Leaky Gut with Dr. Jesse Armine: Rational Wellness Podcast 331

Dr. Jesse Armine discusses Leaky Gut with Dr. Ben Weitz.

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Podcast Highlights


Dr. Jesse Armine is a Doctor of Chiropractic and a registered nurse. He has specialized training in methylation, genetic research, Neuro-Endo Immunology, Functional Medicine, Nutrigenomics, Applied Kinesiology, and Nutritional Counseling.  He specializes in diagnosing and treating complex, multifactorial illnesses with a concentration in neuropsychiatric expressions/autism and chronic illnesses.  Dr. Jess lectures worldwide and continues to treat patients mostly remotely.  He co-authored a book with Elizma Lambert ND entitled, “Leaky Gut, Leaky Cells, Leaky Brain”.  His website is DrJessArmine.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, dr whites.com. Thanks for joining me, and let’s jump into the podcast.

                                Hello Rational Wellness podcasters. Today, we will be speaking about leaky gut with Dr. Jess Armine. Leaky gut is a controversial concept in the functional medicine world. No, I’m not talking about the controversy in conventional medicine about whether leaky gut exists at all. Most of us understand that there’s tons of research substantiating that leaky gut exists and that it’s a problem, but there are differences about how to test for leaky gut. There’s the old lactulose mannitol intestinal permeability test, but most of us today are either using a serum test for zonulin or a stool zonulin test, or a serum test for zonulin antibodies, and there’s a lot of controversy whether any of these are accurate.  I personally run a stool zonulin as part of a stool test, but quite frankly, I assume that most of my patients with gut problems have leaky gut. There’s also controversy about the best strategies for healing leaky gut and whether probiotics, and which ones, prebiotics, which ones, bone broth, et cetera, et cetera. How should we heal leaky gut? I’m hoping that Dr. Jess Armine can give us some clarification and guidance for how to understand leaky gut and how to treat it.

Dr. Jess Armine is a doctor of chiropractic. He graduated in 1986, a year before me, and a registered nurse. He has specialized training in methylation, genetic research, neuro-endo immunology, functional medicine, nutrigenomics applied kinesiology and nutrition. He specializes in diagnosing and treating complex illnesses. Dr. Jess lectures worldwide and continues to treat patients mostly remotely. He co-authored a book with Elizma Lambert, ND entitled, Leaky Gut, Leaky Cells, Leaky Brain. Jess Armine, thank you so much for joining us.

Dr. Armine:         Thank you for inviting me. Basically all that stuff means I don’t know what I want to be when I grow up.

Dr. Weitz:            Me too. Personally, I hope I never grow up.

Dr. Armine:         No. I’ll tell you something. I have multiple, multiple interests, and like you said, we’re going to talk about leaky gut today, and leaky gut is more of a euphemistic term. And I have a little presentation. I’m going to zip through it and stop at the areas that are important because you’ve already gotten my qualifications and so forth. And I want to tell you some really important things about leaky gut that most people don’t realize. It’s not that difficult to fix, a little patient with it, but why it’s so important to fix it, whether a test positive for it or not. Okay, so can I start the presentation?

Dr. Weitz:            Yeah, yeah, go ahead. And I just want to tell everybody who’s listening, if you happen to be listening to this on your phone, you can go to the YouTube page, Weitzchiro YouTube page, and you can see Jess’s presentation there if you want to see the slides.

Dr. Armine:         So this is me. I’m from Brooklyn, as some people might tell by my accent. There’s all my qualifications. This was originally made for clinicians and learning to be a clinician, but in order to be a clinician… So this is how you know your doctor’s good. This is the way you should take this. Somebody who just uses signs, the double-blind foreseeable controlled studies, that’s not the way to run a practice. You have to use your clinical acumen, in other words, what you’re observing, what you’re hearing, and your intuitive sense. You put those three together and they agree, you’re all set.

                                Albert Einstein… I think the reason that we have so many problems in healthcare today is that we base our treatment just on scientific evidence. We don’t take observational or anecdotal evidence into consideration. How many moms out there go to the doctor and say, “I think it’s blah, blah, blah.” And the doctor just laugh at you and go their own way. We ignore intuitive insight and we forget the wisdom of Albert Einstein. He said, “The intuitive mind is a sacred gift, and the rational mind is a faithful servant.” And we’ve created a society that honors the servant, and has forgotten the gift. So you know, have a good doctor when they’re eclectic and they listen to you and they consider all possibilities of everything. So guess what? I just gave you a big gift there.

Dr. Weitz:            So what you’re saying is if we just feed our symptoms into artificial intelligence and it spits out a pharmaceutical prescription, that’s probably not the best medicine?

Dr. Armine:         That’s the way of the world now, and that started in the 1970s. The reason that we have these things that we call diagnoses, OCD, ADD, ODD, oppositional defiance disorder, are diagnoses, which are not diagnoses, they’re descriptions that are put in place so that we will have a pharmaceutical protocol to follow, not for any other reason, not for saying, “Hey, why is that like that?” And go backwards. They just say, “Okay, here’s the end result. This is the way we want you to treat it.” We could get into that for hours, by the way, so what you’re always looking for is a doctor who’s going to put the puzzle pieces together because honestly, it doesn’t really matter how many courses you’ve taken, how many degrees you have, how much you know, if you can’t put those puzzle pieces together, it’s all for naught. And really, leaky gut is an importance of the cell membrane. The cell membrane is the thing that covers the cell. We think of it as a piece of cellophane, but it’s not.  The cell membrane is critical. It keeps what’s supposed to be out, out, what’s supposed to be in, in. It has all the various receptors on it, and I won’t get crazy with it, and it’s made of phospholipids. In other words, if you can’t conjugate your fats or lipids, you’re not going to be able to make your cell membranes. I was putting this here for the doctors because the next one was for the mitochondria, that thing that makes your energy… And that uses a different kind of phospholipid, and again, I’m not going to get into that. All energy comes from the mitochondria and is run through the cell membrane through this particular organelle called ATP synthase. Again, I would love to give you a long explanation of it, and it’s not all that hard because I make everything easy, but it does take a bit of time.

                                So the fact is that I want you to remember… This is the takeaway before we even get into leaky gut, that the master of the cell is not the nucleus, it’s the cell membrane. If your cell membranes are, I’m sorry, holy or leaky, nothing is going to work because it involves everything. But in the good gut, by the way, you see the cell membrane over in here, and that prevents all these bad guys from getting through, and everybody’s talking about the tight junctions or the mucus layer and so forth. The fact is that once this opens up, all this bacteria, all the antigens and stuff can get in, and what happens then? What causes this, by the way, things like bacteria, medications, too much alcohol, lots of inflammation. We are an inflammatory society. Chemicals, lack of fibers, lack of something that creates butyrate and a lack of friendly bacteria, and you can see here where a normal gut has these little hairs here, and that just creates more area for absorption. Whereas, let’s say, a celiac intestine, it’s so inflamed that you have not much area for absorption.

Dr. Weitz:            So those are called the villi?

Dr. Armine:         Yes, these are called the villi. I like to call them fingers because it’s easier to remember than villi.

Dr. Weitz:            Those are on the inside of the intestine and allow for greater absorption of nutrients.

Dr. Armine:         Exactly. The more room you have here, the more absorption of nutrients you have, but when you get an allergic reaction, like gluten, it starts looking like this, and you just don’t have enough area, and you’re not only going to get a pain, but you’re not going to get the absorption you’re looking for.

Dr. Weitz:            Yeah, you’re going to get nutritional deficiencies significantly.

Dr. Armine:         Absotively. And this is super advanced, but I’m going to just run through with you. What happens is once the antigens get through, once these cells start dying and that separates the cells, the antigens get through and they interact with the immune system, and that’s where you get a lot of T-cell or B-cell, a lot of antibody, just think about as antibodies being created, and that’s what creates inflammation. The more this happens, it starts creating things called memory cells, and those memory cells, every time the antigen is seen, it starts producing more and more and more antibodies, and that’s more and more inflammation. And the reason for all of our problems these days is chronic inflammation, which is coming from a progressively worse leaky gut syndrome.

                                So if nutrients and toxins can’t move in and out freely and they get stuck along the way, we end up with nutritional deficiencies, like Ben just said, toxin accumulation expression of genetic predispositions. Real fast about genetics, the presence of a polymorphism, a snip, an allele, whatever words you want to use, doesn’t make a difference. Something’s got to make it express. This is one of the things that will make it express. Just because you could look at, let’s say, a folate pathway and it doesn’t look so hot to you, it doesn’t mean you’re not going to be producing at the end five methylfolate. What it means is that if you don’t give that pathway what it needs to work, that’s when you’re going to see an expression of genetic predispositions. It’s an interesting subject, but we tend to look at a gene and say, “This is what’s going to happen,” and that’s not true.

Dr. Weitz:            By the way, Jess, in terms of nutrient deficiencies and toxins getting in, logically, you might think if the junctions are open, short toxins are going to get in, but nutrients are going to get in more easily. Why is it that we have nutritional deficiencies?

Dr. Armine:         For a couple of reasons. Number one, when we’re digesting, we’re not digesting completely down to the point of the constituent parts. For instance, if you have a protein and you break it down to the amino acids, how does it actually get into the body if you have a good gut? It goes right through the cells. But since we’re not digesting completely, what we’re doing is creating short chain proteins that are antigens. So yes, it’ll get in easily, but what’s getting in? What’s getting in are the antigens or what are antigens like.

Dr. Weitz:            Right. In other words, instead of break in the proteins, instead of the proteins staying in the intestinal tract, until they’re broken down into individual amino acids, which is how they’re supposed to be absorbed, the entire protein or some part of that protein is getting absorbed through the intestinal lining, and that’s not a form in which our body is prepared to deal with it, and that’s why the immune system tends to attack it and create antibodies.

Dr. Armine:         We have a real problem with that these days. After 35 years of age, we usually don’t have enough hydrochloric acid. We are doing exactly what you said before, too much alcohol, too much junk, too much this, too much that, so-

Dr. Weitz:            Chronic use of proton pump inhibitors like Prilosec and acids and et cetera, et cetera.

Dr. Armine:         So all those things, all those things, and combine them, you get a stomach ache, you start throwing Maalox from Mylanta down. If that doesn’t work, you go to the doctor and he gives you a proton pump inhibitor, like a omeprazole or so forth, and what does that do but slow down or stop the production of hydrochloric acid, and often I’ll treat my patients with hydrochloric acid or some digestive enzymes actually making them better. Because if you think about it, if you don’t produce enough hydrochloric acid, aren’t you making the condition worse? You’re creating more antigens. This is a little complex. I’m not going to go through it. For those of you who love genetics, live by genetics, you won’t hear me sit here and explain it, but I put the genes that are associated with leaky gut syndrome and their explanation. So when you want to repair, why do we want to repair a leaky gut?

Dr. Weitz:            Wait a minute, let’s go back to those genes.

Dr. Armine:         You bet.

Dr. Weitz:            I want to talk about… There we go. So let’s highlight a few of these genes.

Dr. Armine:         I did.

Dr. Weitz:            I know. I want to talk about the first one, PEMT. Tell us a little bit about that. It looks like it would be an important gene also for brain health.

Dr. Armine:         Absolutely. Anything that creates a cell membrane is going to stop leaky gut, leaky cells and leaky brain.

Dr. Weitz:            Because there’s a similar membrane in the brain that prevents bacteria and toxins from getting into the brain, just like-

Dr. Armine:         The exact same reason for the gut is for the brain. The only thing that’s a little different is the mitochondrial in a membrane that uses cardiolipins, but let’s not get into that. PEMT, phosphatidylethanolamine N-methyltransferase is part of the process that we create phosphatidylcholine, which is what we use as a cell membrane, and this is part of your methylation pathway. Just if you would see where SAM is, S-adenosyl methionine, on one side you would see GAMT, which creates creatine, which creates muscle, and on the other side, you’d see PEMT, which creates your cell membranes. Now, if you don’t have enough SAM, if that particular enzyme is working slowly, if you have the inability to properly conjugate breakdown your lipids, you’re not going to be able to create your phosphatidylcholines. And if you can’t, it’s going to affect every cell membrane in the body.

                                And if you want to know how many cell membranes we have, we have 30 trillion cells, 200 to 2000 mitochondria per cell, and within the mitochondria, there’s something called the electron transport chains, and there’s about 30,000 per mitochondria. I’ll let you do the math. Now, here’s a little secret for you. If you’re looking at your genetics and you see FADS1, FADS2, may alter the metabolism of phosphatidylcholine, and the conversion of fatty acids, fish oil, microalgae oil, flaxseed oil to the phospholipids, we tend to think that omega-3s are the better way to get our phospholipids. And yeah, that would be correct, but if you happen to have these guys on board, these polymorphisms, that’s going to alter the conversion. So if you have PEMT and the FADS, you’re going to have to consider your diet, consider what co-factors allow this to work, make sure you’re digesting things correctly, and maybe lean towards the oils that create the phospholipids rather than the oils that don’t.

Dr. Weitz:            What oils would those be?

Dr. Armine:         Well, some people are going to throw rocks at me, I know. Omega-3s, whether they’re microalgae oils or whatever, are the easiest ones to create phospholipids. They also create an anti-inflammatory prostaglandin. Whereas things like omega-6s and omega-9s, and I won’t say the product, they have to go through a series of changes via dismutases and one of the stops is… Well, the last stop is omega-3s, but just before that, you have arachidonic acid. Put enough or arachidonic acid in and that goes into inflammatory prostaglandin pathway, which is why arachidonic acid has been demonized. We need it for our cells, but we don’t need as much as we’re taking in. So when you’re looking at your oils, the common wisdom is if the oil is solid at room temperatures, probably not the best thing for you, so if you want to use that as a guideline. Butter is solid, but that’s solid because it’s been churned, but margarine has had hydrogen bubbled through it in the presence of a metal, and that’s what makes it solid.

Dr. Weitz:            That’s a hydrogenation process.

Dr. Armine:         Exactly, exactly.

Dr. Weitz:            Which is why you don’t want to eat margarine, but butter might be okay, depending upon your cardiovascular risk.

Dr. Armine:         Even with a reasonable cardiovascular risk, the less natural it is, if you will, the more the risk is. The other part of-

Dr. Weitz:            So for patients who say have polymorphisms in these genes and they can’t produce the PC, does that mean it’s better for patients to consume polyene phosphatidylcholine directly or other forms of choline?

Dr. Armine:         Well, there’s other forms of choline that produce acetylcholine, which is a different story, but one of the old ways of doing this, and it still works, is to use lecithins.

Dr. Weitz:            Right, which is phosphatidylcholine, right?

Dr. Armine:         Which is phosphatidylcholine, phosphatidylinositol, and phosphatidylethanolamine.

Dr. Weitz:            Right.

Dr. Armine:         Okay, the problem these days when I was first starting this and everybody was using soy lecithin and-

Dr. Weitz:            Now everybody’s using sunflower lecithin.

Dr. Armine:         Exactly. But you know what? There’s another lesson then you can use if you’re not allergic to it is egg lecithin. That works just as well.

Dr. Weitz:            Okay.

Dr. Armine:         But given what you have either are liposomal PC out there, there are emulsified PCs. Emulsification is when the lipid is broken down to a small little drip drop called a micelle, and where you see those villi, that’s where they fit in. So there are ways around this. There’s a lot of tricks up the sleeve to start getting your… but, what do you really need to do? Fix your digestion.

Dr. Weitz:            Right.

Dr. Armine:         Fixed digestion and then-

Dr. Weitz:            Let’s just touch on this one other gene too, because this is another important one, is this diamine oxidase, and this is often mentioned when we’re dealing with patients with histamine intolerance or mast cell activation syndrome that they may lack this enzyme that helps break down histamine.

Dr. Armine:         There’s two paths to breaking down histamine, the extracellular and intracellular. The extracellular, the first enzyme you’re going to run into is diamine oxidase, which is also known as APP, the AOC1, you’ll see it like that. And what that does is start breaking histamine down to an aldehyde. Now, understand that it also produces ammonia, so then when it gets down to the aldehyde stage, there’s a big long word with the ending aldehyde. So whenever you see that, just think of formaldehyde, it’s much easier. Seriously, you ever try and pronounce one of those words? And even acetaldehyde or acid aldehyde, there’s only one carbon off, and it sounds like, oh, I’m saying this big scientific word. But if they say formaldehyde to people, they understand that. It may not be as injurious as formaldehyde, but you get the idea. The next set of enzymes is the aldehyde dehydrogenase family, which breaks the aldehyde into acetic acid, which is vinegar, and that’s much more easily excreted by the body. That’s the whole idea.

                                Internally, intracellularly, we use HNMT, which SAM is the co-factor. That creates N-methylhistamine, and that is broken down by MAO A and B to another aldehyde with big long name, and then the aldehyde dehydrogenase family breaks that down into acetic acid. There’s a side pathway that’s run by NAT2, which uses B5, and that creates acetylhistamine, which is for some reason more easily excreted. But there’s two things about histamine you have to know. One, what’s creating it? It’s not just a matter of how well we break it down, it’s what’s causing the extreme stimulation of one of the receptors to release it and why it’s being created, which is because of what a particular condition you have, and then it’s a matter of how quickly you can break it down. Most people are concentrating just on this, which is not a good idea.

                                There’s your HNMT, NAT2. Your FAT2 is going to get smacked around about this also, has mainly to do with your B12 conjugation, and I know that this is secretor and a non-secretor type, but I think the people who concentrate on that are concentrating too much on it, and this has more, in my opinion, to do with B12 than anything else. So repairing leaky gut, why do we want to repair it? Well, let me tell you a secret. You had mentioned before that there’s been a lot of testing out there.

Dr. Weitz:            Right. And should we test for leaky gut?

Dr. Armine:         I’m going to tell you no, and I’m going to tell you why. If anybody has a chronic illness that got leaky gut and that one-tenth of 1000000th of 1% that don’t, this is why it’s not dangerous.

Dr. Weitz:           Well, let me just put you on the spot for a second. How do you know that?

Dr. Armine:         How do I know what?

Dr. Weitz:           How do you know that most people have leaky gut? What’s the gold standard? Is the lactulose mannitol the gold standard?

Dr. Armine:         By chronic inflammation.

Dr. Weitz:           But you can have inflammation without leaky gut, right?

Dr. Armine:         Really? Listen to my explanation first and then decide whether my rationale is reasonable. If you have leaky gut, you’re going to create progressively more inflammation. It’s going to start out as food intolerances and overactive immune systems and autoimmunity of all sort, and then dysautonomia. That’s the way it’s going to go.

Dr. Weitz:            Yeah, I have no argument with that.

Dr. Armine:         Well, that’s good because we’re all in agreement that yeah, it’s a little complex when you think about it, but-

Dr. Weitz:            I’m just saying from a scientific perspective, we want to make sure we’re on firm ground when we say most patients have leaky gut.

Dr. Armine:         Okay, so whenever you decide to treat someone, the very final arbiter is the risk benefit factor.

Dr. Weitz:           Okay.

Dr. Armine:         So if what you’re going to do has very little risk and a very high probability of improvement, then you go, “Okay, that’s going to be all right.” When I go to tree leaky gut, I’m going to try and recreate a mucus layer. That mucus layer can be created by fructooligosaccharide, [inaudible 00:28:39] oligosaccharide, things like slippery elm, Sialex, [inaudible 00:28:45] oligosaccharides. They’re all over the place. I’m going to provide for cell physiology by using butyrate, maybe support the tight junctions with zinc-L-carnosine. And if the person’s been ill for a long time and their gut is not working as well just by listening to them, I might start using serum-derived bovine immunoglobulin isolates, which are big long words from mega mucosa, and those products have been known to fix the guts of HIV patients.

                                And then we can go back and forth with the probiotics of what creates what or who creates where. And that’s a big long discussion. So if I do that, if I do nothing but give somebody some digestive enzymes so you don’t create your antigens, give them something for the mucus layer, provide for the cell physiology, which is the butyrate, and maybe give them something for their tight junctions, am I hurting them in any way?

Dr. Weitz:            No.

Dr. Armine:         Okay. All right. Now, if someone has leaky gut and they took a zonulin test and the zonulin test was negative or below whatever, so forth and so on, for whatever reason, you know how tests are, and I don’t treat the leaky gut, am I hurting that person or not? And the reason I would say I’m hurting them is because since most people, they’re going to be hurting their guts and antigens are going to go through and inflammation’s going to build up, that inflammation will constantly get worse and worse and worse until, yes, your tests will become positive, but you’re not helping them as much as if you treat them at this real basic level with these real simple things that need to be done anyway. And the probability that’ll hurt them is very little, but if the probability of not treating it, the probability of them getting hurt is quite high.

Dr. Weitz:           Well then another question that comes out of this same way of thinking is if we are just assuming they have leaky gut and there’s no reasonable way to test for it to be sure that they have it, how do we know how long to treat them for this? How do we know when the leaky gut is better or are we just basing it on symptoms?

Dr. Armine:         Well, to a certain degree, you’re basing it on symptoms. To a certain degree, when you give somebody vitamins and minerals that are getting into the cells, when do you stop doing that?

Dr. Weitz:           Well, vitamins and minerals, a lot of them I consider just something that you should take for the rest of your life.

Dr. Armine:         I agree. And if somebody has a job that has a lot of stress, they may need to do a lesser version of this so that it doesn’t keep going back. Personally, I will stop treating a leaky gut and if a certain symptoms start coming back, you start seeing the buildup again, then one of two things. Either you haven’t fixed the leaky gut or it’s whatever is causing the leaky gut is taking over again. And remember, it’s not just this. We still have to look at things like H. Pylori. We have to look at dysbiosis. You have to look at SIBO. I’m just talking about real basic bio-terrain work that is normally ignored. That’s the problem. It’s normally ignored, and that’s why people don’t get better. It’s not just leaky gut.

                                It’s the whole bio-terrain thought pattern where you’re not giving people absorbable vitamins and minerals. When I say absorbable, if you takes it like that little one a day pill, which is Italian for… Seriously, if you take something… I’ll give you a real good example. Ladies are being told that they’re going to get their calcium to prevent osteoporosis by taking what? Calcium carbonate. Okay, well, I’m sorry, calcium carbonate, the last time I took chemistry, when you put calcium carbonate in hydrochloric acid, you get the bicarbonate ion, which neutralizes everything, which is why it’s Rolaids and Tums, but the calcium combines with the chloride becomes a rock, becomes limestone. And when it becomes limestone-

Dr. Weitz:            That’s a white stuff that builds up in your pipes.

Dr. Armine:         That’s right. So you’re not getting ionic calcium are you, that you need for your bones? So let’s face it, not only do you have to do your own thinking, you can’t trust the vitamin companies. You have to get a vitamin that has been made to absorb really, really well so it gets into the cells. Now, there are liposomal vitamins, there are liquid vitamins, there are some very well-made powdered vitamins that will actually preferentially get into the serum and then get into the cells. If your vitamins and minerals don’t get into the cells, you’re not going to get better. Why? Because all those biochemical processes, they need those co-factors in order to run.

Dr. Weitz:            I would like to say that I think everybody should take a multivitamin and better to take a higher quality, more absorbable one, but even taking just the basic multivitamin… We just had a study showing that taking Centrum, not that I’m a big fan of Centrum, but people who took a Centrum had a significantly decreased risk of dying from cardiovascular disease.

Dr. Armine:         So the people who did the studies, let’s not go down there, all right?

Dr. Weitz:           Well, who pays for studies?

Dr. Armine:         Who pays for studies? Way back when we were in school, way back when, when you listened to a scientific study, it was the greatest thing for insomnia because you had this guy talking blah blah blah, but now you got to be careful in who is doing the study. And when I look at a vitamin, I’ll look at each form of vitamins to see if in my head it’s absorbable. And that’s fine. And yes, if you are not ill and you have a need and everybody does for vitamins and minerals, you’re going to have certain improvements. I don’t know I’d go as far as saying that it’s going to prevent cardiovascular disease or is it less of an incidence? I’d read the study over again, then I’d see who is doing the study and how they did it and yada, yada, yada. Is it right? Yeah. Is it right to say that somebody gets a good absorbable vitamin and Centrum is not, I’m sorry.

Dr. Weitz:            No, I’m not a big fan of Centrum. I don’t like-

Dr. Armine:         The fact is that the principle is correct. The product is wrong.

Dr. Weitz:            So now in terms of healing the leaky gut, a lot of us in the functional medicine world are using some version of what Jeffrey Bland called many years ago, a Four R program. Dr. Bland explained it as replace, remove, reinoculate and repair. And there’s different versions of that. And so I think a lot of us are using some version of leaky gut repair, but we’re typically using it in the repair stage.

Dr. Armine:         The problem with that is that we all learned it that way, and then the argument came out, should we treat the dysbiosis or treat the leaky gut?

Dr. Weitz:            Right.

Dr. Armine:         And then it becomes an argument of-

Dr. Weitz:            Right, the fungal infection, SIBO, et cetera. So what you’re saying, treat to leaky gut first?

Dr. Armine:         I’m saying that’s the way I usually start… In my head and it’s only in my head, there’s no Armine method out there, by the way. You’ll see a lot of stuff that I’ve written, but in my head I say to myself, what has not been done? Because when I see somebody, the reason I’m successful, what I do is I actually take a history and my history is take a good hour and a half and I’ll see what has been done, just ticking it off, what has worked, what hasn’t, and so forth. There are some people, I’ll treat them simultaneously. There’s some people, I’ll treat the bug first, and there’s some people, which is most of them, I’ll treat the leaky gut first, which includes the vitamins and minerals and maybe some liver cleansing and so forth, so I can get their body to a more alkaline state, to a more healthy state, which makes it easier for me to go after the bugs. The fact is, the bugs love an acidic environment. You make that environment inhospitable for them, you won’t kill them, but you’ll slow them down.

                                See, in the 1980s, if you remember everything was candida, candida, candida, candida. And they used to put people on these horrible, horrible, strict diets and everybody stopped because it was too strict and it didn’t kill the candida, slowed them down to a crawl, but it didn’t kill them. You can’t starve them out because all they’ll do is go back into their little capsules and hang out like this because they’ve taken those capsules out of the intestines of mummies, put them into a nutrient broth and they start replicating. So you’re not going to get away with it, all right? And that goes for most things, but if you want to make the fish better, you treat the water. You want to make the body better, treat the body, then treat the bug. That’s not always true.

Dr. Weitz:            Yeah, so essentially what you’re telling us that what we want to do is do the repair first, then do the remove.

Dr. Armine:         Excuse me, yes. That’s the way I usually do it, but that’s the way I-

Dr. Weitz:            How do we fix these cell membranes? You’ve given us some of the things to do, now we have using phospholipids?

Dr. Armine:         Well, you want to fix the cell membrane, you want to give it what it needs to fix. So aside from the vitamins and minerals and everything else I said, if you want to supply people with phospholipids, you can either give them phospholipids or they’re going to need, and I know I’m going to get it, they’re going to need animal fats or they’re going to need a arachidonic acid. I know my vegan patients will really go after me for it. You also want to think about butyrate, and there’s a liquid butyrate that I suggest, which because if you open butyrate capsules, it smells like somebody dragged a dead body into your house and left it there for two weeks, or Gut+ or Tributyrin 350 is butyrate that’s been put into a triglycerides, so it spreads it out, time releases it.

                                If the immune system is weak in your opinion, or you have a test that you’re looking down, you say, “Oh my god, this is a weak immune system,” you can safely help that by using the serum-derived bovine immunoglobulin protein isolates, and they’re sold as SBI or EnteraGam, Mega IgG2000, SBI Protect, MegaMucosa, which I misspelled, and the study is right there. I have found that if somebody has a hyperactive immune system, just reacts to everything, this is probably not the thing you want to use. You want to just keep using the butyrate. If you have somebody whose immune system has been weak for a very long time, like I said, like an HIV patient… You know the worst looking food allergy test I’ve ever seen?

Dr. Weitz:            Oh, patients who have leaky gut.

Dr. Armine:         Yeah, but you have somebody who-

Dr. Weitz:            But see, everything comes up positive.

Dr. Armine:         Thank you, but it’s the opposite. The worst ones are the ones that show nothing.

Dr. Weitz:            Oh, okay.

Dr. Armine:         That means the immune system’s not working.

Dr. Weitz:            Oh, okay.

Dr. Armine:         Okay. So when I look at that and I’m like, “Mm, okay,”

Dr. Weitz:            Got to strengthen their gut immune system.

Dr. Armine:         Yeah, so some of the source of phospholipids, phosphatidylcholine, the lechtin, phosphatidylethanolamine, phosphatidylinositol, there’s sunflower lecithin, soil lecithin, egg lecithin. There’s liposomal PC. I know Quicksilver Scientific has that. For the mitochondria, there are wild caught fish eggs because they use fish eggs or cardiolipins for the inner membrane, that can be gotten. There’s two different products out there, and what they do is they freeze dry it without de-fating it.

Dr. Weitz:            So you say caviar will fix our leaky gut?

Dr. Armine:         Exactly. If you’ve got the money for it, use the caviar. I have a lot of patients… This actually was a lecture that was given to the Japanese doctors, and they had no problem. They were like, oh, salmon roe, they get in a bottle like that. I’m like, “Salmon Roe, we get a bottle like this and we empty out our bank accounts.” Some of the animal will be organic ghee, organic butter, and believe it or not, organic lard. And if you are looking for arachidonic acid, protein from fish, fowl, so forth, as long as it’s organic.

Dr. Weitz:            Bring on the yak.

Dr. Armine:         Bring on the yak, exactly. I put it in there as a joke because one day when one of my sons was young, he wanted to have a special party. So I emailed this place and they sent me all these different exotic meats. So if you wanted a yak burger, I could give you a yak burger. They never forget that. They never forgot that party, I’ll tell you.

Dr. Weitz:            They yacked it up.

Dr. Armine:         They yacked it up. Listen, with probiotic strains, you mentioned it before, the reason I didn’t jump right into it is because there’s so much research out with so many different strains of probiotics that do different things like inflammation, constipation, for diarrhea, for anxiety, depression. If you don’t know what to use, a simple combination of lactobacilli and bifidobacteria probably is a good way to start because that’s your basic microbiome. I personally use something that’s a spore based biotic because they tend to hold on to the insides better, make a spore biotic, stuff like that, but that’s just me.

Dr. Weitz:            Right.

Dr. Armine:         But if you don’t know what to use, a simple lactobacilli, something that has just a long list of lactobacilli and bifidobacteria, I would start with, if you want to do it at all because sometimes things like Gut+ have certain prebiotics in there that tend to feed your microbiome and start building that up. People forget that microbiomes were very, very local. You ate locally, the bugs that you were eating were in the food and so forth. It’s only when we became a worldwide society do we have a lot of problems with this. So just remember that this is what you use. This is my big thing is whatever you learn, you can use it on Monday morning. Some membrane integrity is an integral part of life’s function. You can’t ignore it, and most people do. You can’t heal without patent cell membranes.

Dr. Weitz:            You just mentioned probiotics. We now have some newer probiotics on the market such as akkermansia and muciniphila. Is that something that can be helpful as far as mucus membrane restoration?

Dr. Armine:         Yeah, there’s a bunch of them that are new. I’m not passing the buck, but that’s one of those things you should discuss with your practitioner because there are real good new ones. If you have a lot of oxalate crystals, HU58, which is a very large amount of either [inaudible 00:47:57], I forget the exact name, but what it does is it’s… [inaudible 00:48:11]. Now you can see that I really am Sherlock Holmes. Sorry, I’m getting blind to my old age. Bacillus subtilis, its byproduct, its metabolism produces the oxalate degrading enzyme. They used to have that out as Nephure, but that company went the way of the dark side and sold it to big pharma, in which case you’ll never see it, but for those people who have oxalate problems, and there’s lots of them-

Dr. Weitz:            You’re saying take spore-based probiotic for patients with oxalates?

Dr. Armine:         No, I’m saying take this, which is bacillus subtilis right now. In the MegaSporeBiotic, there is bacillus subtilis. This I give one bottle for a month because it has an enormous amount in it.

Dr. Weitz:            Okay. And the name of that product is called HU-

Dr. Armine:         HU58.

Dr. Weitz:            58.

Dr. Armine:         You want to give people a high dosage of bacillus subtilis, so it’s for about a month, and then they go to the other product.

Dr. Weitz:            MegaSpore.

Dr. Armine:         MegaSpore, thank you.

Dr. Weitz:            Okay, great.

Dr. Armine:         That works really well. But in my opinion, that’s where you start and it’s really not hard to reestablish your cell membrane because the body wants it and it’s going to suck it right up. So basically if you follow fix the cells and the membranes using absorbable vitamins and minerals, sources of phospholipids, cardiolipids, fix the gut, the mucus layer using some kind of… There’s several different things. Some people are allergic to the fructooligosaccharides, in which case you can use oligosaccharides. If they are allergic to everything, try something called Sialex. The enterocytes can be healed with the SBI maybe and butyrate, and you go on from there. But liver cleanse microbiome, you can’t go wrong, and I should have put digestive enzymes on the top, you can’t go wrong by doing a core treatment on somebody.

Dr. Weitz:            So on the average, how long should a course of leaky gut treatment last?

Dr. Armine:         Well, you know something, you ask a really great question because when you and I first started, it would’ve taken a year or two years, whatever. Now anywhere from three to nine months.

Dr. Weitz:            Do you remember the Model T cars?

Dr. Armine:         Actually, I’ve been doing, just like you have, I’ve been treating leaky gut before it was called leaky gut, and then I was treating leaky gut when everybody was laughing at me, and then I was treating leaky gut when… You can always tell the pioneers because they have the arrows in their backs, and then it became a thing and lots of different products started coming out. I remember the Neuroscience Corporation had a box of products that you did one thing after another after another, and were just progressing along with each portion that can be fixed. The biggest research right now is in mitochondrial function. If you can get the mitochondrial function back, if you can fix the inner membrane, then you don’t lose all those protons, then you run ATP synthase. Now, I didn’t go through that, that’s why it’s not understandable, but the fact is that it’s getting shorter and shorter, depending, of course, on how sick the person is.

Dr. Weitz:            On the average one to three months?

Dr. Armine:         No, more three to six.

Dr. Weitz:            Three to six, okay, great.

Dr. Armine:         Yeah, I wouldn’t count on one to three months. That’s an unusual thing. And always remember the Chinese proverb. The person who says it cannot be done should not be interpreting the person who’s doing it. Here’s, for your practitioners, some-

Dr. Weitz:            Want to look up the references.

Dr. Armine:         Yeah, there you go. And I’m always happy to answer questions. My partner in Japan is Yoko Arima, who’s a certified nutritional therapist and one very intelligent woman, and basically what people ask me what I do, I say, “If your doctors told you that there’s nothing else that could be done, if you’re getting the impression your doctors think it’s in your head and you feel like nobody can help you, that is definitely in my court.” And the way you get in touch with me is just go to my website. You can schedule a 30-minute free conference and we can just chat and I can let you know if we can do anything about it. If not, I can point you in the right direction.

Dr. Weitz:            Thank you so much, Dr. Armine.

Dr. Armine:         Are you kidding? That was great. I enjoyed being with you. I appreciate you letting me be here, seriously.



Dr. Weitz:            Absolutely. And we enjoy your pearls of wisdom. 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.


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