s one of the reasons why we know instinctively, without even being told that spring water’s kind of better for us than municipal water. I like to say that municipal water will keep you alive, but spring water will help you thrive, right?

Karen:                  I do a couple of things to my spring water. I think it’s structuring it, so I’m not sure, but water needs to be moving. So I’ve worked-

Michael:               Absolutely.

Karen:                  And then I also have a tensor ring. Are you familiar? That [inaudible 00:31:56] tensor ring over the spout and that’s supposed to structure it?

Michael:               Yeah, and now we’re back to the question you asked me. I’m sorry. I kind of went off out into the hinterlands there about structured water and about how important it’s for our body. But I think that’s some background. So if you ask the question, what is structured water? At least one of the definitions of structured water is it’s a water that when you pass light through it at different frequencies that it absorbs in a specific range, okay? Because remember water, when you shine light through it can just pass a fair amount of that light through.

                                But there is some part of the spectrum that is absorbed. And if you look at some of the work that Gerald and those folks have done looking at a characterization of structured water, it’s water that absorbs in the 240 to 280 nanometer range, okay? So turns out interesting fun fact that DNA and many of the organelles inside of our cells absorb light in the 240 to 280 nanometer range. So again, the argument is, and this is true, that around DNA inside of our cells and so forth is this crystalline structured water which aids in the communication of all of the bodily functions. We are electric after all. So anyway, if you wanted to take some water and have it tested through spectroscopy, and again, a lot of spring waters absorb in this range, and that’s an indication that there is some structuring going on. I want to speak to Robin’s point… Sorry, let me just finish this. I want to speak to Robin’s point about there are a lot of devices in the market, some of which involve electromagnetic treatments, some involve magnets.

                                Often they involve turning the water. And I think to Robin’s point, that the water that we drink should have been active on some level, and that’s another indication of spring water because what happens with spring water, it’s been turned and so forth in the streams before it’s collected and so forth. And so yeah, there are different devices that I do think structure water, do they structure it in a way that’s beneficial for us? I can’t speak to that, but water is this wonderful molecule that is really the source of life.

Dr. Weitz:            Cool, so you also say that your water is deterrent depleted or low deterrent, and I’m sure that’s a concept that a lot of people are not necessarily familiar with, though we have had several discussions on the podcast about the issue about deuterium and why it’s beneficial to have low deuterium water and even how to structure your diet so you get a lower amount of deuterium as being beneficial for health.

Michael:               Yeah, yeah. I want to speak to that, but it just occurred to me that I misspoke and called your wife by a different name, Karen, is what I meant to say. I get caught up and so forth. And I think I was so surprised that she’s part of the podcast that I’m still getting used to her wonderful presence here. So about deuterium. So deuterium for me, it’s as controversial as structuring of water. And what I mean by controversial is that there are a good number of people that are suggesting that water that is deuterium depleted however it is naturally, which in the case of Aquene springs water, it just comes out that way. It’s naturally that way. There are methods to produce deuterium depleted water. You could think of deuterium depleted water as light water as opposed to its counterpart, which is heavy water, which is used in hydrogen bombs.

                                So the process actually of making deuterium depleted water, not in the earth, but in real life, and with some of these companies that are offering deuterium depleted water is one of separating… It’s a byproduct, let’s call it, of the making of heavy water for different industrial processes. So let’s just take a step back for those people that don’t know what deuterium is. Deuterium, it’s a molecule that is closely related to hydrogen instead of hydrogen has, according to the physicists, an electron that circles a proton. It’s the most simple of the elements. Deuterium has an extra neutron, so there’s a neutron and a proton at the nucleus, and there’s still one electron. So the significance of that is that it’s heavy, it’s heavier than a hydrogen molecule. And it turns out-

Dr. Weitz:            Let me just butt in really quick. It’s interesting, there’s actually an element that has three neutrons, and that’s called tritium. That’s actually the basis for the hydrogen bomb.

Michael:               Well, and by the way, it’s something that as a result of those explosions, has shown itself in small quantities, but measurable quantities in the atmosphere and in almost all water sources that are part of the hydrologic cycle. So for example, Aquenes springs water when tested does not have any tritium. It’s never been to the surface before. Now, I’m not going to suggest that drinking tritium depleted water is going to make you live longer, but that’s just an interesting, fun fact.

                                So anyway, so deuterium occurs naturally in water, and in fact, in saltwater in the oceans, there’s 155 parts per million of deuterium in the water, and that’s the standard right? So if you say, what is deuterium depleted? It’s anything below that. And there are some people that say, well, if it’s really deuterium depleted, it’s got to be 125 parts per million. But the truth of the matter is that anything below that 155 parts per million is considered to be deuterium depleted. Now, why is that important? That’s where I think the controversy comes in, because there’s a scientific theory or model of the way the cell makes energy or the way that it operates.

                                And I know you’ve been involved in this or you probably know about this, Ben, it involves a shaft and a rotor and a shaft. And these rotors and shaft turn around with little hydrogen molecules that get freed up from the structured water in the cell and they pass through the rotor, and that’s what causes them to turn. Well, the deuterium molecule is a little fatter. It’s a little heavier. And so it kind of gums up that process according to the theory. And so the idea would be then that if you drank deuterium depleted water, that you’d have more energy, there’d be less deuterium to gum up the energy production inside the cells.

Dr. Weitz:            Yeah, I mean, higher levels of deuterium according to that line of thinking and research is related to higher levels of cancer and heart disease and mortality. And so if it’s really true, it’s really a big deal.

Michael:               Agreed, and the only reason I describe it accurately that way, but the reason I say it’s controversial is to be honest, I’ve never been down into the cell and seen those rotors and the shafts and so forth. So I can’t speak intelligently about whether that’s actually on or not.

Dr. Weitz:            Now interestingly, the folks who promote, I’m trying to have a low deuterium level. Number one, they do sell a low deuterium water, but it is unbelievably expensive. We’re talking about, I don’t know, somewhere’s on order of $20 for a quarter or something and-

Michael:               It’s actually much more than that.

Dr. Weitz:            Much more than that, okay. It’s really expensive, right?

Michael:               Yeah, it makes our water, which is a premium water, seem really quite inexpensive.

Dr. Weitz:            Okay, and then number two,

Michael:               You’re talking about between a $102 quite often for a bottle of this water.

Dr. Weitz:            Oh, really? Okay, I knew it was really expensive.

Michael:               It’s really expensive.

Dr. Weitz:            Number two, their conclusion is in order to get less deuterium, because water generally contains a certain amount of deuterium, you want to follow a ketogenic low carb diet because carbohydrates have more water, and if you get more water through your food, you’re going to have more deuterium.

Michael:               I think that that’s a logical set of conclusions and steps if one as the old saying, goes into the weeds with this stuff. And I want to shift things a little bit because I think this will play very much to Karen’s expertise in this area, particularly when if she treats people. And so-

Dr. Weitz:            Yeah, lead me down in the weeds where I like to be.

Michael:               The modality. Well, there’s some weeds here too, my friend.

Dr. Weitz:            No, I like to be buried in the research and deeped in the bowels of PubMed.

Michael:               Which is somebody has to do that, and I can’t think of anybody better for the job. I’m going to go on record as saying something that some people find controversial, and that is that because we are almost all water, in fact, by the way, molecularly, if you count the molecules in our body, and this is indisputable 99.999% water. And again, we talked about it being into this crystalline state, and we know about how important it is.  Fritz Pop knew how important it was, another Nobel Prize winner in terms of cellular communications and so forth, both from an electromagnetic, a photonic, and from a vibratory standpoint. And what I’m going to suggest is that our thoughts get expressed in our body vibratory, and that’s what happens to a lot of the cells and tissues in our body, is that by virtue of whether we have thoughts that are life enhancing or life detrimental, and I think people can pretty much easily understand what those are, that that changes the structure of the cells in our body, the size and shape of them, and that impacts their function, right?

Karen:                   Yeah, I always say to Ben, because he does functional medicine and he gets to the root cause, and I always say I get to the root cause of the root cause through thoughts, and I can say the words you speak is the house you live in.

Michael:               Absolutely, absolutely. And so I personally have come to understand, and I won’t go into details about that, probably not the right space for that, but that our voice is the vibratory equivalent of our thoughts. And we’re given this voice for a number of reasons, by the creator or nature or whatever, or evolution. And one of those is to change ourselves and to affect others. When you go to a music event, when you go watch a movie where people are speaking or you’re at a concert or you see someone of great stature speaking and you’re affected by that, that doesn’t just come I think from the intellectualization of what they’ve said, it comes from an impact on your body.

Karen:                   Sure, when I do sound healing, I just had a client whose whole body vibrates from the sound and the water starts activating, moving in their body, and sometimes they get uncomfortable, their arms get heavy, their hands curl up so much activity from the vibration of the sound against the water in their body.

Michael:               Absolutely, and so I think if we look forward, I think more and more we’re going to understand that there is two ways to approach the human body. One is from below, which I would say is the biochemical approach, which is what we eat, what we drink, the supplements we take, and so forth. And by the way, let’s not forget something, that every single one of our senses is vibratory in nature,

                                Every single one of them, okay? So our sense is the way we experience the world is vibratory in nature. And let us also not forget that we’re on a planet that’s spinning at a thousand miles an hour at the equator. Everything is constantly moving. Everything that we put into our body is moving, and everything has a pattern to it as we sense it. When you look at a painting that affects you by virtue of the vibratory pattern that your eyes see, and that affects your body, and sometimes it repulses people and sometimes it makes them feel wonderful. So I think what I’m trying to say is that what I call the top down approach, which I’m not suggesting is the only or the best approach, just another way to think of it is from the vibratory standpoint. And those two kind of meet in the middle, if you will.

                                And I’ll suggest this, although it might make some of the MDs and the pharmacists out there crazy, but I think all the compounds that are in drugs have exactly that effect. I think that’s the mechanism, this lock and key mechanism, I don’t see it, but there’s a lot of people that are bought into that and they can’t see it another way. But the truth of the matter is all compounds vibrate. So you put a compound into your body and it has a vibratory impact and it has an outcome in effect, and sometimes it has some side effects, right? It’s the same exact situation with homeopathy, right?

Karen:                   Yeah, well, they say the medicine of the future is frequency.

Michael:               It is. I think it is but again, I want to marry these two and suggest that it is about frequency and vibration in terms of everything we consume, everything around us, everything we consume with our senses, everything that processed through our bodies, and it’s all passed around in the context of water.

Karen:                   Yes, water has memory, the memory of water.

Michael:               So sorry, Ben, I probably overwhelmed you there.

Dr. Weitz:            No, that’s good.

Michael:               Sorry my friend.

Karen:                   Well, he had me on. He knew that it had to go in that direction.

Dr. Weitz:            Absolutely, so I want to cover just one more topic. And then I think that our listeners can get the water at some sort of discount, but I can’t remember what the code is.

Michael:               We set up a special code for your consumers and it’s rational 10. Okay, so rational 10 and that’s a coupon code that if they go to our website, which is www.aquenesprings.com-

Dr. Weitz:            Can you spell that?

Michael:               Yeah, that’s A-Q-E-N-E springs.com. At checkout, you can put that code in. It’ll get you a 10% discount, so yeah. You want people to try it, I think once you try it… Now I have a question for you, and that is, I think we sent you out some water to try. What did you think? Put you on the spot.

Karen:                   I should speak to that because-

Michael:               Please, thank you, thanks Karen.

Karen:                   Because I can taste every water, and he used to think I spent a lot on water and that it was all the same once upon a time. And I had him put 10 different waters out and I could tell you what each one was, and then he understood that I really have that ability to taste. So when I tasted your water, the first thing I noticed was the softness to the texture of the water. So that kind of surprised me in a good way. The taste is so clean, so easy, it feels very healing. But I just was surprised by the softness and the texture, so.

Michael:               Yeah, you are a great candidate for becoming a water sommelier.

Michael:               I know you’re actually water sommeliers, believe it or not,

Karen:                  There’s such a thing. I would be right.

Michael:               There really is and there’s a training that one can take and golden tongues and so forth.

Dr. Weitz:            For those who don’t know, a sommelier typically is an expert at wine, right?

Michael:               Exactly, there are water som… And in fact, believe it or not, there are restaurants that have a water menu now.

Dr. Weitz:            Really?

Michael:               Yes, really. I was at a fine tasting, it’s called Fine Waters Event that was held in Athens, Greece a couple of months ago.

Karen:                  Gosh, I would’ve loved that.

Michael:               I’ll tell you honestly, I really learned something. We went to a local restaurant that was a very well-regarded restaurant, and we had, I think six or seven courses. And with each course, the water sommeliers who were there at the event and who were also judges, because this was a worldwide competition of specialty waters, high-end waters. But they paired the waters with the different dishes and it’s unbelievable.

Karen:                  Oh my God, I-

Michael:               Really is unbelievable. So yeah, there is a lot to be said. I think one of the things we talk about is the mouthfeel. So there’s a kind of softness of velvety, and then there’s what we call the leaf, which people talk about in wine tasting as well. But there’s a slightly sweetness, and we don’t put anything in the water, so it just is naturally that way such that almost it becomes addictive in a kind of a way. Once you have it, you sort of go, geez, tap water just isn’t quite the same after that.

Dr. Weitz:            Okay, so the final topic is… I just wanted to ask about, your website states that the water has low surface tension. What is this and why is this beneficial?

Michael:               So surface tension is a characteristic of fluids. So it applies to everything. There’s a surface tension to oil, there’s a surface tension to water. And so it has to do with the interface. And what I mean by interface is the interfacing waters’ case with the air or with other molecules, let’s call it, right? So for example, if you said, I have a high surface tension water, which by the way, a lot of municipal waters are high surface tension, I’ll just throw that out there as a fun fact, then the water is able to support things more readily.  So you could float a penny or a pen or something more easily in a high surface tension water. And by the way, I think surface tension is a characteristic that also floats boats, right? It’s part of that interface base with the water that makes things float. So by comparison, low surface tension is something that is less structured, if you will, in the tension state at the interface. The implication of which is that high surface tension water doesn’t combine well with other things. It likes to be on its own. Low surface tension water on the other hand, is more readily combined or absorbed in this case by the tissues and cells. So low surface tension water in general would be something that would be typically more hydrating and allowing more of the uptake of the water into the body. Municipal water, a lot of it just passes through.

Dr. Weitz:            Awesome.

Karen:                   When people say drink eight glasses of water or gallons or however many, would you say you don’t need as much water drinking your water?

Michael:               I would say just in general that people don’t need… That was an old rule of thumb, either eight glasses a day, there’s another rule of thumb that was half your body weight and ounces, which for some people can be at least three liters, sometimes close to a gallon. Again, it sort of depends. If you’re drinking tap water and a lot of it’s just passing through, you probably do need to drink a little bit more. If you’re taking a long leisurely bath every day, you probably don’t need quite as much, right? If you’re living in a climate where it’s a little cooler and maybe humid, then you don’t need as much. In Southern California, in desert areas, I think you need more in those cases. So it’s really hard to sort of pin it down.

Dr. Weitz:            Depends how much activity you do in your day, how much exercise, how much you’re sweating.

Michael:               I mean, if you’re on a century ride on a bicycle, you better be taking a bunch of fluids or you’re going to be in trouble. So it’s a difficult thing to say, but also keep in mind we make water in our body as well. So it’s trying to keep things in balance, and it’s a little tricky. I read somewhere recently where this woman was dehydrated as a result of being in the weather or in inclement conditions, and she drank a gallon of water and died as a result of drinking too much water. You can actually drink too much water. And then there’s another thing I think, Karen, you’re probably aware of as well. Some people have this idea that drinking distilled water that’s devoid of any other minerals is a good thing to do, and some people do that to detox, and I think under the right supervision, maybe that’s a good idea. But in general, we do need minerals in our body for reasons that I already mentioned. And so I would never advocate that people exclusively or on a long-term basis, drink nothing but distilled water.

Karen:                   Yeah, well, your water is very easy to drink so I’m Grateful for that.

Michael:               Thank you.

Dr. Weitz:            Okay, great. So thank you, Michael. Thank you, Karen. I guess one more time, tell us your website again so we can find out more information.

Michael:               Yeah, thank you. It’s a Aquene Springs, and that’s www.aquenesprings.com. and again, the promotional discount code is rational and the number 10 at checkout, and that’ll get you a 10% discount. And we just really want people who care about health for longevity to give this water a try and if it works for you, great.

Dr. Weitz:            Excellent.

Michael:               Okay.

Dr. Weitz:            Thank you.

Michael:               Thank you.

Karen:                  Thank you.


Dr. Weitz:            Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review. That way more people will discover the Rational Wellness Podcast, and I wanted to let everybody know that I do have some openings for new patients, so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardio-metabolic conditions, or for an executive health screen, and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way.  That usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective. So if you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111, and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.

 

Dr. Jane Levesque discusses How to Improve Fertility 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

0:55  One of the biggest obstacles for couples trying to conceive is that there is so much information that it is difficult to know what is true and what’s not and where you are in your journey.  Some couples wonder if the conventional route, whether it’s IVF, IUI, or medications like letrozole or Clomid to stimulate ovulation is the only option.

3:00  When Dr. Levesque sees a new client for the first time, she spends a lot of time going through their history and then she starts by looking at their previous labs, which often their doctors have not looked at very closely.  Often their doctors may have told them that their labs are normal because they are busy and skim through them and they also are only looking at the reds and have no sense of what optimal ranges are.  For example, when it comes to vitamin D and the normal range is 30 to 100, but if you are at 30 is that good?  No, that’s low and vitamin D is important for hormone production, to make our neurotransmitters, and for our immune system function. There’s actual vitamin D receptors on both the egg and the sperm.  Dr. Levesque likes to see vitamin D levels in the 60 to 80 ng/mL range. 

6:35  For women it is important to figure out if they are ovulating and if the quality of their eggs is good.  If the woman is not healthy, then her eggs will likely not be healthy.  If they are struggling with fatigue, digestive disorders, anxiety, or skin issues, then they are not going to have healthy eggs either.  We need to look at the FSH to LH ratio and estrogen and testosterone on day three and at progesterone on day 21 or 22, if they have a 28 day cycle.  We also want to look at electrolytes, at a liver panel, a kidney panel, and then it is helpful to get a Gut Zoomer stool test.  Dr. Levesque has seen a number of women in their 20s with an FSH well above 10, which is a strong indication that they are no longer ovulating and this may indicate premature ovarian failure.  When testing on day three, we want a FSH/LH ratio to be close to 1:1.  If LH is really high, this is a sign of Polycystic Ovarian Syndrome.

10:04  Hormone testing.  Dr. Levesque likes to test estrogen on day three of the cycle but she also likes to look at the DUTCH (dried urine) hormone panel to look at the metabolites to see you well you are breaking down your hormones.  A lot of symptoms, such as painful periods, heavy periods, fibroids, and even endometriosis are related to the bad estrogen, Estrone, due to endocrine disrupting substances.  There are three main forms of estrogen: 1. Estradiol E1, 2. Estrone, E2, and 3. Estriol, E3.  Estradiol is the good estrogen, Estrone is the bad estrogen and the one most associated with breast cancer, and Estriol that is in the middle. Estriol is high during pregnancy, but also high in fibroids and endometriosis.

14:09  Birth control.  Many women have been taking birth control for years and sometimes for decades and this can make it difficult to become pregnant. Birth control is synthetic hormones and your body has to process it and this takes a lot of nutrients, including N-acetylcysteine and CoQ10, zinc, and selenium. There’s also a connection with the gut microbiome.  Imbalanced hormones affect the microbiome balance, which makes it harder for the body to produce neurotransmitters like dopamine and serotonin. 

16:01  The microbiome and hormone connection.  There’s a connection between the microbiome and our hormones.  If you have imbalanced hormones you likely have microbiome issues.  We think that our gut is separate from our reproductive system but your uterine lining is only separated from your GI tract by a tiny, little membrane.  If you have a bunch of pathogenic bacteria surrounding your reproductive organs, this can make a successful pregnancy more difficult.

 

 



Dr. Jane Levesque is a Naturopathic Doctor, who specializes in fertility. Her mission is to help high-achieving couples get pregnant naturally, have complication free pregnancies and give birth to healthy babies.  Her website is DrJaneLevesque.com.  You can also contact her through her Instagram account @drjanelevesque.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their 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.

                                           Our topic for today is infertility with Dr. Jane Levesque. Dr. Jane Levesque is a naturopathic doctor who specializes in fertility. Her mission is to help high-achieving couples get pregnant naturally, have complication-free pregnancies, and give birth to healthy babies. Thank you so much for joining us, Dr. Levesque.

Dr. Levesque:                    Thanks so much, Ben, for having me. I’m really excited to chat with you today.

Dr. Weitz:                          Excellent. So, what are some of the biggest obstacles that couples have when trying to conceive, especially today in 2023?

Dr. Levesque:                    I think in 2023 the biggest obstacle is that there’s so much information and it’s really hard to decipher what’s true and what’s not. I have a lot of patients coming to me basically just, “I’ve already tried this. I’m taking a handful of supplements. I have no idea what to do, what’s working, what’s not working.” And feeling like the conventional route, whether it’s IVF, IUI, even medications, letrozole, Clomid, to stimulate ovulation is the only option.  And so, it’s being able to have a filter on the information and also understanding where you are in your journey that makes it difficult for couples. Because if you’re just starting out your journey and you have no idea what it’s going to be like, your biggest obstacle that I see for couples is that you’re just overwhelmed and you’re fearful of the future and sometimes unnecessarily so, and sometimes there is, of course, a reason to that fear or anxiety. And couples who have been struggling for a long time, it’s like, “I have no idea what to do. I have no idea what’s working. I don’t have any answers, and I’m tired of throwing things at the wall and hoping something that’s going to stick.”

Dr. Weitz:                          Not to mention that fear, stress and anxiety is a major obstacle to getting pregnant.

Dr. Levesque:                    Absolutely. Absolutely. Yeah. And it’s this vicious cycle where I follow a lot of people in the infertility community where it’s, “Stop telling me to relax.” Or, “Going on a vacation doesn’t help.” And I know what they’re saying because obviously if you have endometriosis or PCOS or fibroids or other conditions, going on a vacation isn’t going to fix that.

Dr. Weitz:                          Right.

Dr. Levesque:                    But relaxation and having a calm and soothed nervous system is absolutely part of being able to conceive.

Dr. Weitz:                          So, when you’re seeing a new client for the first time and going through their history, what are some of the things that come up most commonly?

Dr. Levesque:                    Yeah. A lot of the times actually as a general thing is people have no idea what’s going on even though they’ve had all the testing done. So, one of the things that I’ve been really telling my couples and on my channels is, make sure you have copies of your lab tests and your practitioner should be going through them with you. What we’re seeing now is you’re getting this, “Labs look normal, nothing that we know of.” And then you’re left feeling, you’re in this space like, “Okay, well, I guess I still have my painful periods. I can’t get pregnant. I’m still tired. I still have brain fog, but my labs look normal.”   Where in reality they’ve never actually even looked at their labs and they haven’t seen if there’s any L’s or any H’s or any just abnormals, reds, because the doctor is just skimming through and a lot of the times they’ll miss information. And so, I have patients who had no idea that they had adhesions on an ultrasound or even little fibroids that were present. They had no idea that their estrogen was out of range for the mark that they were in. And so there’s, of course, the normal range and the optimal range, and that’s the initial consultation when I first see people, it’s like people just have no idea.

Dr. Weitz:                          Maybe you should explain the difference between the normal range and the optimal range.

Dr. Levesque:                    Yeah, for sure. So, let’s take vitamin D. Everyone talks about vitamin D now. It depends if you’re in the US or Canada, but the range can be anywhere between 25 to 100 or 120.

Dr. Weitz:                          Right.

Dr. Levesque:                    If you’re at 25, are you really at an optimal range? It’s like to me that’s a low … Especially if you’re trying to conceive, because now vitamin D is important for hormone production, it’s important for mood, our neurotransmitters, our immune system. There’s actual receptors on both the egg and the sperm, vitamin D receptors. So, if both male and female are going to be low on that, that reaction isn’t going to be as strong for fertilization.  So, if you’re telling me that, “Okay, I’m in the range.” But you see that you’re on the bottom half of the range or on the top half of the range, it’s likely that you’re probably low or there is and imbalance, right? Because everything in the body is about balance. Even too much of a good thing is, it’s too much and obviously not enough isn’t as well.

Dr. Weitz:                          Yeah, I think in the US the average doctor will say, and I think most of the labs say, “Over 30 is normal, anything more than that is a bad idea.” And yet, I feel for a couple trying to get pregnant that they should get their vitamin D level at least up to 50.

Dr. Levesque:                    Yeah. And I say 60 to 80 is a good range. I have a couple patients in California, so it’s, if you have access to the sun, you need to be going out to the sun. I live in Calgary, Alberta where we don’t get a lot of sun for a lot of time of the year. So, when we can get access to it, go for it. But when you can’t, that means you need to supplement. And the best way to know how much you need to supplement is just by doing some testing.

Dr. Weitz:                          Besides low vitamin D and fear and stress, what other sorts of things do you see come up in history?

Dr. Levesque:                    For sure. So, for females, it’s figuring out if they’re ovulating and if that ovulation is good and the quality of the egg is good. Now, there’s no tests that show quality of the egg, but the way that I look at it is your eggs are your cells. If your cells are healthy, then chances are your eggs are also going to be healthy. Because women who struggle with low quality eggs are also women who are struggling with fatigue, with digestion, anxiety, skin issues, you name it, weight, all that jazz.  So, for women, I’m always looking at the FSH/LH ratio, estrogen and testosterone on day three from hormonal perspective. And then day 21, day 22, 7 days post-ovulation ideally you’re looking at progesterone and that’s going to give us a really good idea if number one, you are ovulating and number two, how strong that ovulation is. And then we want to look at your electrolytes, your liver panel, your kidney panel, and then I’ll go deeper into Gut Zoomer and all that. Usually people don’t have that when they come to me. They have just the basic information. And I’ve had women who had their FSH well above 10 in their 20s, which is a strong indication that that woman is no longer ovulating and it’s whether it’s premature ovarian failure-

Dr. Weitz:                          Maybe you can explain about LH and exactly what that indicates at what range.

Dr. Levesque:                    Yeah, for sure. So, the LH strips is something that women use to help them detect that ovulation halfway through the cycle, which again is something that I don’t want to say I advise against, but it’s not a super reliable way to tell if you’re ovulating or not, because LH is a pulsatile hormone. So, sometimes it comes before ovulation, sometimes it comes after. And so, it can confuse women.  Where when we’re testing it through blood on day three, we’re looking for a FSH and LH ratio to be close one to one. So, if that LH is really high, usually it’s a sign of polycystic ovarian syndrome. Now, that’s not the only thing, but you need to look at that ratio. The FSH, the follicle stimulating hormone, if it’s above 10, let’s say between day three and five, it’s typically a sign that the body is not ovulating or that ovulation is really sluggish.

                                                And the way that I like to describe the relationship between the FSH, if you will, is FSH is a brain hormone and the brain is where ovulation starts. The brain is the one that has to tell the ovaries to start growing the follicle, getting it ready to produce. If FSH is nice and low, it’s like the brain has to just whisper to the ovary, to say, “Hey, it’s time to ovulate.” Versus if that FSH is really high, that means now the brain is screaming. It’s like a parent-child relationship, whether you tell your kid really quietly to put on their shoes and they do it, or you have to yell at them several times and they still don’t do it, then that’s the relationship there. So, when that FSH is high, it’s a sign that the brain and the ovaries are not communicating. And so, we want to address that because obviously if you’re not ovulating, it’s going to be very hard for you to get pregnant.

Dr. Weitz:                          What are some of the other things you’ll see on a hormone panel besides FSH and LH?

Dr. Levesque:                    Yeah. So, estrogen, if you test it on day three, for the most part, I find women are in range. So, this is testing it through blood. Now you can test estrogen through blood, through saliva or through urine, and blood is going to be your gold standard diagnostic. Will show you exactly what’s happening in the body this moment in time. Whereas I do a lot of urine analysis, I’ll use the DUTCH hormone panel by Precision Analytical, where we’re looking at the metabolites, so how are you breaking down your hormones?  And that breakdown then shows us what’s happening with your progesterone, what’s happening with your estrogen, what’s happening DHEA, testosterone.  And so, I like to compare the two because we want to see what’s happening in the body right now versus how is your body breaking it down?  And it gives us an idea of some genetics.  It also gives us an idea of how your liver is working.  So, I’ll typically see really high estrogens or you’re favoring a bad estrogen versus a good estrogen.  And a lot of symptoms come with the quote, unquote, “bad estrogen.  Whether it’s painful periods, heavy periods, fibroids, and even endometriosis.  All those conditions are driven by an endocrine disrupting process.  It’s a hormonal imbalance, right? For [inaudible 00:11:29].

Dr. Weitz:                          Right. Explain what you mean by a bad estrogen.

Dr. Levesque:                    Yeah. So, there’s three different metabolites, E1, E2 and E3, and so there’s some that are more harmful and some that are better. Right? So, E1 is the good one, if you will, and then there’s E2 that’s more of the bad estrogen. And then E3 is kind of this in the middle where we see it in conditions where there’s a lot of replication, if you will. So, we’ll see that a lot in fibroids. We’ll see it really high in pregnancy because there’s a lot of growth that’s happening during pregnancy. And then you’ll see it in fibroids, endometriosis, and in pregnancy. And then E2, usually we see it in relation to cancers, whether it’s breast cancer, whether it’s cervical cancer.

Dr. Weitz:                          You’re referring to estrone as the bad one, estradiol as the good one, and estriol as-

Dr. Levesque:                    This middle where sometimes it’s okay to have it, but other times … It’s more about the ratios than it is anything else.

Dr. Weitz:                          Right. Some doctors consider estriol a weaker estrogen and estrone a stronger estrogen.

Dr. Levesque:                    Yeah, for sure. And like I said, in the body, it’s all about balance. Right? So, if I look at, they give you the gauges, and if you’re seeing someone really push towards one side, then you’re asking … Because some of it, it’s like I said, you’re going to see a little bit of genetics too. Right? We have certain enzymes that are upregulated, and so they’re going to push certain pathways, and so you might need to eat more cruciferous vegetables just because that’s what your system needs in order to function at its best. And this is where we can get into more customization and personalization as opposed to this generic advice of, “Yeah, absolutely everybody should be eating vegetables and having good quality protein and clean water and all that jazz.”

                                                But when that’s not enough or when you’re not getting results from that, it doesn’t mean that, “Oh, okay, I guess this isn’t for me.” It’s more like, “Well, what else is missing? And let’s dig deeper and maybe we need a little bit more of something and maybe now we need to tweak your supplement routine and take a look at your environment a little bit deeper.” Because we know those are the basics. We can’t get away from that in terms of as a human, everybody needs to move their body. We can’t not move our body and say that we’re healthy. That’s the same kind of what I see with some of the basics of the protein and eating enough protein, eating enough veggies, water, all that jazz.

Dr. Weitz:                          Now, when it comes to hormones, one factor that I know is very common is quite a number of women who’ve been taking birth control and often taking birth control for years and years.

Dr. Levesque:                    Yep.

Dr. Weitz:                          How do you deal with that?

Dr. Levesque:                    It’s a huge problem. Yeah, it’s a huge problem. I mean, one of my patients right now, she just conceived, she’s at 10 weeks. She was on birth control for 20 years. Since basically 12 years old, was put on birth control, whether it was PCOS or something, and then just one of those never got off it. Didn’t know enough about it. And so, it took us almost a year to regulate her cycle to a point where instead of it being every 60 days and then 55 days and 42, and it was a lot of work.  So, birth control, that relationship that I talked about, the brain and the ovaries, it just shuts down that communication altogether. So, now the brain and the ovaries are not talking. And if they’re not talking for a year, okay, the brain can restore that relationship, and maybe it’s even five years, it’s okay, it might take some time. But if it’s been a decade, if it’s been 15 years, it’s going to be harder and harder for those pathways to come back and to come back in a good strong way, if you will.

                                                Then the next component with birth control is, I mean, it’s a synthetic hormone, so your body has to process it, and it takes a lot of nutrients, so it depletes a bunch of nutrients from your system. And of course, like I said, it’s a synthetic hormone, so it’s strong. Your system has to work through that. And so, we see deficiencies in B vitamins, in a lot of antioxidants that are really important for fertility, like an N-acetylcysteine and CoQ10, zinc, selenium. Things that are of course also important for the thyroid.

                                                And then there’s a connection between the microbiome as well of the gut. We talk about hormones a lot, but it’s like you can’t balance hormones without gut function. If you have poor hormone function, guaranteed you’ll have something in the gut even if you quote, unquote, “Go to the bathroom, have a bowel movement once a day, twice a day, and you don’t have any issues. I have mild bloating.” I find a lot of us are disconnected and have no idea what a good bowel movement actually looks like and feels like. And so, if you have imbalanced hormones, you probably have microbiome issues as well. But the connection there, Ben, is that it’s a huge impact on … It wipes out a lot of the good bacteria, and so then, hey, that’s going to make it really hard for the body to produce neurotransmitters like dopamine and serotonin. And so then there’s anxiety and depression that’s associated with that. So, it can just spiral downwards.

Dr. Weitz:                          Yeah. Shame on them. They should have the Bristol stool chart on their wall.

Dr. Levesque:                    That’s it. Exactly. Exactly. But in all honesty, we’re not really taught and I’ll have a lot of women who have shame around even talking about bowel movements because it’s like it’s a private thing, you shouldn’t talk about it. And we’re holding this all the time, and so our pelvic floor is really tight. And we’ll look at the stool analysis and it’s like there’s an insane amount of overgrowth and there’s so many pathogenic bacteria there.  And we think that our gut is so separate from our reproductive system, but if you look at the abdominal cavity, it’s like it’s all crammed in there. Your uterine lining in your uterus is separated from your GI tract by a tiny little membrane, and all of that stuff travels back and forth. And so, you might not have a bunch of yeast infections or UTIs or whatever, urinary tract infections, to have pathogenic bacteria that’s all surrounding your reproductive organs, which becomes really vital for a successful pregnancy.

Dr. Weitz:                          So, how do you like to analyze the stool? What’s your favorite stool test you like to run?

Dr. Levesque:                    I’ve used the Diagnostic Solutions before and over the last couple of years I’ve switched to Vibrant America and I love it. It’s probably the most comprehensive. The Gut Zoomer is the most comprehensive one I’ve seen to-date. They test up to eight inflammatory markers, and they do all the immune system and the microbiome and the pathogens. Detecting your pancreatic elastase, so how well you’re absorbing, digesting food. Short chain fatty acids.  So, I’ve really learned to love the test and I find it gives me so much information to just really look at the gut in depth, so we can start attacking and addressing some of the things that are going to come up. Because there’s no such thing as a normal stool analysis. There’s a little bit of fear, I think, from people like, “Well, I don’t want to invest into lab testing because everything is always normal.” And it’s just like, yeah, it’s not possible.

Dr. Weitz:                          Well, the other thing is patients, they don’t understand the levels and depths of lab tests that are available.

Dr. Levesque:                    Exactly.

Dr. Weitz:                          And they go to their doctor, they get a CBC and a chem screen and maybe a basic lipid profile if they’re lucky, a couple of hormone tests. And each test is put on a separate sheet of paper, so it looks like they had every test that you could possibly get. And actually-

Dr. Levesque:                    Is that why they do that?

Dr. Weitz:                          … on the scale of lab tests, they had this much done.

Dr. Levesque:                    Totally. Yeah. No, I agree. And that’s the point that I made before, it’s like, you want to understand what really got tested. I just took on a couple a month ago and they were like, “Yeah, sperm analysis is fine.” And I put out this freebie to be like, “Hey, if you’re not getting pregnant, make sure you check your partner’s sperm analysis, and these are the parameters.” Turns out he didn’t even have enough volume to run the test. And so they read it as, “Oh, it’s normal, don’t worry about it.” Versus he had to go back in and do it. And so, it’s like there was this six months period that they had no idea that something was wrong, where in reality there was a lot of things wrong.  So, infertility and fertility in general, once, especially we as women decide we want to have children, that time is on. You just feel like every month the clock is ticking. And so, from the perspective of not feeling like you’re wasting time, you want to understand what’s going on, both of you because it takes two. And so hopefully whoever is listening is like, “Hey, collect your labs and take a look at them yourself.” And if you have no idea what you’re looking at, your doctor should be showing you that. That’s what a good doctor does is, hey, doctor is teacher, right? “I’m going to show you that these are the things that are wrong. This is how you’re going to fix it.” Instead of waiting for the big red diagnosis, you can do something about things … We all have something to improve on, right? Always.

Dr. Weitz:                          And I think the health of the man gets overlooked quite a bit. And that’s at least 40%, right, of the potential issue?

Dr. Levesque:                    Huge. Oh yeah, for sure.

Dr. Weitz:                          It’s easy for a guy to say, “Well, I’m fine. It’s not my problem.”

Dr. Levesque:                    Yep. Totally. And the saying that I like to say is, men don’t go to the doctor, they go to the emergency room. All my men who come on, they’re like, “Everything’s fine. Everything’s fine.” And then I look at even half the stuff and we test and I’m like, “Oh my God, how are you not…” Because there isn’t that report card that you get every month. Males in general are not … You don’t have this cyclical, where we as women, if something is wrong, we will know it in the second half of the cycle. Men’s cycle is daily, right? That testosterone, it’s up and down and then peters and then up again and down. And so, it takes a lot for a male to be very aware and in tune to say, “Hey, something is off.”

Dr. Weitz:                          And men tend to ignore their health.

Dr. Levesque:                    Yes.

Dr. Weitz:                          They fill out those health questionnaires that we have everybody fill out, and the guys will have one or two and you start asking them and they go, “Yeah, actually I do have constipation and bloating, but it’s fine.” So, they put zero down. And, “Yeah, I do have fatigue, but I put nothing down because it’s okay.” And once you start going into their history, there’s a million things going on. They just don’t-

Dr. Levesque:                    For sure. And some of that I think is training, right? I’m not sure what you experience in your practice, but societal that, “Hey, I have to be the strong tough guy and I can’t show weakness.” That we really need to start breaking that barrier because I know for me, it was a big, with my husband when we first met, it’s like I’m a naturopath, he was into fitness, but it’s like there’s a big discrepancy in terms of what you do when you’re working out in a gym versus a naturopath. And I was very straightforward of, “This is really important to me. I want to grow with someone who is also going to want to be healthy and grow a healthy family together.” And this was before we got married, because it’s like, “Hey, if we’re not on the same page now, it’s going to be very hard to be on the same page down the road.”

Dr. Weitz:                          Your husband’s into fitness?

Dr. Levesque:                    Yeah. We owned a CrossFit gym four or five years and we have been in the fitness industry. I was a personal trainer for a while, and then looked into nutrition and just deeper layers of like, I had IBS and weight loss resistance after you gained the freshman 15. For me, it was more like freshman 25. And it’s like, hey, I’m exercising, I’m eating well and my weight is not coming off, so something else is going on here.  And as a trainer, I used to see women and men who would work so hard and they would eat so well and nothing would happen. And it was just like, okay, there’s more to it than just nutrition and exercise. I think it’s an important piece, but I call my approach the pizza approach, where nutrition and exercise is important, but now you have to look at detoxing. You have to look at environmental toxins. You have to look at labs. You have to look at supplements. You have to look at mental and emotional health. You have to look at community and who’s supporting you, and stress.  So, when you look at just exercise and nutrition, now you’re like, oh, that’s just two pieces of the pie. So, if you’re doing that and you’re not seeing results, just know that it’s not that you don’t need to do those pieces. You absolutely still do, but there’s at least six other pieces that are missing.

Dr. Weitz:                          Yeah. My path to functional medicine and health and chiropractic came initially via fitness, and I did the whole bodybuilding thing back in the ’80s.

Dr. Levesque:                    For sure. Yeah.

Dr. Weitz:                          And learned how to manipulate body fat and everything else.

Dr. Levesque:                    Yep. Yeah, it’s funny, we’ve come full circle. I started in the bodybuilding and then we got into CrossFit, and then we went back a little bit into bodybuilding. Now we’re getting into running. And it’s just exploring different ways of moving your body and what your body’s capable of. But the theme doesn’t change. It’s what I was saying in the beginning, it’s like you have to move your body. That’s not an option, not to.

Dr. Weitz:                          Right.

Dr. Levesque:                    That’s just the machinery and how it works and what it needs. So, how can you make it fun for yourself?

Dr. Weitz:                          Yeah. So, you mentioned nutrient levels and looking for micronutrient deficiencies. What tests do you like to run? My guess is you like the Vibrant micronutrient test.

Dr. Levesque:                    Yeah. Yeah, I do. I like to run the same lab if I can, because for the most part, it makes it easier for myself, but obviously for my patients as well, because they’re getting one package versus 17 different ones.

Dr. Weitz:                            Right.

Dr. Levesque:                    And they run the red blood cell and the white blood cells. So, the red blood cells show us what’s happening now versus the white blood cells shows us what deficiency has been around for longer, so usually minimum three months, but sometimes we can see that six to nine month mark if it’s been truly deficient for a long time.   So, I like that test. And it gives, of course, lots of different antioxidants and vitamins and minerals and amino acids and fatty acids. And fatty acids are really important, like the omega-3, omega-6 ratios, because there’s a lot of different diets out there now. And so, people have thrown themselves into different diets, whether it’s keto or metabolic diet or you name it. There’s just so many different stuff that people are trying. Where I like to see, hey, how’s the body doing? And then we feed it what it needs, because if your diet is missing something and you need to supplement, like we all need to supplement now, but you know what I mean? It’s like if it’s really deficient because you’re not getting in your diet, then it’s probably not a good diet for you.

Dr. Weitz:                          Right. Better to test, don’t guess, rather than just pick a diet based on philosophy.

Dr. Levesque:                    For sure. Yeah. Yeah. And with that advice, I say it depends on where you are. If you’re just starting out, you can probably get away with just some general advice of, “I need to drink more water. I need to start moving my body.” But if you’ve been at this for a while and you feel like the amount of effort you’re putting into your health doesn’t match the output, meaning, I’m putting in all this effort and my cycles are still irregular and I still can’t lose weight, then there’s a missing piece. And so those general approaches are not going to work for you anymore because you’ve already done that.  And so, that’s kind of, if I can bridge the gap for some people to say, “Oh, and I’m ready for the deeper level.” Versus just generalities of eat better, exercise, sleep more, all that jazz that we all need to do anyways.

Dr. Weitz:                            What are some of the most common micronutrient deficiencies you’ll see, let’s start with women who are having issues with fertility?

Dr. Levesque:                    For sure. So ,I mean, vitamin D is pretty up there. Selenium usually. Selenium and zinc. So, thyroid. Sometimes I see things like the vitamin A and vitamin E, so those really strong antioxidants. Surprisingly enough, I don’t see a lot of CoQ10 because so many women will supplement with CoQ10 because they’ve seen the research and the studies. And so, one of the things I always say is, “You might need CoQ10, but you might not.” And so, if your CoQ10 levels are good, but you’re taking it, that’s the whole, “Well, I tried this and it didn’t work.”  So, a lot of the thyroid nutrients, like I said, the selenium, zinc, vitamin A, vitamin E, even sometimes vitamin C. And that usually depends on what’s going on with the immune system. Vitamin K, if there’s a lot of digestive stuff, K1 and K2, because we produce a lot of that in the gut. So, I’ll see that deficiency. So, usually I never just run one test, right? Not one test is going to give us all the information. So, it’s being able to connect those dots.  And then the omega-3 and omega-6, the omega-6s are usually high and the omega-3s are low, so it makes that ratio way off. And so you’re more inflamed, and that comes out in different ways for women, whether it’s painful periods, whether it’s heavy period, maybe it’s skin issues. It’s inflammation, so it shows up in different ways for people.

Dr. Weitz:                            So, let’s talk about fish oil or omega supplementation. For a woman who tests is low, what would be a typical recommendation, let’s say for 100-and, I don’t know, 30 pound woman?

Dr. Levesque:                    Yeah. So, I actually first look at the diet because sometimes it’s not so much that the omega-3s are really low, it’s that the omega-6s are really high and that ratio is thrown off. And so, omega-6s are going to come from seed oils. Right? And it’s not that we don’t need omega-6s, it’s just that we can’t have too much, and there’s even omega-6s in eggs. Right? So, it’s not that, “Oh my God, I need to stop eating eggs.” It’s understanding the ratio and how much balance.

Dr. Weitz:                            Yeah, there’s omega-6s in nuts and seeds.

Dr. Levesque:                    Exactly. And so, it’s not that we don’t need it, it’s that where’s it coming from? And so, the big popular trends of the oat milk and the almond milk, if you look at the ingredients, and I like guilty, jumped on the train was like, “Oh my God, amazing. Another milk alternative.” But if you look at oat milk, it’s seed oils and it’s really high in sugar because it’s oats, oats are sweet. And so it’s probably one of the worst combinations that we can throw into our system with this really high bad fat, high seed oil and high sugar.

                                                And then you look at conventionally grown meat, and even chicken, chicken breast has probably the lowest nutrition profile. So, all my fitness geeks out there who love chicken because it has the best macronutrients on there, it’s so high protein, no fat, no carbs. It has the worst nutritional profile, and it depends on what those chickens were eating. So, if they’re eating a lot of seeds, and the same with beef, it’s like why grass fed? Well, grass fed beef becomes high in omega-3s, but conventionally grown corn and grain fed beef is now high in omega-6s.

                                                So, it’s switching the type of food that you eat will actually make this big difference because now let’s talk about fish. We have to look at, it’s really hard right now to source high quality fish without any contaminants of heavy metals, plastics, BPAs and phthalates and all this stuff that literally the fish is absorbing, and that includes getting really high quality fish oil. So, I would make sure that that company is reputable and they do the testing. And you probably are still getting some exposure, but it’s very minimal and the pros are going to outweigh the cons.

                                                So, I go through the food first to make sure that, hey, what’s happening with our diet? Because again it’s, “Oh, I’ve been eating chicken breasts exclusively for however long. I don’t eat red meat because I thought…” Whether it’s a macronutrient thing or, “I can’t digest it because I don’t have enough…” Or whether it’s, “I decided to be a vegetarian or a vegan.” And then, “Oh, I’m having all these milk alternatives that turns out have really high seed oils.” Or even crackers and popcorn, things that are healthy, there’s still a lot of seed oils in there.

                                                And so, it’s everything in moderation, but it turns out you’re not having it in moderation. It turns out it’s the majority of your diet. And then we look into high quality supplementation, and I’ll do anywhere three grams to six grams of total omegas. The EPAs we’re looking at probably a gram a day is what I’d like to get in. So, you have to read your labels, because like a high potency one it’s usually one teaspoon twice a day versus if you’re just getting something on the shelf, it’s like you’ll need to take 12 caps to get that.

Dr. Weitz:                          Yeah. Especially if you’re using a … What’s that one source of omega-3s from the little fish? What’s it called? I drew a blank. Anyway.

Dr. Levesque:                    I know, I was like aqua-something, but I’m not sure if that’s the same one that I’m thinking about.

Dr. Weitz:                          Anyway.

Dr. Levesque:                    NutraSea.

Dr. Weitz:                          What about adding additional DHA, since DHA is so important for the nervous system, brain development?

Dr. Levesque:                    Usually, I do both.

Dr. Weitz:                          You do both?

Dr. Levesque:                    Yeah. Usually it’s a combination. Yeah.

Dr. Weitz:                          So, you do a typical EPA, DHA and then add additional DHA? Yep.

Dr. Levesque:                    Yeah. The-

Dr. Weitz:                          Yeah, oh krill oil, I was talking about. Most krill oil capsules have maybe 100 milligrams of EPA and DHA.

Dr. Levesque:                    Yeah, that’s right. So, I mean, it’s really understanding because the micronutrient testing again will show you the EPA and DHEA. And once my patients are pregnant, especially in that second trimester, I’ll put them on a much higher dose of DHEA. But usually the fish oils, they’re not just one omega, they have the ratio, and so it’s just playing around with the ratio. So, instead of it being two-to-one of EPA to DHEA, that ratio is flipped.  And so, it really will depend on your needs and where you are in the process. Like I said, in pregnancy, I’ll hype that up even more. And with supplements, when you’re just exploring it yourself and doing it yourself, you’re going to stick on the lower side of the recommendation or whatever the recommendation is. But it’s like half the times that’s maybe a quarter or maybe half the dose of what you need. So you’re like, “Oh, I didn’t notice the effect.” It’s like, well, yeah, what if you got prescribed a medication and you only took half the dose? Unlikely you would feel that same effect. Right? So, it’s the same with supplements.

Dr. Weitz:                          Yeah. In terms of not getting enough EPA and DHA, the same thing goes for some of these prenatals.

Dr. Levesque:                    Yes.

Dr. Weitz:                          Sometimes they’re prescribed and they contain fish oil in it, and patients feel like, “Well, this has everything I need.” But if you’re taking one tablet or capsule, the amount of EPA and DHA you can get in there is minuscule.

Dr. Levesque:                    Well, in sticking fish oil with everything else, the way that fish oil is stored should be different than the rest of your vitamins.

Dr. Weitz:                            Right. For sure.

Dr. Levesque:                    And so to me, that’s a red sign. If anyone who’s watching this was like, “Don’t want to do that.” Because number one, I know you’re going to get a low dose. Number two, it’s unlikely that you’re keeping your prenatal in the fridge. And then you can’t extract where that fish oil is coming from. So yeah, there’s certain things that we just need to keep separate. And that, I would say, is one of them.

Dr. Weitz:                            Yeah. What are some of the other nutrients that women particularly tend to need more of during trying to get pregnant and important for raising a healthy baby?

Dr. Levesque:                    Yeah, I think protein is really under … If I go back to the micronutrient analysis, if I test the amino acids, you can see different types of amino acids that are missing for women. So, if you have a lot of digestive issues, L-glutamine is going to be way off. Usually if you’re seeing a lot of stress, serine is going to be off, and that heightens that anxiety and inability to sleep and just feeling like things are not right, if you will.  So, women need that 30 to 40 grams of protein per meal. And ideally, it depends on if you’re exercising or not and what your goals are, but you should be hitting that minimum 100 grams a day. And I think you would be-

Dr. Weitz:                          Yeah, I would say most women are not getting that or even close to that.

Dr. Levesque:                    Yes. No. Yeah, if you actually track your food, use MyFitnessPal and write in what you’re eating. I have a lot of people, even my marketing manager was like, “I’m eating so well.” And blah. And I’m like, “Show me your breakfast.” And as soon as she shows me her breakfast, it’s like, that’s seven grams of protein. You have one egg, you have a bagel, and you have some whatever fruit on there. And it’s just like that’s considered a healthy … And then it’s like punch that in and understand that you need to make that 30 grams. And she’s like, “Oh, so even two eggs is not enough?” Yeah, even two eggs at breakfast is not enough.  And so that if you think that you have enough protein and you think you’ve tried everything, just go ahead and punch your food in for three days and you’re going to learn so much about what’s happening in your system. Because I can tell by just the way that the body looks as I’m sure you can, how the person is feeding themselves, how they’re taking care of themselves, what they’re taking, what they’re doing. And so, it’s like if you’re not getting enough protein, you need that for literally everything in the system.

                                                But your hormones, we talked about FSH and LH, they’re amino acid hormones. We have fat-based hormones, so those are all steroid hormones. Vitamin D is needed for that. Omega-3s are needed for that. Then we have the amino acid hormones, they’re peptide chains, that’s your FSH and your LH. So, your system literally cannot function without protein. And then talking about building a new human, guess what it’s build out of? The things that you eat and your tissue. And so, if you’re tired and exhausted and your nutrients are depleted, the body has nothing to draw from, and so it just can’t do it.  I say that we as women create from a place of abundance and vitality. It’s like that energy needs to be overflowing like it has nowhere else to go but to make a baby. It’s like, how many women listening to this right now feel like that? 1%, 2%?

Dr. Weitz:                            A nutrient that’s come up on the radar screen for me and I’ve seen it on some of the micronutrient tests with women trying to get pregnant or even who are pregnant, being low, and at least one company has started adding 500 milligrams to their prenatal is L-carnitine. There’s actually quite a bit of interesting research on its importance for fertility.

Dr. Levesque:                    Yep. Yes. Yeah, I don’t see it a lot low on my stuff, but I do know about it. Of course, it’s the same as CoQ10, I think it just depends on who comes through your … But L-carnitine is huge. I see it a lot in weight, of course weight loss, but L-carnitine is important for mitochondria. Right?

Dr. Weitz:                          Yeah.

Dr. Levesque:                    And so, mitochondria is the essence of our fertility. Everyone is doing research on it in terms of aging, anti-aging. If you have good functioning mitochondria, you’re basically, you’re set because the mitochondria does so many things for us, but it’s a very important nutrient. I would agree with that.

Dr. Weitz:                          What are some of the micronutrient deficiencies that tend to come up among men?

Dr. Levesque:                    Yeah. So, for men, again, it’s going to depend on what’s their picture, but for fertility sake, if you will, so stress is a big one. And then stress impacts testosterone levels. And so, then you’re looking at is it digestion that’s preventing you from absorbing all those nutrients? Do you have pathogens that’s taking that up?  So, in males we’ll see actually very similarly, selenium, zinc, vitamin A, vitamin D, vitamin K, if their digestion is off. But now it’s playing a different role for them, meaning that it’s not so much the thyroid, but production of usually you need all those nutrients for production of good, strong sperm. And then with the immune system connection, if there’s a lot of environmental toxins or even pathogens like gut pathogens, then if all those nutrients are going towards dealing with that instead of making good sperm.

                                                I’ll see amino acid deficiencies as well. And cysteine is a big one. So, N-acetylcysteine, that’s a really important antioxidant, really important for fertility as well. And so it’s funny, right? The nutrients that we as females need are very similar to the nutrients that the males need as well. They just play different roles within the body.

                                                And then L-glutamine if there is a lot of digestive. And I’ll see glutathione low, and glutathione is a really strong antioxidant. And I find typically that’s because males are not as … Even when couples say, “Oh, we basically eat the same thing.” But the female just adds a little extra micronutrient, microgreens on her salad, or she throws a little extra hemp seed or some other antioxidant powder into her smoothie that the male just doesn’t tend to do unless the female is making it for him. But those little things add up.

                                                Like the females will get the salads at the restaurant where the males are more likely to go … Right? And I know that I’m making some general statements here because obviously, it’s not true for everyone. But what I see is that glutathione will be on the low sign because males are more likely to drink a little bit more, they’re more likely to maybe stay up a little bit later. Not make those little choices of … And I speak from my experience, my husband is not the one who’s like, “I should sprinkle some microgreens on this.” I’m like, “Put this on there.”

Dr. Weitz:                            So you mentioned toxins, and we’ve heard a lot about estrogenic substances in the environment that are common in BPA and phthalates and pesticides, et cetera. What type of toxin testing do you like to do? And then, what are some of the typical detox strategies you like to incorporate?

Dr. Levesque:                    Yeah. This is a big topic, and honestly that is the 99% of my practice is getting people cleaned, cleaning out their environment and helping them clean out their system so their body can work the way that it’s designed. I use CellCore products. I don’t know if you’ve heard of CellCore, but they’re really big in the detox space and have made some groundbreaking products that have been very defining for my practice and my patients and myself.

                                                But I use the Vibrant America total toxin burden test because I get the heavy metals, I get all the environmental toxins, so the plastics, the phthalates, the parabens, the volatile organic compounds. They actually just released a test where you can test the PFAS, so the forever chemicals as well, to see how much your system is excreting. And I’ll look at organic acids, which is just how your cells are metabolizing things, right? Nutrients, fatty acids, carbohydrates, and then bacteria, yeast, that fungus, we can see that.

                                                Because the belief here is that the toxicity is actually the thing that’s causing the nutrient deficiency. I’ve come from a place where I’ve supplemented a lot and nothing shifted. And so, the idea that if you have to throw a bunch of supplements at your body just to barely function, doesn’t add up. So, I use the bathtub analogy a lot like with a shower head, and then you’re the goldfish swimming in that bathtub. The water coming in, the cleanliness of that water is going to be really important. So, that’s you figuring out what’s in your environment that needs to be tidied up. Is it the lotions and the potions that you’re putting on your face? Is it the quality of the water that you’re drinking? Do you have a good reverse osmosis or distilled water or are you still drinking BRITA and bottled water?

                                                What is the quality of the food that you’re eating? How much of it is organic or locally grown or you grew yourself versus processed versus conventionally grown and heavily sprayed with pesticides? Because we can look at all those things and we can test all those things. And then of course, any past exposures, like I have patients who grew up with parents who smoked in the house. And unfortunately some of those heavy metals like cadmium and mercury, they’re still very much present and persistent in the system because it takes a long time for the body, the body tries to protect you, and so it stores it in the fat. And so, those are the same women who have a hard time losing weight, they have painful periods, they have endometriosis, adenomyosis, because they’ve had this really heavy toxic load and the body has just not been able to process it.

                                                So yeah, we’re going to clean up the environment, that’s the shower head, but now let’s look at the drain and then let’s look at the sewer. Because if you put clean water in, that’s fantastic, but what about all the grime that’s still left on the sides? What about the murky water? You need to open up that drainage. So, you need to make sure that that liver is working, that gut is working well, right? You’re sweating on a regular basis.

                                                And then once that drainage and the sewer is working well, then we’re going to get in there and we’re going to scrub and we’re going to scrub the sides. And so, you’re not going to start with a heavy metal detox. You just need to open up that drainage first and make sure the body has enough energy to even detox. And then once you’re having two or three bowel movements a day and they’re really full and you’re eating enough veggies and you’re sleeping well … And for some people that takes months, for some people it takes years. So, I always say, “I don’t care if you’re a slow cooker or a microwave, you want to move in the right direction. It doesn’t matter the speed, but move in the right direction, but don’t start scrubbing before you do the other things because it’s wasted effort. Right? We don’t want a wasted effort. Let’s be strategic because we all have limited amount of time. That’s our most precious resource.”  So yes, clean up the environment, open up that drainage, make sure that sewer is not clogged and nothing is coming back up. And then we scrub so that water is clean and that fish can be happy.

Dr. Weitz:                            Cool. Let’s hit one more topic. Let’s hit thyroid and then we’ll wrap and you can give us your contact info.

Dr. Levesque:                    Yeah.

Dr. Weitz:                            So, thyroid is super important for fertility, for being able to get pregnant. There’s been a lot of focus on it.

Dr. Levesque:                    Getting pregnant.

Dr. Weitz:                            So, give us your take on thyroid. What tests you like to run, what interventions do you recommend?

Dr. Levesque:                    So, I’ll say that thyroid is never the only thing. I find it’s rarely the culprit. I find that it is impacted, but it’s not the root cause. And so, it works in conjunction with stress with the adrenals and the ovaries. It’s a whole hormone picture. But most people, first of all, do not get the proper thyroid panel. So, you test your TSH and you’re told that it’s fine. Your TSH just tells us how well the brain is communicating to the thyroid, doesn’t actually tell us how much thyroid hormone your body has. And so, that’s not a complete test. So, you need to have a TSH, but you also should do free T3 and free T4. And then you should probably run some antibodies to see if there is an autoimmune condition that’s present within the thyroid, because autoimmune conditions are going to put you at a much higher risk for miscarriages, and they go unnoticed, undiagnosed all the time.

                                                And then even things like reverse T3, I don’t want to say that necessary, but it’s good to look at it. Right? I’ll run all that stuff. A lot of docs will just run the free T3 and free T4 and the TSH, and it won’t look at the antibodies. But thyroid, it’s your metabolism hormone. It turns everything on. It’s so important for being able to conceive, but also to be able to maintain the pregnancy, and that’s something that should be checked. Again, I have so many patients who have to fight to get these tests, which is insane to me that, hey, your TSH is high, you’re pregnant. You should be like, “We need to address this right away.” As opposed to, “Oh, it’s okay, it doesn’t matter.”

                                                So, I find that a lot of people will focus on thyroid if they have weight issues especially, because everyone’s educated themselves, “If I have poor thyroid function, I’m going to struggle to lose weight.” But in reality, usually there’s a bigger component. Usually the liver is involved. Usually there’s some sort of inflammation. For some people, the immune system is going to be involved. And so you want to look at the gut, thyroid, the stress, the inflammation, and look at it as a whole picture instead of just these single … When I see the thyroid is off, I just know that something is off, but we don’t understand why. So, let’s dig deeper.

Dr. Weitz:                            So, let’s say you get a patient, and I am not sure what figure you like to see as far as TSH, if it’s 1.5 or 2 or 2.5.

Dr. Levesque:                    1 to 2. 1 to 2 is where I’d like to see, yeah.

Dr. Weitz:                            1 to 2. Okay. So, let’s say you get a patient who has slightly elevated TSH, like 2.5, 3, and then their free T3 and their free T4 are in the low end of normal, maybe there’s no antibodies. What would you do? Would you send them back to their primary care doctor to get Synthroid or what would you do?

Dr. Levesque:                    Yeah. That’s a great question. So no, usually when it’s just you’re starting to see it low, this is where natural medicine really, this is our jam. Right? We just start to see that the thyroid is sluggish. The next thing I’m going to look at is, well, why is that low? So, if both free T3 and free T4 are low, it’s likely that you don’t have enough nutrients to make those hormones. And whether it’s amino acids, whether it’s that vitamin C, selenium, zinc, vitamin A we talked about, or iodine, or then the communication between the brain and the thyroid, because everything is a negative feedback loop.

                                                So, you’re just going to look at, okay, if both of them are low versus we make mostly T4 and then it’s converted into T3 in the liver. If you’re making lots of T4, but that T3 is really low, chances are that liver is sluggish and so that conversion isn’t happening. And so, you can start to get an idea of what’s going on, but this is worth some more testing. If I look at micronutrients and all your thyroid hormones are low, hey, guess what? You probably just don’t have enough of the actual nutrients. So yeah, we want to boost that.

                                                But then the next question is, well, why are those things low? “Oh, let’s look at the gut. Okay, you’re not absorbing. You have these pathogens. Okay, so let’s fix the gut.” And then, “Why do we have all these pathogens and why is the liver overburdened? Let’s look at the environmental toxins.” So, I say there’s the test that shows what’s happening and tests that shows why it’s happening. We want to know the what because it helps us get quick wins. I want you to feel better now so you can keep going, but if we don’t address the why, you’re going to be stuck in the what all the time, right? You’re going to be now dependent on those supplements. So, that’s my approach is that, okay, this is good. We want to keep an eye on this, but let’s go deeper. Let’s go a little bit deeper.

Dr. Weitz:                          And that, of course, is the true magic of the functional medicine approach and what really looking at root causes is.

Dr. Levesque:                    100%. Yeah. And I have a lot of people come to me who’ve come to practitioners said, “Well, they never looked at this.” And so if there’s practitioners listening to this, I encourage you to dive deeper. I know that some of your patients don’t want to do it. I have a ton of patients who I don’t accept because they don’t want to do it. They’re just like, “Oh, I want help, but not really.” So, it’s okay. What I hope is recognized for those patients that know that you don’t really want the help, and that’s okay if you’re okay with that, but if you want the help, this is the work and there’s people who want to do the work.  And I think it’s our job as practitioners to really show people that this is what’s possible and here’s some general advice that’s really great, but if you want to take it to that next level and actually heal your endometriosis or your PCOS instead of just manage it, then it’s not going to be just take CoQ10 and inositol and whatever and hope that it works. It’s going to be doing some much deeper work, the scrubbing, getting the gloves out, and doing the scrubbing.

Dr. Weitz:                          That’s great. Good. So, how can people get a hold of you? What’s the best contact information?

Dr. Levesque:                    Sure. Honestly, the best place to contact me is going to be through my Instagram. I’m on there, really active. I go on stories, I share lots of valuable content. I have my own podcast as well, Modern Health with Dr. Jane. But @drjanelevesque and lots of resources. On the Instagram you can send me a DM and say hello, and then I have the resources for the website.

Dr. Weitz:                          Can you spell your name for the listeners?

Dr. Levesque:                    Yeah. So, Dr. D-R J-A-N-E and then L-E-V-E-S-Q-U-E.

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

Dr. Levesque:                    Thanks so much for having me, Ben. It was a pleasure.

 


 

Dr. Weitz:                            Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five-star ratings and review. That way more people will discover the Rational Wellness Podcast.   And I wanted to let everybody know that I do have some openings for new patients, so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardiometabolic conditions, or for an executive health screen, and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way. And that usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective.   So, if you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111, and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.

 

Dr. Tom Fabian discusses Mast Cell Activation, Dysbiosis, and IBS at the Functional Medicine Discussion Group meeting on August 24, 2023 with moderator 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

6:18  IBS is a condition that is diagnosed mainly by symptoms and these are part of the Rome IV Criteria.  [These are found at TheRomeFoundation.org]  There are four recognized subtypes of IBS: IBS-C (constipation), IBS-D (diarrhea), IBS-M (mixed), and IBS-U (undefined).  Bloating and distension are common symptoms associated with IBS, but they are not officially included in the Rome IV criteria.  There is no currently accepted test for the diagnosis of IBS.  This is a good review article on what we currently know about IBS: Camilleri M, Boeckxstaens G.  Irritable bowel syndrome: treatment based on pathophysiology and biomarkers.  Gut. 2023 Mar;72(3):590-599.   

11:38  There are a number of conditions that result in similar symptoms to IBS, including Bile-acid malabsorption, exocrine pancreatic insufficiency, carbohydrate intolerance, SIBO, SIFO, Dyssynergic defecation, Ehlers-Danlos syndrome, mast cell activation syndrome, eosinophilic gastroenteritis, intra-abdominal adhesions, celiac disease, and giardiasis. Dr. Fabian noted that we are learning that a significant number of patients with IBS symptoms, esp. on the diarrhea side, have a sucrase-isomaltase deficiency, which is one of the brush border enzymes in the small intestine.  This leads to a malabsorption of sucrose and certain starches.

16:15  IBS Mechanisms.  Diet is an important factor since 85% of IBS patients report their symptoms are triggered by eating, often 60 min or so after eating.  Leaky gut is a factor in most GI conditions. We see immunoactivation/inflammation, though a more subtle form of inflammation than what we see with inflammatory bowel disease like Crohn’s disease. This is where mast cells come into play. There is also the gut-brain axis.

18:12  Disorders of Gut-Brain Interaction.  The new name for functional GI disorders being adopted in research is Disorders of Gut-Brain Interaction.  This is a good review article on this:  Vanuytsel TBercik PBoeckxstaens G.  Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders     We see as part of the pathophysiology in IBS a subtle mucosal infiltration of immune cells, especially mast cells and eosinophils, along with the increased release of  nociceptive mediators, which lead to visceral hypersensitivity, which plays a role in abdominal pain.

22:20  The pathogenesis of IBS is explained well in the following article: Carco C, Young W, Gearry RB, Talley NJ, McNabb WC, Roy NC. Increasing Evidence That Irritable Bowel Syndrome and Functional Gastrointestinal Disorders Have a Microbial Pathogenesis. Front Cell Infect Microbiol. 2020 Sep 9;10:468.  Dysfunctional microbiota leads to increased intestinal permeability that leads to immune activation that results in mast cell activation and visceral hypersensitivity that leads to abdominal pain, bloating, and altered motility. 

       

              



Dr. Tom Fabian is a leading expert on the role of the microbiome in health, immune function, chronic disease and aging. He received his PhD in molecular biology from the University of Colorado Boulder, and he’s worked as a biomedical researcher in the biotechnology industry and more recently as a consultant in the microbiome testing field.  Currently, Dr. Fabian serves as a consultant and science advisor with Diagnostic Solutions Lab. Tom’s website is Microbiome Mastery.com. 

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their 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.

                                                All right. Hello, everybody. I’m Dr. Ben Weitz, and welcome to the Functional Medicine Discussion Group meeting tonight with Dr. Tom Fabian on the connection between diet, gut dysbiosis and mast cell activation in IBS, quite a title. I want this meeting to be interactive, so please participate by typing your questions into the chat box and then I’ll either call on you, or ask Dr. Fabian your question when it’s appropriate. Thank you for joining our monthly meeting and I hope you consider attending some of our future events.            September 28th, we have an integrative approach to depression and anxiety with Dr. Peter Bongiorno. October 26th, we are going to go back to our in-person meetings at the Santa Monica Library, and that will be an integrative approach to cardiology with Dr. Howard Elkin. I don’t know if I’ll be able to make it available remotely live, but I’ll certainly record it. I’ve got to figure out how to possibly do that. November, I’m not sure what the date is, but we’ll probably do it on the third Thursday instead of the fourth Thursday since third Thursday is Thanksgiving. December, we won’t have a meeting, and then we’ll start up again in January.   If you’re not aware, we have a closed Facebook page for practitioners only, the Functional Medicine Discussion Group of Santa Monica, that you should consider joining so that we can continue this conversation when this evening is over. I’m recording this event. It’ll be included in my weekly Rational Wellness Podcast which you can subscribe to on Apple Podcasts, Spotify, or YouTube. If you enjoy listening to the Rational Wellness Podcast, please go to Apple Podcasts or Spotify and give me a five-star ratings and review.

 


 

Our sponsor for this evening is Integrative Therapeutics and Steve Snyder is here with us this evening. And so Steve, why don’t you tell us about a couple of the integrative products?

Steve Snyder:              Well, hi, Ben. Thank you. The conversation earlier about the gluten, we learned this kind of the hard way. There is actually a lower limit of gluten you can have in products, which you can call them gluten-free even though they’re not gluten-free. You were talking about where are people getting exposed to gluten when they’re really sensitive, all over the place. We had a product called AllQlear that had a vanilla flavor in it. It had a little bit of gluten in it. It was below that lower limit, but we kind of pride ourselves on truth and labeling, so we said, “This product contains gluten,” and everybody freaked out and wouldn’t use it. It turns out it had less gluten than half the things in Whole Foods Market that say gluten-free, so that’s just a little nugget there.

                                                I know that we’re going to talk about SIBO again, and you guys have heard this all before. But we have reformulated the Elemental Diet, it’s quite a bit less sweet, quite a bit fewer calories from carbohydrates, so it’s much better tolerated. It’s a super powerful treatment option for SIBO. We do really great with it. Something around the neighborhood of 85% at three weeks have a negative breath test. So we have lots of support materials for it, lots of suggested protocols. We have samples. So if anybody’s interested in at least learning about it, you can reach out to me. We have several other products that go with that that we can talk about as well, some good prokinetic formulas, things like that. Yeah, we can talk about it any time you want. That’s it for today.

Dr. Weitz:                            Yeah, I use the Motility Activator, and that’s my favorite go-to natural prokinetic.

Steve Snyder:                      And we appreciate that.

 


 

Dr. Weitz:                            Okay. So thank you, Steve. Our speaker for this evening is Dr. Tom Fabian, who’s a leading expert on the role of the microbiome in health, immune function, chronic disease and aging. He received his PhD in molecular biology from the University of Colorado Boulder, and he’s worked as a biomedical researcher in the biotechnology industry and more recently as a consultant in the microbiome testing field. Currently, Dr. Fabian serves as a consultant and science advisor with Diagnostic Solutions Lab.  Tom, you have the floor.

Dr. Fabian:                          All right. Well, thanks so much, Dr. Ben, for inviting me here. And it’s great to be here this evening. Good to see everyone. I know it’s probably a little late in the day. I know it is here. I’m in Denver, Colorado and it’s not too far away from my usual bedtime. So bear with me, because my brain is slightly slower in the evening. So you can see here the title again is really all about the connection that we’re learning from just kind of an inundation of research the last few years on the links between diet, the microbiome, and particularly mast cell activation, IBS.

Dr. Fabian:                          So I’m going to go ahead and start here. I do have a fair amount of content to cover, but again, feel free to interrupt whenever you have any questions or anything you want me to clarify. I’ll be happy to stop and just answer any questions or discuss any of these topics. So just kind of a quick refresher here. I think everybody knows most of this stuff already. But in terms of diagnosis, we know IBS currently is still based primarily on symptoms and especially the Rome IV criteria.   So, of course, that really includes just a couple of things, altered bowel habits that are a main part of the differentiation between the subtypes, IBS-C, IBS-D, et cetera. And also abdominal pain. That really cuts across all types of IBS, so that’s a common feature. We’re going to talk about some of this pathophysiology research that’s coming out, and that really relates to both of these mechanisms and especially to abdominal pain, and that’s really where the mast cells come into play.

                                                We all know that bloating and distension are also common in this condition, but actually not officially included in the Rome IV criteria. The stats are a little bit different between IBS-C and IBS-D, so there’s tends to be a higher rate of bloating in constipation dominant IBS. There’s currently no widely accepted tests for diagnosis of IBS, although there’s lots of activity in this space, some tests that are available out there that I think over time some of these as they gain traction will become widely accepted. But currently there isn’t a given test that’s widely accepted across the [inaudible 00:07:58].

Dr. Weitz:                            By the way, Tom?

Dr. Fabian:                          Yes.

Dr. Weitz:                            IBS, you have IBS-C and D, which are constipation and diarrhea, IBS-M is mixed, and then IBS… What is IBS-U?

Dr. Fabian:                          So that’s a definition that I see sometimes and it, excuse me, refers to the mixed version. I mean, I’m sorry, the undefined version. So I guess that’s kind of a catchall for suspected IBS based on symptoms that doesn’t fulfill the other criteria.

Dr. Weitz:                            So that person doesn’t know if they’re coming or going?

Dr. Fabian:                          Exactly. Yeah, I’m really not that familiar with that definition other than it’s kind of the catchall bin for patients that don’t fit the other categories. So this is a really great recent review article, kind of on this trend now that we have so much research into these underlying possible connections with what’s going on in IBS that we’re possibly able to just start down this path of looking at what are some of these mechanisms, what sorts of tests can reflect these mechanisms, and some of these that are probably going to end up being emerging biomarkers. So this is, again, great review article by two of the leading experts in the field. That’s Dr. Camilleri, who’s been around for a long time. He is a big name in the IBS field. And also Dr. Boeckxstaens, who’s done some really great research recently on some of the aspects of this mast cell connection.  So they cover some of this in this review article. But I just want to cut to their summary here, where they sort of talk about this trend that we’re moving towards as we have more availability of these non-invasive clinical tests that can appraise the symptoms responsible for symptom generation that provides the opportunity to advance the practice from just treatment based on symptoms to individualization of treatment that’s guided by this pathophysiology, then, of course, based on the identified micro biomarkers as well. So I think this is a very exciting area of research. That’s definitely why… my motivation behind presenting this information, because there’s just so much of this research out there, thousands and thousands of papers, and I think it’s hard to keep up on all this information. So I think this is really especially useful for those of you who do a lot of gut microbiome stool testing, because some of what’s coming out really pertains to markers on these tests including GI-MAP.

                                                In terms of IBS pathophysiology and symptoms, when we’re looking at these underlying factors, obviously they have to account for these main symptoms. They have to help explain the altered bowel habits, particularly abdominal pain since that cuts across all types of IBS. But also the related symptoms, particularly bloating, distension and even the comorbidities. We know that stress, mood disorders, anxiety, depression are much more common in patients with these types of conditions like IBS. Even allergies are noted to be more common in patients with IBS. And then also clarify the relationship with these related conditions, we’ll see a list in a moment, that feature similar symptoms. And in many cases, the symptoms are almost identical so it’s hard to differentiate between IBS and some of these other conditions without specific testing, and sometimes unfortunately invasive testing.

                                                So, this is an example of one of those lists. This is by no means exhaustive, but these are some of the common conditions. You can see the title of this table here from a recent review article that references at the bottom. So they’re basically looking at all these different conditions that have symptoms similar in this case to inflammatory bowel disease, which certainly, especially in terms of IBS-D, diarrhea dominant IBS, tends to overlap with IBD. But just to give you a sense here, here’s IBS, and of course these are the common symptoms. If you look through that symptom column, you can see that there’s quite a few things there that have virtually identical or at least overlapping symptoms.  So, at the top we can see… Actually, let me go back to that. You can see bile acid malabsorption, pancreatic insufficiency, carbohydrate intolerance. So those are related to different aspects of digestion absorption. We certainly see evidence of that with our experience with GI-MAP. And there’s a fair amount of research, especially on bile acid malabsorption pertaining to IBS-D. It’s thought that 25, 30% of IBS-D patients actually have bile acid malabsorption. Pancreatic insufficiency is fairly common as well, not necessarily the full outright pancreatic insufficiency.  We also see patients with decreased pancreatic function based on the elastase marker. That doesn’t necessarily constitute full-blown insufficiency and yet we still see patients frequently will have bloating and IBS-like symptoms without sufficient pancreatic enzymes. [inaudible 00:13:23]-

Dr. Weitz:                            And Tom, the bile acid malabsorption, is that seen with the fat in the stool?

Dr. Fabian:                          So sometimes yes. You can imagine if basically foods are moving through too fast, there’s not sufficient time to absorb the fats, that can be part of the picture. We do see that sometimes. We don’t actually see high steatocrit all that often though. It’s usually in pretty extreme cases, and a lot of that actually has to do with a pancreatic insufficiency. So patients have really a poor pancreatic function, then they’re much more likely to have steatorrhea, i.e., fat in the stool.   The carbohydrate intolerance aspect is important. Of course we’re all familiar with FODMAPs and that FODMAPs can cause symptoms in IBS patients. But there’s greater recognition now that other types of carbohydrates… depending on the details for the patient. So there’s growing recognition, for example, of this sucrase-isomaltase deficiency, so that’s one of the brush border enzymes in the small intestine. Patients may be actually having IBS symptoms, especially on the diarrhea side, due to a malabsorption of sucrose and also certain starches. It’s thought that if a low FODMAP diet isn’t really helping patients and they seem to still have some sort of carbohydrate tolerance, it may be the starches and sucrose.  And again, some studies suggest that that may be as high as one third of IBS-D patients may have this sucrase-isomaltase type deficiency. So a lot of active research there. We’re going to to go into a little bit of the connection there between that and the microbiome, especially Klebsiella, small intestinal bacterial overgrowth, I know your audience was very familiar with that as well through Dr. Pimentel’s work, small intestinal fungal overgrowth. And then there’s of course a number of other things here. Mast cell activation syndrome itself has overlapping symptoms, and of course now we think that mast cell activation, not necessarily the MCAS syndrome, the classic syndrome, but a form of mast cell activation seems to be part of the picture in IBS, at least a subset of IBS patients.  Then there are a few other things here. You can see celiac disease near the bottom, even giardia infection can mimic IBS symptoms. So important to kind of consider this whole picture, and not necessarily just to any one particular conclusion off the bat. You do want to consider what else may be going on for patients.

                                            All right, so quickly, this emerging paradigm, I’m just going to summarize it here and then show a fair amount of the supporting evidence that we can talk about as time permits. But certainly, again, there’s this focus on switch from the assessment, diagnosis and treatment going towards the evidence-based pathophysiological mechanisms. And these leading mechanisms mostly currently implicate diet. So there’s a major role for diet. About 85% of IBS patients report that their symptoms seem to be diet triggered. And some of these studies that look at the occurrence of symptoms and the timing of symptoms, symptoms tend to occur in most patients, the majority of patients, within about an hour after eating, and then it sort of trails off after that.  So it is going to be variable, but the data does show that that’s pretty common for symptoms to be pretty soon within that 60 minute or so after eating.  First microbiome, we’re going to talk a lot about that today. Intestinal barrier dysfunction is well noted, not just in IBS but a long list of conditions. Immunoactivation, it’s not the type of inflammation we see in IBD, inflammatory bowel disease, it’s a more subtle type of inflammation. It’s more akin to a allergic type inflammation. So that’s really where mast cells come into play, because they do play a known role in allergies. And actually now it’s thought that dissimilar mechanism may be at play in IBS patients.  Then, of course, there’s the enteric nervous system, and then the connections with the gut-brain axis. All of these areas are actively being researched. And again, it is challenging to stay up to speed on all of this. But that’s where these review articles, I think, can be very helpful.

                                               This is another great review article that just came out earlier this year, Understanding Neuro-immune Interactions. And so this refers to the new name that’s being adopted in research for functional GI disorders. The primary ones are IBS and functional dyspepsia. And again, that new name is disorders of gut-brain interaction, to recognize this connection on the nervous system component.  So again, this article includes a couple of the researchers whose research we’re going to be talking about today, who’ve done a lot of work in this mast cell connection to IBS. Actually, I probably am going to go through most of this abstract just because I think it’s such a nice summary of the current state of research in this area of IBS. So at the top, they just sort of refer to that these functional GI disorders are now renamed into disorders of gut-brain interaction. Then they go on to say in the middle highlighted area, “Our understanding of the pathophysiology has evolved significantly over the last two decades, especially the last few years. Initial observations of subtle mucosal infiltration with immune cells, especially mast cells and eosinophils, those two are often related, are since recently being backed up by mechanistic evidence demonstrating increased release of what’s called nociceptive mediators,” those are pain mediators, “by immune cells in the intestinal epithelium. These mediators activate sensitized neurons leading to visceral hypersensitivity,” which is what they think primarily leads to abdominal pain.   So IBS patients tend to be more sensitive to even normal stimuli, such as even… Well, we think of gas production as being part of IBS. Studies indicate that IBS patients don’t necessarily always have more gas production, but they’re more sensitive to that based on this hypersensitivity. And then the last part they say, “This interaction between immune activation and impaired barrier function of the gut is most likely bidirectional with alterations in the microbiome, stress and food components as upstream players.” So that tells us a lot about how we can potentially intervene in terms of diet, modifying the microbiome, and of course, behavioral approaches as well.  This is from that same article, just kind of represented visually. So you can see here there’s the brain part of the gut-brain connection. Stress is a major factor. Stress certainly is known to activate mast cells. I will look at one of those example studies in a little bit. Food composition has a big effect on IBS. We know that that can be partly through altering the microbiota and its metabolites that it produces. The list of metabolites now that are implicated in IBS just keeps growing. There’s a lot of different vernaculars that they can produce.  And then we have those effects then of these different components on the intestinal barrier immune activation, and that can lead to neuronal hyperexcitability, which then leads to this… Just let me go back here. … disturbed gut-brain interaction and then the visceral hypersensitivity and motility. So we talked about the pathophysiology has to explain those two features of IBS, abdominal pain and motility differences. So this is representation at a high level of all these factors that we currently know can come into play. Is there any questions on anything so far, before we can dive into some of the details here?

                                                All right, so this is a… We’re not going to zoom in or look at this figure here. I’m going to zoom in on it just a bit. But another great review article. It goes through the evidence currently on the role of the microbiome and linking all the dots here. So this is a really busy figure, but I just want to break it down here real quick. We have the dysfunctional microbiome, also increased intestinal permeability, so things like LPS, some of these other factors they can produce histamine, et cetera, can get through and then affect the immune system and that can activate the immune system. That can then lead to this hypersensitivity that then explains these phenomena in IBS.  I just note off to the side here, they depicted mast cell activation degranulation that then can have an effect on the sensory nerves in the gut. And that’s thought to be one of the main ways in which mast cells can cause abdominal pain and also may have effects on motility as well. So it’s kind of a nice visual summary, once you break it down, on some of these key mechanisms. So a little bit of history on mast cells. It’s kind of a long history. It goes back as far as the late ’90s. This is an article from 2007 where they already were aware of some of these mast cell numbers increasing in IBS patients, mast cells being more active in IBS patients. So they knew some of these details as much as 15, 20 years ago. You can see there it’s 2007.

                                                Now, this is from a review in 2016, in terms of what they knew at that point. And this is kind of a nice summary of the different mediators that are released by mast cells. I’m just going to touch on some of the top ones here. Again, this is from a few years ago. Histamine is probably the best known. That’s thought to be involved based on various animal studies and a few human studies in IBS-C and IBS-D. Tryptase is what’s called a protease enzyme. Proteases are also implicated in IBS. You can see here both types, IBS-C, IBS-D. Serotonin actually is another one released by mast cells. We certainly know that has major effects in the nervous system, also thought to be involved in IBS-C and D. So this is kind of a summary of what’s been known.

                                                And this is, I think, overall just kind of a nice summary visual. You can see the reference at the bottom for all these different ways in which mast cell activation is thought to play a role in the different aspects of IBS. At the top here are different things that can actually activate mast cells. This highlights stress, food and bacterial products. We’re going to talk about some of those here. And then that can cause mast cells to be activated, then it releases these mediators that we just talked about like serotonin, histamine and proteases. Then that can lead to further immune system activation, possibly chronic inflammation. It can also lead to altered permeability, i.e., leaky gut, smooth muscle cell effects that can change motility. And then again, affects on the enteric nerves that may increase visceral hypersensitivity.

                                                So essentially, even though mast cells are not necessarily thought to be the only mechanism of course, they certainly seem to play a significant role in all of the major aspects of IBS. This is a quick just example here that we know that stress… This is a study from a few years ago. You can just tell from the title, Psychological Stress. And then corticotropin releasing hormone, that’s one of the sort of high level hormones in the brain that’s released as part of that HPA axis stress response, that basically stress causes that to be released. And then that can affect an increase intestinal permeability in the gut through a mast cell dependent mechanism. So that’s been established for quite a while. We know that that’s one of the ways in which stress can affect the gut and leaky gut.

                                                All right, we’ve talked about the various connections here where stress, again, can disturb the gut-brain axis, impair the barrier, cause immune activation, neuronal hyperexcitability, et cetera. But now I want to talk about the microbiome a bit more and some of the metabolites. So the connection between the microbiome and mast cells seems to be through many different ways. But we know some of these microbes that are associated with mast cell activation, and in some cases we know the mechanisms for how they can activate mast cells in the gut. So this is a review article that summarizes some of what’s known about these various microbes. So in terms of the ones that are mentioned in this article, the key ones would be Staph aureus. That’s probably one of the key microbes overall, especially in studies on allergies, that are known to activate mast cells. Streptococcus species, Pseudomonas aeruginosa, Enterococcus faecalis, Candida, H. Pylori, and then these LPS-producing microbes like Klebsiella, E. coli, and others that also can produce histamine in many cases.

                                                So a lot of different types of opportunists. We have all of these on GI-MAP so they can be assessed in terms of whether they’re elevated compared to normal. But again, there’s links to activating mast cells in the gut from these various microbes. A number of them have also been implicated directly in IBS. We’re just going to focus on a few examples here. But just on a side note, at some point a little bit later when we have more of the Q&A, I do have a link that I could provide to this reference here if you’d like to have access to some of the list of functional groups that we have on GI-MAP, such as these mast cell activating microbes.

                                                So this is an example of recent study where they did this high-tech multiomics approach, looking at the microbiome, looking at their metabolites and other measures. But basically one of their observations summarized here… And you can see off the right here, whenever there’s a article that’s available that’s open access, that you can just go and download and read the whole article, I’ve noted that. So this is definitely one that doesn’t have a paywall, you can actually access it for free. So they say, “When using average data, but not the single time point data,” so this is basically looking at patients longitudinally, “we found a significantly higher abundance of multiple Strep both in IBS-C and IBS-D as well as in the composite IBS group compared to healthy controls.”

                                                There’s also an older study here also linking Streptococcus to IBS through an immune activation mechanism by promoting this inflammatory cytokine, IL-6. This is just an example of a study from about 10, 12 years ago linking Staph aureus also to IBS. So here they noted that about 17% of their population tested positive for Staph aureus versus none of the healthy controls. So again, another research association there. But this is thought to be one of the ways in which Staph… Again, this is probably one of the best linked to mast cells. But you can see here that it releases a number of these toxins that can induce allergic skin reactions in this case. But those have also been noted to be released in other areas where Staph can overgrow, such as the gut. So they noted this one is a potent inducer of mast cell degranulation.

                                                One more study here on Staph and Strep. Yet another pretty sophisticated study where they’re looking at gene interactions in a variety of different common GI conditions. So they specifically looked at colorectal cancer, IDB and IBS and looked at what are these interactions with various microbes, particularly with a genetic component of susceptibility. And you can see here on the left, they basically found that there were three microbes that were common to all three conditions, and that includes, and they show those on the other side here, Staph and Strep. So we see these commonly elevated on GI-MAP. Probably among all the opportunists, these are the most commonly elevated. It may be that they’re linked to so many different conditions. We also know that upstream, poor digestion also has been shown to increase their levels, especially low stomach acid. And we all know, I think, that issues with digestion tend to be pretty common as well, whether it’s low stomach acid, pancreatic function, et cetera. So not too much of a surprise there.

                                                There’s just this growing amount of evidence that these two certainly are associated with IBS and likely play a role partly through mast cell activation. This is just one of those examples of a meta-analysis where they looked at 19 eligible… So these are high quality studies looking at the effects of PPIs on the microbiome and they found consistently across these studies that PPIs, they inhibit stomach acid, lead to increased Strep and Enterococcus, Staph and Bacillus among others. So certainly that’s one of the common things we do see clinically as well.

                                                Just a couple more notes on some of these other microbes that are associated. Definitely some studies linking Pseudomonas to IBS going back about 12 years or so, and several other studies since then have also found the same association. Pseudomonas’s interesting, it’s a little bit different from some of the other LPS producers like E. coli and Klebsiella that can be in the small intestine and large intestine. This one is primarily in the small intestine. It’s not thought to be active in the large intestine. A little bit about Candida and fungal dysbiosis, that’s also been associated with IBS type symptoms and also specifically visceral hypersensitivity. So, of course, I’m not going to go through all these, but this is just showing you that there’s a fair amount of research linking Candida also with mast cell activation through specific mechanisms. So we know Candida is another one of these microbes that can activate mast cells.

 


 

 

Dr. Weitz:                            So we’re having a great meeting, but I’d like to pause for a second to thank our other sponsor for this evening, which is Diagnostics Solutions Lab. Diagnostics Solutions Lab offers the GI-MAP stool test, which is the stool test that we use most frequently in our office, and I rely on it very heavily because the results are very helpful and very accurate. It’s been just a godsend for our functional medicine practice. So the GI-MAP from Diagnostic Solutions Lab is a comprehensive gastrointestinal assessment that uses quantitative PCR technology to detect parasites, bacteria, fungi and viruses. Results from the GI-MAP help reveal the root cause of diagnostic complaints, immune dysfunction, skin conditions, and more. For unparalleled results that optimize patient outcomes, leading practitioners rely on GI-MAPs, so go to Diagnostic Solutions, get an account and start utilizing the GI-MAP stool test. I think for sure you’re going to find it very comprehensive, very accurate, very helpful and the technical support is also great. So now, let’s get back to our discussion.

 


 

Dr. Weitz:                          Hey, Tom, with respect to Candida being picked up on a stool test like GI-MAP, it doesn’t seem to come up that often. There’s a thought in the functional medicine world, and I’m not sure about the research on it, that stool testing is not that sensitive to Candida. A number of practitioners will use organic acids testing because they see that as a more sensitive way to pick up Candida. What do you think about that?

Dr. Fabian:                          Yeah, I mean I think we do know that PCR is pretty sensitive, so if it’s there in appreciable numbers, we will pick it up. Candida actually is a little bit more challenging from the standpoint that when you kind of do that whole processing of the stool sample, basically you’re having to open the cells to release the DNA so that you can purify the DNA and then run the PCR. Candida cells are harder to break down. Our lab does use the methodology that’s recommended for Candida to break those down, so they’re pretty confident that if it’s there we are likely to see it. But there’s always the chance, because it is harder to break those cells down, that we may be not seeing as much as what’s actually there. I think our overall [inaudible 00:36:52] is… Sorry.

Dr. Weitz:                            I’m sorry, go ahead.

Dr. Fabian:                          [inaudible 00:36:56]

Dr. Weitz:                            I was going to say another issue might be that Candida could be found in other parts of the GI tract besides the colon.

Dr. Fabian:                          Yeah, yeah. I mean we can detect organisms coming from higher up. I mean H. pylori is kind of the case in point, coming from the stomach but it is easily picked up in stool. And we even know from lots of studies that oral microbes, depending on the microbe, can be detected in stool. So it is going to depend on the microbes. Some survive the transit, they’re more hardy. Some don’t really survive the transit, so it’s a little spotty. If you want to know the composition of the oral microbiome, you have to do a saliva sample, for example. But we can pick up some of these. So long story short is it’s certainly possible that the higher up you go in the GI tract, the less likely we are to detect low level Candida. But if it’s a high level, we’re highly likely to detect it. So it’s hard to say because there haven’t really been studies comparing those two tests with a gold standard. That would really be what’s needed is looking at organic acids versus stool PCR versus some other ways to confirm the actual presence of Candida.

Dr. Weitz:                            Okay, thanks.

Dr. Fabian:                          But I see them as kind of a little bit at both ends of the spectrum because it does seem to be commonly assumed that organic acid testing may pick it up more frequently and we don’t have, again, any studies we can point to saying that that’s not the case.  

                                                All right. I’m just coming back to this list here of these organisms that are known to stimulate mast cells. We talked about Staph, Strep, Pseudomonas, Candida. Now I want to focus on these histamine and LPS-producing microbes a bit. And then once we get done with that, I’m going to go into a quick case example, unless there’s any questions before we dive into that. So this is a major study that just came out last year in one of the top journals, Science Translational Medicine. It’s kind of after all these years of research into the mast cell connection with IBS and knowing that there’s probably some general association with microbes in mast cells, this one really, I think, drove that point home in demonstrating in many different ways.  This is a very involved study. They looked at microbes in human, some of the products they produce and also looked at animal models to look at specific mechanisms. So it’s a very thorough study. But they were able to show… Actually, I’ll bring it up here in the next thing here that, “We observe that the fecal microbiota from patients with IBS with high, but not low, urinary histamine produced large amounts of histamine in vitro. We identified Klebsiella aerogenes carrying a histidine decarboxylase gene,” that’s the gene that converts histidine to histamine, “as a major producer of this histamine. Also, this bacterial strain was highly abundant in the fecal microbiota of three independent cohorts of patients with IBS compared to healthy individuals.”  They kind of went on to show that this histamine actually not only activate mast cells, but acted as essentially a chemokine, which is an immune molecule which attracts immune cells. So they found that histamine increased the number of mast cells in the gut, and then also activated the mast cells. This was thought to be produced in this case primarily by this Klebsiella species. From previous research, we know that there are other organisms, also that we have on GI-MAP, that are known to produce potentially high amounts of histamine. Morganella and Klebsiella pneumoniae are two additional ones. We often see these elevated in patients with IBS type symptoms as well.

                                                We do have these listed on our resource sheet in the histamine producing section. Now I’m going to just talk a little bit more about some of these patterns and additional microbes that are often seen in IBS. This is a review of what was known at the time a couple of years ago, 2019. And they’re summarizing the major findings visually here. So you can see, in general, this is particularly true in IBS-D, that there’s often a decrease in Bifidobacterium, and Faecalibacterium prausnitzii, that’s one of the major butyrate producers. We do see that frequently decreased in patients with different diarrhea conditions, whether it’s IBS-D, inflammatory bowel disease and infections sometimes also, where patients have diarrhea.

                                                And then there’s often an increase in other groups. But the ones that we see most commonly… We don’t see the Lactobacillus one as often, but we do see high Bacteroidetes. And then I don’t know if many of you are familiar with this term Enterobacteriaceae, but it’s commonly used in research to refer to these LPS producers. So organisms like Klebsiella, E. coli, Proteus tend to be in that Enterobacteriaceae group. That’s the inflammatory LPS group, they tend to be elevated. We see that a lot, especially E. coli. That’s a pretty significant signature for IBS-D.

                                                Interestingly, this other study noted that especially E. coli, was found in biofilms that are prevalent in IBS, and also to some extent in ulcer colitis. That’s shown here. For the top… mostly in health individuals that lack biofilm. And they found that the biofilm was mostly in the ileum and the first part of the colon. So that’s where the biofilm was mostly concentrated in IBS patients. For ulcerative colitis, it tended to be more in the colon, especially the distal colon. But you can see for the healthy individuals, they generally had good levels of Faecalibacterium prausnitzii. But in the ones with biofilm, that was about 60% of IBS patients, more likely to be the IBS-D patients, again, Faecalibacterium was low. E. coli was one of the organisms that was increased and found in the biofilm. So we do see these patterns quite a bit on GI-MAP. These LPS producers are also noted in this review resource article. 

                                                Interestingly, a few years ago, they had already noted that patients with IBS-D had increased serum levels of lipopolysaccharide. So it’s likely that this increase in LPS producers is part of that picture. And this is where the diet component starts to come into play. So, of course, it’s always been thought that FODMAPs likely cause symptoms through fermentation and gas production, which certainly is part of the picture. But these FODMAPs actually can feed the LPS producers, and we’re going to see some of that evidence with Klebsiella. But they say here, I’ll just cut to the part that’s underlined, “That our findings indicate that a high FODMAP diet causes mast cell activation by promoting LPS, which in turn leads to colonic barrier loss, meaning leaky gut. And then a low FODMAP diet reverses these changes.” So this is thought to be a major mechanism now for how FODMAPs actually when they’re high can cause symptoms, and how the low FODMAP diet may be beneficial by reducing this LPS.

                                                So to summarized so far, these are some of the key microbes that have been implicated in IBS pathophysiology. Klebsiella, Staph, E. coli, Pseudomonas, et cetera. And then of course there’s products that they produced, and there’s more and more… This is just kind of a short list. These are some of the ones that are better studied, but probably the one at the top that has the best evidence is histamine. Lots and lots of research now is showing that excess histamine seems to play a role, at least in a subset of IBS patients. But there are others like serotonin, lipopolysaccharide. Obviously it would take a lot longer to cover all these different metabolites in the evidence behind them. But just be aware that there are quite a few. All right, so any questions on any… We covered quite a bit here. Any questions before we dive into a case example?

Dr. Weitz:                            In terms of mast cell activation, where do we think it most likely fits in? Is it resulting from dysbiosis, bacterial overgrowth? Is it occurring at the same time? Is it leading to dysbiosis?

Dr. Fabian:                          That’s a great question. So it’s thought that for many patients it is dysbiosis. So Klebsiella is, again, one of the best studied ones in terms of that link. But then there are these others like Staph and E. coli. When you go through all the upstream triggers of IBS, so we know that there’s postinfectious IBS, so we know gastroenteritis can cause that, there’s lots of evidence that all kinds of infections, bacterial, viral, parasitic infections. Once they’re gone in a subset of patients, those patients have persistent dysbiosis and persistent either outright inflammation, which could actually lead to things like inflammatory bowel disease, or more subtle inflammation.  So that probably depends on the patient’s genetics and other variables, but there’s often a trigger. So antibiotics are thought to be a key trigger. Lots of research now shows that antibiotics can lead to a bloom of these LPS producers and then they can potentially shift the balance long-term. Diet, lots of studies show that high-sugar diets promote these LPS producers. So it’s probably a combination of things. I’m sure diet is a major component, but maybe not sufficient all by itself. There has to be usually some sort of initial trigger or even just a genetic susceptibility.

                                            Are there any questions in chat that we want to take now?

Dr. Weitz:                            Yeah, I don’t know. Some of these questions have to do with treatment like use of diamine oxidase for treating mast cells, probiotics possibly making things worse or better. Berberine, does that affect a microbiome? Do you want to address those later?

Dr. Fabian:                          Actually, yeah, if we go through the case example, I do have a section on some of the treatments, and I know Berberine was actually in one of those resources. So short answer is yes, there’s actually… In terms of the approaches, certainly we know that there are diet triggers, FODMAPs being one of the best known, but there are others. I mentioned the sucrose and also the starches, so the whole carbohydrate intolerance piece is part of that. And then there’s some other things as well, but there are also things that can address the dysbiosis. There’s also treatments for mast cells and histamine, so there’s potentially different ways to approach it depending on-

Dr. Weitz:                            And do you have a sense of… Do you recommend doing multiple things at the same time? So if you’re going to try to use diet for SIBO, you’re talking about the low FODMAP diet, but then if you’re trying to address histamine, there’s a low histamine diet. Do you layer that on top? Do you treat the dysbiosis first and then if you still have a problem, then look at the histamine? In terms of the treatment protocol, where do you think you put the focus on the histamine?

Dr. Fabian:                          That’s a great question. So certainly depends on where that histamine is coming from, so if we do see histamine producing type microbes, and especially if symptoms are consistent with that. I don’t work directly with patients, but I work on these free consults that DSL offers for practitioners. So I review a lot of cases, and it’s pretty common for us to see pretty significant dysbiosis, like Klebsiella overgrowth, Morganella, in patients where they’re described as having histamine type symptoms or mast cell activation type symptoms.

                                                So definitely if it’s suspected based on symptoms and we see those organisms, then those would be likely a key target for practitioners for using antimicrobial herbs. But you have to look at the big picture. So a lot of practitioners kind of go top down. If they see something happening upstream, like H. pylori, or something that’s more small intestine like Candida overgrowth or evidence of poor digestion… So there’s lots of evidence now that poor digestion is a major cause of dysbiosis. If digestion is not optimal, certainly that needs to be addressed. And that could be one of the reasons why antimicrobials alone either don’t work sometimes, or they work temporarily and then patients relapse, which is pretty common. And that’s likely because some of these other upstream root causes are not being addressed, with digestion being one, certainly diet.   It’s really going to depend… My experience in working with so many practitioners is it’s going to depend a lot of the patient and the details of their assessment, and also what the test results show. They rarely just treat the test results by themselves. They’re certainly taking that into account with everything else that they know about.

Dr. Weitz:                            Yeah. You’ve mentioned H. pylori a couple of times. That seems to be a more and more controversial finding on a stool test. I recently did a podcast with Dr. Steven Sandberg-Lewis, and he’s a big believer that you should, in most cases, not treat H. pylori, even if you find it. In fact, he says don’t test for it, and he feels that it’s typically a commensal and helps protect against reflux.

Dr. Fabian:                          That’s a good question. So certainly if you look at the research, that is recognized that it’s not necessarily automatically pathogenic or that it always needs to be eliminated. But even in research and medical circles, there is disagreement over just how pathogenic it is, how aggressive the treatment should be. Overall though, just from reviewing all these studies, I would conclude that at low levels, likely it does not need to be treated. So on GI-MAP, we have about probably 80% of patients that have that E2 level that’s not flagged as high. Most of those patients don’t seem to have significant symptoms that could be attributed to H. pylori, so it doesn’t appear that it’s something that would need to be treated. The higher the level is-

Dr. Weitz:                            What you’re saying is if we see H. pylori, it’s above detectable levels, right? Because theoretically, all these potentially pathogenic or pathogenic bacteria should be below detectable levels. So it’s above detectable levels, but it’s not flagged as high.

Dr. Fabian:                          Correct. Yeah.

Dr. Weitz:                            Okay.

Dr. Fabian:                          Yeah. So E2 range generally is considered pretty low, detected but usually not an issue. Some patients do seem to have issues though, and that’s mostly based on practitioner feedback that they decided they wanted to treat because it made sense in the context of patient’s symptoms, and then they report that the patient improved after treatment. So that would be evidence suggesting that in some cases, based on your assessment, that you may still want to consider treating. But I think there’s two categories of treatment. There’s the classic view of H. pylori as being very inflammatory, causing ulcers, increasing risk for stomach cancer, et cetera, causing severe gastritis. Certainly in those cases, obviously would have to be aggressively treated, or patients that are high risk for stomach cancer and other conditions.

                                                But in patients that don’t necessarily have a high risk or any severe symptoms, we do know H. pylori, from a functional standpoint, can suppress stomach acid. So it is often one of the contributors to hypochlorhydria. So I think that’s where practitioners in the functional medicine space may be more likely to treat at levels that are maybe lower than what would be treated in conventional medicine.

Dr. Weitz:                            And what part does the… GI-MAP, for those who don’t know, also listed virulence factors for H. pylori. To what extent the appearance or non-appearance of those virulence factors, how does that change whether or not we should consider treating H. pylori?

Dr. Fabian:                          That’s a good question. So as always, it’s in the context of the patient, your assessment of the patient, their symptoms, but in general, they’re considered risk factors. So it’s a bit of a numbers game. The more virulence factors that are detected, the more likely the strain or strains that are present are more aggressive, more potentially pathogenic. And even there’s some differentiate among the virulence factors, with CagA and VacA being kind of the most widely recognized, more inflammatory type of virulence factors. So it does add some weight to treatment, but again, by itself it may not be sufficient unless the patient is obviously really symptomatic or high risk. But it’s really up to practitioner judgment as to… We try to educate them on these various considerations, but it’s every practitioner’s decision on whether they feel it should be treated or not.

Dr. Weitz:                            Okay. Great. Thanks, Tom.

Dr. Fabian:                          You’re welcome. So I’m just going to cover this quickly here. It is 8:30, at least my time, so we’re at the hour mark. Not your time. What time would you like me to completely wrap up by?

Dr. Weitz:                            I mean, we sometimes go till another 30 minutes, but it’s up to you.

Dr. Fabian:                          Okay. I do have the time to go through the… I do have another 30 minutes.

Dr. Weitz:                            Okay.

Dr. Fabian:                          So for those who want to stay, I’m happy to continue going through-

Dr. Weitz:                            Okay, great.

Dr. Fabian:                          So as far as this case example, it’s a pretty interesting one because it pertains to one of these sort of differential diagnoses and where there might even be an overlap. And kind of a side note is there’s a relatively new video I just saw. I’m not sure if anyone in this group is familiar with Dr. Lin Chang. She’s at UCLA, she’s one of the leading IBS researchers globally. At the DDW conference this past May, she gave a keynote lecture on the connection between stress and IBS. But she had kind of a short video with one of the other leading IBS researchers on this sort of differential diagnosis and overlap of IBS, especially IBS-D and inflammatory bowel disease. And that’s actually what this case here is about.

                                                So if you look that up. I think it was on… I’ll have to put that in the chat as well if I can find that link. But I think it was on something like Medical Xpress or one of those websites. But I’m sure if you google her… And then the other researcher is Magnus Simren, S-I-M-R-E-N. And they had a helpful video on this overlap scenario. The patient here, as you can see, is female, 74 years old, diagnosed with Crohn’s disease decades ago. The practitioners that we consult with don’t always have the full information, but they mentioned that part of the intestine was removed. They did not have the details of how much, which was certainly a key piece of information that does help with interpretation. But we certainly know that part of the intestine was removed.

                                                This patient always has some degree of diarrhea, depends a lot on Immodium. But recently, kind of inexplicably, their diarrhea worsened. So this patient has really been adamant about avoiding the standard medical approaches. For a while had been on steroids, for example, but eventually went off them with the help of a functional practitioner. You can see her had been taking a Chinese herbal colitis formula, also supplementary short-chain fatty acids, particularly butyrate and the typical probiotics, some polyphenols, definitely increasing the berry intake, more vegetables. And unfortunately multiple three-month rounds of antimicrobial herbs, and then three months on an elemental diet, basically none of these ultimately helped, and this patient’s diarrhea is still not so good.

                                                So the patient’s very discouraged because the natural approaches weren’t working and they really don’t want to have to go back on steroids. This patient, I think, from what I understand, hadn’t had a recent colonoscopy. Of course, that was discussed as well as to… Depending on how recent that was, that’s something that probably would need to be repeated. So this is their GI-MAP, no current pathogens detected. H. pylori was negative. Now, we’re looking at two time points here, so that’s why this looks a little bit different. They had done these about three months apart, with some of these antimicrobial herbal protocols in between. But again, really no significant improvement in symptoms.

                                                So this is the normal commensal section. You can see there’s a little bit of a shift here overall. Generally though not much… kind of some slight improvements, like you’ll see the Akkermansia was not detected, now it’s detected. So there were some minor improvements, but also some things that worsened. One thing I want to point out here, and I’m actually going to… I think this is highlighted. Yeah. So that classic signature of IBS, diarrhea dominant, is very similar to inflammatory bowel disease. Both of those conditions feature typically increased Escherichia, that’s E. coli. We did see that. It was high certainly on the second test. Faecalibacterium prausnitzii is typically seen as low or not detected with patients with inflammatory bowel disease and also diarrhea dominant IBS.

                                                So that signature was present. That’s a common signature. It’s known in literature, and we see this a lot in patients with diarrhea. Same with the high Bacteroidetes. We don’t always see the high… Or actually, no, this is low Formicidaes, but we do see a high Bacteroidetes. That’s thought to maybe play a role in this bile acid diarrhea scenario, which I won’t get into the details there, but there seems to be a link where Bacteroidetes may worsen the symptoms or contribute to bile acid diarrhea. So this is a classic signature. We definitely saw this for this patient. We do know that she was already diagnosed with inflammatory bowel disease, so not a surprise.

                                                And again, this is just reiterating that this is a common signature, well known in research for inflammatory bowel disease, and it over laps with IBS-D. So that’s, again, high Bacteroidetes, these Enterobacteriaceae, LPS producers tend to be high, Faecalibacterium tends to be low. You also note Roseburia, which we do have on GI-MAP, is also something that tends to be low in IBD. So this is their overgrowth opportunistic microbe section. Still looks pretty bad both times, despite all these treatments. You can see Bacillus was high, and Terracoccus, Morganella, that’s one of the key histamine and LPS producers. That was super high.

Dr. Weitz:                            Hey, Tom, in terms of Bacillus being high, Bacillus is a bacteria that’s included in spore-based… All spore-based probiotics, I think, are Bacillus based.

Dr. Fabian:                          Right.

Dr. Weitz:                            So should we think of Bacillus as potentially bad in some situations?

Dr. Fabian:                          It’s listed in this. You can see the title here, not the main title, but the subtitle is Dysbiotic and Overgrowth. So it’s really just an overgrowth bacteria. It tends to be elevated, especially in patients that are not digesting very well. Whether or not it actually contributes to symptoms is unknown, but not likely. Numerically, it’s not that prominent in the gut. And we get asked that question a bit, if it’s high, is it something where we would not recommend taking these spore-based probiotics? I don’t think it would be contraindicated. And there are plenty of practitioners that still supplement because they suspect SIBO or other conditions where these are commonly used and patients tend to improve. Part of that could be-

Dr. Weitz:                            If a patient were taking a spore-based probiotic, would we expect a Bacillus potentially to be high?

Dr. Fabian:                          It can, yeah. And that may be one of the reasons why we didn’t… In the early years of GI-MAP, we didn’t seem to see the Bacillus as high as often. And then these spore-based probiotics came out, became very popular, then we started seeing higher levels. We have no way of knowing whether that’s due to the probiotic, but it doesn’t seem to be a negative to supplement even though these numbers are high. And that could be because the specific species and strains in the probiotics are not the same as the ones that are in the patient’s microbiome, so they may still be getting the benefit of those probiotic strains.

Dr. Weitz:                            Are the Desulfovibrio and Methanobrevibacter broken out because those are often known to be associated with SIBO?

Dr. Fabian:                          No, they’re broken up because… So the commensal term just means that they’re present, they’re normal residents of the gut. They’re present in virtually everyone. And they’re thought to be beneficial at normal levels. And then they’re thought to be an issue when they’re overgrown. So again, that’s why they’re in this overgrowth section, because-

Dr. Weitz:                            I thought all the dysbiotic bacteria were potentially present in normal levels.

Dr. Fabian:                          It’s kind of a fine point of distinction, but it has to do with overall prevalence. So that’s frequency in the population. So these commensals are highly prevalent, so most people have them, whereas most of these dysbiotic microbes, with a few exceptions… So streptococcus arguably could be under the commensal, because it is a commensal in the mouth all the way through the small intestine.

Dr. Weitz:                            Okay.

Dr. Fabian:                          So it’s a little bit of a mixed picture, and there’s just kind of these nuances with the microbiome. But Desulfovibrio and Methanobacteriaceae, the methanogens, are present in virtually everyone, and usually not an issue unless they’re overgrown.

                                                So we definitely see an overgrowth pattern here. One of the most common contributors to this type of pattern, both from research and what we see clinically, is poor digestion. So it certainly doesn’t prove that patients have low stomach acid or pancreatic dysfunction. Luckily we do have a pancreatic marker on our test, so that can be checked, but it’s certainly something to suspect when you see these elevated. And many of these are more predominant in the small intestine. So that’s true in particular for Pseudomonas, which wasn’t initially in this case. Especially true for Staph and Strep. Those are much more common and much more abundant in the small intestine. In fact, Streptococcus is usually the number one most abundant species in the mouth, all the way down through the small intestine.

                                                So, again, Morganella tends to be one of these that is commonly associated with inflammatory bowel disease, and it does produce high amounts of histamine, so it may also be a contributor to IBS type symptoms. In this next section or two, we have the inflammatory microbes, particularly Klebsiella in this case. Now note that Klebsiella is not officially high. But there’s some nuances with these organisms and we do tend to see that patients often have symptoms when Klebsiella pneumoniae is present. And it’s thought that actually Klebsiella is a lot like Strep in its location. It’s actually thought to be a resident in the oral cavity and the respiratory tract. You can kind of guess by the name that it’s found in the lungs, Klebsiella pneumoniae. But they’re generally found pretty commonly a higher up and tend to populate the lower gut after there’s disruptions.

                                                It’s been linked to low stomach acid. Antibiotics can predispose to its colonization of the lower gut, et cetera, and it’s likely coming from higher up. And studies actually show that, that once you detect it in stool, that means it’s definitely colonized and likely overgrown higher up. In the commensal inflammatory section, this patient also had, at least on the second test, high Escherichia, that’s E. coli, high Fusobacterium, which has also been linked to inflammatory bowel disease. Several different studies out of different labs have linked Fusobacterium to some cases of IBS-D as well. And also Prevotella, which can be an inflammatory microbe in some cases. No fungi yeast, no viruses, no parasites at all. So those look good. And then we get to this last section, the intestinal health markers. So digestion actually looks like it’s, from the steatocrit standpoint, improved with the treatments. So a little bit of fat malabsorption before, now it’s fine. Pancreatic function looks to be pretty good. But look for that to be around 500 and above. It’s pretty close, not too bad.

                                                Again, we might suspect low stomach acid based on the overgrowth patten, but there’s no way to test for that directly with stool testing. GI markers, the first one looks good, Beta-Glucuronidase. Of course the occult blood, which is a common feature of IBS-D, this patient did have… I’m sorry, I should say inflammatory bowel disease, not IBS-D, especially ulcerative colitis. So this patient still had detectable occult blood. It was a little bit better. Secretory IgA went down, so that’s an improvement. Anti-gliadin actually went up. So this patient may have had some gluten exposure, which may have been related to some of these other patterns that worsened over the second time.

                                                This eosinophil activation protein, so that’s… I want to take a minute there just to talk a bit about that connection with mast cells. So mast cells and eosinophils tend to work together. They tend to activate one another. We don’t have a direct marker for mast cells, but eosinophil activation protein can be taken as a potential indirect marker. We also know from studies that this protein is linked to, and just general eosinophil activation is linked, most commonly to food sensitivities, but also to inflammatory bowel disease as well. So it’s again, another type of inflammatory cell. It’s telling us that there is an issue there as well.

                                                But calprotectin, which is a classic marker that we look at for especially inflammatory bowel disease, wasn’t too bad before. It was kind of in that yellow range, only 69. I didn’t include the cutoffs here, but it’s at 173, so it’s pretty far below 173. But the second time around with this patient not improving and some of the inflammatory microbes getting worse, calprotectin looks great. Right? So this patient’s been very concerned about having to go back on steroids. But so far, based on the calprotectin, that would suggest that this IBD scenario, that the patient may still be in remission. Only a colonoscopy would be able to confirm that. But this is suggestive then that this patient’s current symptoms may not actually be due to an IBD flare and it may be related to this IBS and IBD overlap. So this is one of the markers that is often used to differentiate between IBS and IBD. And again, at this point it appears like this patient may have actually IBS, diarrhea dominant.

Dr. Weitz:                            Would they still be having blood in their stool if they were not having an IBD flare?

Dr. Fabian:                          That’s a good question. Yeah. I mean that’s why likely this patient, if they haven’t had a colonoscopy recently, their gastroenterologist likely would want to, of course, revisit that, because occult blood is potentially concerning. But that would not be a common finding in IBS-D. So again, this speaks to this overlap where it’s kind of an in-between scenario, not fully consistent with IBD, but suggests possible overlap with IBS.

                                                And we’ve just talked about those markers, so I’m not going to focus on that. But that kind of takes me to… So that’s basically the patient scenario. I’d love to chat about… if you have questions about any of the potential ways to address those imbalances. But just a couple of things I want to talk about before we do. So we didn’t really talk about this food component here. I just want to touch on that a little bit, especially with regard to Klebsiella. So we tend to think of Klebsiella as a bad guy. It’s linked to all these different conditions. It’s also linked to a variety of autoimmune conditions, rheumatoid arthritis, ankylosing spondylitis, et cetera. So it’s found in a lot of different conditions, not just IBS-D. And I think we’ve known for a long time, especially those who are maybe more familiar with the ankylosing spondylitis scenario and the connection between Klebsiella and starches, this reinforces that. It’s just a brand new study. And also extends that observation that basically a full range of simple carbohydrates promotes Klebsiella growth. And that includes sugars, starches and even FODMAPs.

                                                That’s from various studies as well, not just from this study here. But they say, “We identify simple carbs as critical to the colonization of Klebsiella.” So that’s something to assess, of course, with patients’ diets, especially if the antimicrobial isn’t working so well. And they also find the opposite, that dietary fiber is necessary for colonization resistance against Klebsiella. So that gets in the conversation of if you’re eliminating FODMAPs then how do patients still get adequate fiber?

                                                Just another kind of interesting insight here. So they found that lactulose can be utilized as the sole carbon source, this is of course done in culture, minimal media for the tested strains of Klebsiella pneumoniae. “We confirmed that the addition of lactulose to cecum extract, so basically colon contents, increased the the growth of Klebsiella pneumoniae measured by optimal density, et cetera. Mice were provided lactulose in drinking water after colonization of Klebsiella. Compared to the water control, lactulose increase Klebsiella pneumoniae by tenfold.”

                                                So technically lactulose is considered a FODMAP, even though it’s not a natural compound. But interestingly, it kind of makes you think about the breath test prep and the breath test itself, because patients are recommended to avoid fiber, at least for a short period, maybe longer for constipation, and then they’re given a large dose of lactulose. So if they happen to have Klebsiella, technically this may actually make their Klebsiella worse. So I’m not sure how that might affect the breath test though.

                                                A couple of other things, so in terms of the fiber, we know that fiber definitely inhibits a range of these LPS producers, inflammatory microbes. And that’s likely through this mechanism, at least in part, that basically fiber leads to short-chain fatty acids, and then that can help to help to acidify the local environment. That’s just noted here. They say, “Here we demonstrate that an antibiotic, naive microbiota, suppresses growth…” So that’s basically commensals, “… suppresses growth of antibiotic resistant Klebsiella, E. coli and Proteus by acidifying the proximal colon and triggering short-chain fatty acid mediating intracellular acidification of those bacteria.” So that’s thought to be one of the key ways for how fiber helps to protect against these bad guys. So pretty essential in considering dietary approaches to keep these microbes from overgrowing.

                                                So I just want to mention real briefly some of the articles that point to some of these factors that may help with mast cells. There’s a lot of research on this. Certainly you know about certain things like quercetin that can inhibit mast cell activation. This figure shows a few others like lipoic acid, N-acetylcysteine or taurine, even biotin. So there’s growing research now that lack of biotin promotes these inflammatory microbes. And making sure there’s adequate biotin in the diet can suppress the inflammatory microbes.

                                                And that’s where berberine… I know we talked about that earlier, but berberine comes into play. Interestingly, this is a conversation for another day, but hydrogen sulfide I think these days has kind of a bad wrap over concerns about hydrogen sulfide SIBO and things like that. But normal physiological levels of hydrogen sulfide are thought to actually promote health in the gut. There’s a fair amount of research showing that normal production of hydrogen sulfide… Even certain beneficial bacteria can produce hydrogen sulfide and sulfur related compounds. So it’s thought that one of the ways in which berberine might be helpful, and/or hydrogen sulfide related compounds, is through these same mechanisms that can help to reduce mast cell activation. And I actually looked into that a bit, so that was an interesting connection. But hydrogen sulfide actually, there’s a lot of research now showing it can inhibit mast cell activation.

Dr. Weitz:                            Interesting. Hey, Tom, in terms of antimicrobials like berberine, have you seen, from looking at all these stool tests and talking to clinicians, et cetera, that the use of antimicrobials like berberine… do you see that they tend to damage the microbiome?

Dr. Fabian:                          That’s a good question. So it depends on, of course, the dosing and how long. So generally, no. A typical course of antimicrobials, afterwards the microbiome usually looks noticeably better. Frequently your key targets, which are those opportunists on page three, tend to be much improved in most cases. And that’s a major deal, because you need to get those opportunists down to help the good guys to recover. So for the most part, no, we don’t see that. But I have had a few unusual cases, for example, where for example a child, an autistic child, had been on Biocidin for a year or more and was really deficient. And for whatever reason, I don’t know why, but the clinician recommended that they just keep taking Biocidin indefinitely. So that’s an anecdote. We don’t have statistics, of course, to show for sure what’s happening. But from a clinical anecdote standpoint long-term… And it’s surprising how many clinicians will have patients on these antimicrobials for months and months or longer. So I’m not sure exactly why that’s the case. But I past a certain point, I would assume that if it’s not working, that suggests a different approach is needed.

Dr. Weitz:                            On the opposite end, in terms of probiotics improving the microbiome, we know that probiotics typically don’t become permanent residents. But now we’re starting to get a new breed of probiotics, in other words, Akkermansia is now available, and I think that Faecalibacterium prausnitzii may also be available. And there’s some speculation that those probiotics may actually colonize the gut. Have you seen anything in terms of that?

Dr. Fabian:                          Not so much yet in terms of published data. So probably the closest would be FMT, which is of course less defined than a probiotic. But FMT if fecal microbiota transplant, some of the microbes it depends on the individual, but often a large proportion of them seem to colonize. But some don’t, not sure why. And then some of these more defined commensal probiotics, I don’t think we have enough data on them yet to know for sure, but so far preliminary data suggests that probably they do colonize to some extent, certainly more than the typical probiotics.

Dr. Weitz:                            Okay.

Dr. Fabian:                          I think we’re just about at the end here. I think I had a couple more. One was about resveratrol, several studies showing that that also could inhibit mast cells, and probably many other polyphenols. Probably won’t get into this since we’re just at the end. I want to make sure we have some questions. But this is just getting into the idea that it’s not just FODMAPs and carbohydrates, that also some patients with IBS may have a food-allergy-like scenario where their mast cell activation and their IBS symptoms are due to a specific immune reaction that’s similar to a food allergy, but they have IBS symptoms instead of food allergy symptoms. So that would suggest some patients may have to get pretty specific about what foods that they’re avoiding because it may be very specific foods and antigens in those foods that are triggering symptoms. And that’s basically what this is speaking to, a major study from a couple of years ago. So I think I’m going to end here. Yeah, that was my last slide.

Dr. Weitz:                            Okay. So anybody who hasn’t been able to ask a question, do you have any questions you want to ask Tom about the microbiome or mast cell activation or IBS?

Dr. Fabian:                          I see Steve has his hand up.

Steve:                                   Right. Thank you, Ben. Thank you, Doctor. Quick thing I wrote in there, do you see any cross reactivity that people have had long-term Strep infections, especially some of our younger children now, and taking a probiotic that has Strep in that, do we see any cross reaction?

Dr. Fabian:                          I wish I had a good answer for you, but I’m not aware of any research on that and I haven’t come across that specific scenario clinically either. So theoretically, certainly I think that that could happen, but I don’t have any specifics that I can point to.

Steve:                                   Okay, thank you. Also, with the carnivore diet, do you see any pathologies in these patients that have gone carnivore?

Dr. Fabian:                          So that’s a really interesting topic and we don’t have enough samples, or at least I haven’t come across enough samples to say conclusively. I would say in total I’ve come across only a handful, maybe 10, over the last couple of years or so. And in most cases, but not all, and some cases there was a before and after, the microbiome often looks very dysbiotic. Whether that’s a long-term problem or not, we don’t really know. But from a standard assessment of the dysbiosis, we would say the dysbiosis tends to be pretty bad on the carnivore diet. That may be due to the fact that we know that amino acids, when there’s an excess that gets into the colon… So if you eat too much protein and you’re not digesting it optimally, and some of it gets into the colon, that can stimulate dysbiosis and protein fermentation. So I think a lot of it has to do with digestion as well.  If you digest protein really well, you may be doing much better on a carnivore diet than someone who does not digest well. But I do wonder about how these microbes with all these beneficial products fare without a good source of fiber because that’s really what they thrive on.

Dr. Weitz:                            Steve had also written a question about is there anything on the GI-MAP that has any relationship with polyps? And I would ask, and is there anything on the GI-MAP that might tell us anything about the potential risk of colon cancer?

Dr. Fabian:                          That’s a great question. So probably the number one marker that would at least raise suspicion of something off would be the occult blood. Fortunately, that’s pretty rare that a patient who hasn’t, for example, had a colonoscopy in a while but turns up with high occult blood. Usually it’s something temporary or it turns out to be something like an inflammatory bowel disease. But in rare cases, I’ve heard of a couple examples, where the patient went on to have a colonoscopy and they did find colon cancer. So the fecal occult test is one of the tests that can. It’s not exclusive to colon cancer, that’s the issue. So there is no marker that says, “Yes, of course.” We don’t have anything on the test that would be diagnostic for colon cancer. We have a few markers that would raise suspicion. A Fusobacterium would be another one. There’s definitely links between increased Fusobacterium in general and a higher risk for both IBD and colon cancer.

Dr. Weitz:                            Oh, interesting. I think Fusobacterium is one of the bacteria associated with hydrogen sulfite SIBO.

Dr. Fabian:                          Yeah, it is a significant hydrogen sulfide producer and it’s thought to mostly be present in the oral cavity. It’s known to produce a lot of hydrogen sulfide there. But when it gets down into the colon, it’s thought to stimulate inflammation in the colon. Not necessarily in everyone, but it’s something that can happen more frequently. It is an LPS producer, so that may be one of the ways in which it actually contributes to inflammation as well.

Dr. Weitz:                            Awesome. Thank you so much, Tom.

 


 

Dr. Weitz:                                                 Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five-star ratings and review, that way more people will discover the Rational Wellness Podcast. And I wanted to let everybody know that I do have some openings for new patients, so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardiometabolic conditions, or for an executive health screen and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way.  That usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective. So if you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111, and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.