Dr. Har Hari Khalsa discusses his Modern Approach to Chiropractic with Dr. Ben Weitz.
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Podcast Highlights
Revolutionizing Health: Dr. Har Hari Khalsa’s Innovative Holistic Treatments
Join Dr. Ben Weitz, host of the Rational Wellness Podcast, in a fascinating discussion with Dr. Hari Hari Khalsa, a chiropractor from Los Angeles. Dr. Khalsa shares his journey from traditional Western medicine to discovering holistic healing through chiropractic care. He discusses his innovative treatments that combine naturopathy, cutting-edge technologies like CyberScan, PEMF, and hyperbaric oxygen therapy, and shares compelling patient success stories. Learn how these techniques can provide comprehensive health assessments, enhance cellular health, and potentially improve conditions like chronic lung issues, long COVID, and even cancer support. Don’t miss insights into groundbreaking therapies and how they might transform your approach to wellness.
00:00 Introduction to the Rational Wellness Podcast
00:26 Meet Dr. Har Hari Khalsa: A Journey into Holistic Healing
00:53 Discovering Chiropractic and Naturopathy
04:33 Starting a Practice in Los Angeles
05:51 The Power of CyberScan Technology
12:28 Exploring PEMF Therapy
18:19 Hyperbaric Oxygen Therapy Insights
21:07 Hyperbaric Therapy Success Stories
21:44 Mitochondrial Biogenesis and Immune Boosting
22:56 Antioxidants and Hyperbaric Oxygen Therapy
23:25 Methylene Blue and Other Therapies
25:08 Follistatin and Genetic Therapy
28:56 Cancer Care and Biohacking
33:28 StemWave Shockwave Therapy
35:45 Connecting with Dr. Har Hari
37:18 Podcast Conclusion and Contact Information
Dr. Har Hari Khalsais a Dr. Har Hari Khalsa, DC, is a highly experienced holistic chiropractor who has been assisting people on their healing journey since 1988. At Transformational Healing Universe in the Pico-Robertson neighborhood of Los Angeles, California, Dr. Har Hari focuses on a holistic approach to patient wellness and longevity. He specializes in several fields of healing, including gentle computer controlled chiropractic adjustments using the Sigma Instrument (ProAdjuster), Stemwave tissue/joint regenerative therapy, Cyberscan biofeedback analysis and remedies, Hyperbaric Oxygen therapy, Pulse PEMF therapy, Red-light bed therapy, EMTT tissue healing therapy, Class 4 Infra-Red laser therapy, fasting consultation, Kundalini yoga, Paida/Lajin traditional chinese medicine and the Wim Hof Method. His website is TransformationalHealingUniverse.com.
Dr. Ben Weitzis 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.
Podcast Transcript
Modern Chiropractic Care with Dr. Har Hari Khalsa- Rational Wellness Podcast 389
Dr. Weitz: [00:00:00] 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.
Today we’re having a discussion with Dr. Hari Khalsa, a chiropractor in Los Angeles who has some innovative ways to treat his patients. So Dr. Khalsa, or should I call you Dr. Hari or Dr. Khalsa?
Dr. Khalsa: It’s well, it’s Har Hari. Get it clear. It’s Har Hari. It’s Har
Dr. Weitz: Hari. Yeah. Yeah. Yeah.
Dr. Khalsa: Yeah.
Dr. Weitz: Okay. Tell us about yourself. How did you get into health care? Tell us about your journey.
Dr. Khalsa: I grew up here in Southern California and born here, born and raised in LA and didn’t really have much knowledge of holistic healing when I was growing up. I, my parents were pretty much into western medicine. I was kind of gearing up to go to medical school when I was in high school. I actually worked in a heart valve factory. My first job was, I was a tech in a heart valve factory. Okay. And I was in the return department, if you know what that means.
Dr. Weitz: A lot of people complaining, right?
Dr. Khalsa:A lot of people were actually dying. Oh, okay, I see. I got it. Most of my days were spent with court reporters and lawyers going over the damage that the surgeons did to the heart valve. They ended up stroking the patient out. Oh boy. Yeah, okay. But anyway, I ended up going to the University of Oregon. And I had, I, you know, I was kind of a daredevil. I don’t know if you’ve seen any [00:02:00] of those videos from like the seventies where the kids, you know, kids in the seventies were pretty much like little daredevils. Like I was exactly like that. I was like an evil Knievel. Like I had three major injuries in one year.
And I’ve never had any physical pain in my whole life. And by the time I was 20, I was racked in pain. I was going to yoga class and the yoga teacher said, why don’t you go to a chiropractor? And I’m like, what is a chiropractor? I didn’t even know what the term was. But he, that chiropractor fixed me up and a lot more than the medical doctor who just wanted to give me drugs which I just intuitively knew that I didn’t want to take drugs. So the chiropractic opened my eyes to the whole, you know, holistic healing model. He was actually a chiropractor that was, It was both a naturopath and a chiropractor. So I got to see the whole realm of naturopath and chiropractor, my very first doctor, and that excited me. I was very excited about, you know, what he was able to accomplish with me as a patient. And so that kind of launched me into this whole world. That was 1980.
Dr. Weitz: Okay.
Dr. Khalsa: Yeah. So I ended up going, you know, and that, I liked that guy so much that I was like, I want to go to the school he went to. So I ended up, he went to the Western States Chiropractic School up in Portland, Oregon. And I didn’t even look into the school. I’m like, that’s my guy. That’s my school. That’s where my guy went. Didn’t even look into anything about the school or anything. And that’s where I went. And I quickly learned that when he was at the school, it was a chiropractic and a naturopathic school in one school. And they had divided the school into two schools, into national naturopathic and then western states chiropractic. And I was a little bit disappointed because I really wanted the naturopathic along with the chiropractic. So I kind of had [00:04:00] to learn all this naturopathic stuff that I do now. on my own. Okay. Just, you know, you know, piecemeal, like going to different workshops, seminars, biohacking events, you know, for the last, what, 40, 44 years I’ve been like, you know, studying this stuff, right? Right. That’s kind of my history. Yeah, a little bit.
Dr. Weitz: Sounds good. So now you have this chiropractic clinic in Los Angeles. And how do you incorporate the naturopathic and some of the other natural healing modalities into your treatments?
Dr. Khalsa: That’s a good question. You know, I got trained in AK, you know, muscle testing back in the day with Versendaal. Do you remember that guy? What’s the name? Versendaal. It was standard process. Oh,
Dr. Weitz: I heard the name.
Dr. Khalsa: Yeah. Yeah. Back in the day, we’re talking back in the eighties. Yeah. So I got a lot of training in that and, you know, touch for health and, you know, a lot of muscle testing. So I started my practice off doing that kind of [00:05:00] technique. Although what I found is I started, you know, incorporating a lot of herbs. I was working with all the different, you know, vendors for, you know, Apex Energetics, Standard Process, you know, all the nutrition that we do as chiropractors, right? You know, I kind of got burned out on that. A lot of my patients. You know, in LA it’s funny because we got a lot of vegans and vegetarians, you know, and standard process is very heavy in the organ meats, right? It kind of killed my practice, you know, that side of my practice. I was like, I was kind of bummed because I really like standard process. But anyway I ended up learning from a naturopathic friend of mine, about technology they use in Germany.
It’s called CyberScan. It’s on our website. You can do a deeper dive if you want, but basically it’s a biofeedback system. I pretty much like to start with my patients with that because it’s like a full body analysis. It shows us all the underlying things. pretty much as [00:06:00] comprehensively as what I was used to doing with muscle testing. I, you know, I can identify all the organs, systems that are weak you know, if they’ve got pathologies pathogens toxins, deficiencies. We’re looking for everything with Cyberscan, so that’s a really comprehensive test. And I always pretty much try to start with everyone with that.
Dr. Weitz: How does that Cyberscan work?
Dr. Khalsa: The patient puts their hand on a plate, and it generates a scalar wave, which is kind of a woo quantum physics type term, but it’s basically like a wave of energy. It’s not EMF though, that’s the unique thing with the CyberScan. It’s not like a lot of these testing devices, they use electricity to run through the body, right? This doesn’t put any electrical energy at all. It’s a pure scalar wave, which is generated by a series of Tesla coils, it’s [00:07:00] just a coil array. And so that what happens when the patient puts their hand on their The scaler wave has, the machine has the ability to actually capture the energy of that patient in the machine. And now that’s the, you know, that is the what do you call it? The secret sauce of the cyber scam, I’d say. It’s like, how does it do that? To this day, I really don’t even know. And this borders on woo science, but one thing I can tell you for sure, is the CyberScan is extremely accurate. I’ve been, I’ve probably tested over 10, 000 patients in the last 10 years with the CyberScan and the results are you know, mind blowing, just mind blowing as far as
Dr. Weitz: So give us some examples. Patient comes in, They put their hand on this thing and then what kinds of results might you get?
Dr. Khalsa: Okay, so just an example, I had a guy let’s see, what was their problem? Oh, this is a sad case, okay? Really sad. The guy, he had developed a duodenal tumor, [00:08:00] okay? Which was causing like a stenosis of the, you know, small intestine, so the food could barely get through, right? And so I scanned him and the, literally the very first thing that showed up was a stenosis in a small intestine, you know, and then it showed up the series of tumors and blah, blah, blah. And I tell the patients, you know, this is not a medical diagnosis,
Dr. Weitz: all this No. Before he saw you, he didn’t know about the tumors?
Dr. Khalsa: No. He knew about it. He knew about it. Oh, okay. Yeah. But the cyberscan picked it up. On the very first reading, it picked up a stenosis of the intestine. And all the other different symptoms he was having, it picked up all the stuff. You know, you know, so that’s just one example, but I had people who’ve had, you know, face trauma, head trauma. It’ll pick up details of the trauma they had. You know, it’ll pick up you know, underlying congenital heart. problems that people know that they have. And sometimes they [00:09:00] don’t know, but I had a patient yesterday who knew that he had, he actually had a surgery for it a few years previous to correct a congenital heart problem. And it should, you know, it picked it up. So it, it’s very accurate. I have no idea how this technology underlying the physics of how it works, but I know this is it, that it doesn’t work. There’s no doubt.
Dr. Weitz: Give us an example of how this helped you to help your patient better.
Dr. Khalsa: Okay basically, that’s great because that’s where we go with this. So basically, I go through this entire report with them and, you know, we get the picture, the overall picture of what’s going on with that patient. with their hormonal system, their respiratory circulation, nervous system, musculoskeletal, all the different systems of the body. So they get a big download of, hey, this is what’s going on with you, right? And then what I’ll do is tell them, you know, very specific things. that they can [00:10:00] do at home you know, detox protocols you know, vitamin mineral supplements, depending on what shows up, because, you know, it could show up that they have a zinc deficiency, or B12, or this or that, so they get all of that from their reading, right? Everything they need to know about their nutrition, detox.
Dr. Weitz: Do you ever follow that up with labs to confirm it?
Dr. Khalsa: If they do labs, I don’t do a whole lot of labs. And and to be really honest with you, I find the CyberScan is way more accurate and more detailed than any lab. that I’ve seen, it gives you way more information, and so I, to me, it’s you know, why waste the time? I mean, I get the data when I scan them. I mean, I’ll look at their labs if they have them, but sometimes I’ll do that, but it’s rare, because the information is It’s way more comprehensive on a Cyberscan.
And then the other thing we do that we offer the patient, although it’s not like a [00:11:00] requirement or anything, but we make a remedy card where we actually put the frequency of their scan on the card. And then the patient wears the card on a necklace and the frequency. Just like a homeopathic, if they were taking something orally, it’s just working on the energy field of their body to help align or correct whatever imbalances there are.
So yeah, that’s kind of the, that’s the overview of it. I’d love to have you do it some point. Cause you’re here in LA. You can come by, I’d love for you to come experience it. Okay. Sounds good. But that’s the core of the analysis. As far as. You know, other things, like I’m a big believer in PEMF, hyperbaric red light as a,
Dr. Weitz: so why are you such a big believer in PEMF?
Dr. Khalsa: Because first of all, it’s helped me more than just about any therapy I’ve ever done but specifically [00:12:00] the pulse, PEMF the pulse, PEMF. is the most powerful high powered PEMF. There’s a big difference in a beamer or any other lower powered unit versus a pulse machine. A pulse machine, first of all, is like 45, 000, so they’re not cheap machines to start with but you’re paying for, you know, results and quality. I got introduced to Pulse, I think it was about eight years ago, at A4M, and I got on a Pulse table, the first time I’d ever been on a Pulse table. No one was in the booth, I turned the thing on. Have you ever been on a Pulse table? No.
Dr. Weitz: I had somebody come by and give me, I’ve had some demos at the office. One of them was this like oval thing that she put on my stomach. I had another demo where there were these coils that you wrap around your arms.
Dr. Khalsa: I was using the pull the pulse. The one I have is [00:13:00] a bed. It’s a full size bed that you like. And it’s like a zero gravity thing. So it totally hugs your body. And it’s pumping the PEMF signal through every cell of the body. You know, for you know, primarily what I tell the patients with that is, is it, you know, any disease that you’re dealing with, At the root of that disease is cellular voltage. So if you can raise the cell voltage with a PEMF unit, you’re taking that cell out of a diseased state into a healthy state.
So
Dr. Weitz: that’s the But I mean, how do you know, let’s say they have cancer, how do you know you’re not going to promote more cancer growth?
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Dr. Weitz: And now back to our discussion.
Dr. Khalsa: That’s a good question. You know, we, that when I did my training and they, by the way, Pulse makes no medical claims whatsoever about this. device. The only thing that they make a claim for is cellular exercise, basically working the cell out with magnetic pulse energy, right? But I can just tell you anecdotally the guy who did our training when we went back to Atlanta to do the training about six years ago, he had just recovered from fourth stage cancer. And the only therapy he did was the pulse machine. So there is some efficacy. And I think in the literature, It shows that it can be effective.
Although
Dr. Weitz: I wouldn’t Speaking of the literature, what kind of scientific studies are there on this?
Dr. Khalsa: There’s [00:16:00] a lot. If you go to PubMed and just put in, you know, type in PMF and in any condition you can think of, there’s a study. You know, there’s over at the time that I was doing the academics on it, it was over 6, 000, probably now it’s probably over 10, 000, you know, there’s a study on, yeah for, you know, just what I’ve seen with myself there’s not been one accident injury back, you know, I, and I’m talking even broken bones and different things that happened to me personally, where I did, you know, where I got on the pulse machine and it healed me in one third of the time.
Dr. Weitz: Okay.
Dr. Khalsa: Yeah. So it’s the heavy hitter. I’d say it’s like the, You know, it’s like the forklift that gets people out of the trench when they’re really down. Okay. Yeah.
Dr. Weitz: So using this for musculoskeletal injuries, as well as whatever else might be going on.
Dr. Khalsa: For like sprain strain, it helps [00:17:00] fractures heal in like a fraction of the time. Okay. A number of people with fractures, it heals much, much quicker, you know.
Dr. Weitz: Okay. Yeah. . Okay. So what’s the next thing you want to tell us about?
Dr. Khalsa: Hyperbaric,
Dr. Weitz: Okay.
Dr. Khalsa: That’s another thing.
Dr. Weitz: This is a high pressure, oxygen tank.
Dr. Khalsa: Yeah. Yeah. Getting into high pressure. I, you know, during the pandemic I had a lot of time to do research ’cause there was no patience. I was just like, I was just going down different rabbit holes and and I think it was, I’ve known about chiropractic for decades, or hyperbarics for decades, but I never really thought about it as something I wanted to do in a clinical setting. But then I started seeing these studies that were done in Israel. I don’t know if you’re familiar with ’em, but they showed. A 25 percent increase in telomere length.
Dr. Weitz: Now, the the only thing I would say about that is, my understanding is they were using these hard [00:18:00] tanks with really high levels of pressure, and you have to do it 40 times.
Dr. Khalsa: Yeah, no, it was, yeah, it’s, yeah, it’s intense, you’re right. It’s actually 60 times. 60 times, okay. 62 hour dives. Wow. But that’s to, you know, what they showed is they increased the telomere length by 25%, which is to me, that’s mind blowing because I’ve been around the biohacking and this community and the most I’ve ever seen You know, with supplements and things like that is maybe 5%, you know, that’s what the kind of the mean level of increasing telomere length is. If you’re using the high level stuff.
Dr. Weitz: Yeah. We stopped running a telomere length years ago. We’ve been using the true age genetic, yeah.
Dr. Khalsa: But regardless, there’s a lot more other types of studies that, that was the one that kind of. Open my eyes, but the bigger, I think the biggest study, and [00:19:00] it’s even true with the lower pressure hyperbarics, like what we use the soft shells is one week. And this is an unpublished study. I got this from the owner of oxy health. Cause they, they’re going to probably release this study this year, but basically what they showed was it in one week in a soft shell chamber, you’re tripling your circulating stem cells. in one week.
Dr. Weitz: So that’s cool.
Dr. Khalsa: Yeah, that’s pretty good. And we’ve seen really amazing results.
Dr. Weitz: And these are one hour sessions?
Dr. Khalsa: Yeah, one hour. Yeah. But we’ve seen amazing results with a lot of conditions with hyperbaric. The most amazing one recently was this woman who had 50 years of chronic congestive lung issue where she couldn’t get a full breath. and her lung was kind of gurgled and she’s been like that for 50 years.
Dr. Weitz: Wow.
Dr. Khalsa: Yeah, and literally after one week of doing [00:20:00] Hyperbaric, she was also doing the Red Light and Pulse, but I think primarily the Hyperbaric was the key thing for her. Her symptoms went away in one week. It was unbelievable. I was like, we were like, wow, that’s amazing. But we’ve seen like that similar types of results with Long COVID. People with long COVID where they just are flat out, they have no energy, and it takes a little longer, but 20 sessions. They’re back to their normal self.
Dr. Weitz: So is it like rebuilding the mitochondria?
Dr. Khalsa: Oh, that’s, yeah. It’s mitochondrial biogenesis. It’s neuroregenerating, it’s regenerating neurons in the brain. It’s getting, you know, increasing your, you know, circulating stem cells. It’s helping with overall body inflammation. It helps with immune, it helps boost the immune system. So it’s good for a lot of things. Wound healing it’s, you know, we’ve treated animals we had a cat [00:21:00] that, we didn’t know what the vets couldn’t tell us what was wrong with the cat, but the cat literally was like, fall, fell over sideways, we thought, oh god, the cat’s dead, you know, and we just started putting him in the hyperbaric he came back to life.
Dr. Weitz: Interesting.
Dr. Khalsa: Unfortunately, it doesn’t always work there because we had another cat that just passed away, unfortunately, but we didn’t get to him quick enough, but they put him in hyperbaric in Florida. My wife’s in Florida and he was too far gone, I think, but it just depends, you know, where hyperbarics.
Dr. Weitz: Okay. Yeah. What about, yeah, I was just looking into I was actually talking to somebody online about antioxidants and cancer. What about antioxidants and hyperbaric? Cause hyperbaric is high pressure oxygen. So it’s a oxidative stress. So you probably don’t want to take antioxidants like right before or right [00:22:00] afterwards, right?
Dr. Khalsa: Some doctors incorporate Methylene Blue into hyperbaric, because Methylene Blue is an electron donor to the electron transport chain, so you’re getting that mitochondrial boost, and then when you put it, add in that extra oxygen, it’s supercharging your mitochondria.
Dr. Weitz: If you did an IV vitamin C, would that also have a supercharging effect?
Dr. Khalsa: Probably, I mean anything you do with it, but I think methylene blue is the big one that people are using.
Dr. Weitz: Okay.
Dr. Khalsa: Yeah.
Dr. Weitz: Yeah, I know a lot of people are talking about methylene blue.
Dr. Khalsa: Yeah. We use it also with a red light too, it also goes good with red light bed too.
Dr. Weitz: So does a person turn red or blue?
Dr. Khalsa: No, your pee turns blue. Have you taken methylene blue? I have not
Dr. Weitz: yet.
Dr. Khalsa: Oh when you take it Your pee turns blue.
Dr. Weitz: Okay.
Dr. Khalsa: Yeah.
Dr. Weitz: I know there’s a blue man syndrome where if you [00:23:00] take silver, you can turn blue.
Dr. Khalsa: Yeah, a lot of people’s mouths, their tongue will be blue. I think a form of it now, which is in the pill, that you can swallow it so you don’t get the blue in your mouth.
Dr. Weitz: Okay.
Dr. Khalsa: But it does happen, though, so you can get a lot of them.
Dr. Weitz: Yeah, I’m doing the Urolithin A and the NR. I’m doing a ton of the anti-aging and the longevity things. I haven’t gotten to Methylene Blue yet, though. Methylene Blue is a good one.
Dr. Khalsa: That’s a good one. I like it.
Dr. Weitz: I just added some of the plant peptides. That’s a new thing.
Dr. Khalsa: Oh, yeah. Yeah. Yeah. Yeah. I like peptides. Oh, by the way, that brings up an interesting. So I recently had a Follistatin shot. Do you know what that is? Follistatin? It’s a peptide. Okay. Oh, okay. But Follistatin, okay. Normally our bodies produce it when we’re young, like teenage years and stuff.
And it, it grows muscle. It’s protein [00:24:00] synthesis. It grows your muscle. And it encourages fat loss, basically. Okay. And it’s anti aging as well. Most people do it as a peptide, they’ll inject it, but there’s this company called Minicircles, that I don’t know if you’ve heard of them, but it’s a genetic therapy where they They actually they, they splice in the gene to produce the folastatin in your own body.
So they use a plasmid DNA from a bacteria and they put the folastatin gene in that plasmid DNA and then they give you an injection. It goes into your cells. It doesn’t interfere with your body’s own DNA. It stays within the cellular matrix. And it will reproduce the thalastatin for two years after you get the shot.
Dr. Weitz: Interesting. I gotta look into that. Send me the data on that.
Dr. Khalsa: Yeah, it’s really interesting. I went to this biohacking event, it was in February, you know, and all the guys [00:25:00] like, You know, Ben Greenfield, Dave Asprey, all those guys were there. I didn’t even know what this event was about. I just got invited and the main topic was this pholostatin and it just so happened that, and this is a fantastic story too, by the way, because it just so happened that the CFO of the company we were already in communication before I came to that seminar and he came up to me.
And he is Hey, Dr. Harari, he knew me just because we had already been communicating through WhatsApp, but I didn’t know who he was. And then he introduced me himself and then he tells me I need to do a trade with you guys. ’cause he had lost so much weight with the fall statin shot. He weighed 350 pounds. Right. And he got the shot, he lost over a, I think it was 150 pounds.
Dr. Weitz: Kid
Dr. Khalsa: just
Dr. Weitz: short off his
Dr. Khalsa: body. Sure.
Dr. Weitz: You didn’t inject him with Ozembic?
Dr. Khalsa: No. This was from the fall set.
Dr. Weitz: Okay.
Dr. Khalsa: Anyway. So what happened is, you know, because when you lose that much weight in that short of [00:26:00] time, you end up with folds, you know, like skin folds, right? So you have to have surgery to repair the, you know, pull the skin up. But the problem was, is his body. Every time he’d do the surgery, he’d get these little infections, in the, you know, where they put the sutures or whatever. He had to go back 12 times. Oh my god. He’s preparing, right? And so he’s listen, I gotta do some major biohacking, I want to do a trade, because this Follistat shot’s not cheap, it’s only given outside the country, it’s not legal yet in this country.
Dr. Weitz: Okay.
Dr. Khalsa: And, anyway. Yeah. He’s listen, I want to do a trade with you guys. Because he knew he knows what we do in our clinic. And so he came in two weeks prior to the surgery. He did all the therapy, did red light, hyperbaric pulse. And a few other therapies we’ve got. Anyway, he went in that surgery, came out, kept doing the treatment, had zero problems. Zero [00:27:00] problems post surgery, whereas previously, every single time he had systemic infection.
Dr. Weitz: Interesting.
Dr. Khalsa: That was amazing.
Dr. Weitz: Cool.
Dr. Khalsa: Yeah.
Dr. Weitz: What about cancer? Can these therapies be used as adjuncts to cancer care?
Dr. Khalsa: Yeah, I would definitely say as an adjunct. I would not say by themselves as a cure or, you know, a treatment even. It’s more like supporting the body’s natural immunity and detoxification. You know, in that regards, I think they can be very helpful. I’ve seen cases of patients that were in hospice specifically I had this one guy, he came in, he was actually in a coma, he had a brain tumor, and his wife was like really insistent that he get the care, and so we, you know, we brought him in a wheelchair, he was literally in a coma, and we put him on a [00:28:00] pulse bed, yeah, this is a crazy story, this guy’s 90 years old, right, we put him on the pulse bed, and he wakes up!
Out of the coma! Really? Yeah. And so he started coming in and getting regular care and he lived, you know, they had given him previous I think two weeks to a month maybe, like he was in hospice care, right? He lived another four months and was completely communicative with his wife. He was able to enjoy his life up to the last moment.
Cool. Without being in a coma.
Dr. Weitz: That’s great.
Dr. Khalsa: That was an interesting one.
Dr. Weitz: Dr. Harari awakes the man from a coma.
Dr. Khalsa: That was crazy. That was really crazy. But no, I had another patient though that, oh my god, this is a wild case. This is the case for the medical journals. This woman came to me from Iowa. She was the [00:29:00] wife of a farmer and she had where the town where she lived, they did glyphosate spraying, you know, for decades.
Yeah, she told me that pretty much everybody in the town died from cancer where they lived, right? She ended up getting cancer and she had pancreatic cancer that had spread to her liver And it created a tumor There was and i’m not joking dude. It was the look the size of a nine month pregnant woman.
That’s how big It was huge and she was they you know, they had our morphine She was basically in hospice at that point and you know, she was like You I just want to live because I just want to live. I’ll do whatever it takes. And I’m like, okay I mean, the medical doctors had just written her off, you know, they put her on morphine.
It was it was done. And so I said, okay, let’s see what we can do, you know. So I actually had her, and this was that without much knowledge at the time, I, there is more [00:30:00] data now, but I was getting into the Wim Hof method where, you know, getting into ice water. And so I said, listen, you know, this is what I do every day.
I think you should do it. And so she did it. She got into the ice water very first time I met this woman and she started doing 11 minute ice baths, 32 degree water every day. every day. This woman was determined, right? And so I had her doing the pulse, she was doing ozone therapy, she was doing Rick Simpson protocol with, you know, cannabis and, you know, a million, I had her on like at least 10 different therapies, right?
And in two months, Her tumor had literally broken apart and shrunk down by two thirds. Huh? And she got, she was off of morphine. She got off her morphine. She had all her strength back. She could barely walk. When I first met her, she walked away a, after I saw her, she was carrying two 50 pound suitcases.
You know, she [00:31:00] was strong like she like at ox. Huh. Unfortunately though I couldn’t keep treating her because. She had to go back to Iowa. I had to go. I did another you know, thing I had to do anyway. But she did get six more quality months of life, which she would have not otherwise had. So that was quite amazing to see that. I think if I probably stayed with her, you know, six months. We could’ve seen a complete remission, you know, maybe, we’ll see.
Dr. Weitz: Okay. But that,
Dr. Khalsa: that was exciting to see that kind of progress with somebody. It was amazing. Cool.
Dr. Weitz: Yeah. Okay. So what else you got for us?
Dr. Khalsa: The other biggie that I’m really into is the STEM wave.
Dr. Weitz: StemWave.
Dr. Khalsa: StemWave. StemWave. That’s shockwave therapy. Oh, okay. Are you familiar with that? I am.
Dr. Weitz: Yeah, so I’ve been using It’s like a high pressure, sort of compression massage [00:32:00] type device.
Dr. Khalsa: Yeah, exactly. The one we use is called a StemWave. It’s a true shockwave. There’s different types of machines on the market. They’re all good to some degree. They do different things, but the one we have is a you know, it’s really deep, like it, is that
Dr. Weitz: the name of the company or yeah,
Dr. Khalsa: it’s called stemway. That’s the name of the company, but it’s a, it’s an electro hydraulic machine, meaning it’s running the shockwave through water. So the head has water in it. And so when. When that shockwave hits the body, it’s traveling at 3, 355 miles an hour into the body.
Dr. Weitz: Okay.
Dr. Khalsa: It has a massive stimulatory effect on healing joints. So I do mostly joint rehab with that machine. Okay. We had about I think we have about six or seven people in the last year that avoided different types of joint surgery, you know, shoulder [00:33:00] surgery, back surgery, hip surgery, or recovered from. I mean, we’ve had, we had some people that had really bad fractures that helped in their recovery, you know, post surgery, but that, that, that therapy is To me, as a chiropractor, it’s a godsend, because I’m able to help people with bad knees, bad hips, you know, low back disc problems, neck. I had one guy who was scheduled to have a disc replacement. C67 after two and a half weeks of doing the therapy, he had no more symptoms went away. Cool. They canceled the surgery. So that was beautiful, you know, yeah. That’s great.
Dr. Weitz: Yeah, it’s fun stuff. Okay, cool. How can our listeners find out more about you and connect with you at your clinic?
I’ll
Dr. Khalsa: Yeah, they can go to THUHeal, H E [00:34:00] A L dot com, that’s the website.
Dr. Weitz: Okay, and you’re in which part of Los Angeles?
Dr. Khalsa: We’re like South Beverly Hills, like Robertson Pico neighborhood.
Dr. Weitz: Okay, cool. Great, so thank you so much for joining us.
Dr. Khalsa: Yeah, I think we have a lot of friends in common too, by the way. Do we? Who’s that? Yeah, I mean, what’s your oh, what’s the woman’s name? She’s a holistic psychiatrist.
Dr. Weitz: Oh, Hyla Cass. Hyla. Yeah. Oh, okay.
Dr. Khalsa: She’s done stuff with you. Yeah. Yeah. Oh,
Dr. Weitz: okay. Yeah.
Dr. Khalsa: I’m friends with her. I’ve known her for a long time.
Dr. Weitz: Oh, okay. Yeah. I’ve known her for a long time too. She’s kind of a little bit of a mentor to me. Yeah. I organize these Functional Medicine Discussion Group meetings where we bring in speakers. You’re welcome to attend. I’ll add your name to the mailing list.
Dr. Khalsa: Awesome. How often do you do those?
Dr. Weitz: We’ve been doing them every month. I think we might go to every other month because since the pandemic, the, you [00:35:00] know, turnout hasn’t been as good, but we have Dr. Pimentel joining us in January. Okay. But we’ll be having a discussion about SIBO and IBS.
Dr. Khalsa: Okay. Sweet. I’d love to come. Okay.
Dr. Weitz: Sounds good. Okay. Thank you for having me. Thank you.
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 very much appreciate it If you could go to Apple Podcasts or Spotify and give us a five star ratings and review. As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would help overcoming a gut or other chronic health condition, and want to prevent chronic problems, and want to promote longevity, Please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111 and we can set you up for a consultation for functional medicine. And I will talk to everybody next week.
https://drweitz.com/wp-content/uploads/2024/12/rwp-389-website.jpg350785drweitzhttp://www.drweitz.com/wp-content/uploads/2017/06/drweitzdsamplelogo-withtext.pngdrweitz2024-12-03 18:50:432024-12-06 07:56:13Modern Chiropractic Care with Dr. Har Hari Khalsa: Rational Wellness Podcast 389
Dr. James LaValle discusses Metaflammaging 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
Exploring Metaflammation with Dr. James LaValle: Insights into Health, Nutrition, and Longevity
In this episode of the Rational Wellness Podcast, host Dr. Ben Weitz engages in a comprehensive discussion with Dr. James LaValle, an internationally recognized clinical pharmacist and nutritionist. They delve into the concept of metaflammation—metabolic inflammation—and its impact on health and aging. Dr. LaValle shares his personal journey into integrative and functional medicine, his work with athletes and professional teams, and his development of the Metabolic Code. He also discusses the significance of various biomarkers for assessing health, the role of GLP-1 agonists in obesity and diabetes management, and the potential benefits and concerns surrounding peptides. Additionally, they cover the importance of lifestyle changes, stress management, and innovative health technologies in promoting longevity and well-being.
00:00 Introduction to the Rational Wellness Podcast
00:29 Meet Dr. James LaValle: A Journey in Integrative Medicine
05:26 The Metabolic Code and Personalized Care
06:33 The Role of Lifetime in Promoting Wellness
07:31 Understanding Biomarkers and Metabolic Health
18:02 The Impact of GLP-1s and Lifestyle Changes
27:12 Concerns and Considerations with GLP-1s
31:05 Inflammation Markers: Mean Platelet Volume and Neutrophil Lymphocyte Ratio
31:42 Understanding Metabolic Inflammation
32:09 The Role of Basophils and Cortisol in Inflammation
32:25 Neutrophils, Lymphocytes, and Immune System Stress
33:27 Monocytes and Macrophages: Indicators of Inflammation
36:12 The Importance of Urinary pH and Kidney Health
37:47 Root Causes of Obesity: Genetics, Environment, and Nutrient Deficiencies
39:14 The Impact of Prescription Drugs on Weight Gain
39:49 Magnesium Deficiency and Metabolic Syndrome
40:54 The Problem with Ultra-Processed Foods
42:36 The Importance of Personal Health Responsibility
44:11 Exploring Peptides and Their Benefits
48:54 Innovations in Longevity and Health Supplements
54:22 The Science Behind Synapsin and RG3
58:45 Conclusion and Final Thoughts
Dr. James LaValle is an internationally recognized clinical pharmacist and a board certified clinical nutritionist for close to 40 years and he is the author of more than 20 books including, “Cracking the Metabolic Code.” He has lectured for more than a decade for the American Academy of Anti-Aging Medicine. Jim has served thousands of patients using his “Metabolic Model for Health” through his integrative health practice, LaValle Metabolix in Orange County, CA. James is best known for his expertise in personalized integrative therapies uncovering the underlying metabolic issues that keep people from feeling healthy and vital. And he has also worked with many professional athletes and been a consultant to many professional teams and leagues. His website is JimLavalle.com. To find out more about his nutrition products that he has developed, including Synapsin, please go to MetabolicElite.co.
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.
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. Today, we will be speaking with Dr. James LaValle about metaflammation and inflammation. James LaValle is an internationally recognized clinical pharmacist, board certified clinical nutritionist for close to 40 years now, right?
Dr. LaValle:Yeah.
Dr. Weitz: And he’s the author of more than 20 books, including Cracking the Metabolic Code. He’s lectured for more than a decade for the American Academy of Anti-Aging Medicine. Jim has helped thousands of patients using his metabolic model for health, and he currently is at the Lavalle Metabolics in Orange County, California. James is best known for his expertise in personalized Integrative therapies, uncovering the underlying metabolic issues that keep people from feeling healthy and vital. He’s worked with many professional athletes. Been a consultant to many professional teams and, like me, way back in the day, both Jim and I were competitive bodybuilders.
Dr. LaValle: There you go.
Dr. Weitz: For me, it was way back in the eighties.
Dr. LaValle: I think I was in the seventies, my friend.
Dr. Weitz: Oh, okay. I think we’re probably around the same age though.
Dr. LaValle: Yeah, yeah.
Dr. Weitz: I’m 66 right now, so.
Dr. LaValle: Well, yeah, we’re right there together then, man.
Dr. Weitz: So how do you first get involved with Functional, Integrative medicine?
Dr. LaValle: Yeah, it was interesting. My cousins were importing, they were actually importing products from Germany, Rekwig homeopathic formulas, and then representing the Saroyal nutritional brands. And they were actually calling on a lot of doctors of chiropractic in the 70s. And I was training, I was, high school athlete, and, got injured, couldn’t play football in college. So I, started doing bodybuilding. And I, I just started listening to them, but really what got me in it was I’d finished my second competition, national qualifier, won the thing, took all the trophies home, right? Right. But I felt like I was 80 years old. I felt horrible. And so I asked them, Hey, you got a recommendation on somebody that I could go to? So I went to this doc, he was up in Medway, Ohio, middle of nowhere, but he had a massive practice. He was a doctor of chiropractic, he was a chiropractic physician specializing in nutritional therapies. I did what he said, he did the, did electrodermal screening on me, measured my acupuncture meridians. Did some adjustment stuff with me, which was super important because of all the, the 900 pound squats I was doing. My spine was a little compressed… just a little bit. And but I did what he said. And it changed my life. I mean, I felt so much better. And I was just finishing pharmacy school then. I literally got out of pharmacy school and I was like, I got to get involved in this. I don’t know how I’m going to do it. But why I ended up literally I met,…a rich history with doctors and chiropractic for some reason,… met a doc, and I went to a weekend seminar, met my second mentor, because the guy I went to ended up being my first mentor, teaching me a lot about nutritional medicine and labs and biochemistry. My second mentor was Dr. Alexander Wood, God rest his soul, passed away a few years back, started the Ontario College of Naturopathic Medicine, went through the chiropractic school, got his degree in psychology, actually taught at Baden Baden at Medicine Week in Germany. So he was one of these guys. He was into the chemistry, right? Right. And It just took me by storm, man. And it’s been 40 years, 26 books, five databases, 200 articles, I mean, research, teaching at College of Pharmacy and Medicine, University of Cincinnati, New York State College of Chiropractic and Oriental Medicine, George Washington School of Medicine. All of it was just this journey. And I actually, started seeing a lot of people. So I had a clinic in Ohio. We were seeing 300 to 400 people a week. Wow. And that’s a lot. And all on personalized care. So I got to see a lot of people and I got to see how people were falling in these clusters of dysfunction. And that’s when I, in 1997, I did my first lecture on the metabolic code. And now in 2024, we’ve got, a full database, informatics. It takes people’s labs, their symptoms, their biometrics, and all their data and shows where they’re clustering. And so it’s been a, It’s been a minute. I’m, it’s kind of crazy how 40 years goes by when you’re passionate every day. I mean, every day I wake up, I mean, I’m taught my son’s in the business with me now. I must have pulled seven studies last night and was shooting them to him like, Hey man, you gotta look at this. We gotta add, we gotta get going on this, right?
Dr. Weitz: Oh, cool.
Dr. LaValle: So it’s just fun, so that’s how I got started in it. Personal journey, personal healing, and then seeing how powerful it was for people, through my last 40 years of being a service to folks. And now working with Lifetime, 200 clubs, 2 million members, and as their Chief Science Officer, actually designing programs where we can really affect a large population of people. So, pretty keyed up about it.
Dr. Weitz: What is Lifetime?
Dr. LaValle: Lifetime is Lifetime Fit, used to be Lifetime Fitness. So they’ve got the 200 fitness, I call them country clubs of wellness, right? Cause they have so many services in them. Okay. We’re doing a longevity centers in them where we’re, doing labs and we’re, really working at driving back this concept of metabolic inflammation or metaflammation. And [00:07:00] the byproduct of suspending metabolic inflammation is that you don’t age as rapidly, right? I mean, for all the work in anti-aging medicine, I don’t have any 40 year olds come back to me looking 10 years old. I mean, we’re just trying to suspend our, to suspend, just suspend that process, right? How can we be as productive as we can, enjoying our life as long as we can?
Dr. Weitz: Right. Yeah. How to slow the rate of biological aging. That’s right. That’s exactly it. Yeah. Do you use those methylation time clocks as a measure of it? Have you run some, have you run like the true age test?
Dr. LaValle: I know Tru age really well. Like I love their multi organ tests that they just came out with. And I think those are great tests that kind of give you a mark of where you’re at, but what you really need is to dive into where’s your metabolomics? What is your blood showing what is going on? Or urine or [00:08:00] saliva, right? There’s all kinds of ways to get data off the table. Sure, yeah. But looking at your metrics and saying, where am I? And what do I need to do? What countermeasures do I need to do in order to create health? And, and I think the, the process, I don’t think it’s hard to do. I think the further along you’re down a disease path, the harder it is to turn that ship around. But I’m really trying to get people to identify where they’re at earlier in their life. Where are you at in that process? So we can get you in the right spot quicker. Yeah. And I always tell people, look, there aren’t any magical Tibetan goji berries picked in the moonlight that are going to fix everything for you. It’s got, it’s going to be work, it’s going to be work, but it’s worth it when you’re just waking up thinking about what you have to do that day, instead of how bad you feel.
Dr. Weitz: Right. Yeah, I’m constantly keeping track of what the latest biomarkers are that we need to be paying attention to. Uric acid, which is the best cholesterol marker. Is it LDL C? No, it’s LDL particle number. No, it’s small dense LDL. No, it’s ApoB. It’s, LpA. It’s Lp little a. It’s, there’s always a new one.
Dr. LaValle: Right, exactly. Well, my hot one right now, and it’s been for a long time, but it’s finally become more popular, is measuring Galectin 3. A lot of people, just thought, wow, it’s, oh yeah, if you’re an endurance runner and you got a high Galectin 3, you’re going to get fibrosis and get some heart failure. But, it turns out that it’s pretty tied to neuroinflammation and dementia risk and stroke risk and diabetes risk. And, it’s one of those markers that you can get pretty easy, but…
Dr. Weitz: We don’t measure regularly mostly ’cause we’re using Vibrant and they’re not offering it right now. And it’s, of an expensive marker too, isn’t it?
Dr. LaValle: It’s not too bad. Really. Okay. It’s not too bad but you know the, yeah, no,
Dr. Weitz: I talked to Isaac Elias a lot. He’s mister galectin 3/modified citrus pectin…
Dr. LaValle: of course. Yeah. Drink that modified citrus pectin. But yeah, no, it’s I think it’s interesting because I think what we end up doing is a lot of times we look for these really avant garde labs, which I’m, like, I dig it all, right? I mean, I’ve got my second edition of Your Blood Never Lies book I’m editing right now. So I dig that, but I think a lot of times, People miss foundational issues and foundational issues is what, it’s what creates the ripples in those avant garde labs. If you didn’t have insulin resistance and you didn’t have metabolic inflammation, inflammatory cytokines being dug up and pushed out through your gut and then affecting your enteric nervous system, triggering your brain. Well, [00:11:00] you know what? You wouldn’t have to worry about measuring a galactin 3, right? Because you’d have. Fixed your glucose, fixed your insulin, had better lipids, had better red blood cell mag, less C reactive protein, right? These foundational markers that I think, sometimes we just look past them. And we really need to pay attention.
Dr. Weitz: So are fasting glucose, insulin, hemoglobin A1c enough for insulin resistance? Or do we need another marker? I know there’s some new tests available.
Dr. LaValle: Yeah there’s, obviously there’s the glyc, glyc A, there’s the HOMA IR, but honestly, if you have an A1c, a fasting insulin and a fasting glucose, and if for some reason that person’s sitting in front of you fooling you on a fasting insulin, Yeah, they’re overweight. They got a lot of visceral fat. You could see that. Well, sure, man, give them a 75 gram carb load and then have them do their glucose and insulin and watch that insulin come to life.
Dr. Weitz: Right…
Dr. LaValle: So, [00:12:00] but I mean, certainly you could look at, HOMA IR, look at GlycA, and I think you would see If you can’t pick it up there, you’re probably, you’re looking in the wrong area then. But I mean, let’s face it, you got half the U. S. population for sure. Yeah. One out of two people walking around are either insulin resistant or diabetic already. and people that are overweight, but they don’t meet the criteria for insulin resistance. They probably got some level of insulin resistance going on. So we’re probably talking about 7 out of 10 people.
Dr. Weitz: Sure, we all know we’ve seen patients who have like a fasting glucose of 95 and because it’s not over 100, they don’t qualify as pre diabetic. So, their doctor tells them not to worry about it.
Dr. LaValle: And they’re already in trouble,
Dr. Weitz: right?
Dr. LaValle: I mean, you’re already in 95 blood sugar, you’re 60 percent risk of being a diabetic and you’re already damaging your arteries. So yeah, 100%.
Dr. Weitz: What about the cholesterol metrics? I’ve been diving into some of the [00:13:00] research recently and some of the papers are kind of mixed as to how important LDL is and Whether a super low LDL is super beneficial or not. I know some people I’ve traditionally tried to get the LDL below 70 but I just recently read a paper from a couple of years ago showing that LDL Below 70, there was an increased mortality and that the target was like between 100. What was it? 120 and 180 was the sweet spot.
Dr. LaValle: Yeah. I mean, you know what? I think for one, we’re so focused on LDL and I think there’s a couple things. One, if your LD L’s too low, you’re gonna have a hard time making your sex hormones, especially testosterone. If your LDL gets too low, am I [00:14:00] going to be able to repair my cell membranes, especially in the brain? So I think there’s a little bit of concern when you drive it too low. I think the type of LDL cholesterol you have, are they big and fluffy? Are they small and penetrating the glycocalyx or the inner lining of the artery? Right. And even when it’s small particle LDL, it depends on, well, what’s your redox poise, right? Or are you under a high oxidative rate? So do you have a lot of oxidized LDL? Do you have a high myeloperoxidase? Right. I think all of those are important. And then of course, We certainly see populations that have elevated LDL, but very low rates of heart disease, right. So there are subpopulations in different countries where we see that, and it doesn’t matter as much, we’re not in other countries So that’s the one thing I always laugh about when people say that. It’s like, oh, well guess what? And and when you live in Sardinia, you live to a hundred and look at the carbs that they eat. Well, yeah. Well, if I was in Sardinia. And eating clean food and walking up 400 steps a day, I’d be in good shape, but I’m in America.
Dr. Weitz: We’re driving in the car, going in the elevator, getting as little exercise as you can.
Dr. LaValle: Oh my God. It’s just a different world and the quality of the food. And there’s so many different things. So I think that. Cholesterol, there’s, there are issues around Apolipoprotein B, Lipoprotein little a, Lppla2, so these fractions of lipoproteins that show that there’s metabolic inflammation. So one of the earliest signs of metaflammation is that you start making more bad actor lipids, smaller particle LDL, more lipoprotein little a, more apolipoprotein B, more oxidized LDL. And then your blood gets stickier, right? Your fibrinogen gets higher. All of those are kind of like the canaries in the [00:16:00] coal mine, right? It’s, it’s not I think lipids are important. And I think it’s, but it’s one aspect of important. If you didn’t have, how many times have you seen people that they’re 80 pounds overweight and their lipid profile looks perfect is genetically. They’re just not predisposed. And you look at somebody like myself, all the genes for diabetes, all the genes for heart disease, all the genes for obesity, I gotta watch everything I’m dang doing or all of a sudden my lipid profile looks like a bomb hit it, right? And so I think there’s that individuality where the person that might have the good lipids may have issues in other areas because, 40 percent of heart attacks come on people with normal lipids and no plaque, right? So it’s not just a lipid problem. But it is our heart disease is our number one killer. I don’t think we put enough attention on the neurovascular network or our nervous system, or what’s going on with the central nervous system.
Dr. Weitz: Let me, let me just ask you, you said 40 percent of the population has, that has a heart attack, has normal lipids and no plaque. I thought it was normal lipids, but still have plaque?
Dr. LaValle: No, they’ve got that. It’s a variance, right? You’ve got some that have normal lipids that may have plaque burden, and you’ve got some that don’t have plaque burden and still have heart attack. Okay. And the problem with that is, and even though your lipids are normal, of course, you get plaque burden when you’re insulin resistant, right? I mean, by, without a doubt insulin resistance is our big cause. And that’s why when you look at the data on GLP 1, so the, people thinking about Ozembic and Monjaro, that the information there shows that when they give a GLP 1 and it reduces that non stop glucagon activity, that cardiac remodeling takes place. The ventral goop gets smaller. There’s less, less coronary artery burden. Blood pressures go down. There’s a lot of positives because you’ve regulated another [00:18:00] aspect of pancreatic function.
Dr. Weitz: Isn’t it interesting that at the same time that we have these peptides, because these drugs like Ozambic are peptides, are the most prescribed drugs in the country and the FDA is restricting the use of peptides.
Dr. LaValle: Yeah, it’s, it’s interesting. I went to the the hearing on October 29th to do public comment on peptides, and then we’re going to be doing nominations for peptides on December 4th. I’d say there’s a happy middle ground in it. I don’t think that there’s been enough clarity on what can be done for compounding, like give enough evidence that should be nominated to category one for compounding. And that’s what I learned when I was there is, the FDA saying, look, show us some data on some patients, gender, age, labs, dosage given, and what’s the outcome. And then you’ve got rationale for putting things on Category 1, which is of course where you can, nominate it and then they can be made. And so I do think it’s an interesting time. I mean, look, peptides aren’t new, right? Insulin 1923. So peptides have been around 100 years. And I always make that, I try to get people to understand because there’s all this negative and positive brouhaha about GLP1s. Oh my God, you’re only going to lose lean muscle. Oh my God, you’re going to be on them forever. Well, if you don’t change the way you eat and the way you exercise and the way you sleep, you’re right. You’re probably going to be on them forever. You’re going to have to change. It’s work, but it’s worth it, right? You got to change.
But, a lot of people, nobody argued. And I had to do this when I was with, when I first came on to Lifetime because we were utilizing GLP 1s there. And people were upset initially. Some of the members, oh my god, we’re here because of a healthy way of life. Well, you [00:20:00] wouldn’t deny people insulin. Right? No, I mean, you wouldn’t say to people, hey, never give insulin. GLP 1s provide as peptides, just like other peptides, whether you’re looking at Sermorelin to help with reinitiating growth hormone and people that have shut their growth hormone down due to excess stress. GLP 1s are helping us with the chronic problems of poor glucose utilization. So you don’t die overnight like a person that doesn’t have insulin and they’re, their glucoses are in the 800s and they’re damaging their eyes and their arteries, amputations, all the terrible things that happen if they survive, they don’t go into a coma. But what is happening is when you’re using the GLP 1s chronically you’re reducing that future risk of heart disease, dementia, helping with food noise and addiction of food. And it’s a different path. And I think peptides are You know, an invaluable part, but just another tool in our toolkit. Let’s don’t lean on them so heavy that we don’t think you need to [00:21:00] change the way you’re eating, get core nutrients that your body needs, understand how to cope with stress. All of that stuff still needs to happen.
Dr. Weitz: Make sure you’re including resistance training. Make sure you’re eating healthier.
Dr. LaValle: A hundred percent. And I don’t think…
Dr. Weitz: I’m a little skeptical though, because not a week goes by that there’s not some other positive benefit of GLP 1s. I mean, it’s just it’s almost ridiculous. I’m like, are you kidding me? It’s like everything it helps.
Dr. LaValle: Yeah. Well, I, I think if you, so here’s how I look at that. If you look at insulin resistance and everything it causes.
Dr. Weitz: And Obesity and everything it causes, right? So you reduce obesity, you reduce insulin resistance. Okay, I get it. I get it. So
Dr. LaValle: I but I will say. I think that [00:22:00] just relying on the drug and not trying to change your lifestyle, I think there’s going to be a rate limiting benefit for people.
Dr. Weitz: I’ve seen a number of patients who took the drug, lost 30, 40, 50 pounds, stopped taking it, gained it right back.
Dr. LaValle: Exactly. And, and so I think once again, whether I look at a botanical, a nutrient, a lifestyle modification, homeopathic medicine, whatever it is, you gotta have a fully formed thought about where am I going with my health? First of all, what am I willing to do? Like, how much am I willing to change the way I eat, the way I move, how I address my stress? What environmental burdens have I been exposed to? Am I, am I willing to dig deep and to really clean my chemistry up so that I can turn back that inflammaging process that is going on?
And I [00:23:00] wish I made that term up. That term is in the medical literature since 2008. I mean, that’s almost 20 years we’ve been talking about metabolic inflammation because I, I mean, the biggest thing is you have a lot of people that got frustrated. They ate right and they exercised and they didn’t lose a pound. And, and so, in a lot of ways, the, this category of medications are somewhat of a miracle. I call them a lifeline to getting your health back. It’s interesting that when people take GLP 1s, they’re two times as likely to go back to the gym than if they don’t take them.
Dr. Weitz: Is that right?
Dr. LaValle: Yeah. Yeah. That was a statistic that just came out, which makes sense. Hey, I’m starting to lose weight. Wow. My self esteem is coming back. Hey, maybe I should come. I should go back to trying to take care of myself. Right. So I think it’s good. I just think that [00:24:00] even when I started out with peptides, you get enamored by the power of them. Right? Because, you take BPC, great for connective tissue, healing up the gut, or you look at the growth hormone secretion, hey, it helps me to sleep better because I’m restoring my circadian rhythm to my sleep weight cycle and cortisol and growth hormone, right?
You feel better, but You know, you still got to look at those labs and go, where are you going? Is your blood sugar still at 93 in the morning 97? Is your insulin still 10? Where are your lipids? What’s your mean platelet volume like? Because that’s a marker of inflammation. Is your homocysteine elevated?
Yeah, you got to dig in, and really drive yourself. It just depends how passionate you are. about getting well. And unfortunately, I think in our culture, a lot of times people don’t, it’s changing now, but I would say, I’m putting on [00:25:00] my hat like you, we’ve been in this business for a minute, right?
Yeah. And a lot, the previous 30 years, nobody really changed until they felt bad enough. For the most part. They felt bad enough, they got scared enough, and they said I gotta change. What’s exciting about the last five years is people are having that forward thought of, gee, I want to measure my biological age. I want to learn about how to take care of myself. And so I think that’s fantastic. I wish it would have happened 20 years ago so I could have 20 more years of having fun with people being more proactive.
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Dr. Weitz: My biggest worry with the GLP1s is, Reducing gut motility. Because, yeah, I treat a lot of patients for gut problems, IBS, SIBO, reflux, etc., and reduced gut motility is a big factor in all those patients, and we know that these drugs reduce gut motility.
Dr. LaValle: Yeah, I mean, I would say I worry about that when people are going in and they’re getting them prescribed by their physician, their primary care, and they’re taking the full dose right away. I know they’re going big right away. Right. It really runs the risk of reducing gut motility. But if, and what I have found is by titration of dosing, If you know if and a lot of clinicians have said the same thing right is if you can titrate the dose [00:28:00] get to the minimum effective dose where people are losing weight make sure they’re taking fiber maybe make sure they’re doing some artichoke extract and look everybody’s gut needs worked on regardless right I mean how many people have a great gut microbiome these days right you know I mean it’s like oh yeah right that’s a unicorn you know I mean you know and so you know people don’t get prebiotics they You know, probiotics are all over the place in terms of their efficacy.
Dr. Weitz: We’re all getting exposed to antibiotics and glyphosate and, look at all the hand sanitizers and pesticides people use the last few years. So,
Dr. LaValle: 100%, right? And so, I think that as long as people are, you keep their bowels moving regular, and they didn’t have pre existing SIBO, right? I mean, they got a pre existing condition, it’s a different story, but as long as they’re, Bowels are moving good. They’re not bloated. They’re not gassy. [00:29:00] They’ve, they’re losing weight. It’s a good thing, but I also worry about people doing this stuff on their own. They’re buying for research only or, not for human or animal use products. Yeah. Yeah. And they’re taking GLP 1s on their own. I mean, if you looked on Facebook groups for GLP 1s, you’ll have people, they show their syringe and they’re asking, is this the right dose? That is scary. I mean, we want people empowered, but we want people to have guidance. Get, get someone you can work with that’ll help you. Yeah. Because there, there are concerns. I mean, you could have a side effect. It can happen.
Dr. Weitz: Right. No, I come across that all the time. I’m also a little nervous about, even though I think it’s great that people are empowered, that now people can go and order their own labs and then they’re interpreting themselves based on Dr. Google and, you know.
Dr. LaValle: That’s legitimate though. I mean, once again, there’s a reason why people spend time going through. College and Learning Healthcare is so that we can provide a full thought for people about a plan. And that’s probably the biggest thing that I think I try to encourage people is get a plan. If your cortisol is high, your morning serum cortisol is high or you’re stressed throughout the day and you get a four point salivary cortisol and you flattened your cortisol curve, you need help to correct it, and because there’s downstream problems that have occurred because of that, and you want to follow it.
I mean, look, unfortunately, I don’t even think people know their blood pressure and they’re worried about getting the Tibetan goji berry laced with peptides. It’s, it’s, make sure you master those basics and then move forward into as advanced [00:31:00] as you want to go, right? If you want to live, I always say, everybody’s wanting to talk about living to 120. Let’s get people to 85 without being sick.
Dr. Weitz: Right. Peace. You mentioned one of, one of the interesting inflammation markers. I want to ask you about two of them because I know you’re an expert at lab interpretation. You mentioned the mean platelet volume. I also want to ask you about the neutrophil lymphocyte ratio, which is another way to get a gauge on inflammation. So talk about the mean platelet volume. What, why does the number of platelets have anything to do with inflammation and how, what number should we be looking at to indicate inflammation with mean platelet volume?
Dr. LaValle: Well, so the mean platelet volume is going to be, the volume of the platelet, right? And it turns out that they get bigger as there’s metabolic inflammation taking place. Typically, what I tell people, because depending on which lab you get, when you get into the fourth quartile of normal, so when you’re at the high end [00:32:00] of normal, you’ve probably got some underlying metabolic inflammation. Now, what would you compare against that? You could look at basophils. If your basophil is one or more, then you know you’re making more interleukin 6, which is an inflammatory cytokine. If your cortisol is elevated. You’re making more IL 6. It just happened automatically. And then when you look at neutrophils and lymphocytes, that starts to get interesting because ratios are kind of, ratios are interesting to me because initially you may see a high neutrophil.
Right? Which a high neutrophil is telling you, okay, immune system’s kind of getting jacked up a little bit. But as you stress your immune system over time, those neutrophils start to come way down. And then with lymphocytes, you have this same issue of, you don’t want them too high and you don’t want them too low.
So the initial thought [00:33:00] process is, well, where are my, where are my neutrophils? Are they in the, are they in the seventies and eighties? Are my lymphocytes in the upper 30s? Am I, are my lymphocytes now in the 20s? Am my neutrophils down at 50? So the ratio stayed the same, but you’re wearing your immune system out because you look at your monocytes, your eosinophils, and your basophil percents, and you’re seeing all this activity.
And the problem, I really think, is Monocytes trigger macrophages, right? So you’ve got M1 macrophages and M2 macrophages. You got M, so one’s in pro inflammatory, one’s anti inflammatory. So as you start to look at, oh gee, you got a monocyte of 13, your C reactive protein’s 1. 5, and your basophils are 1, and your neutrophils are 79.
You got all this stuff saying, oh yeah. You’re going down a metabolic inflammation path. Nothing’s really [00:34:00] completely out of whack yet, but you clearly see that path, and, MPB. It’s usually just glossed over, people just go, Oh, MPV, whatever, although when it’s really high, right, if it’s really out of bounds, you got to worry about neoplasms, you got to worry about cancer. But that’s trending beforehand is where it gets interesting in terms of looking for that inflammation.
Dr. Weitz: And you’re saying if it’s not necessarily even in the red, but if it’s in the highest quartile, then you should start worrying. Like the labs we use, I think over 12 is considered
Dr. LaValle: Yeah, it depends on which lab you look at. Some of them are 12. 5. Some of them is 12, one’s 15, like depending on your quest, LabCorp, Vibrant, wherever you’re, wherever you’re getting it. So you just want to look at that quartile and go, well, I’m solidly in that fourth quartile, or how I like to tell people is, if you’re a hundred yards away from the Grand Canyon and you take one [00:35:00] step, it’s not a big deal. If you’re at the edge of the Grand Canyon and you take one step, you’re still on good ground. You’re still on good ground, but that one step is a way different experience. And so, that’s why a lot of times I look at both ends, some labs, if you’re really low like a 3T3, you’re at 2.3 and 2.2 is the limit. Maybe look at how you’re converting your T4 to T3. So that’s the part, that’s the part that’s important. So yeah, MPV big, homocysteine big, galactin 3 big obviously the the obvious markers, looking at basophils, that’s a big one. To me, monocytes are a biggie.
And then of course, looking if you’re making bad actor lipids. And where’s your insulin? And where’s your glucose? I mean, those are all really key factors. Uric acid, you had mentioned. a biggie for oxidative stress in the body. These are easy ones to get, right? Yeah, without even, going [00:36:00] to the more avant garde looking at glutathione peroxidase and, looking at my, looking at deoxyguanosine, 8 OH DG is phenomenal, right? For damage to your DNA. But yeah, look, we don’t even look at urinary pH. My cheapest marker in the world for me for baseline health is urinary pH.
Dr. Weitz: Yeah, if it’s too acidic.
Dr. LaValle: Yeah, too acidic, you’ve got excess hydrogen ions, bottom line. And in human studies, it’s been correlated to renal vascular damage, so damaging the, blood flow to your kidneys, and the progression of renal disease, even after you correct for lipids, blood pressure and blood sugar. So if your pH is still acidic, you’re still damaging your kidneys. And oh, by the way, we give people sodium bicarb when they’re nearing the need for dialysis to extend the time before they need dialysis. Right? But so why are we waiting until [00:37:00] you need dialysis to alkalinize your urine? Let’s try giving you some magnum potassium and eating some greens. Keep your urine alkaline. Protect your kidneys. These are things in medicine. It’s not like that.
Dr. Weitz: But that’s the first thing they’ll tell you if you’re, if your kidneys are if your kidney markers are starting to look bad, they’ll tell you not to have any potassium.
Dr. LaValle: Right? Exactly. Exactly. It’s like, get your, get your pH up. You’ll be okay. Now, you don’t want it too high, right? Because then you’re not digesting your proteins and, so you don’t want a pH of 8, but you certainly don’t want a pH of 5 or 5. 5, which is common.
Dr. Weitz: Right. So what are some of the other root causes of obesity? How much of obesity is genetic? And why do some people have a slower metabolic rate?
Dr. LaValle: Well, I mean, on obesity, I would say it’s not that genetic. [00:38:00] I’d say there’s a small fraction of people where it’s genetic. I would say there might be genetic markers that lead you to root causes that could get you to become obese. Like, you have a really strong, maybe you’ve got multiple genetic markers for, say, diabetes and blood sugar dysregulation, and maybe that precludes you there. Okay. But, but, even then. I think the genetic side is low. I think when I look at obesity, there’s environmental burden. We know that things like pesticides are a big problem for how your insulin receptor works. Stress, cortisol is a big one for telling your body how to store fat. And then nutrient deficiencies are big.
So you’ve got environmental burden, That would even include like mold people that are, kind of what we call the moldies or the chronic inflammatory response syndrome folks. Yeah. Because they go into aerobic glycolysis as well. And so therefore they become metabolically [00:39:00] inefficient then. Then now they’re making two packets of energy instead of, 30 plus and now, so they’re good at storing fat as well.
Dr. Weitz: And we have these chemicals that are known as obesogen that are directly hundred percent contributing.
Dr. LaValle: Drugs, I mean, there’s a lot of drugs, the chemicals, including prescription drugs, cause weight gain. So, women on oral contraceptives the the drug that’s used a lot of time it, in mental health issues, Seroquil, people will gain 30, 40 pounds on Seroquil, right? Yeah. And they didn’t eat 800 pounds of food. Right. They get the extra 30 pounds on, right? Yeah. But, their metabolism got altered. And then, I mean, I think things like, look, there are
Dr. Weitz: basically Move your camera up a little bit. We’re losing the shot. There we go.
Dr. LaValle: Yeah, so, I mean, one of the other issues, of course, is, magnesium, for example. Right. Low magnesium status, you’re talking about probably the number one cause [00:40:00] of a functional deficiency that causes prediabetes. Prehypertension, and Obesity, or basically the prevalence to metabolic syndrome, and that’s NIH data, and why is it a surprise? We don’t put magnesium sprinkles on our nachos, it isn’t in our chicken wing sauce, we don’t breathe it in from our catalytic converters in our environmental air that we breathe in, and if you’re not eating greens on a regular basis, and the greens aren’t rich, and trace minerals from the soil that they were grown in.
Right. Where are you going to get your magnesium? Yeah. And, an estimated 73 percent of the U. S. population is below the optimal level of magnesium. And that’s what the government studies say. I think it’s more like 90 percent of the population.
Dr. Weitz: Sure. Absolutely. That’s, we see the same thing. Isn’t it insane that in our society, We got all these [00:41:00] companies making and marketing ultra processed foods that are creating a big part of this obesity and then we have to spend thousands of dollars per month putting people on GLP 1s to overcome the side effects of eating all this crap. It’s insane what we’re doing.
Dr. LaValle: That’s the dog chasing its tail. I mean, it’s terrible. I, I, and we’ve all heard about it now. It’s finally being popularized, but those of us that have been in this industry for years, like you and me we know that, the food that’s in Europe is better than the food that’s here because they have mandated regulations.
There’s no GMOs. You can’t add a bunch of stuff to the food. The ingredient list is way shorter. And we honestly don’t know the impact when we start to put all these chemicals together in our body. We have not studied [00:42:00] it. And even what, even like the EPA was supposed to be doing studies on, all the different pesticides and different chemicals in the environment and its impact on us. Those studies were mandated. They haven’t been done and so you, oh,
Dr. Weitz: They’re not gonna be done in the next four years. .
Dr. LaValle: If we even, if may, if we even have a
Dr. Weitz: DPA in four years,
Dr. LaValle: yeah, maybe when I’ve got a bronze statue of me, I hope, with an urban my hand, but of course probably there’ll be a pigeon or two on top of it, putting some stains on my copper. I don’t know. It’s it’s, yeah, it’s not getting done. in the near future. And, that’s why it’s so important for people to understand. I mean, nobody is going to give you the right to good health. Nobody, like, I don’t have a card to give someone and say, here’s your good health card. You have to attack it. Cause I, the one thing I always tell people, and I have a lot of, like, you’ve got a lot of people that come in here pretty sick. And. And I’ll say, [00:43:00] and I’ve got my full team, nurse practitioner, medical docs, I mean, we’ve got a team of dieticians, you name it, right? In the end, if you get sick and God forbid you passed away, right?
People are going to be at that coffee or at the water cooler or at the luncheon table just saying how much they miss you for about one week. And then somebody’s gonna be sitting in your spot and it it sounds cruel, it’s don’t sacrifice your health. At any stage, because, you know what?
You’re here for your loved ones and your family members and your community, and you have to, if you think there’s a magic bullet out there, there isn’t. There isn’t one in the natural world, there isn’t one in the peptide world, there isn’t one in the drug world. Now, can we have heroic things happen?
Absolutely. You can save a person’s life who’s in an acute [00:44:00] situation from modern drug therapy, surgery and drug, that’s all good. But, it really, you got to work at your health. That’s the bottom line, man. I mean, I’m glad we’re getting to talk about this because I rarely get to espouse this message because everybody just wants to say, Hey, what’s the next peptide? Is it OSO 1, which is a small molecule that improves mTOR signaling and AMP kinase and induces autophagy at the same time? Love OSO 1.
Dr. Weitz: Okay, that’s a new one, never heard of it. Well, you’re going
Dr. LaValle: to have to look that one up, man, because that’s the next hot thing. Oh, that’s fine. But yeah, but it’s, and it’s great, but it still doesn’t take the substitute of, Hey, what am I, is my stress good? Am I holding in a bunch of penned up negative emotions? You got to get through, you got to slug through some of that residual tar and residue so that you can really, grab that health you deserve.
Dr. Weitz: When it comes to peptides, [00:45:00] I, what just came across my vision recently, the last couple of weeks is there’s now vegetable based peptides, there’s, polypeptides. Yeah. Yeah there’s the one from what’s it called? Peptostrong? Peptostrong. Yeah. Supposedly helps you build muscle?
Dr. LaValle: I gotta be honest, I have not found the peptides to be that effective. Okay. I’ve known about them for a while. I mean, I’ve been lecturing on them for about three, four years now. And I think there’s a space for them. I think they’re doing things that are positive. But what people are trying to do in the marketing world is, Hey, here’s these plant peptides that are kind of like the peptides that you already know about. I can’t get, they don’t have that same level of impact in your chemistry that the other peptides have. Okay. But There’s peptides all throughout nature.
Dr. Weitz: They’re just small chains of amino acids, right? That’s [00:46:00] all
Dr. LaValle: they are.
Dr. Weitz: They’re just the whole key is do they signal to ourselves to do, you know, the right things?
Dr. LaValle: Yeah, exactly. And look, I mean, I think one of the issues that came up, at least when I was at the FDA, I thought, you know what, this is a good thought as You gotta look at immunogenicity, I mean, you’re shooting, you’re, if you’re injecting a peptide and you’re putting into the tissues, what is that? How is the immune system identifying that, you know? And are there any adulterants in the peptide if it’s not made in a compounding pharmacy for human use? You’re just out there searching on your own and grabbing stuff. You can be reacting to an adulterant. It could be not the peptide. It could have not been fully synthesized. And I think that’s another thing that, I think people need to realize it’s not like going out and buying vitamin A or ashwagandha. Right. It’s different than that. Yeah.
Dr. Weitz: Yeah. The plant based peptides I’ve seen recently are [00:47:00] oral and some of them are being sold by some of the professional companies.
Dr. LaValle: I think they’re good. I think they’re good. And I think there’s a market opportunity because peptides is on the front of everyone’s mind. Look, there’s a group out of out of Taiwan that is taking and making proteins that have peptides embedded in them, and it’s just a protein powder, but it’s got peptides that are embedded in them.
I think that’s interesting. I think that there’s going to be more interesting delivery methods to take natural peptides and get them into the body. And you can, because now the, the science is there. The awareness is there from the consuming public and that’s what drives innovation.
Dr. Weitz: Yeah. You mentioned BPC 157, but the, that’s one of the ones that’s been taken off the market, right?
Dr. LaValle: Well, can’t be compounded as a drug. Okay. But there is the. It is a naturally occurring compound in your gastric juice, so [00:48:00] people are selling it as a dietary supplement. And so depending on the type of BPC, Right, you
Dr. Weitz: mean oral, you can sell it orally.
Orally,
Dr. LaValle: yeah. Well, yeah, you can. There’s no injectable, even a B vitamin is considered a dangerous drug and would require a prescription. Anytime you do an injection, by default, it falls in the dangerous drug category. Dangerous drug just means caution. It’s not like dangerous to do it. It’s just, it creates an extra layer of, attention and the need for a prescription from a licensed provider that can write a prescription. Right. That’s why when people are buying peptides on their own and injecting them, like you said, you’re concerned of people being cavalier about what they’re doing. Hey look, they’re called a dangerous drug for a reason. Maybe you just shouldn’t buy that and inject it yourself because you think it’s a good idea. Right.
Dr. Weitz: And that is happening a lot. Are there any strategies or supplements for longevity that you’re particularly [00:49:00] excited about these days? Yes.
Dr. LaValle: Well, I mean, I probably take a little bit different look at it. I think, I think that, there’s a new extraction coming out that is going to raise oxygen in tissues.
That’s a, it’s a solidicide extract. That to me is exciting because When you can improve oxygen perfusion in the tissues, you’re going to have healthier tissues. So I think that is interesting. I think Revasca, which is a combination product that was developed by Hans Vink, and Hans was the scientists that first discovered the glycocalyx.
So when you see those, when you see those pictures of the hairy like projections of the artery, that was Hans Vink’s work. And they actually developed a nutrient that helps to improve your microcapillary score. And they have publications, stage four renal disease reversal, [00:50:00] using that nutrient, which is a combination of those seaweed, glycosamin, glycan.
Dr. Weitz: Oh yeah, because there’s several seaweed products on the market already. We got Arteriosil, and then we have the brown seaweed, and we have the, yeah.
Dr. LaValle: Yeah, exactly. So I think, once again, it doesn’t matter how much goji berry you take, if your blood can’t get the nutrient to your tissues. So I’m pretty excited about, always excited about that.
Obviously, I still think people need to manage, there’s basics, like people need to manage their stress. Now, we could go into the senolytics, so, you know, we, the recent Stanford study showing that people have two stages in life where they get accelerated aging. around the age of 42 to 44 and around the age of 60 to 64.
And they have this accelerated, just kind of metabolomic uplift of aging. And we should be moving into those times of our life where we’re protecting against that. So, the [00:51:00] Fisetin, Dihydrocorsetin, very interesting in terms of, helping with, senescence. But here’s what people were doing.
You got 24 year old. biohackers that, oh, sorry, but they’re like, oh, I’m going to take rapamycin. Why? You’re not at that age. You don’t need to take something like that. But, which is of course a drug, but I, I think those areas are interesting. Delivery systems are interesting to me. For example, I’ve done a lot of research work with solid state liposomes.
So, in a tablet, solid form liposome that takes particles that are under 100 nanometers and is able to deliver them across the blood brain barrier, that’s interesting. I mean, I’ve, I’m, I’m full disclosure, I mean, I did all the research on synapsin and RG3, the Jacinicide R3, which decreases, the, helps with microglial [00:52:00] management, so you keep your microglia from getting too active. And I used liposome solid state technology to do it and people chew it up and they go, Hey, you know what? My brain’s clear. I don’t feel
Dr. Weitz: So how does liposome solid state technology, how does that say compared to like the liposomal products that Chris Shade has developed and designing the liposome, the liquid liposome, so it’s the right size?
Dr. LaValle: So there’s a lot of, yeah, there’s a lot of liquid liposomes out and I know Chris Shade, good guy. I inherently, and you can look this up, the FDA, their biggest issue with liquid liposomes is it stable? And for how long is it stable? So in a liquid state, you get this, you know how liposomes work, right? You get this this electronic, repulsion, but over time they start to get attracted again like a magnet and then you go from a 100 nanometer molecule to a 3, 000 nanometer [00:53:00] cluster and now you can’t absorb it. And so the interesting thing on solid state, and it was interesting, I just, I ran into an old school pharmacist on this technology and he had developed it for delivering oncology medications and pain medications because you can do a lot less Get it into the cell and not create so much extra toxicity, right?
So they’ve been able to show that you keep the particle size under 100 nanometers for two years, it stays stable, and they do that through electron microscopy, where you can see and fluoroscopy, where you can see the particles staying individuated instead of aglomerating. So nothing against any other liposome that’s out there, I’m just working in the solid state side of it, because I like the fact that it’s stable, I like the fact that I can show the particle size, and so I’ve done a lot of work with that recently and really have been enjoying the success seeing [00:54:00] people like taking 50 milligrams of curcumin, some bits of curcumin and getting the impact of even better impact in terms of inflammation than taking a 500 milligram curcumin. Right? Well, we got the Curcumin Wars out there. Yeah, there’s, yeah, Curcumin, no doubt, right? Yeah. And I’m not once again, it’s
Dr. Weitz: So, so tell us about Synapsin and RG3. These are products that you developed, but they’re Available. They’re only available through compounding pharmacy. Is that right? Or.
Dr. LaValle: Well, synapsin in a nasal spray is only available by prescription because you don’t eat through your nose.
Dr. Weitz: Okay.
Dr. LaValle: Right. You don’t eat, you can’t eat through your nose. Everybody, anybody do something at your nasal, it can’t be a dietary supplement because you don’t eat through your nose. So we developed Ginsenicide R3 through Metabolic Elite is a chewable tablet that is available because it’s an [00:55:00] extraction and fermentation from Meyer’s Panax Ginseng. And so that’s available as a dietary supplement. And interestingly, we’ve got, I don’t know if you’ve heard of the Arctic Challenge. The Arctic Challenge is a U. S. Special Forces guy. Seal Team Member, Jimmy Graham, future NFL Hall of Famer, and two U. S. Olympic Rowing Team Members that are rowing the Arctic Ocean.
More people have been landed on the moon and walked on the moon than have. Road, the Arctic Ocean. And we’re working with them to prepare them for it. So we’ve been giving them ginsenoside R3, this oxygen product, which I can’t, that’s soon to be released. And these are guys that are super fit. Right? They’re already super fit. And they’re just saying, holy crap, I can’t believe how well I’m doing. And the real reason RG3 is so interesting to me is that it just helps your brain to maintain its balance [00:56:00] because you’re keeping the microglial cells from getting overactive. And it helps with regeneration of neurons because of the upregulation of BDNF.
And if you look at the chemistry side of it in published labs, it reduces calcium ion influx in the NMDA glutamate bridge from breaking, creating excitotoxin. If you’ve read Russell Blalock’s book, Excitotoxins, a phenomenal book from 20 years ago, he is a neurosurgeon. I, I, if you’re that person that says, Hey, I’m cognitively two o’clock, I don’t make, I don’t like making decisions after 2:00 PM ’cause my brain’s foggy.
I feel like I’m pushing the thought through Jello. You gotta think about using genocide R three or now genocide, RB one in RG three together, another IDE that helps with just. Protection of that cognitive space and protecting the neurons and reducing oxidative stress. It’s pretty, [00:57:00] it was pretty amazing because we used that with Corvette Race Team.
That was the first time we used, in a sports way, Corvette Race Team. It came to Dr. Heyman, Andy Heyman he was as my chief medical officer at Metabolic Code. And they’re like, hey our racers were crashing cars and we’re not winning Le Mans. I’m like my initial thought was, well, why don’t you get different drivers?
Maybe you need a different driver. And and Bates. We cleaned them up and what we did was we measured their core body temperature racing around the track and it turns out their core body temperature was, as your body temperature goes up at core, your brain coherence goes down. So now your brain can’t tell your reaction time what to do as well. We had them use synapsin and what happened? Core body temperature went down, reaction time stayed good, and they won Le Mans. No, so it’s kind of cool. That was the first foray into the sports side. And then of course we were using it for people for cognitive function and executive function for, a long time.
Dr. Weitz: So [00:58:00] synapsins, you got to get a prescription from your MD?
Dr. LaValle: On the spray, on the tablet, you could just go to Metabolic Elite, metabolicelite.co and you can get synapsin tablets. And they work, you chew them up, they’re in a liposomal base. Thanks. Oh, Lipotab base. It worked really well.
Dr. Weitz: And the RG3, that’s also available from that same company?
Dr. LaValle: Yeah, that’s, that is actually what’s in Synapsin.
Dr. Weitz: Oh, Synapsin is RG3. Is RG3. I see. That’s the oral form. I got it. Yeah. Okay, cool.
Dr. LaValle: I, and I, I just, I love inventing and looking at compounds. I just can’t, can’t help it.
Dr. Weitz: Me too. I love it as well, so,
Dr. LaValle: yeah.
Dr. Weitz: Cool. Okay, Jim. Alright. I really appreciate it.
Dr. LaValle: That was fun. I enjoyed it.
Dr. Weitz: Yeah, I did too. I’ll send you links when we post it in about a month or so.
Dr. LaValle: It’s very good. Yeah, let’s get after it. We’ll do it we’ll post it up through all our little network too. [00:59:00]
Dr. Weitz: That’d be great. That’d be great. And I’ll see you at the next big conference.
Dr. LaValle: Yes. Okay.
Dr. Weitz: All right, see you soon. Okay. Thanks Jim. Alrighty. Bye-Bye.
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 very much appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review. As you may know, I continue to accept a limited number of new patients per month for functional medicine. Thank you If you would like help overcoming a gut or other chronic health condition and want to prevent chronic problems and want to promote longevity, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310 395 3111. And we can set you up for a consultation for Functional Medicine. And I will talk to everybody next week.
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Dr. LaKeischa McMillan discusses Progesterone with Dr. Ben Weitz.
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Podcast Highlights
Exploring Progesterone: Benefits, History, and HRT Insights with Dr. Lakeisha McMillan
In this episode of the Rational Wellness Podcast, Dr. Ben Weitz discusses the history and controversial aspects of Hormone Replacement Therapy (HRT) with integrative OBGYN, Dr. Lakeisha McMillan. They delve into the benefits of progesterone for women, including its neurological impacts, and the differences between bioidentical progesterone and synthetic progestins. Dr. McMillan shares insights on hormone testing, natural ways to boost progesterone, and practical applications for both perimenopausal and menopausal women. They also touch on the safety of HRT, testosterone therapy, and its potential uses in older women. Listeners can expect a comprehensive discussion on hormone health, replacement therapies, and practical advice for integrating these solutions.
00:00 Introduction to the Rational Wellness Podcast
00:30 History of Hormone Replacement Therapy
02:29 Controversies and Studies on HRT
04:21 Introduction to Dr. Lakeisha McMillan
08:15 The Role and Benefits of Progesterone
08:43 Progesterone’s Impact on Neurological Health
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.
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.
Today our topic is progesterone, and we’ll be joined by Dr. Lakeisha McMillan. Because I am a somebody who studies history and thinks that history is really important so we don’t repeat the wrong history. I would like to start this discussion by giving a little talk about the history of hormone replacement therapy, specifically in the United States. So, hormone therapy [00:01:00] replacement today continues to be controversial in the mainstream medical community, and when we go through this, you’ll understand why. So, part of this discussion of the history comes from an article I recently read in Circulation. It’s from 2023, and it’s called Rethinking Menopausal Hormone Therapy for Whom, What, When, and How Long.
So, hormone therapy, or replacement hormone therapy, abbreviated HRT, started during the Great Depression. with estrogen derived from the urine of pregnant women. In order to save money, this was replaced with estrogen derived from the urine of horses, referred to as conjugated equine estrogen, which I think is outrageous. Such therapy became gradually more popular, and after the popular book Feminine Forever, published in 1966, which proposed that menopause was a state of hormone deficiency that led to painful intercourse, the loss of sex appeal, and youth. This, combined with the changing status of women in the feminist movement, HRT became increasingly prescribed, with annual prescriptions exceeding 50 million by the 1970s. But then some studies showed that just taking estrogen increased the risk of endometrial cancer. And this led to a decrease in the use of HRT, until it was discovered that if we combine progesterone with estrogen, this protected the uterine lining. Then, in the 1990s, several studies, including the Nurses Health Study, showed that HRT reduced the risk of cardiovascular disease. This led to an all time high of 90 million prescriptions of HRT in the U.S..
But then, the infamous, and I use the word infamous carefully, Women’s Health Initiative study was published in 2002. And this showed that those who took oral conjugated equine estrogens and Medroxyprogesterone Acetate had an increased risk of breast cancer, heart disease risk, stroke, blood clots, leading to an approximately 80 percent decline in prescriptions for HRT in the U.S. and a similar decline worldwide. Since that study, there have been a number of looking back at the Women’s Health Initiative Study, re analyzing the data and there have been a number of studies showing that when prescribed in a [00:04:00] proper form, at the proper time, that the risks of HRT are minimal at worst or don’t exist at all to Help us sort out some of this information about HRT, and in particular, I wanted to focus today’s talk about progesterone, which doesn’t get talked about as much as estrogen.
We have asked Dr. Lakeisha McMillan to join us today. Dr. Lakeisha McMillan is an integrative OBGYN. She graduated from Loma Linda University School of Medicine, where my good friend Dr. Arista Vojdani also teaches. Dr. Lakeisha wrote a best selling book, The Other PMS, Your Survival Guide for Perimenopause and Menopause. And she lectures frequently on perimenopause and menopausal health and hormones. On social media, she’s known as the hormone hottie. So, Dr. Lakeisha, thank you for joining us today.
Dr. McMillan: Thank you so much for having me here. I’m so excited to be here with your community. I love, I always love coming into communities that already have this foundation of wellness a conversation that’s already going. And so I feel so at home to be able to just jump in and kind of, you know, give some more of my opinions as well as and be able to help build this foundation even stronger. So thank you for the invitation for having me here today.
Dr. Weitz: Absolutely. I just wanted to mention something on my mind. One of the reasons I wanted to read that intro was because in thinking about hormone replacement therapy, I thought, I can’t believe that we are giving women hormones from horses. And I just thought, you know what, if that was proposed to men, yeah, we’re just going to give you hormones from horses. There’s no way that would have happened. But anyway,…
Dr. McMillan: You said it, you said it, you said it! I mean, seriously, yes. And I was looking back at kind of like the social construct of menopause, and I think that’s part of it as well. I remember doing a CME a few years ago, and it took me through the history of how we even looked at menopause. And I think that’s part of the story too, is that It began in the 1600s of looking at it as a moral, failure on women’s parts. Like all of a sudden you weren’t holy enough, you weren’t doing your part, and so you had this wandering organ that started wandering about your body causing hysteria, right? And so we have to be able, this is why I love these discussions, because this is another layer to that foundation, right? And then, you know, we’re, like you said, it was like, oh, we think we found the fountain of youth.
This estrogen seems to be the [00:07:00] answer to all the questions and all the problems. And I think that’s when we get in trouble, when we think we have this panacea, when we think we have this utopia, we have the one thing. Stop looking at somebody as a whole person and being able to address that whole person. So I love the wellness part of, of your, of your approach, your practice, your discussions. And you’re right. If we had said to men, Hey, let’s make. This, cheaper so that we can manufacture it in mass. But you know what? We’re not going to give you the biological equivalent. We’re going to actually make a synthetic formula that can act the same way. So it’s like we’re making a different key that can fit in the lock, but we’re not going to worry about what that key does after it turns on the lock. Right?
Dr. Weitz: Right.
Dr. McMillan: We’re just going to give you this synthetic form. And you’re right. Like, what are you doing?
Dr. Weitz: Exactly. And even [00:08:00] worse, what if we said we were going to take the hormones from a duck or something and give them to a man? Exactly. But some guys might be saying, Horse, Horse Hormone? Maybe I’ll take that. Absolutely. Anyway so I want to start by talking about progesterone and the benefits and functions in a woman’s body, and then eventually make our way to the risks later on in the discussion. So let’s talk about some of the benefits of progesterone. And I know one of the things that I heard you talk about in one of your discussions that I don’t think is very well known are the neurological benefits.
Dr. McMillan: Oh, I’m so glad you’re starting this discussion here because what it does is it actually helps to challenge an old paradigm that most physicians have been taught, which is, Women that have hysterectomies that don’t have a uterus [00:09:00] don’t need progesterone because as you so eloquently stated in the beginning with the history is that we were like, oh, there was a time where we saw progesterone helped with preventing that uterine cancer. If you just gave estrogen unopposed, then you had this outcome. And so there is this thought, oh, progesterone has only one benefit, but like you’re saying, we are now understanding that the metabolites of progesterone, so progesterone can actually turn into what we call neurosteroids, and those neurosteroids cross over the blood brain barrier and go into the brain and interact with neurotransmitters.
And it can impact the serotonergic pathway, dopaminergic pathway, cholinergic pathways. And so what are we looking at? Progesterone can help with pain. We know that there have been studies that actually looked at progesterone [00:10:00] being a form of an analgesic because we know it has those properties. It was actually, I know, in my OBGYN literature, back, you know, in a historic literature, they actually looked at it to, to actually administrate it to women in labor. But the half life is very short. It wasn’t that, you know, powerful. So it was not a long lived option for labor and delivery. But we know that progesterone can be helpful with our own pain pathways. It can actually help to block some of those COX pathways, the COX 2 inhibitors and those type of paths with the prostaglandin pathway is actually what it interacts with.
So then it can actually help women that may have issues with having pain with their periods. So that’s only one of the things that progesterone can do. It can interact with the serotonergic pathway which helps with our mood, which helps with making, you know, that making it Sorry, it interacts with, say, the GABA pathways [00:11:00] and making sure that it calms down that, that shoulders raising up to our ears that, you know, oh, okay, everything’s okay. You don’t have to be so super anxious, those type of things. So that is one of the benefits that progesterone has just a You have them and a lot of people don’t talk about it. And what I see in my work with helping with perimenopausal menopausal women is that when I give them progesterone, they go, Oh, it’s almost like you see it just in their face, they just, Oh, thank you. I feel so much better.
Dr. Weitz: Yeah, I have two thoughts. I wanted to touch on both from one is. When you talk about the fact that progesterone metabolism leads to these neuroactive steroids, it would be really cool if, like, Dutch testing actually measured those neuroactive steroids. Wouldn’t that be cool? Because we get [00:12:00] so much into the metabolism of estrogen, but we don’t learn that much about the metabolism of progesterone. Progesterone. And this would be very cool to look at. And then the other question I have is about the idea of possibly using progesterone for men, because I’ve had a discussion with neurologists about using progesterone after a brain injury. And it’s, there is good data showing after a traumatic brain injury that Progesterone can have some benefits and I’m sure it must be related to these neuroactive steroids.
Dr. McMillan: You know, that is a very interesting and promising area. I’m so glad you brought that up. That actually just made my brain start ticking. I was like, Ooh, yes, that actually sounds really great because again, it can help with the analgesia. It can help with the cholinergic pathway. It can help with the serotonergic pathway, the [00:13:00] dopaminergic pathway that can help with that reward pathway. focus and being able to help these various brain structures literally heal or actually give them protection as they heal. So there’s so much that could be explored through that. I love that. I love that discussion.
Dr. Weitz: So besides neurological, what are some of the other benefits of progesterone?
Dr. McMillan: So progesterone also helps, of course, women, you know, if we go back to the basics, I always like to start there. It helps you to have a set interval of your cycle. So it helps with that 28, 30, 32 day cycle. I always say think of progesterone as being in charge of the lawnmower service. So what happens is if you think of your period in terms of grass growing, the estrogen helps the grass grow tall, or proliferation of the uterine lining, progesterone kind of holds back the lawnmowers until it gets the signal.
Was there an egg fertilized or not? If it doesn’t, if there was no egg fertilized [00:14:00] and it says, okay guys, we’re gonna help mow the lawn in two weeks, right? So it helps to make sure that. One, your breast tissue doesn’t get overstimulated by estrogen as well. It also helps to make sure that you have this nice type of increase or crescendo, decrescendo of your hormones during that set interval.
And progesterone also helps with metabolism. So we know that it can help with making sure that your body is able to it helps with the kidneys and helps them to dump off those, the, what the, oh, sorry, I’m getting all tongue tied here, y’all, because I have so much going in my brain.
Dr. Weitz: Well, benefits of progesterone for the kidneys.
Dr. McMillan: Kidney, it has protection so that you can actually dump all the metabolites that you’re not using, so it can get rid of those toxins as well. So progesterone has all these different types of jobs, I call them, that progesterone will do.
Dr. Weitz: Right, and it works as a perfect companion with estrogen.
Dr. McMillan: Absolutely. Absolutely.
Dr. Weitz: So when you prescribe progesterone it’s common for doctors to give women progesterone every day of the month. And they assume that most women don’t want to get a period anymore. And it’s not surprising. And I, I suspect that a lot of women don’t want to get their period, but what is the best way to prescribe progesterone to menopausal women?
Dr. McMillan: That’s a great question. Okay. So to menopausal women, um, I actually look at the individual and I’ll look at their testing and their symptomology. So if they’re having issues, so if they’re menopausal, which means they’re not having a period anymore, they’ve gone through that transition, then I will prescribe a low dose of continuous progesterone. If they can tolerate it. That’s the other [00:16:00] thing, because if you cont, if you do a continuous progesterone type of pro pr preparation, you can actually downregulate estrogen receptors and they won’t get the benefit of the estrogen that they have on board. So then they can represent with either an intensifying of their vasomotor symptoms or they can have a surgence of that where they didn’t have it before. So that’s where I say, look at the individual, see what their symptoms are and look at their tests that you, that you’ve decided to run. If they are perimenopausal, which means that they could be still having a cycle. It could be this intermittent, or it could not be a regular interval.
Then I will say, Hey, let’s go ahead and create a set interval. which means we either look at your, if you can map out your cycle now and we can find the luteal phase, then we can do that and just support the luteal phase. And that will be where you cycle your progesterone. If you can’t, then I say, [00:17:00] let’s just, let’s make one. So then we look at the calendar and I find it easy just to follow the calendar days. And so in the beginning, I have to, You know, counsel them that it’s going to be a little rocky road. You may have some intermittent irregular spotting, but about month two to three, it may start getting in a set interval. And that way we can create this luteal phase that’s supportive.
Dr. Weitz: What about doing that cycle mapping testing from Dutch that helps you?
Dr. McMillan: Absolutely. You can absolutely do that. You can do the cycle mapping. I do cycle mapping though with my patients if they are having an interval. If there’s, if they’re having a set if they’re still having cycles pretty consistently, when I say consistently, I’m saying if they haven’t had a gap for, if they have like a six month gap, they haven’t had a cycle, then I say, well, let’s just do the Dutch complete where I look at the just, we just look and see what’s going on with how you’re metabolizing them. But if they’re like, Oh, I have one, maybe [00:18:00] like every other month or every 45 days. And I say, yeah, let’s do the cycle mapping so we can see what’s going on in your cycle, in your interval.
Dr. Weitz: Now, when looking at hormones measurement of hormones during perimenopause, they tend to be a little bit all over the place. So how do you decide this patient needs? hormones or how much hormones given the fact that it’s sort of erratic depending upon when you measure it.
Dr. McMillan: That’s a great question. This is where the art of medicine comes in. And this is where I sit and I really dial into what they’re experiencing in terms of their symptoms. What is the most impactful in their life and where are we trying to go? And so then I take my expertise and put that into the mix too. So what I’ve come to find is that when you have a perimenopausal woman, say for instance, her biggest issue is sleep. And she’s not, and say she’s having an erratic cycle. So she’s now having this cycle that is now spacing out, is now, you know, further apart. I will say, hey, maybe we should do a little bit of continuous. And I, when I say a little bit, I’m talking low dose, maybe starting at 12. 5 milligrams or even 25 milligrams, titrating up just slowly. And then when she feels the difference, because most women can build that change in their hormones. And she’s like, Oh, my sleep is now interrupted again. Maybe she doesn’t have enough progesterone. Then I’ll bump it up a little bit for just those 14 days and then come back down. So it’s, it’s more of, this is where the art comes in. Like you said, their hormones can be all, like we say, all over the place.
We can have this. cycle that we were looking at and we’re not sure where we’ve caught them in their cycle. So I really have to explain this is what I’m doing. This is how this may show up for you because you [00:20:00] may have some intermittent spotting. It may take us a month to get everything in, in order. So it’s really a matter of setting the expectations of why I’m doing what I’m doing and what to expect and how long it’s probably going to get us to get you feeling back into your, your own body again.
Dr. Weitz: So with respect to testing, what kind of testing do you like to do?
Dr. McMillan: I do a combination. So I will look at the Dutch testing, the urine testing for the metabolites because I want to see how your body is metabolized. I want to see What pathway your body actually likes to favor. I like to see if you need some certain types of minerals or organic acids that will help those different process pathways. I also know that your gut is very important. So I want to make sure your gut microbiome is intact, so I will actually have patients do a gut testing and look at their microbiome, [00:21:00] and I look at your thyroid, because I know the thyroid sometimes gets gets taxed with everything else that’s going on, and I want to make sure that we’re not missing something that could be thyroid related that has an overlapping symptomology with hormone depletion.
Dr. Weitz: So far, so good. younger women who say have some hormone issues. Can we increase progesterone levels naturally? Is there some benefit with using chase tree or maca or other herbs or inositol or healthy diet?
Dr. McMillan: Oh, you are speaking my language. Oh my God. If you have a video portion for your podcast, people will see me clapping on screen. I, you are saying everything.
Dr. Weitz: Yeah, it’s, it’s on YouTube as well.
Dr. McMillan: Awesome. Awesome. Awesome. Because yes, the straight answer is yes. So if I do have patients that are [00:22:00] early perimenopause, when I say early, they’re like, maybe in their late thirties, early forties, and they are having some extreme symptoms. One, we have a really frank conversation and I asked them about their life. I ask them, what is going on? And, and they, and I need a timeline of what has happened. How did we get here? And then I say, okay, do the testing. And when we do the testing and I review the testing and I know the information that they’ve given me, then I’ll say, okay, you could be a candidate for doing some natural, like maybe even seed cycling, you know, doing certain seeds at certain times in their cycle to, to help boost their own natural progesterone along with those herbal supplementations. Because we know that the adrenals, when they get pulled on, they actually can interrupt the entire system. So all that you’ve said, yes, I utilize all of that. I use maca root. I will use adrenal. I’ll use [00:23:00] ashwagandha to calm down the adrenals. I’ll even use licorice root for those that are a good candidate for licorice root to convert their cortisone to cortisol. So that they have the right fuel on board. So that while we’re doing this and taking care of the, of the ovaries and making sure that they can produce, we haven’t neglected other areas that are under attack as well.
Dr. Weitz: Yeah. I like the adrenals. Let’s see. So, when you prescribe hormone therapy, what type of hormones do you like to prescribe and in what form and how do you like to cycle it or use it consistently, et cetera?
Dr. McMillan: Oh, wonderful question. I really like using something that’s transdermal. We know that if we use the skin and we bypass that first pass metabolism, that’s usually the best, right? Now, progesterone, you can use bioidentical progesterone that is in an [00:24:00] oral form. I usually use that from a compounding pharmacy, and we know that that can actually help with the uterine protection but there are some patients that just can’t tolerate capsules. They don’t do well with it. They don’t like it. And so I will use a cream or suppository form. So I’ll use cream forms, suppositories, patches. I’ve even done pellets where I’ll, you know, you place that little pellet right under the skin and let the body naturally utilize it as needed. But the dosing really is based on the patient’s labs or the, what I see in those labs, especially the gut and making sure that I don’t overload the system and it can’t process what I’ve put inside.
Dr. Weitz: When it comes to estrogen, you use Estradiol, or do you use
Dr. McMillan: Bias? Yes, I use Estradiol, but I do there are times I’ll use Bias, so I’ll use Estriol, Estradiol, if that person is if I do the Dutch, and I see that they are [00:25:00] not pushing towards that Estriol pathway, because some people naturally push to the E3 pathway, and when they do that, It actually, E3 is not that estrogenic, but it kinda takes up space, is what I, the way I think about it, and I’m like, okay, I don’t necessarily need you to make more estriol, I really want you to make the estradiol, so that you can utilize that, and feel the difference.
So that’s when I’ll say if I see them making more E3, naturally, I will just use estradiol. But if they’re not making too much of that through the Dutch and I see the, the gauges are saying which one, you know, which type of E1 that they’re making, then I may do an 80 20 or a 50 50. There are some, I have one patient now, I think about it, and she was at a 50 50.
And I was like, Oh, let’s try 80 20. Cause I looked at her stuff. She wasn’t making that much E3 and I switched her to 80 20 and she didn’t do well on it. [00:26:00] Like her body just liked the 50 50. So we had to put her back on that. So that’s another thing, really listening to your patients when they come back and tell you, I don’t feel good on this.
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Dr. Weitz: Yeah, I know some doctors are real big believers in estradiol and feel that that’s really the hormone they should be taking. Yeah,
Dr. McMillan: I think it really is a matter of the art because you have to remember that you’re, if you think of it this way, [00:28:00] I think of it as Putting something on a conveyor belt and if I put too much and the conveyor belt speed is slow then I’m gonna have the Lucy the Lucille Ball type of Situation right where you have all these chocolates coming down the conveyor belt and you got to stuff the chocolate somewhere Because you don’t have the containers ready Right?
Right. So that’s the way that I’m thinking. And then I also use testosterone. I think, I think testosterone is, is woefully underutilized in women. And we know that there are some papers that have come out and they’ve said, well, testosterone is great for overall wellbeing. Well, what does that mean?
That’s like your mood. That’s like motivation that can be focused. And so we, when I tell women, you know, you make testosterone, they’re like, what? They’re like, really? I’m like, yes. And you make it in your ovaries and in your adrenals. And so your body needs that. And when I give them some of that [00:29:00] testosterone, they’re just like, Ooh, I feel so much better. Like energy wise, even I feel like I can be my, myself again.
Dr. Weitz: What about Pregnenolone, DHEA,…
Dr. McMillan: Oh man, yes. I use that in my perimenopausal women more so because in, in the way that I’m thinking, it’s actually helping to stimulate what they can still produce.
Dr. Weitz: The precursor.
Dr. McMillan: Exactly. So it can be taken in the body and the body can say, Oh, I know what to do with this. I want to make this. They’re not, they don’t have enough of Progesterone. They don’t have enough of the testosterone because you remember the pregnenolone is like that parent molecule. And so it can go down. I call it the Plinko. So it’ll go down and it’ll go wherever it’s needed. And that is why I like that. I like DHEA. I like a small dose of DHEA for women because DHEA tends to go down the androgenic pathway and you don’t want to make those heavy [00:30:00] androgenic hormones. I just was joking with a patient earlier. And she was like, Oh, well, you know, can I just go ahead and up my DHEA? And I was like, well, now let’s, let’s do that gingerly because you don’t want to become this pimply hairy person. Right. Like, oh yeah, no, no, no, no. So yes, I use those as supports to help the system be able to do what it needs to do.
Dr. Weitz: Right. So what about the benefits of natural progesterone versus synthetic progestins?
Dr. McMillan: Oh, that is such a huge topic. So I have to go back to something you said in the beginning, which was that whole WHI study. And I feel like I have a special connection with that study because I was an intern.
Dr. Weitz: Oh, okay.
Dr. McMillan: That study came out in July of 2002. I just started July one and we [00:31:00] is the middle of July. My program director, we’re sitting there morning report, waiting for her to come through the door. She walks in waving this paper. Like this was FedEx to my home. We have to stop everybody. We have to stop. And what happened is that if you look at it, so now I’ve been practicing for 20 plus years now, my initial my initial introduction into being a full fledged doctor is don’t do this anymore. It’s. It’s bad, it’s bad, it’s bad, but we didn’t have the ability and the support systems in place for us to go back and dig into that information and find out.
And I’m saying all this to say, the progesterone that was studied in that study or was given in that study was a progestin. And so we have this nomenclature that if anything has this chemical structure that looks like this, we call it progesterone. And that’s where a lot of the [00:32:00] confusion can come about.
So when you’re talking about this to your patients or colleagues, you really should say, is this a progestin or a progesterone? or progestogen. So a progestin is that synthetic. This is the one I was talking about earlier that is made to look like progesterone. It can fit in the receptor, it can kind of turn it on and make it do some things, but then when the body breaks it down, it breaks it down into these metabolites that the body has no idea what to do with, versus Your human progesterone and your bio identical progesterone, which looks chemically just like what your body used to make, it fits in the receptor, it turns on the receptor, it does what it needs to do, it breaks down to the same metabolites.
Your body takes it and goes, Oh, okay. This goes over to the kidney. This goes over to the GI system so that we can get rid of them. And that is why it’s really important to, to know the difference. [00:33:00] And that’s why I take time with my patients to help them understand bioidentical versus synthetic versus the medroxyprogesterone acetate, what’s in your birth control pills, what’s In your IUDs, you know, these are, yes, we call them progesterone. They’re under the same umbrella, but that’s just for nomenclature. And for us to be able to do our studies, it does not give you the full story of the molecule.
Dr. Weitz: So where are we in terms of safety of HRT considering the Women’s Health Initiative, other studies, et cetera, and, you know, is the main problem with the Women’s Health Initiative, is it the timing hypothesis, a lot of people criticize the fact that most of these women were not put on hormones till 10 or more years after menopause, and some of the cardiovascular Disease risk had already occurred because [00:34:00] they went that period of time without the protection of estrogen or is it more about the fact that they were using these synthetic forms and horse estrogen and synthetic progestins Or is it really a fact that whatever increased risk of breast cancer was there was very very small anyway what do we do with, and where are we what do you tell you women is taking a bioidentical hormone replacement therapy? Does that increase your risk of breast cancer?
Dr. McMillan: I’m going to answer that last question first, and I’m going to say no, it does not.
Dr. Weitz: Okay.
Dr. McMillan: Learn that does not increase your risk for breast cancer. Now let’s go back and look at the study, like you said. So now what we learned is that when they went back and looked at the statistical analysis, the statistical significance of that breast cancer, what looked like a breast cancer bump, was not [00:35:00] statistically significant above your risk of just being a woman. So there were a couple of cases, but when they did all of the analysis, the statistical analysis, there was not an increased risk. There have been subsequent studies, like you said in the beginning, that have looked at bioidenticals, that have looked at the studies, that have re evaluated the data. And we’re saying what we need to help people understand is that hormones do not cause cancer.
There are some cancers that can be fed or augmented by certain hormones. That’s what we need to understand. But bioidentical hormones are not the ones that can do that. We need to make sure that you differentiate that study was synthetic. We don’t use those anymore. Like, if somebody is trying to give you Prim Pro Primarin, the, no, absolutely not. The bio identical ones, and [00:36:00] this is where I stay a lot of my time in teaching, is that it’s bio identical. It looks just like what your body used to make. It breaks it down the same. It does not increase your risk. There’s so many other life factors that do. And we need to look at that as a whole picture so that we can have that as part of a conversation as well.
Dr. Weitz: And when it comes to cardiovascular risk, a big factor is not using oral estrogen.
Dr. McMillan: Yes. So the, the cardiovascular, I’m glad you said that. So when you use oral estrogen, what typically happens is that you’re with first pass metabolism, you tend to make estrone, which is the E1 versus the E2. And then when you look through the Dutch test, if you use Dutch tests to look at the metabolism, it, for some people, they push towards the 4 OH E1 pathway. And if you don’t have enough of your anti inflammatories like your glutathione, your, your great antioxidants. they can cause that [00:37:00] DNA damage that changes the DNA and can cause these cancerous cells to grow. So this is where this nuance comes in. This is why I really like adding the Dutch so I can know intrinsically where your body likes to push things, right? And so that’s why I do like to use transdermal estradiol. The body usually takes it and breaks it down and make it makes the form that your body really likes. And can metabolize and utilize correctly.
Dr. Weitz: Are you familiar with this study that came out in May of this year? It was in menopause and it was the title of the study was use of menopausal hormone therapy beyond age 65 years and its effects on women’s health outcomes by types, routes, and doses.
Dr. McMillan: No, I need to get that. Okay, it’s,
Dr. Weitz: it’s kind of a confusing study. It’s it generally showed that Hormone Replacement Therapy is [00:38:00] safe in women over 65 years of age, but they had these different arms and, one of the arms where they were taking progestin seemed to be safer than taking progesterone. So I don’t know. It was a very sort of confusing study. Generally, it was showed that hormone replacement therapy is safe and beneficial, but it was a little confusing.
Dr. McMillan: I’m going to have to look that way. I’m already going on Google Scholar right now. Like, because so one of my, one of my philosophies is that I believe depending on your patients their, their lifestyle, what they’re looking to accomplish, that Hormone Replacement Therapy, or I like to call it BHRT, is going to be a part of their lives longer than what we have initially said because of all the [00:39:00] benefits, especially the osteoporosis benefit.
Right. Preventing osteoporosis. That’s a big deal. Huge. We know that that is the number two. It’s like, it’s cardiovascular for women. When we’re talking about morbidity and mortality, it’s cardiovascular number one, osteoporosis number two, and then breast cancer. And, and breast cancer, I always say has a great PR department. That’s why a lot of people think it’s number one, right?
Dr. Weitz: Far more women die of heart disease. Exactly.
Dr. McMillan: Exactly. A hundred
Dr. Weitz: times more.
Dr. McMillan: And when we look at what these hormones can do, and, and I, tend to think the way that they were looking at the WHI was like, Hey, how can we prevent this? Oh, what happens that women’s risk of heart disease goes up when their hormones go down? I think that was a great hypothesis, a great place to start, because we wanted to prevent these things from happening. And so I have a discussion with my patients saying, Hey, I mean, I [00:40:00] have, Marathoners, I have cyclists, I have people that are very, very active, and they’re now pushing their 60s and mid 60s, and they’re saying to me, okay, do I have to stop this? And I go, you know what, let’s continue to monitor. I believe in monitoring and seeing how your life changes, so that we can be very responsible about this. But not just cut you off so that you decline significantly and rapidly.
Dr. Weitz: Right. What you mentioned seed cycling. I suspect that some of the listeners are going to go, what?
Dr. McMillan: Yes. Seed cycling. And you probably hear me typing because I love it.
Dr. Weitz: So this is when you’re taking certain kinds of seeds, like flax seeds. Yes,
Dr. McMillan: absolutely.
Dr. Weitz: And other kinds of seeds that have a different effect on different types of hormones. Right?
Dr. McMillan: Yes. [00:41:00] Yes. So, so like I said, when you’re in that perimenopausal phase, or if you are some of my, you know, women that are still in there for, for, fertility phase of life and they just need some, some, some, some help with making sure that their hormones are going where they should.
I tell them about seed cycling. So days one to 14 of your cycle. This is where you have menstruation and to ovulation. You can do one to two tablespoons of ground flax seeds. along with one to two tablespoons of ground pumpkin seeds. And I tell them to go to like mom’s organic market or someplace that has them whole where you can get them and you can use your more, you know, your pestle and you can actually ground them a little bit.
You can put them over your salads. You can put them in your food. You can use, you can put them in your shakes. And so that’s, that’s the first half and that’s going to help with your estrogens that’s going to support that, [00:42:00] that phase. Days 15 to 28 are ovulation 2 menstruation. That’s 1 to 2 tablespoons of sunflower seeds, ground sunflower seeds. And 1 to 2 tablespoons of ground sesame seeds. And this supports your progesterone production. So that’s the seed cycling that I, that I tell patients to do.
Dr. Weitz: Cool. That’s a great clinical pearl.
Dr. McMillan: Wonderful.
Dr. Weitz: So what do you think about Pellet Therapy?
Dr. McMillan: I think it has a place. And I know that the, some people are all or none. I tend to live in gray areas. I like, I like the, I like the ability to have some flexibility. And, and as somebody, and I can tell my own story.
Dr. Weitz: In the functional medicine world, we sometimes have to live in gray areas.
Dr. McMillan: Yes, yes. And, and, and my own story, I’ve done pellet therapy myself. I remember this was now, oof, 10 years ago. This was 10 years ago. I [00:43:00] was 40 years old. And I had, you know, been going through a lot of life changes, a lot of life changes. situations had hit me. And I believe that really those stressors pulled on my physiology in such a way that it made me slam into perimenopause. And one of those things was my testosterone numbers. It was not even measurable in the bloodstream and my adrenals were shot. My DHEA number was 37. It was horrible. And so I did pellets. I did one round, I did two rounds of testosterone pellets, but I’m one of those people that metabolizes towards the androgen, more androgenic hormones. And so I got the acne, I got the oily skin, my hair was shedding.
I was like, nope, this is not it. Now the benefits were excellent. I will tell you that, right? Excellent. But this is where I, the second round. So most people will [00:44:00] do pellets every four months. So like, once every four months. So when I was time for my next round, I went down in dosing, but still had the same level that it showed up in my bloodstream, still had the same types of symptoms of side effects.
And that’s when I switched over to creams. And the testosterone cream for me has been wonderful. It has really allowed me to build muscle again. I go into the gym and I feel the difference. My clarity of thought has definitely improved. My mood is better. And now that I’m, you know, in that phase of life where I’m really going into that transition, it has really helped with sleep.
I was out of my cream for a while. I started having a little warmth. Splash in my face. I was like, Whoa, what is this? So this is where pellets to me are for someone that knows they’re not going to really utilize the creams like they should, because creams you have to be consistent. [00:45:00] You have to take it the same time every day.
And sometimes you may have to do multiple applications in the day to get your bioavailability in the range that is helpful for you. So that’s why I say, You know, there are different tools for different people. Now, the discussion comes around the levels at which some people are trying to have, you know, women at you know, is, is this, you know, they’re going past the physiological range.
And yeah, you feel great for a while. I will say, I mean, when my levels were really high, they were great, but then the side effects were, were something I did not want to deal with.
Dr. Weitz: I want to go back to testing again for a minute. I have two questions. One is, what is the best way to monitor women who are taking hormones? There’s some dispute. Some people feel that using salivary hormone testing is better to [00:46:00] measure topical hormones. We have serum, we have Dutch Urine Testing. And then the second question is, I’ve talked to some practitioners who say there’s no point in testing women’s hormones after menopause because their low period doesn’t matter.
Dr. McMillan: Okay, y’all, this is one of my gray areas. This is where I’m gonna sound like I’m sidestepping the question, so I’m just gonna say it up front. So, I feel that The practitioner has to know what they’re looking for and what will change their management. So for me, I do Dutch testing, I do serum testing, and part of the Dutch that I do looks at the adrenals through saliva. Right. Okay. So I get all that and I do the blood for thyroid. That’s just an easier fit. Sure. Yeah. But I think for patients, [00:47:00] once they’re on a regimen, if they are getting better and improving, I will do a follow up of serum testing alone, just to see what’s available in the serum. If they are Does,
Dr. Weitz: does serum accurately reflect transdermal hormone use?
Dr. McMillan: For me, it gives me a guide post so that this is what I was saying. So if they’re doing fine and their levels were increasing and their levels were changing in the serum on the, on the transdermal, particularly creams, because I have a, most of my ladies are on creams, if not all of them I can think of, and they, it does change in the, in their levels on the serum. But then I have some where it stops working, like their symptoms get worse. Something happens and they’re like, Oh, I don’t feel the way I need it.
Dr. Weitz: By the way, why do you use the creams versus the patch?
Dr. McMillan: Oh, I use both. I’m sorry. I meant to say both. So it [00:48:00] depends. I have some people where I started them on creams because it was just easier, I think, to start that way. And it’s easier to titrate. And it was like, OK, we’ve maxed out on this. Let’s go to the patch. And they actually metabolize the patch better. You know, so I will say that if they’re, they’ve been fine and then something happens and they’re not fine anymore, then I’ll go back to Dutch testing. Cause I’m like something in the metabolic pathway has been interrupted.
I’ll go back and say, okay, what has changed in your life? Because clearly there’s something, either they went on a cruise or they’ve, they’re selling their practice or they’re, you know, something has happened. There’s a stressor and that gives me more information. So I have, I have a few in my, in my, I call it my hormone hottie handbag that I’ll pull out according to what is presented to me.
But I say for practitioners, [00:49:00] get a, a regimen that you are comfortable with, that you know, you know it, and you know what you’re going to do with the information. You have a protocol in your head. And I don’t live just on protocol, but at least it gives me a foundation. And then I can make the adjustments and kind of change the levers, the levers that way.
Dr. Weitz: And let’s say you’re working with a woman who’s not taken hormones before, and she’s menopausal, and you measure her serum levels of hormones, and they’re really low, what, how does that guide your care? Does it change?
Dr. McMillan: It will, it at least will help me see what’s going on from the adrenal side. Cause you remember your, the adrenals are, are, should take over at least a little bit.
Dr. Weitz: Right. Yeah, of course.
Dr. McMillan: I should see something happening in the bloodstream. And that’ll at least guide me as to how much, what I’m going to prescribe. The amount.
Dr. Weitz: So even though their estrogen, their progesterone [00:50:00] are low, there’s a difference between being this low and this low.
Dr. McMillan: Yes, to me. Okay. And what I’ve come to find over the years. Yes. And what they’re telling me. So I have some women that I would, I would say, Oh my gosh, you’ve been in menopause for say five years. And I’ll ask them, do they have any vasomotor symptoms? And they’re like, no, I don’t have any, I don’t have any hot flashes nights. So it’s that, you know, that vaginal dryness, the triad, right.
And I get their, their serum levels say I, you know, if I used to just do serum only be, in the beginning before I did that. And say I got their serum levels, and I could notice their estradiol was not that below 5 register. It was actually like about 10. And I’m like, oh, okay, so clearly you’re making enough that it’s not impacting you symptom wise.
Now, let’s talk about do you have enough on board for your cardiovascular, for your brain health, for your breast health, all of that. [00:51:00] And that’s where we start, that’s where the conversation goes from there.
Dr. Weitz: So what about women who’ve been in menopause, haven’t been taking hormones, they’ve been in menopause for 10, 20, 30 years, maybe they’re even in their 70s or 80s but they’re struggling with sleep, they have other issues, does it make sense to put them on hormones and or progesterone.
Dr. McMillan: You ask some great questions, great questions because this is where I would probably, people would probably go, why is she going to do that? Oh my gosh. But I’m just like, why are we letting women be miserable? So this is where I would start them on progesterone, a little bit of progesterone.
And this is the person I would monitor even more closely. And I want to make sure they’re metabolizing everything okay, [00:52:00] because I know that they have liver and kidney and all of these other systems have decreased in the way that they, their production and their performance. So, and it’s interesting because I look at my mom and she’s in her mid 70s, and she had a hysterectomy in her 30s, and she was never placed on any hormone therapy, and I look at the, at all of her comorbidities now, and mainly it’s heart, mainly it’s cardiovascular, and I wish I could just bathe her.
Hormones now. I was like, Oh my gosh. I even cause she has some CHF and I went down the rabbit hole and I saw a small study on how testosterone can be utilized in treating CHF. And I was like, Oh my gosh. But of course I do not treat my mother. So I am respectful of her cardiologist and they are wonderful.
She has an amazing team. I mean, to the point where they even call me up and they’ll, you know, Schedule stuff according to my schedule [00:53:00] when I can get there. But I wish we had this information and now I’m utilizing it for myself so that I can make sure as I age, I don’t turn on certain genes that I know are in my line.
Dr. Weitz: So sometimes in these women, you’ll just prescribe progesterone.
Dr. McMillan: We can start there. We can start very low. I have had a 70 year old woman that could not sleep. Actually, she was just Her mind was just waking up at that 3 a. m. It was at 2, 3 o’clock in the morning. So of course, I was like, let’s go down the blood sugar pathway. Let’s make sure you’re not bottoming out having that that phenomenon in the middle of the night where your blood sugar drops, you know, and I was like, let, let me be mindful of the internal medicine side of things. Right. And she wasn’t, it wasn’t happening. And her hemoglobin A1c was great.
Her fasting blood sugars were great. And I said, you know what? Let’s try a little bit, let’s just try a little bit of your, [00:54:00] of progesterone. And I gave her a little testosterone, I think, at the time. And she came back and was like, thank you. She was like, I’m, I’m not sleeping like I did when I was younger. She was like, but at least it’s better. Better.
Dr. Weitz: Yeah, I was just thinking of this one patient who has just horrible sleep. She’s in her later 70s, but 10, 15 years ago, she had an unexplained blood clot. And as far as we know, there’s no risk factors. We’ve done detailed testing. We don’t see any genetic risk, but no doctor wants to put her on hormones.
Dr. McMillan: Well, okay. This is where I would say testosterone, remember some of your testosterone aromatizes into estrogen. So sometimes just starting a little bit of testosterone could give them a little bit of estrogen that would be helpful without giving them the estradiol.
Dr. Weitz: And progesterone doesn’t increase clot risk, right?
Dr. McMillan: No. No, it does not. It does not.
Dr. Weitz: And we also have Dr. Dale Bredesen, who’s been pioneering the use of hormone replacement therapy in older women for the prevention and reversal of Alzheimer’s.
Dr. McMillan: Yes.
Dr. Weitz: And other neurodegenerative diseases.
Dr. McMillan: Because we need this for our brains! Leave me alone. We are one big bag of hormones. This is why I also say To women, you can’t go to your doctor and say, test, give me the test for perimenopause or menopause. They’re just like, they wouldn’t test me for that. I was like, well, there is, it’s, there’s a nuance to this. You, there are different things that we look at because we’re bag of hormones. You have to say which hormones you, we need to look at and pull that story together to give us the story of you. But yes, there’s so much neural protection with our hormones.
Dr. Weitz: This has been a great discussion, Dr. Lakeisha.
Dr. McMillan: Thank you. My pleasure. Same here. I’ve enjoyed my time.
Dr. Weitz: How can listeners, viewers, find out more about you, get in touch with you work with you, or use some of your programs?
Dr. McMillan: Awesome. Yes. If you want to be one of my hormone hotties, go ahead and grab the freebie that I always give out. It is cracking your hormone code. It is hormonequiz. co. co and take your hormone quiz and crack your hormone code. After you do that, you will get an email that Invites you to make your consult, virtual consult visit with me by going to talkhormones.com. And that’s the way that you can get in touch with me. Now you can follow me on all social media platforms at Dr. Lakeisha M. D. That’s D R L A K E-I-S-C-H-A-M-D.
Dr. Weitz: Great. And do you also have a podcast or have you had a podcast?
Dr. McMillan: I do. I have my Hormone Hotty Hotline podcast, so you guys can come on and listen to this on any of your favorite platforms. It’s where Hormone Hotties come and share their stories. I have experts like Dr. Ben here to come and give their expert opinions, and then I give my corner. the corner of a perimenopausal doctor because I’m in the fight with y’all.
Dr. Weitz: Great. Thank you so much.
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 very much appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review. As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health condition, and want to prevent chronic problems, and want to promote longevity, Please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310 395 3111 and we can set you up for a consultation for functional medicine. And I will talk to everybody next week.
Dr. Philip Goglia discusses Sports Nutritionwith moderator Dr. Ben Weitz at the Functional Medicine Discussion Group meeting on October 24, 2024.
[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
In this episode of the Rational Wellness Podcast, Dr. Ben Weitz discusses the challenges of organizing functional medicine meetings post-pandemic. Special guests from different sponsors introduce their products, and Dr. Goglia provides extensive insights on nutrition, metabolic typing, and personalized dietary recommendations.
00:00 Introduction and Podcast Overview
00:26 Challenges with Functional Medicine Meetings Post-Pandemic
01:36 Upcoming Meetings and Announcements
02:32 Sponsors Introduction
02:47 Integrative Therapeutics Overview
03:49 Quicksilver Scientific Overview
05:10 Vibrant America Labs Overview
06:20 Sports Nutrition Overview with Dr. Weitz and Phillip
07:05 Dr. Goglia on Metabolic Typing and Nutrition
57:08 Audience Q&A and Discussions on Supplements
51:21 NBA Athletes Dietary Programs
01:29:25 Closing Remarks and Contact Information
Dr. Philip Goglia has a PhD in Nutritional Science and he is also the best-selling author of Turn Up the Heat–Unlock the Fat Burning Power of Your Metabolism. Dr. Goglia sees clients at his office in Santa Monica and he can be contacted at 310-392-4080 and through his website http://www.pfcnutrition.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.
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.
So thank you for joining the Functional Medicine Discussion Group. And since the pandemic, we’ve had, …it’s been more of a struggle to get people to show up in person. And I recently realized that a lot of the mailing lists I put together, uh, is a little bit dated. And there are a lot of people on the mailing list that moved away and stopped practicing, etc. So, I would like everybody’s help to tell some of your colleagues and feel free to send me an email and we can get their email on the email list so we can get a fresher email list, so we can keep these meetings going because we need a certain amount of numbers to make everything work for volunteers and everything else. So we’re not going to have another meeting this year. We’re going to start up again in January.
Dr. Goglia: We are the last meeting?
Dr. Weitz: We are the last meeting.
Dr. Goglia: Let me know. No shit. No pressure.
Dr. Weitz: January 23rd, we have Dr. Mark Pimentel, and he’ll be talking about SIBO as a cause of IBS. He’s the guy who really came up with the whole concept. Very important meeting. You gotta be there and as of right now, we’re probably going to have meetings every other month to potentially increase the attendance. But all these meetings are being recorded and you can watch them on my rational wellness podcast. So if you don’t listen to it or check it out. We also have a YouTube page, you can see the videos. We also have a closed Facebook page, Functional Medicine Discussion Group in Santa Monica. You can join that, we can continue the discussions. It’s devoted to functional medicine discussions. And we have three sponsors for this evening, and so we have Integrative Therapeutics, we have Quicksilver Scientific, and we have Vibrant America Labs.
Let me say something about Integrative Therapeutics. They’re one of the few lines of professional supplements that we carry in our office. And they have a number of great [00:03:00] products. One of my favorites is their Theracurmin, which is their highly absorbable form of curcumin. And now they have a new product in a more absorbable form called Curalieve. And so that’s a great product for inflammation, for healing, for, everything and anti cancer, et cetera. I don’t,.. let’s have Quicksilver Scientific come up and tell us about Quicksilver Scientific products. So.
Emily: Hi everyone. My name is Emily. I’m with Quicksilver Scientific. Has everyone heard of Quicksilver before? Today? Today. Okay, very good. so we [00:04:00] were founded in 2006. by our CEO and founder, Dr. Chris Shade. He has a PhD in aqueous chemistry as well as environmental chemistry. So we do specialize in detoxification as well as liposomal delivery. So you’ll find a lot of our products are a liquid base. You hold them in your mouth for 30 to 90 seconds, and peak uptake actually happens in 11 to 20 minutes, so it’s very fast acting. You know, if you have a patient who has, let’s say, sleep issues or anxiety, they don’t want to wait an hour to two hours for the supplements to kick in. They want instant relief. So, it’s great with that and we do have a spectacular product specifically for anxiety called Gaba L- theanine. It does peak in 11 to 20 minutes. Um, so very fascinating for your patients. Thank you.
Dr. Goglia: Thank you. Anybody else want their blood run? Come here. I’m, uh, it’s quantum physics, [00:05:00] really. It’s like, no, it’s, I’m taking people’s blood. But if I take your blood, it means I have to talk about it. Alright, so you’re next. So, Bob, sit back.
Dr. Weitz: So, we’ve got a rep from Vibrant America Lab to come up and tell us about Vibrant American testing, which we use in our office. They have the most incredible testing. Everything you can think of, we want for a functional medicine practice.
Matteo: Hello guys, I’m Teo with Vibrant Labs. Well, I’m new with Vibrant, so I don’t know when we were founded, but I know it was over 10 years ago. But our CEO has a tech background. So, he comes from Intel. Our tests are super advanced. Some of our most popular tests are like the total tox burden test. It’ll measure your mycotoxins, environmental toxins, and heavy metals in your blood, which would be, you know, super valuable to know, especially in the functional space. And for longer than we saw on and so forth if you guys are interested in receiving a test, Dr. Weitz here can order that [00:06:00] test or any practitioner, um, that you work with, you just have to contact me. I have some catalogs in the back and I hope to talk to you after. Thank you so much.
Dr. Weitz: And so now we’ll get back to our discussion about sports nutrition with Dr. Philip Goglia. Philip, why don’t you tell everybody about yourself? Phillip’s been doing nutrition for many years, works with a whole bunch of professional athletes, NBA players, actors getting ready for Marvel movies, he’s worked with professional boxers, and he is a…
Dr. Goglia: Whatever, I don’t have a blog. I’ve been working at Starbucks recently, it’s pretty cool.
Dr. Weitz:Phillip does a lot of interesting things, including working with the Boxing organization on their anti doping policy. And Phil’s in [00:07:00] practice in Santa Monica. So, Phillip?
Dr. Goglia: I’m here. Yeah. So, uh, real quick, my background, I know it’s time to say, can everybody hear me? All six of you. I’m Duke university based. All these protocols kind of came out from Duke university through The Rice Diet. I don’t know if any of you guys ever heard of the Rice Diet years ago. It was Duke’s first attempt at a heart healthy food plan. Back in the 80s, for those of you that can remember back that far. We thought fat was a bad guy. That you should not eat fat. It was bad for your heart. So everybody was very plant based. Duke came up with a food program called the Rice Diet. It’s a bunch of rice, a bunch of vegetables, some ferry dusting and some chicken. So we walked our fat people into Duke Track hoping they’d drop weight. It was an interesting process because we had a bunch of folks dropping weight on a high carbohydrate food protocol. We had another patient population falling asleep and [00:08:00] gaining weight, and we couldn’t figure out why. So we gave them meds, we gave them amphetamines, thyroid medication, we gave them all kinds of stuff. And it still wasn’t working until we started assessing lipid profiles, HbA1c, hematocrit, and hemoglobin. This is years later. As we look at these markers, we realize that the folks that are falling asleep, we’re practically making them diabetic. Like, they couldn’t use a sugar to save their life. Their HbA1c was elevated, their trigs were elevated, glucose was elevated, but they had really high HDLs, very low LDLs. Genetically, naturally, they had an amazing capacity to utilize fat and protein efficiently, but we weren’t feeding them any. We’re pulling off the rice, and the veggies, we’re giving them fatty fish. Veggies is a splash of some carbohydrate. Poof! They woke up, they started losing weight like crazy. A great example would be, let’s say you set the need, I want to go plant based, I know cows give you cancer, I’m not eating any more goddamn cows, forget it. I’m going plants, [00:09:00] and I say to you, plants are great, but you do know they’re all sugar. Yeah, I know they’re sugar, but they’re in the ground. They’re healthy. It’s a healthy sugar for you. And I say, yeah, but doesn’t your dad have type 2 diabetes and don’t you have an HbA1c of 6.1 with elevated trigs and glucose? Yeah. Well, maybe sugars aren’t such a good idea for you. So, in that perspective, a high carbohydrate food plan, plant based, wouldn’t suit that individual. Flip it around, and you say, I’m getting rid of plants. I’m going high fat, high protein, I’m eating nothing but cow, no more carbs for me. Put your dad out of a heart attack. And you’ve got an LDL marker through the roof and low HDLs that won’t go over 20. You don’t have the capacity to manage proteins and fats through your system. You would more than likely end up creating plaque from all the fat you’re consuming and the protein that you’re consuming. Bad idea.
So, at Duke, we discovered three metabolic types. Either you are fat and protein efficient, carbohydrate efficient, or you have a dual [00:10:00] metabolism. Everybody’s one of those three. There are only three nutrients. There are only three different ways of eating. So, based on your lipid profile, hematocrit, hemoglobin, and HbA1c, you fall into one of those three categories. It’s kind of interesting because most folks come into my office and I see 18 to 24 folks a day. They come in, they sit down in a chair, and they say, I’ve tried five different food programs and nothing suits me. Like, I don’t know what works. And then I always say, you’re not supposed to know what works. Like literally, you’re I’m the best in the world at this stuff. I suck at everything else, but I know this.
And then you know everything else, but you shouldn’t know nutrition. Nobody really does. So you try to get the best of information through it, be it Instagram and TikTok, the web, whatever, your friends, the gym. And you’re always missing something. And what folks really miss so many times is that they, they have it a bit backwards. So many of the times where they think they’re going to hit the gym. They’ve got to hire Tommy the trainer to take him through their workouts three or four days a week. I got to slam their cardio and that, that will change their physique and their aesthetics and their performance because Tommy the trainer says, Hey man, I’m going to make you super strong. We’re going to change your physique here. Tommy’s not really telling the truth. Tommy’s job is to make you weak. Tommy breaks your muscle tissue down. It’s a catabolic event in that gym. And so I always ask my clients, I always say, so, uh, when you leave the gym, you’re stronger and they look at you literally like a possum in headlights. Or what did you just say? So the gym, does it make you stronger? Make you, oh, it always makes you stronger. Oh, it does. So you leave the gym stronger and again, they’re like, what? No training makes you weak. You leave the gym weaker. What did it do to your muscle? It broke the muscle down. It’s a catabolic event. All training [00:12:00] is a catabolic event that is inflammatory and makes you weak. That’s really not where physique changes.
Physique changes in an anabolic event. And that’s not the gym. That’s your kitchen and sleep hygiene. Is your sleep metabolic? Do you know how to sleep? What’s your sleep hygiene look like? Do you even consume enough food to promote the right caloric pattern in the right nutrient pattern that suits you to promote tissue repair? I mean, these are questions that civilians shouldn’t answer. And I work with nine tenths of the NBA, and they’re so damn young, they can’t answer that question either.
And in professional sport, I’m the nutrition chairperson for the World Boxing Committee, and, uh, and in professional sport, the goal is to mitigate injury so that you still have money coming into your bank account. Because the minute you’re injured, you can wake up behind your career path. So, how do you mitigate injury?[00:13:00]
Even the trainers that work at these big facilities will say, We’re going to make you strong today. Let’s train, let’s train. And they have very inconsistent nutritional landscapes thereafter. Where there’s literally like peanut butter and jelly sandwiches in the locker rooms. It’s crazy. And I’ve seen it.
It’s nuts. So it’s always foods first and you hear that little saying 80 percent kitchen 20 percent gym It’s kind of like that. Everybody wants to go to the gym because they’re so fearful of the food They don’t know what to choose. They really don’t. Like what do I eat now? I don’t know. Should I train fasted?
I don’t know. Should I eat something before I train? Should I do cardio first? Should I do weight training first? There’s so much misinformation out there that you gotta hand it to the regular civilian, even the athlete, for trying. God bless them. God bless everybody trying. God bless everybody that’s giving as much information as they know about.
But together we can dial it down a bit more and really hone in on what is specific. [00:14:00] Here’s yours, Jeff, speaking of specific. For you here’s your card. So, when folks come to my office We do a one hour intake and we pull a lipid profile and see hematocrit and hemoglobin. And we start talking about foods.
And the first thing we talk about is kind of the landscape of nutrition. And immediately people will say, well, you know, I really want to mitigate my inflammation. You know, what are my inflammatory foods? I want to take an ALCAT test. And the ALCATs aren’t for their sensitivities. They’re not for allergies, like a true allergic anaphylactic reaction.
In fact, I ate so much damn salmon that if I took an ALCAT test, I’d pop positive for salmon. Because there’s just so much of it. So again, in speaking to nutrition, you try to simplify things and you say, look, you know, there’s this old saying, feast or famine, right? Famine people die, feasting you live.
That’s important. So eating is important, but people are so fearful of [00:15:00] food. They would rather skip a meal than think about eating a pattern. And they’re so confused about what to eat next. So someone comes into my office, we run full lipids and we go through a Tell me what you ate in your particular day.
We total some calories and it’s so interesting that folks still view nutrition or metabolism as something that is fast or slow and I learned years ago that the definition of a calorie is a heat energy unit. I think everybody in this room knows that. So how can metabolism be fast or slow? It’s actually hot or cold.
Metabolism is a function of heat. It is hot or cold. So eating is not eating. Eating is heating. Not eating is cruel. It is very easy to lose weight on a low calorie food program. You can stop eating, and we can all lose weight. But is that really what you want to lose? Don’t you really want to weigh as much as you can, and take up less room in the room?
And worry about your [00:16:00] waist, not your weight? Five pounds of fat, five pounds of muscle. Muscle’s heavy. It doesn’t take up much room. Fat is light and fluffy. It literally takes up an assload of room. I’m here all night. So, weigh as much as you can. Take up less room in the room. But especially in both communities, female and male.
But especially in female communities, we’re so scale obsessed. And then we relate that to hormones, but we don’t. Think about hormones and menstrual cycles, when the scale is a complete asshole, two weeks a month. You only have 2. 3 weeks a month as a female to drop any decent weight on the scale. The other two, which you play with hormones, you got a three to seven pound gain.
So who cares what you weigh, as long as your genes out of the dryer are looser on you. Take up less room in the room, weigh as much as you can. Worry about your waist, not your weight. So that’s a big [00:17:00] conversation in the office to begin with. And for people to wrap their brain around that, it’s a, it’s a tough one in the beginning because they’re so scale obsessed.
Many times when people come in, the scale will stay the same and their body fat would be down 1. 3 or 2%. And they’ll say, I know I’m lighter on the scale. Let’s get on the scale because my pants are looser and the weight is the same. And then it’s easy to do the math based on your body fat percentage.
Here’s the math. Your fat percentage is this, so you’re carrying 35 pounds of fat. Last time you were carrying 40 pounds of fat, you’re down 5 pounds of fat, but you gained 5 pounds of muscular density. And then you hear, it’s so hard to gain muscle. If you are underfed when you walk into the office, and you are more catabolic than anabolic, it’s very easy to add muscular density.
density, the healthier a muscle is, the more it weighs per square inch, the more nutrients and water it needs. So it’s easy to do that. It’s not that hard. As a [00:18:00] bodybuilder, you’re in a training journey, put 10 pounds of muscle on your ear and you’re like a rock star. But we were way beyond our genetic potential already.
I was a wrestler for dude. I competed in bodybuilding for years as the Southern USA, Atlantic USA, I won all kinds of bodybuilding stuff. And I was eating 9,800 calories a day. Yeah, 48 eggs a day, 5 pounds of flesh, I’m eating a lot of food, but I was a 310 pound bodybuilder at one time. My competition weight was about 250 back then. So eating is feeding, like we were talking about. Oh wait. I’ve got Leonardo’s blood. Ooh, Leonardo, we’re gonna have a chat, my brother. Wait a second, I have to put a pause on this, mate. Because I can’t multitask. Because I’m like, I’m a guy. Guys don’t multitask.
Dr. Goglia: Alright, so, [00:19:00] these calorie things are heat energy units. Here’s one for you. When you put butter on a stove, what’s it do? It melts. When you put butter in the fridge, what happens? Hard as a rock. Our body fat is a lipid. It only converts to calorically hot environment. Like I said, you can lose some weight on a low calorie food program, but is that really what you want to do? And then you’ve got to ask yourself, what weight are you losing? Do you feel stronger or weaker in the gym? And if you are under eating and you are training with Tommy the Trainer at 5 days a week, shit, before you know it, you’re going to bend over to grab a dumbbell or pat your dog and your back will go out. Or you’ll pull something and you’ll say, screw this, I’m just going to order pizza. It’s not working for me, which is why we always go back to food is not adversarial, food is an advocate. It’s an advocate to create a change in physique and aesthetics and performance. So ultimately, if food is an advocate, isn’t it just consequential? What’s [00:20:00] consequential mean? Three bites of a cookie will not turn into salmon. It’s a goddamn cookie. Eat a salmon, look like a salmon. Eat a cookie, look like a cookie. Just saying. It’s very simple, and it’s kind of sarcastic and comical because it should be. Because people are so concerned about aesthetic and physique and performance, and they’re self shaming already, which is a whole other conversation about GLP 1s and some of the benefits it has there for, you know, getting rid of that cluster of talk in your brain about how horrible you are because you can’t lose weight.
But if you can view food as an advocate, as a consequence, Then you can justify eating. Eating is a pain in the ass. It’s hard to get your breakfast in, and then a snack, and then lunch, and then maybe two snacks in the afternoon, and then dinner. Most folks are interesting in that they are so busy in their day, they have a tendency to under eat in their day. And then blood sugar levels drop. And then wild horses can’t drag them away from [00:21:00] pasta at night. And they say, but I’m not eating much. And I say, granted, yeah, you’re not eating much, but damn, look at the starch you’re eating at night. Yeah, but I’m eating some chicken. Well, chicken’s great, but isn’t the best time to repair muscle tissue is when your body is at rest?
And isn’t your biggest rest time sleep when you really are the most metabolic? And if protein, meat with eyes, chicken, fish, steak, turkey, eggs, so if you’re gonna run, swim, take a dump in the woods, or bite you it’s a true protein. So, the protein thing, if it repairs muscle tissue, and the best time to repair it is when your body’s at rest, shouldn’t dinner be your biggest protein meal with a bunch of veggies for digestion?
But wait, you just had a bunch of pasta, or potato, or rice, or yam, because your blood sugar was so low, wild horses couldn’t drag you away from that big ass potato, and you ate it up. It’s a carbohydrate. It’s a sugar. Who’s running the marathon after dinner? What are you going to do with that thing? It’ll promote restless sleep.
We’ll store it. Ends up in your liver as triglyceride [00:22:00] fat. Or just elevated glucose. Or it can promote Simoji Syndrome, like Don effect. So, placing your foods in a particular order do certain things for us. The folks that are counting their grams of carbohydrate, proteins, and fats. So many times I hear, Yeah, you know, I didn’t have my 84 grams of carbohydrate at lunch, so I’m going to have it at dinner.
Well, it’s going to do two different things. You’re not going to use those 84 grams of carbohydrate as an energy source at dinner. You’re going to go to bed. So, nutrients are specifically placed within your day based on your lipid profile or metabolic type. When you start a food program, calorically speaking, because calories are heat energy units, you don’t get hot right away.
It generally takes, metabolically, about 48 hours to establish a new heat pattern calorically. So two days to heat up, let’s [00:23:00] say. At the end of those two days, you start counting off your timeline of the days of the week, but let’s say in day four, you skip a snack in the afternoon, You eat a cookie, you’re hungry, you have starch at dinner.
If you adversely affect your caloric pattern, you have adversely affected heat. Metabolism will cool. You will lose that day that you’re in for the true efficiency or utilization of fat. It’ll now take you 48 hours to reclaim your pattern again. You just lost 3 days. If you do that twice a week, goodbye.
How many people have you spoke to and talked to? Man up. I started my food program and then I ate something. I haven’t dropped any weight at all this week because they’ve created a caloric inconsistency. So calories need to remain stable across a seven day week. Generally speaking, we say you get one date, night meal of the week, eat whatever you want, get it out of your system.
The other six plus days, keep it tight. So this math assumes a date night meal, let’s call it. [00:24:00] Any more than that, and you’re about to break even. Additionally, as you take a look at calories in these heat energy units, they need to be meticulously placed within your day. And then we try to stay away from, generally speaking, like inflammatory foods.
So, no dairy. Dairy is like eating phlegm. No athlete consumes dairy. It adversely affects coronary well being, oxygen utilization, the whole bit. Someone’s triple nonfat cappuccino, fine. You know, I generally get that. But, for the most part, dairy is out. Beans, unless you soak them, are generally considered high mold.
So, beans can be inflammatory. They’re out. If you soak them and sprout them and sprout them a whole lot of them, great. One stupid vegetable, eggplant, seems to be very inflammatory for most folks. And even me, when I have it, my tongue gets all prickly and kind of swells up a little bit. So eggplant is generally a no.
Coconut oil is popular because it has some benefits, but it is a triglyceride. So if you have a diabetic marker and you trap sugars, you’re trapping a triglyceride. [00:25:00] So. Consuming a triglyceride for somebody with a diabetic marker is a bad idea, though it might be beneficial for your brain, but there are a lot of other things that are beneficial for your brain, too, that aren’t necessarily a triglyceride. So generally speaking coconut oil is, for most folks, a no. 70 percent of our population have a diabetic marker. That’s why Atkins esque food programming from the very beginning has been always so successful. Higher fat, higher protein. About 20 percent of our population is more carbohydrate efficient.
About 10 percent of our population is dual, where they utilize all three nutrients. And where did they come from? Think about geography, Alaska. Anybody there plant based? Probably not. It’s a little cold. So everybody’s eating fatty foods, eating animals. And then you move to Africa, and the animals are fast, and they’re mean, and they’re going to bite you and eat you, so it’s very plant based over there, and then the United States really became the melting pot, as did Spain and Italy, [00:26:00] where everybody’s eating a little bit of everything, and everybody ended up here. So really, these metabolic types have a geography behind them. Once you understand that, understand your metabolic structure that we will now talk about, it’s great to create patterns, even as it relates to gastric health. You know, so many folks are eating inflammatory foods or inconsistently eating, they’re adversely affecting gut health.
So they feel bloated, distended, and then they think, well, I’m going to start eating a whole bunch of raw vegetables and salads. That’ll help me because salads are healthy, but for the most part, generally speaking, the raw vegetables are more gastrically interrupted than cooked vegetables, because of the fiber count.
So, that’s a bit about Nutrition 101 and metabolic typing. So, consistent patterning, eating is heating, eating over not eating, and then the final thing, hydration. The definition of water is fish must swim in it. Not sparkling, bubbly flavored, plain ass water. Those other things are beverages, and you can [00:27:00] have them as a beverage, but you can’t classify them as water.
Especially the sparkling water and the deep mineral density in them, because it’ll actually hold water on you, because the minerals are so dense in it. The purpose of water, other than moving nutrients and toxins through your system, is to regulate your temperature, perspiration, and sweat. Like, we know it is cold in here, like a, Operating room.
Jeez. We are still creating perspiration and sweat to regulate the temperature to manage our environments. If your water is low and you cannot regulate temperature correctly, your body will perceive that as trauma. Once it senses trauma, it will figure out a way to adapt. So it has been proven that if your water intake is low and you can’t perspire correctly through proper water intake.
Your body will become insulatory. You start to actually hoard fat under your skin to act as insulation to control your temperature. So if your water’s low, you hoard fat. If your foods are perfect, your water’s low, you still hoard fat. Water really runs the show. And then you take that into account with skin tones and muscle tones.
Muscles are over 70 percent [00:28:00] water. If you don’t drink enough water, you can’t hydrate correctly. And you adversely affect range of motion and risk of injury. I have so many women that come into my office after drinking their water. They’re saying, you gotta believe this, man. My sister, my best friend said, my skin looks bad.
I don’t get it. And it’s really comes from hydration. So food is your friend. You gotta eat, especially if you’re training, because training makes you weak, kitchen makes you strong. You gotta drink your water. Water is a pain in the ass, but the rule is if you’re an inactive human, the general rule is. Half of your body weight in ounces of water consumed a day.
And if you’re active, it’s literally up to, if you’ve got a high sweat rate up to your body weight in ounces. And then folks are always concerned about electrolytes, especially lately with all the electrolytes that are on the market and people drinking them. With the endurance athletes I work with, We’ve found, we’ve discovered that sweat rate is established first with water only.
Because if you try to put electrolytes into a cell [00:29:00] that doesn’t require them, you actually block sweat rate, the ability to perspire correctly. So athletes, water first, establish a sweat rate, and then you can replenish. One of the best products I’ve seen out there is a guy named ByAlan Lim. Alan did all the scratch labs.
It’s an amazing electrolyte replacement drink. That’s what most of my pro triathletes and cyclists, my NBA guys use. I might say Gator in the bottom, but there’s Scratch Labs in the bottom. So, water first, and then you can replenish, like in your tree.
Dr. Weitz: When it comes to electrolytes, which do you think are the most important?
So, we got sodium, we got potassium, calcium, magnesium. I think they’re all important. Like, but
Dr. Goglia: at what levels, at what ratios? That’s a damn good question. I don’t know, because I just tell people to lightly salt their foods, because so many folks say, well, I don’t salt my foods. Well, do you cramp? Yeah, I’ve got a cramp. Well, why don’t you salt your foods? I mean, salt is like a perfect electrolyte. It’s got great balances, sodium [00:30:00] and calcium, magnesium, all the electrolytes in it. It’s great. If you are a cramper, what is interesting is that many times the cramp doesn’t even come from lack of hydration, it comes from your central nervous system, your horn mechanism.
And what makes the cramp go away is a flavor, weirdly enough, and there are two flavors that do it. One is yellow mustard and one is pickle juice. So like cyclists that cramp easy, they’re hydrating all the time. They’re loaded with electrolytes and they’ll get a cramp from an overuse, like interruption of your central nervous system. So they’ll hit a little packet of yellow deli mustard and the cramp goes away like that. So folks with cramps at night, You know, those sweeping leg cramps. I always tell them, keep a couple packets of yellow deli mustard next to the bed on your bedside table. Hit that mustard, your cramp will go away in a second.
You know, like, they always come to the office going, Damn, I didn’t think it would work, holy shit, that was crazy. It worked great. That’s fantastic. But I think, keeping it simple and keeping it sustainable is super important. And [00:31:00] you and I were just talking about intermittent fasting earlier. You know, Intermittent fasting sends another message that, Food is an adversary because you shouldn’t eat food.
So let me ask you guys, you guys are smart. Everybody in here trains. I introduce you to a pro cyclist. He says, guys, I’m headed out on a four hour ride at 630 in the morning. Shit, I’m intermittent fasting. Probably shouldn’t eat, right? But could I be a bad idea for this guy? He’s got a four hour ride. I introduce you to a guy named Kevin Love, plays for the NBA.
He finishes an ESPN game. It’s 1030 at night. Cause man, I played all game. Freakin hungry, ugh. Shit, it’s 1030. I’m intermittent fasting. I probably shouldn’t eat, right? Like, good idea, bad idea. Intermittent fasting, what, two and a half years ago, they called that skipping breakfast, and now there’s a term for it.
Kind of like, I love the use of a weighted vest for walking. It’s adjustable weight. You know, you start off light, because it’s like cardio and resistance at the same time. It’s very efficient. [00:32:00] But now they got a term for it, they call it rucking. Yeah. I thought rucking was a 50 caliber gun. Somebody’s saving my life in Afghanistan or Iraq. And now they got it. Now they have a term. I don’t know. It’s called weighted vest blocking. Intermittent Fasting. It’s called
Dr. Weitz: skipping breakfast. 30, 40 years ago, we got into this and the concept was everybody’s fat because we skip breakfast, right?
Dr. Goglia: Yeah, yeah, don’t skip breakfast, eat your food, you know. Eat with it. Took a lot of time. You know, and I do also kind of like the protein windows. Oh bro, you just finished training, you gotta get the protein in or else you’re gonna lose your muscle. So what you’re telling me is, if I don’t eat some protein, within 20 minutes after I train, I’m I will lose the muscle I just worked on.
I’m going to have a hard time believing that. That’s a tough one. There are particular patterns for protein consumption, especially at night before bed. You’ve got 8 hours approximately, 6 hours to digest that food at night. Protein patterns at night, for some of my bigger athletes, it’s a pound of flesh post cooking, and a bunch of vessels for digestion.[00:33:00]
But then you hear, oh, you can only absorb 32 grams of protein at a time, especially from the pro athletic team’s nutritionists. Which is very interesting, because you hear you’ve got a 7 foot guy that weighs 250 plus that’s playing for the NBA, and you’re telling me, So if you weigh 120 pounds and you’re a female, and these two, 50, 7 feet tall, that both of you can only absorb 32 grams of protein at once, in a three hour pattern, are you sure about that?
Is that what you want to hang your hat on? Because I don’t think so. I think it’s based on muscular density and how much muscle tissue you carry and your level of activity. I’ll tell you the guys I work with, so many of them are consuming a pound of flesh post cooking at night before bed and a bunch of vegetables for digestion.
And interestingly enough, though a little counter intuitively, A simple sugar, about 40 minutes before bed, simple, like a fruit, like literally 100 calories of sugar, like half a cup of sorbet, weird, right? A tablespoon [00:34:00] of honey, but I don’t want to ask you athletes to use black strapped molasses because of nitric oxide, it’s high iron.
The simple sugar spikes glucose rapidly and then it drops it, releases insulin, pulls your glucose out, and you sleep deeper, faster in that semi low blood sugar state. So then If you can sleep deeper faster, you can REM deeper longer, you can release more growth hormone when you sleep. So sleep actually becomes more metabolic with that simple sugar spike at night.
It’s interesting. But everybody that comes to my office says, Goli, I didn’t believe you that sugar at night, before bed, that’s bullshit. And they come in going, Dude, I’ve had the best sleeps. This is weird. No starch at dinner and that little stupid simple sugar. That’s great, I dig it. Works for me. And then as a party trick, you can pour tequila over your sorbet if you’re out.
Which is amazing. Makes for fun. Dinner party. Sorry. Speaking of alcohol, alcohol falls in, this is crazy, alcohol falls into two categories. It’s either fermented or distilled. The [00:35:00] fermented alcohols are higher yeast, higher mole content. So, Like red wine, and you hear those people say, Oh, my skin turns red and stuff.
So the wines, the fermented alcohols can be more inflammatory. The better choice is distill, vodka, tequila, potato, rye, grain. So vodka, tequila over beer or wine. If you, I always tell people, if you do choose beer or wine to help manage the yeast and wool count, three glasses of water for every glass of wine or beer you drink to manage the yeast and wool.
But, better choice is vodka, tequila. And you need less of it to get that difference. So rather than three glasses of wine, you’ve got a couple shots of tequila in here, and you’re good. And the wine drinkers, it’s always red. You know, you can’t tell a wine drinker to drink dry white, less yeast, less mold.
They’re always in there getting salted, because they want the deep reds. So you’ve got to keep your mouth shut. So that’s a bit of nutrition 101. And then, there’s lipid profiles. So you guys have your sheets. There are these three buckets. I have some blood work. Let’s talk about this. So you can kind of [00:36:00] see where we’re at.
Let’s do Katie. Katie, raise your hand so everybody in here knows who you are. The first number we always talk about to assess metabolic structure is total cholesterol. It is an empty and meaningless number. It’s literally like cocktail conversation. It means nothing. But everybody wants to know the number.
The medical community will say, keep it under 200. The performance community says, no, no, no, it should be 100 plus your age. But no one can tell you why. So, Katie, your total cholesterol is 168. You must be 68 years old. 168 is a great number. It means nothing. The first number of importance, and we can do deep dives like we were talking about near LDLPs and small particle LDLs, but this just gives you a regulation of where you’re at and what bucket you fall into.
So the first number you look at are HDLs. High Density Limits. These are the good guy fats. Their job is to hunt down fat in you. Transport your fat into your muscles so your muscles can use fat as energy. So the more HDLs you have, the more fat and protein efficient you are. Why protein? Because fat’s only found in protein.
Fat’s [00:37:00] not found in a goddamn apple. It’s found in meat with eyes, and nuts and seeds. So again, run, swim, take a dump in the woods, or Bayou, protein, nuts and seeds, mostly fat, little protein, everything else is sugar. Potato sugar, rice sugar, fruit sugar, vegetable sugar, it’s all sugar if it doesn’t have a heartbeat or a nut or a seed.
There might be some amino acids in it. but poorly utilized. So, HDL is good guy fats. Athletes want to be over 70. The scale begins at 35. 35 is considered zero. Here it’s 66. Fucking epic, but nice. That’s sick. It’s a great number. So now you take your 66 and you divide it into your total cholesterol and you get a ratio.
This ratio indicates current metabolic efficiency. Healthy female civilians are generally hanging around 4. 5. Guys, 3. 5. Athletes, 2. 1, 2. 8. 2. 5. Nice freaking job. But the lower the number, the more consequential your metabolism becomes. [00:38:00] So very efficient. So if I said here are 10 rules and you follow the 10 rules, you’ll change.
Assuming there’s no hormonal issues, right? Or other metabolic issues, you’ll change like that. But the lower the number, You don’t follow one eighth of one of the rules, it’s gonna bite you in the ass. So three bites of a cookie is like ten cookies. You’re at 2. 5. NBA guys, they’ll call, Oh, I had a brownie last night with my daughter.
I feel like I had some shit this morning. Yeah, you got a 1. 9 ratio. You literally feel everything. And then you say, Oh, yeah, I get it. Makes sense, I just, my sleep sucked, like that, so, 2. 5 is fantastic, then LDL back on top. LDLs actually have levels, you want an LDL of under 100, that’s considered desirable.
If they sit between 100 and 130, that’s generally considered environmental, where there’s just not enough food to be consumed, inconsistent eating patterns where your body senses the need to trap fat to protect you. So environmental, not genetic. 130 to 160. Environmental, [00:39:00] now a splash of genetics from mom and dad, we call that hypercholesterolemia.
Over 160, that’s your risky zone, that’s your genetic marker for perhaps laying down plaque in your arteries and hopefully picking out a cute coffin over at Costco. Your LDL is 91. Nice number. The last type of fat that floats around you is the most volatile type of fat we have, triglyceride fat. Volatile, inflammatory, aging, water intensive, Diabetic medical rat bastard, under 110 is desirable, like my trigs sit around 48, though I am fat and protein efficient, I have a diabetic marker, if there was cookie dough on your shoulder, I’d eat your god damn arm to get it, like actually great, but if I ate the sugars I wanted to eat, my trigs would be 500 because I don’t manage sugars well. So, under 110, environmental, 145 to 175 environmental splash adenomics, over 175, genetic marker for diabetic like reactions. Your trig is 58. Hell, [00:40:00] it’s almost as low as mine. You don’t have any marker for any adversity relative to fats, proteins, or carbohydrates use. What type of metabolism do you have?
Dr. Weitz: Cool.
Dr. Goglia: Yeah. Nice. Dual, most sensitive of all three types, naturally V shaped, very athletic, equally as good at cardiovascular and weight training, but the most sensitive of all three, in either direction. So if you don’t follow, again, one eighth of one of the rules, it’ll bite you in the ass. If we’re talking motorsport, Dual is Ferrari esque. It’s an amazing car. You can’t drop it off at Jiffy Lube. Pedro doesn’t know what to do to your car. Just saying. Need Anzo Brothers. It’s an expensive car. And, as we talk about this, I’m curious. Have you noticed any of that? Yeah. Like you can flip back and forth easy? Yeah. Does any of that make sense to you relative to being a dual metabolism?
Yes. Absolutely. Finally, I got one. It’s been 40 years of doing this shit. I thought we got one right. It’s crazy. Finally. Thank [00:41:00] you so much. Can I get your autograph before you leave? Just to let people know I, I got one. So that’s you. Anybody have any questions so far? Before I roll into Jeff. Let’s do Jeff.
Jeff, total cholesterol. We talked about that. It’s empty amine at 191. Great number. It doesn’t mean anything. That’s a good number. Good guy fats. You’re an under eating motherfucker. 32 bro, what are you doing? Especially in guy land, because cholesterol is hormonally attached to testosterone. If you’re training, and I can see you’re training, If you’re under eating, and you adversely affect HDL and cholesterol, you’re going to adversely affect testosterone too. HDLs will suppress. 32. What are you doing? You’re a 12 year old anorexic girl. Stop it. I’m sorry. I’m sorry. I’m sorry. You probably shouldn’t tape this.
Dr. Weitz: It’s not terrible.
Dr. Goglia: We’ll get all this hate mail. [00:42:00] HDL to 32. Take your HDL, divide it into your total cholesterol. 6. 0. 7. 3 is a coronary arrest. Let’s get together later and chat. Fish is your friend. Your LDL, your bad guy fats. Here’s an under eating marker for you. We just said under 100 is ideal. 100 to 130 indicates an inconsistent or an eating pattern. What’s your LDL? No shit. It’s not brain surgery. Trades. You’re under eating your day and you’re looking for sugars later in your day. You’re slamming carbs at night. What’s your trig? 185, you carb eating rap bastard. It is over 175. You manage fats just fine, it’s an environmental marker, 122. You and sugars are not friends. If there’s something you crave in the world of nutrition, it’s a carbohydrate. Like long horses couldn’t drag you away from that shit.
So you are fat and protein efficient. [00:43:00] You will always weigh more than you look because muscles heavy and dense. You need cardiovascular work cause you suck at it, but you get strong fast as well because immune systems are protein based. And if you’re eating 50 percent protein, 25 and 25 is a fat and protein efficient guy.
You’ve got a strong resilient immune system, but if you don’t eat that way, your immune system is going to take a shit, which is not appropriate. Don’t invite me back. Does that make sense? Completely. Oh shit, we didn’t talk about hematocrit hemoglobin. Hematocrit hemoglobin. Hematocrit is the oxygen trapped in your red cells.
It indicates things like endurance capacity or, Oh my God, I have anemia, I’m exhausted, tired, I want to fall down. The sweet spot for elite female athletes that are endurance based, 44 to 48. Guys, 48 to 52. At 50, USADA thinks the athlete’s doping, so they send him to the tent with Lance Armstrong. Lance had a problem.
He was an asshole. Anyways, Jeff, your hematocrit is 46. It’s a good number. [00:44:00] And, wait, Katie, 42, good number. High Iron Foods will push that number up. Remember, when you train, you pull that oxygen out of you as a part of your energy chain. Nutrition shoves it back in. High Iron Foods, Beets, Spinach, Asparagus, Almonds, Eggs, Red Meat.
For the most part, Beets and Spinach are your friends. Folks at IC, with smaller red cells, Cells and the inability to trap oxygen correctly, we end up using beat extract on ’em, and all of a sudden they feel a thousand percent better. That natural oxide is huge, more so than even taking an iron supplement. The beat extracts are fantastic. So any questions so far? Nothing. Okay. Oh, I know. Before you talk.
What? What do you want to know? No, I just wanna let you know that Ika happens so Well,
Dr. Goglia: the trigs are a seven day recall, so don’t worry about it. does it.
I always struggled with that Carb, HDL. Yeah. You know, also [00:45:00] have a position always.
Dr. Goglia: Yeah. So there’s always a genetic predisposition of this stuff, but you can mitigate much of it with correct food programming. And then I brought a supplement. I’m going to talk to you about, well, I’ll talk to everybody about, but directed towards you, which is interesting. So, total cholesterol, 253. Sounds high, shit, it’s high.
I don’t care. HDL’s 35 is zero, you’re at 20. My buddy over here is 32. You guys should get together and date, I don’t know, hang out. 20? Jesus Christ. Take your 20 and divide it into 253. It’s a 12. 7 ratio. Like, I would send you to Dr. Raymond D’Andelio to do a swirl. coronary workup type thing. Cause that’s just, that’s a bad number.
I’m going to take a 12. 7. Your LDL bad guy fats are 156. They’re call it 160, right? 156, literally practically the same. So again, something you’re doing with your foods and the way you’re managing fats [00:46:00] and familial, genetic health history, right? Is trapping fat. Triglycerides. Anything over 175 is a huh, what the hell?
You’re 383. Are you using coconut oil by any chance? In any of your cooking and your foods? Doesn’t matter, it’s a 7 day recall. 5 to 7 days for a trade. Yeah, what you ate just now, won’t affect that. Now it’s a seven day pull, five to seven days. So you’re having trouble using fats. You’re having trouble using carbohydrate.
You’re having trouble using protein because fats found in your protein. You have a dual metabolism. You need a balance of all three. You couldn’t go plant based to be diabetic in a matter of seconds. You can’t go high fat high protein. You can pick it out of a coffin over at Costco in a matter of moments, balance.
But for your muscularity and your size, again, my gut tells me. You’re not even close to eating the amount of food you need to eat to stimulate a heat pattern. Thank you, Mother. I know, [00:47:00] Mom. I was just saying, look. I actually stay here, that’s what I do. I’m a nutritionist. Hey. I do this because of her, and all these. I was a 270 pound fat kid, bullied, you know, bullied constantly. And I’m a three time cancer survivor. In fifth grade, they were to cut my leg off. I had osteosarcoma, and I was in a cast for a year, so. I was bullied, people pushed me over, went, you know, casting all the crap. So I’m constantly assessing physique, like, even as a bodybuilder.
On stage, I would sit there and think, I’m just a fat fuck. You know, with real physique change. So I had to shift my mindset and say, I’m gonna perform better. So you train your legs with me in the gym, I’m gonna beat the shit out of you, I’m gonna crush you like that. So I wouldn’t have to think about how I looked, I really had to change my mindset about it.
You know, and it came to like bulky shirts, baggy shirts and all that stuff, it was a real thing. So, I get those young conversations at an age, and then also, you know, just dealing with cancer was a real pain in the ass. So, I [00:48:00] think with you And most folks, you’re a great example of amazing integrity, wanting to learn about your foods, but so many folks need an advocate.
Like, I consider myself a rather inappropriate, semi sarcastic, but smart advocate for you, which is why all my Clients, patients, clients, call them whatever you want. They have my cell phone. Everybody has my cell. I guarantee you right now, if I pulled up my cell, somebody has sent me a text of a picture of the meal they’re eating.
Or, one of my CAA guys has sent me a menu saying, Golia, just pick my food out. I can’t do it. But that’s collaborative, right? If you saw somebody criticizing someone in the parking lot, and hammering them, they’ll piss you off, and you want to walk up to them and go, What the fuck are you doing, man? Chill out.
Collaboration is a big thing. And obviously you gotta collaborate with yourself first in order to collaborate efficiently with others, authentically with others. And I think there’s a part of greatness in all of [00:49:00] us we really lack. Because we’re not clearly aware that we do like to do difficult things.
But then you want to attach a word to it, like stress. It’s not stressful. It’s just difficult on a scale of one to 10. It’s a 8, 9, 10. What is it? It’s difficult. And because most folks in here, I guarantee you, all of you, not bunch of folks, but all of you are here because you are flat out unreasonable humans.
Unreasonable means if your bottle of water is empty, You will stop what you’re doing and fill that son of a bitch up. That’s unreasonable. A reasonable guy will go, Eh, I’ll get it later. Fuck it. I’ll miss my snack. I’ll figure a way around it. You guys are unreasonable. You love difficult stuff. Stress doesn’t have to be a part of it.
And you got to ask yourself, if your food programming were working, what would it look like? So identify, what would my food program look like? And then you got to ask that real difficult question. Who do you need to be to make that happen? Like, what boundaries do you have to set for yourself? What leap of faith do you [00:50:00] need to have to really embrace that greatness you got?
And then, don’t live in a place of justification. Hold your mistakes. The NBA is not paying you to do this crap. You’re doing it because you want to. So you’re supposed to fuck up. That’s the whole idea. But you screw up, you skin your knee, you go, God damn it, that didn’t work. And you get back into it with an advocate.
Somebody that can give you more of like this guy knows more about just about everything, health, wellness, and fitness that I could ever make. He’s forgotten more than I know the way he talks about shit, but I stick to my wheelhouse. I stay in my lane and I know what I know. And that’s what we all have to do.
Stick to your wheelhouse, stay in your lane, and look for advocacy and ask questions so that you can find a better solution. And this was my solution as a fat little kid. I went to school initially as a music major, that didn’t work out so well and I, because I was fat and a wrestler at Duke, I got into fitness and wellness, and then I saw a picture of Boyer Coe on an [00:51:00] Ironman magazine like that, and I thought, damn, that guy gets laid, Jesus. So I’m like, so I’m a bitch, I want to be a bodybuilder, that’s cool. And then come to find out, the girls didn’t like that anyways. So, that’s my journey with this whole thing. Any questions? Sorry, I’ve been rambling. You don’t even have a chance to talk. That’s okay.
Dr. Weitz: Yeah. So, let’s get into how do you work with athletes? And Why don’t we pick a few athletes? You mentioned NBA. Let’s talk about NBA players.
Dr. Goglia: Myers Leonard, LeBron. Okay. These guys they’re so big and manage so much activity that they just really don’t know how much they need to eat. It’s crazy. Like Myers Leonard is seven feet tall, 248 pounds. Guy was a beast and when I met him, he thought he was eating a lot based on the nutritionist he was working with his team at the time. He was consuming about 2,400 calories a day. I [00:52:00] mean nothing and he couldn’t understand why he was so sore and couldn’t recover and why his sleep sucked.
So once adjusting his foods and food programming is interesting. Let’s say we did the math and you need 4,800 calories a day and you’re only eating 1,500. I just came to give you 4,000 calories and expect your body to manage it because it’s adapted this inappropriate way of eating. Maybe high carb, maybe high fat, whatever, but it’s adapted this thing.
And then here are your symptoms. So food programming shifts in about 10, 12, maybe 15 percent increments every seven days. The life of a food program generally 7, 10, maybe 12 days max. But at the end of those days, your body composition will match the food program you’re on. You will not change anymore.
You’re done. If you say to me, Goglia, you know, this week I’m really strong. I’m stronger. I can tell. If you’re stronger, you had to have added something. You must have added more muscular density. You’ve added [00:53:00] more muscular density. Don’t you get more food to make it move and to fix it? Calories always go up.
They don’t go down. And they’re very dynamic. They shift from week to week. Every 7 to max 12 days. Inclusive of your one free meal a week. So the athletes I work with, once they understand that training really does make them weak, Because they think they’re sick, they don’t feel so great. Once they start eating, all of a sudden they spend more hours in their day in an anabolic environment, rather than a catabolic environment.
And then just flipping to a completely different topic. Sorry, I feel like a squirrel. Your LDLs and your HDLs. There’s a product out there. It’s a, it’s not often talked about. It’s called Alpha Cyclodextrin. It is very statin based. It’s what a statin really wants to be. And I didn’t know about it. It’s actually a plant fiber. I didn’t know about this product. One of my clients in Taiwan, who I do zoom appointments with, told me his doctor [00:54:00] wanted him to go on a natural statin product. I said, great. What’s it called? He said, alpha cyclodextrin. I didn’t know what the hell it was. He said, do you know what it is? I said, I don’t know what the hell it is. He said, my doctor swears by it. Is it bullshit? He said, let me put you in touch with my doctor. So I did, and he sent me a bunch of studies on it, a bunch of German studies. And then, my client kept on sending me his LDLs. He started off with an LDL of 208, started to be alpha cyclodextrin. His LDL dropped to 122. Like, crazy. So then I researched it. I even typed it into Amazon because everybody types everything into Amazon. And it popped up. Life Science Solutions Alpha Cyclodextrin. I don’t have an LDL problem. My LDLs always sit around 88, 86, maybe a 90 if I’ve done something stupid. I bought it, started taking two of these capsules a day. Within under three weeks, my LDL was 52. Crazy. So then I thought, [00:55:00] I gotta manufacture this shit. I gotta figure it out, this stuff is amazing. So I called Jeff Galini, a buddy of mine, who owns All American Pharmaceuticals, who I used to train with. You should know back in the day. Yeah, I remember Jeff. Yeah. His company is huge. Billions of dollars. Oh, really? Oh, it’s ridiculous. Wow. That’s where I get my pharmaceutical leg, from Jeff. Yeah. Yeah. So I said, yeah, I want to put alpha cyclodextrin in the capsule. I want to make sure it’s, you know, clinical grade stuff. The real deal. I said, because GLP1s are so damn popular, I want to attach berberine to this stuff too, to support the use of sugars and carbohydrate metabolism. He goes, good idea. Jeff has like 90 PhDs. I said, good idea. Let me work on this for you. So he did. And this is what it is. Metabolic Plus. It’s a combination of alpha cyclodextrin and berberine. And here is the white paper I wrote on it, and you should take this, and if it interests you and you like it, because of your background, I’ll give you a damn ball. [00:56:00] But the stuff is amazing, and I don’t rave much about supplementation. But I’ve been taking it, you know, for my own personal use and watching what the numbers did to me. And then I started giving it to my clients through Amazon. com. And I was running everybody’s blood, you know, every couple of weeks. And I saw the markers drop, the LDLs drop. And people are so afraid of statins and the side effects, and kidneys, joint pain, muscle pain, that I thought, this is just a great alternative. Somebody that just refused to take a statin, even though they really need it. Because statins have such a bad rap. So there you go. Anyways, that was an idea.
The other thing people have been talking about so much lately is like neurology and mental care. One of the things I use in the office, it’s one of the grandfathers of like paracetam and selezolene for neurological focus, is NADH it’s a little particle of niacin, but literally when I take this thing in 15 minutes, I’m absolutely laser focused, I’m [00:57:00] like out of my mind. Not central nervous system like caffeine or any block of cocaine, it’s just like energy from the neck up. It’s really amazing, it just helps me fast. So NADH, paracetam, selezolene. Lately MADD Plus has been a big deal, especially because you can get it in a nasal spray now on a pharmaceutical level. So we do hormone replacement therapy at the office on Saturdays with Dr. Earl Dixit at our gastro at St. John’s. And MADD is very, very popular. It’s a great, great product. So I started taking it myself, and I can’t stop talking. What we think about in our NMN is NAD precursors. Again, the precursors are great, but why not just take MADD? I don’t think that is absorbed, but it is nasal spray. NAD is absorbed right into your nasal cavities. It goes right to your brain. Like, it’s funny. Like, I would say no, it’s not. But I know that when I take it, it’s like, whoa, I feel pretty damn good. I had a first guy that took NAD from us. And I wanted his feedback is [00:58:00] a celebrity photographer, like very artistic guy. So he calls me, says, I took that NAD.
Oh my god, I had to take pictures, and I don’t think I’ve ever been more creative. That shit was crazy, like it’s nuts, and it’s like nasal spray, you know, two pumps up each nostril. But I definitely noticed a difference, in having you know me, having taken every drug known to man, literally, as a bodybuilder. Reese’s Monkey Hormone you know.
Emily: Excuse me, so you’re talking about nasal NAD?
Dr. Goglia: NAD plus, yeah. And what is this NADH? NADH is catch a little part of it. Yeah, NADH is a little part of a niacin. But like all my, it’s funny, my cyclists especially, when I found out about NADH years ago, my cyclists would say to me, Golia, I took that NADH and like, I could hear and feel every bicycle around me.
That was the weirdest shit. Like I knew where everybody was. Even my NBA guys, that aren’t the sharpest tools in the shed, they’re like, I don’t know what happened, but I knew the ball was coming. [00:59:00] And I knew it. I knew where everybody was. I’ve never experienced, like, a game like that, until I tried this stuff.
It was just very, it was very interesting. And he’s like, suntan bottles. Is NADH different than just taking niacin? Well, I think NADH is a little particle that comes from niacin and it doesn’t have the side effects of niacin like the burning of the skin, prickly heat, nothing like that. And it’s really specifically neurologic. Originally it was designed for Alzheimer’s support. It’s kind of mean. Yeah, it’s a hell of a product. So that, these are the scratch labs I talked about, they come in little sachets. We were talking about nutrition, and it has to be sustainable, right? So it has to be easy. It is an absolute pain in the ass to find one fruit and twelve almonds as a snack in the afternoon. No one’s going to do it.
So how do you do it? Here comes a word that everybody will hate. A KIND bar has [01:00:00] 200 calories in it. It’s just sugar and a fat. Something to think about. It’s not perfect, but it’s a sugar and fat. 100 calories of sugar, 100 calories of fat. But it has so much chocolate in it. No, it doesn’t. It has like one eighth of a teaspoon of some slathering of chocolate on it so some civilian person will buy it because it looks like it’s chocolate. It’s a marketing thing.
Dr. Weitz: Let’s get back to that basketball player. Wait, I want to talk about one more thing. Okay. And then there are split packets. Yes? I’ve got a good question. On the NADH, what is the optimal time to take? Fifteen minutes before
Dr. Goglia: a workout. Okay. So instead of like a pre workout shake, or?
Yeah, I’m a big believer in some pre workouts, but specifically designed, like D Rital, so glutamine, citrulline malate Beet extract. We make our little pre training cocktails. All my athletes mix them in like plastic baby sippy cups, like literally seven sippy cups at a time on mark, right? And then they’ll put a little unfiltered apple juice in there or some blackstrap molasses with it, shake it up and slam it.
And in 15 minutes, they’re either training or folding laundry, cleaning, Cleaning our house and [01:01:00] texting people. And this is just another great example of a fruit and 12 almonds. So this is, this is a packet that comes in many different flavors. Peanut butter, though the peanuts have been washed so there’s no mold.
And sugar. So it’s a mashed up fruit, a mashed up nut. 100 calories of fat, 100 calories of sugar. You fold it. tear it like that and eat it, you just have a fruit and 12 almonds, so it’s easy and convenient. No, it’s not a fruit and 12 almonds. No, it doesn’t have all the fiber that a fruit and 12 almonds has, but it’s easy, it’s convenient, it sits in your purse, you can take it on a plane. So again, you’ve got to think about sustainability. No, it’s not going to cause cancer. Yes, it’s in a packet, but it’s not going to cause cancer. But you are breathing the L. A. air. So, careful.
Dr. Weitz: Okay, now we can talk about athletes again,
Dr. Goglia: Sorry…
Dr. Weitz: Yeah. [01:02:00] So, walk us through how you’re working with one of these professional basketball players.
Dr. Goglia: Immediately, I call him a 12 year old international girl. Yes. I fat shame him. Yeah. I don’t know. You know, I’ve been doing this for 40 years. Like, literally, I get phone calls. My business is all referral, like your business, referral based, I’m not on the gram or Tik Tok, I don’t do any of that stuff, I’m too old, 65, I don’t do any of that shit. So, Tommy loses some weight with me, or he doesn’t lose any weight, but he loses pant size, and Pete, his friend says, What the hell did you do? And why are you eating all that food? And Tommy says, I go see Goglia. So they say, well hook me up. So I’ll get a joint text introducing me, and it’s the same way with my pro athletes. Somebody starts playing better, before you know it, I’ve got nine texts on my phone introducing Pete, Tommy, Pauly, you know, whoever to come in the office. And then when I was cycling, racing bicycles, You know, I was [01:03:00] 240 beating people up Pepperdine Hill. And they’re like, what are you doing? And you’re older than me.
Like, how’s that work? Like, what are you taking? So, if you can do it and perform it, then you get that street cred, that respect from athletes. And as a wrestler, as I played rugby for 12 years, as a bodybuilder, as a motorsport guy, I did it. So I’m not an armchair guy. And then working with cancer survivors and folks with disorder and disease, I had it.
I know what it feels like. It sucks. So, I can empathize with that, and I can be sarcastic about it, and get them to think a different way. Like my pro athletes, honestly, quite honestly, their 12 year old anorexic conversation is a big one for them. Like, I was working with Oh, God. New England Patriots. Huge. Whoa, what was his name? Anyways, he’s huge. Here’s the funny story. He had an amazing season. The season was fantastic. And, oh, it’s not Myers Leonard, he’s [01:04:00] basketball. What’s his name? It’ll come to me. And so, he sends me a picture, because everybody has my cell phone. of a huge pizza box from Boston with one slice missing.
I’m like, cool, one slice missing, you’re gonna eat the whole thing? Like, what are you gonna do? He texts me back, question mark, question mark. Like, should I? I text him back, you had a hell of a season. You’re in base season now, you’re lifting. Is that something you really want to do? But I guess if you really want to eat the pizza, knock yourself out.
But it’s not salmon. Nothing happened. Five minutes later, I get a picture back of an empty pizza box. I go, question mark, question mark. He says, question mark, question mark, back to me, guys. It’s funny. So I said, well, he takes me back. You’re an asshole. I threw it away. I’m grilling salmon.
I think the pro athletes, they love, there’s so many people around. Tell us one of these professional basketball players. What are you going to have them eat? What’s a typical day? Yeah, what’s Simvastatin? If they’re training early morning, 90 minutes [01:05:00] or less, it’s a split back and it’s some sugar fat. So when you say training, what do you mean?
Well, maybe they’re knocking out 90 minutes of cardio or, you know, some Some trading session on the court, but 90 minutes or less. Okay. It’s early. It’s 6. Okay. So they’re going to get up and you’re just going to You’re going to get a split pack of sugar fat, 200 calories of sugar fat will stimulate a higher caloric burn, they’ll utilize more fat as energy, they’ll trade more intensely.
Rather than being fasted at the fasted mark at about 25 minutes or so, your body literally says, Okay. Are you still going to train? Oh, are you going to eat? So you’re training intensity dips? Yeah, I don’t take anything else. Well, sometimes they want to take the pre training cocktails. Sometimes they want to use the NADH. These things are, like I don’t push vitamins. So you’re talking about a pre workout? Yeah, like a pre workout. Yeah, yeah. Other than a Red Bull.
Dr. Weitz: So something that maybe has what, like some caffeine? Yeah, like Creatine, Caffeine…
Dr. Goglia: Malate, D ribose. You’re a [01:06:00] fan of creatine? Yeah. I found a Kre-alkaline, not creatine. The buffered version of creatine. Okay. Jeff Galini’s product, by the way. Oh, okay. Always buffered over. It’s called Kre-alkaline. It’s the buffered version of creatine. So it’s not as water retentive. It’s not as tough on your kidneys. The buffered version is much better, and better utilization, I think, overall absorption. So, early morning training, you have to jam it on the bucket. Okay. Now they’re done training. And Myers is going to slam eight eggs, a cup and a half of oatmeal, and a fruit. And leave a little avocado with his eggs. Mid morning snack, he’s going to have a fruit as a little sugar bridge to get him to lunch.
He’s going to have two lunches. So he has eight ounces of flesh. Everybody says, well, what’s eight ounces? Stick it in your hand. Like your hand is a chicken breast. Call it four ounces. This guy’s four ounces. So two hands, eight ounces. Four hands, 16 ounces. So Mars will have two lunches. Eight ounces of flesh and the veggie and the starch.
Take a whole potato, a whole cup of rice, a whole yam. Then he’ll [01:07:00] rinse, sweep, peat. Lunch A, lunch B. then I’ll have two afternoon snacks. Wait, wait, wait. So he eats a second meal right at the same time? No, no, no, no. An hour and a half later, two hours later, he does another lunch. Okay. Lunch, lunch. And then snack, snack.
So sugar fat, sugar fat in the afternoon for energy. So sugar fat, sugar fat, stabilizing his glucose, right? He’s got plenty of energy because he’s trained a second time or a third time. And then dinner is protein heaven. Pound of flesh, a bunch of veggies, and then a fruit snack before bed. Cool. There’s the meal. Anybody want one? So that’s, that’s pro athlete. But in the civilian world, it’s not so different. Like, try to use a score on a 100 to 0 chart for biological use. Like, 100’s an egg. It’s like a perfect protein. So, maybe in the morning. You’re a female, you got a couple eggs, a one ingredient starch like some oatmeal, and half a cup of fruit.
A bridge snack, maybe it’s a fruit snack [01:08:00] as a bridge, 100 calories of sugar is a bridge to get you to lunch. Lunch, four ounces of protein, half a chicken breast, some veggies for digestion, and a splash of starch. Half a cup of rice, half a big potato, half a yam. Now it’s the afternoon, a fruit and nut snack, like a fruit and 12 almonds, a split packet, a kind bar, again, as a sugar and fat bridge, so that you don’t crave carbs when you get to dinner, dinner’s protein and veggies, and then a fruit snack after dinner and go to bed.
And that’s more of a dual metabolism type thing, let’s say you have a carbohydrate sensitivity, so lunch isn’t 4 ounces, it’s 6 ounces of veggies, no starch at lunch. Afternoon snack, the first one might be a fruit and nut, second one might be a veggie and half an avocado, or. or a hard boiled egg. Dinner is still dinner, protein and veggies only. And all proteins are not created equally. So, athletically speaking, athletes will consume poultry at lunch. Fatty fish or lean red meat at dinner because they do things to you while you sleep. Fatty fish and those omegas, they reduce inflammation, they help growth, hormone release, they promote deep REM sleep.[01:09:00] The lean red meats, higher in iron, so it shuttles oxygen to your red cells while you sleep at night, helps to elevate hematocrit. Fatty fish, lean red meat. You always hear red meat gives you cancer. But if you go lean red meat, fillet, flank, or hanger, it’s not a fatty ass tomahawk or a bone in ribeye. So, fillet, flank, hanger, fatty fish, salmon, sea bass, black cod, Arctic char. Oh my god, I’m afraid of mercury levels. I carry meats at the office because I’m, I assume all meat companies lie. So, we have fillet mignon at the office, pre cut, comes in fresh four times a week. We have Salmon, Artesian raised Scottish Salmon. Artesian raised Scottish Salmon is literally, practically organic salmon.
Dr. Weitz: But Scottish Salmon is really farmed.
Dr. Goglia: Yeah, it’s farmed. But it’s farmed from a sustainable environment. I mean, they get massages. They got hand fed food. They got cable TV. They watch, they binge watch Tolstoy. I mean, it’s crazy, these fish. It’s nuts. And then, they’re sleeping, and someone comes and kills them. [01:10:00] Mafia never tells you they’re coming. Uh, we, I use Rocker Brothers Meats, Rocker Brothers Farms. And they supply me with the meats at the office. We use it really as a convenience for our clients because they’re pre cut. Like, like a filet mignon. It’s a 10 ounce slab of filet, it’ll cook down to 8 ounces. So two slabs is a pound. It’s just easy to count. Salmon the same way, 10 slabs of salmon, it cooks down to 8, 2 slabs of salmon, you got 16 ounces. Females, 8 ounces. Easy to count. So, I’m a big believer in most meat companies lie. So, I have stuff brought in. It’s easy, convenient, and I cut it for free. It’s good.
Emily: Yes? Um, I’ve heard for women, like, we should have some protein in the morning, like before working out.
Dr. Goglia: Well, no, let’s think about before working out. You would have protein before working out because they’re fatty. Which is an energy source.
Emily: Well what about like, either, I know it’s not a complete question, but like collagen [01:11:00] powder or what do you think about the perfect aminos?
Dr. Goglia: I love collagen. Collagen’s great. You can put it in your coffee or have a little bit, but before a workout, you’re looking for something that supports energy. Protein is for tissue repair. It’s not for a tissue.
Emily: Okay. Do you agree with like the .7 to 1 gram per pound?
Dr. Goglia: It varies based, yes, So, we eye range from 7 to 1. 3, all the way up to 1. 7 for muscle tissue. Certain folks.
Emily: Yeah. I just find when I’ve done the calculation, getting that much protein, even at the 0.7, I feel like I, it’s just like,
Dr. Goglia: it’s overwhelming. Women especially are so overwhelmed with, yeah. The taste of protein and the texture of it, or the,
Emily: it’s like a fatigue.
Dr. Goglia: Yeah, it’s fatigue. So how do you, how can we mitigate that? Yeah. Eggs are perfect. Protein scramble. Some eggs, post eggs go down Easy. [01:12:00] Use a pharmaceutical grade whey, add some collagen to a protein. So if your dinner meal is supposed to be eight ounces post cooking at night, maybe go six, but have a shake on the side.
Dr. Weitz: You know, use HRV or other agents to find out if the athlete’s recovering. Recovering,
Dr. Goglia: exactly. And you find, you find that number. Yeah, HRV is great for sleep and recovery. So maybe tell us for a minute about HRV. Again, you know, it’s, I just look at the numbers on folks Oura rings and stuff like that, you know. When an Oura ring came out, they sent me one and it was so much information I couldn’t sleep. I can’t look at it. I’m too obsessed about it. But we review it and look at the numbers, you know. But mostly that sleep comes from periodizing your training as well. You know, especially like with endurance sport, they’ll train, they’ll train, they’ll train, they’ll train, and they’ll start to dig a hole and they can’t recover no matter what they eat.
So you really have to look at your training across a month, [01:13:00] three months, six months, a year, and periodonts know when it is efficient to take a week off, especially in endurance sport. When you start digging a hole in endurance sport, you got to take a week off just to recover. You just can’t turn a pedal.
Have, what do you get out in the morning? So it all depends on the type of ride. So he’s riding 90 minutes or less early morning. He’ll still go out on a sugar fat split packet or a fruit and dwell almonds or a tablespoon of jam swim, long butter. It’ll still go on that if you’re riding big. We’ve decided this thing that, that the athletes use.
They decided to call it mash. Mash is a single ingredient starch. Maybe it’s rice, maybe it’s shredded wheat, maybe it’s oatmeal, maybe it’s oat flakes, maybe it’s oat puffs, maybe it’s a yam. But it’s eight ounces of this stuff. With a cup of applesauce dumped on top of it, with a tablespoon of almond butter dumped on top of it, with a tablespoon of jam dumped on top of it.
You crunch it all up, mash it up, mash, and you eat this thing with a couple legs on the side. [01:14:00] You give yourself a good solid hour and a half, two hours to digest it, because God forbid you’re on the bike trying to digest food. If you digest it, you take your pre training cocktail, your NADH, whatever it is you might use, and then you’re on the bike.
That will sustain you for the first 45 minutes or so of training. Now you’re out there for a three, four hour ride. The first ingested is a simple sugar, like a gel or a goo that is not maltose, maltodextrin based, like a, like a honeysuckle. That’ll get you 30 minutes of a bridge for energy. After that, the center parts of your ride, if you’re in this five hour, three hour, four hour ride, is a sugar fat cookie.
Sugar fats are like a Bong Breaker bar, or a Slick Packet, you know, or a Justin’s flavored nut butter packet. Sugar fat gets you 40 minute patterns. When an athlete knows that he’s an hour out from the barn, being home, An hour out, it’s sugar caffeine. That caffeine will stimulate central nervous system, it knocks down your pain, [01:15:00] but it’s only good for 30 minutes.
Then you’re 30 minutes out from the barn, another sugar caffeine hit, like, uh, second stage gel, and then you’re home. Then in hydration, water first, and then you’re always using electrolyte replacement thereafter to manage your sweat rate. Even my NBA guys, like, pre game, we use the mash and the eggs.
Dr. Weitz: And how much, how much water did they have before the game?
Did they, like, drink
Dr. Goglia: electrolytes
Dr. Weitz: before the game, or are we
Dr. Goglia: No, only on the court. Okay. Yeah, I mean, they’re already loaded with electrolyte patterns and a low sweat rate. prior to the game. So they’ve got their mash and their eggs. They digest the food. They might have a split packet before climbing on the court and then they’re on the court.
Dr. Weitz: What would they do at halftime?
Dr. Goglia: Halftime, they usually hit, the ones I work with, will hit half that pre training cocktail. because they use the full pre training cocktail prior to the game. Uh, so they’ll do a half a pre training cocktail in a split packet and they’re [01:16:00] back out on the court. And then third period, like when they’re just about done, again, they, they’re figuring out their time management. They’ll do a sugar caffeine pre training cocktail, D ribose, glutamine. Beet Extract, Citrulline Malate, Molasses, I think that’s it. Oh, and a Lactate Buffer. The product we use is called Sports Lacts. It comes in capsules, but they empty the capsule powder into the cocktail for Lactate Buffering. There is a topical Lactate Buffer called PAMP, which is kind of neat.
It really does work. A lot of my boxers use it. So they’ll apply it topically, and it’s a nuance. It doesn’t completely stop the burning, but it definitely knocks it down. Kinda interesting. Is it it some, something that’s alkaline? Like Yeah, it’s an alkaline, like a, like a baking soda, but a topical, dermatologic, transdermal form. It’s pretty neat. Stuff doesn’t work. Well. Okay. [01:17:00] Any questions? Jesus. It’s probably unlike anything you’ve had here since I last was here 20 years ago. Yes, you in the back with the question.
Dr. Weitz: NADH. Where can I get this NADH? Uh, Amazon. com. I mean, I see a lot of NAD and we have a few back here.
Dr. Goglia: Yeah. I sold them by the way I got. Yeah, it’s still good. The, uh, the NADH is, I use Now, the company Now. Yeah. Yeah. It’s great. Okay. I mean, I really noticed a difference. I don’t think, no, well, this is not any DH is not central nervous system. It’s just neurologic neck up energy. I like that. So try it. And then you can throw in a nuance of a pre training cocktail with your D ribose and L glutamine. So if we use a D ribose and L glutamine because they’re metabolic sugars. What would you recommend to replace caffeine? Taurine. Try Taurine. There are, yeah, but you can make your own. Like, I’m a big believer in making your own. Like, I got my, you know, Mr. Wizard Science Kid all together with my D Ribose, and my, you [01:18:00] know what I mean, and my Taurine, and And so we have a product called, it’s called PreRace, PreRace Powder. And it’s primarily Taurine based. But the name is called PreRace. Amazon. com.
Dr. Weitz: Sorry. Yes. I know we talk a lot about nutrition, but like have a pre-workout. Like a pre-workout. So if we did the Nada HA pre-workout shake, I pre-workout drink. Yeah. And a plunge. And a plunge, yeah. I just plunge. I always do a plunge.
I’ll do a pre-work workout. I run to Florida, get warm, then do a plunge right when I get to the gym and then do a workout. And my workouts are much more intense. Yeah. Um.
Dr. Goglia: It’s too much, too much. I think everybody has their own level of sensitivity. Like me, I can have a triple espresso and go to bed. If I’ll sleep on this stuff, you know, it doesn’t bother me. Some people, I think, I think that’s based on tolerance. Like the cold plunge thing? Yeah. You couldn’t get me near a cold plunge. I know it’s great for you, but as a wrestler, dude, we had to get into those [01:19:00] whirlpools, packed with ice to reduce inflammation and shit that we were breaking and tearing. I had PTSD from cold plunge shit. So, you know. If I get within a hundred yards of a coal plunge, I start breaking out in a sweat. I get shingles. Sorry, too much, too much personal info. I want
Emily: to follow up on the molasses thing. Is that for like serious athletes? Anybody. I don’t have a carb at dinner. I can’t really sleep, but I can skip the carb.
Dr. Goglia: You go with simple sugar. It’ll spike your glucose and drop you, like half a cup of sorbet or a tablespoon of black star molasses.
Emily: Okay, and then do you think where’s my insulin?
Dr. Goglia: No, it’ll spike you and drop. Even, even my diabetics, weirdly enough, will use a splash of sugar to spike and drop before bed.
Emily: That’s 100 calories? Does it matter? That’s
Dr. Goglia: generally the rule, 100 calories. 100 calories of sugar. Like, a fruit is 100 calories. And then a few years back, it was heard that fruit made you fat. [01:20:00] Right, that was a big thing. Oh, don’t eat fruit, man, it makes you fat. So I was thinking one day in my office, what year did fruit make you fat? Was it, I don’t know, 1972? 1998? I don’t know, because fruit’s been around a long time. I know, at what point did fruits start making
Dr. Weitz: people fat? I don’t, I don’t know. Well, I think part of it 10 fruits might make you fat? Part of it comes from the whole concept that the bears eat a bunch of berries, so they can And then they get fat.
produce fat to hibernate for They’re
Dr. Goglia: strong, though. They have low gastric emptying. They store it down there. Yeah. I don’t know. That’s just great. I’m so simple. Go on. Yes.
No. So. Dual? The big guy. So think of markers. So let’s, let’s go back to simple ones. Let’s say I’m diabetic [01:21:00] and I say to you, I want to be that middle guy. I want to eat high carbs, but I have a diabetic marker. My trigs are 385. My HbA1c is 6. Should I really be on a high carbohydrate food plan? Like, this is a bad idea.
Flip it around and say, I’m not eating any more carbs. I need cow and cow only. And some vegetables for digestion. That’s all I need. But my LDLs are 185. And my HDL is 18. Like, I’m not managing fats so well. Just genetically based. Bad idea to eat nothing but cow. So, if you have a marker, it’ll throw you If you don’t have any markers, you And you’re dual.
Balance. He has markers on both sides. It’s called dyslipidemia, right? Marker on the sugar side, marker on the fat side. So he has disproportion in all three areas. Fats, proteins, carbs. He’s dual. So he can be dual for good reasons, he can be dual for, you know, challenge reasons. [01:22:00] But he’s, he’s gotta have balance.
He could never go high carbs. He was shitting insulin in a second. Jeff is dual. Yeah, but his LDL is 122, right? Huh? Oh, yeah, no, no, you’re right. 185. 185 for your treat, right? Was it 185? Yeah. Yeah, fat and protein. Yeah, fat and protein. Yeah, because he doesn’t use sugar as well, with a treat that high.
Emily: His HDL,
Dr. Goglia: well, his HDL is okay, it’s 32. But his LDL is okay. If you said to me, Hey, my HDL is LDL is? I’d tell you a 180. Like, you can’t use a fat to save his isn’t. His is 122. So he’s just between 100 and 130. It’s an under eating marker. He’s trapping fat to protect himself. And then you go, Oh, one more marker. Your HDL is 32. And you’re a dude. So, if you spend more time in a catabolic environment, In an anabolic environment, you’ll suppress [01:23:00] HDL. So what he’s doing is environmental, not genetic. I don’t eat enough and I eat a lot of carbs. And there we go. God, I got two people right tonight. It’s amazing. This never happens.
Emily: Is there a formula you’re using?
Dr. Goglia: Well, you know, you look at the numbers and you use those markers like, like LDL, under 100 is desirable, 100 to 130 environmental, 130 to 160 environmental splashes to an extra moment of death, like hypercholesterolemia, over 160, alright, we got a problem and a Possible coffin at Costco, like that. Trigs, under 110, like mine sits at 48, but they wouldn’t sit at 48 if I ate the sugar I wanted to, because I am fat and protein deficient. So under 110, 110 to 145, you were eating sugar at the wrong time of day, and you were on the bed on it. 145 to 175, splash of mom and dad, still primarily environmental, maybe a little hyper hypoglycemia, like, like that hangry feeling you get for the little sugar sensitivity. [01:24:00] Over 175, that’s a marker. But you and sugars are not friends.
So we look at that. And then we see those numbers improve, as you get on the right food plan, and we run the blood work, every couple of weeks, every three weeks on clients, we see the numbers line up. Like you might start with a ratio of 4. 5, if you’re eating correctly, your ratio will drop into the low 30s.
I love to look at leptin and insulin, it’s cool, and we’ll, we’ll run full panels if needed. But here’s the thing, I love all that stuff, don’t get me wrong, but I’m like, what’s usable? What will you as the client understand without being so overwhelmed, you go, fuck it, I can’t do this. So how do I wordsmith that for you?
How do I get you to buy in and give me a leap of faith when you don’t know who I am? And you’re a female and I’m some dude that says I’ve been doing it for 40 years. I’m the best in the world. You don’t know me. So how do I engage you and get [01:25:00] you to believe that eating more food is going to promote a healthy lifestyle, a loss of body composition, an increase in strength, and a drop in two dress sizes? How am I going to do that? How am I going to get you to give me a buffet? So I’ve got to keep this thing simple, and I’ve got to make it fun. Yes, what do you want? Can I take that lunch?
Dr. Goglia: Yes, you can. Come on up, we’ll do it while I’m talking. Yes. Secretary Phil, do you have a reach for males? That’s a good question, how did the, yeah, as low as possible, as low as possible. Most folks that I get come into the office, the females honestly, the average female that pops into the office is over 32%. It’s crazy. And the guys that pop into the office? They’re over 28. Like, when I get a guy at 22, I’m like, right on, bro.
Here we go. Let’s go. [01:26:00] I want you, if you’re a civilian dude, I’d love to see you at 12. I’ll take 14. I’d love, I’d love to see you at 12. The older guys, like me, you know, happy if you’re 16. Get to 16, shit, you’re killing it. Anything that’s lower than where you’re at now is a win as long as you can sustain it.
I just go back to sustainability, right? Just like with your training. It’s got to be sustainable. You’ve got to be able to want to do this on a daily basis so that what you’re really creating is a youthful future. But more so, I’m a big believer in understanding the distinction between disorder and disease.
So I see a lot of disorders that come to the office. Like, Elevated Trigs, IA1C. It’s not a disease yet, the guy’s not on meds, but it is certainly a disorder. And if not mitigated with nutrition, let’s call it the best of medicine for the moment, then you’re going to have a disease. And then you’re going to adversely [01:27:00] affect your potential for a great youthful future.
And as you get older and you look at retirement, you’re going to be so happy. So how do you keep this thing super simple? How do you create a visual where people can really see it and see their changes? And how do you talk to the other half of our sex, the females that have been told to be scale obsessed?
How do you get rid of that wound? What do you gotta do? You gotta say to them, when you go to Nordstrom’s, you go buy a dress. Do you buy a dress weight or do you buy a dress size? What do you do? Hey, sir, look at you. So, right, so if your weight stayed the same, and you dropped two sizes, would you be happy?
And then you’d be like, well, yeah, I would be happy, so fine, fuck the scale, the scale’s an asshole. So, you gotta make some, you gotta have some fun with it. And, you gotta know that no one’s gonna do it right, not even the guys that get paid for it. [01:28:00] You’re not supposed to do it right. Because maybe you’ve got two kids, maybe you’ve got an ex husband or an ex wife, maybe you’ve got a business you just started up, maybe you’ve got a boss that’s on your ass.
You’re not going to get it right all the time, but if you can give me 80%, and if you can clearly tell me, after getting coached, what you didn’t do right, I win. Because before you saw me, you couldn’t tell me what you did right, or what you did wrong. You just knew you were doing something that wasn’t making it feel so good, and your pants were tight.
So the more nutritional confidence I can give a client, the more I can wordsmith it, the more valuable I feel. And I live in a real place of imposter syndromes, in a special world of nutrition, because everybody claims to be an expert at it. I guess I claim it. But I want to do it. And I’ve had a history of bad food programming and cancer and all that crap, and an Italian father that’s been waiting for me to get a job for a year. Years. You [01:29:00] do what? I tell people what to eat, Chaz. My father’s name is Chaz. You tell me what to eat. Yeah. So people, you got an office? Yeah, I got an office. So people come to your office, and you tell them what to eat? Yes, I do. Do they pay you? Yeah, he’s from Boston. I’m from Boston.
Dr. Weitz: You know what, the library actually closes at 8, so I pick the close
Dr. Goglia: Oh shit, really? I do. I’ll go real fast. Anyways, yeah, you know, so.
Dr. Weitz: So, thanks everybody.
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 very much appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review. As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health ondition and want to prevent chronic problems and want to promote longevity, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111. And we can set you up for a consultation for functional medicine. And I will talk to everybody next week.
https://drweitz.com/wp-content/uploads/2024/11/rwp-386-website.jpg350785drweitzhttp://www.drweitz.com/wp-content/uploads/2017/06/drweitzdsamplelogo-withtext.pngdrweitz2024-11-13 20:38:192024-11-17 07:14:54Sports Nutrition with Dr. Philip Goglia: Rational Wellness Podcast 386
Dr. Dana Cohen discusses her new book, Fuel Up 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
In this episode of the Rational Wellness Podcast, Dr. Ben Weitz welcomes Dr. Dana Cohen to discuss her new book, ‘Fuel Up: Harness the Power of Your Blender and Cheat Your Way to Good Health.’ Dr. Cohen shares insights on integrative medicine, the inspiration behind her book co-written with Colin Sapphire, and practical tips on improving nutrition, hydration, and overall health through simple dietary changes.
00:00 Introduction to Dr. Dana Cohen and Her Work
01:15 Inspiration Behind ‘Fuel Up’
03:02 Benefits of Blending and Nutrition
13:33 Reducing Ultra Processed Foods
20:43 Hydration Insights
37:00 Conclusion and Book Availability
Dr. Dana Cohen is a practicing integrative medicine for over 25 years. Currently in private practice in Manhattan, she is a nationally renowned internal and integrative medicine specialist whose multidisciplinary approach has helped successfully treat thousands of patients. Her new book, which she wrote with Colin Sapire is Fuel Up: Harness the Power of Your Blender and “Cheat” Your Way to Good Health. Her website is DrDanaCohen.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.
Podcast Transcript
Dr. Weitz: [00:00:00] 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. Today, we’ll be speaking with Dr. Dena Cohen about her new book, Fuel Up, Harness the Power of Your Blender and Cheat Your Way to Good Health, which she wrote with Colin Sapphire. Dr. Dena Cohen has been practicing integrative medicine for over 25 years in Manhattan, New York. She’s a nationally renowned integrative and internal medicine specialist whose multidisciplinary [00:01:00] approaches help successfully treat thousands of patients. So Dana, thank you so much for joining us.
Dr. Cohen: Thank you so much for having me.
Dr. Weitz: So what inspired you to write Duel Up?
Dr. Cohen: Actually Colin, so my co author. Okay. Inspired me. So he is the inventor of the NutriBullet and then sold that company and started a new company called The Beast Blender, which is an incredible, beautiful, personal blender, very powerful becoming like Instagram’s favorite blender. And and he reached out to me from my first book, Quench, about hydration. And so for a long time, we were trying to figure out how can we work together? What can we do? And then, and he is loaded with what I call colonisms. So he has all these little sayings that are, he’s a, he’s an incredible marketer, but he’s he lives the life that he, that he talks about. He invented the blender because he hates eating vegetables, and he’s a marathon runner. So it changed his life. And, you know, [00:02:00] me as an integrative doctor know the benefits of that. And so one day in just our talking, I was like, Colin, why don’t you, would you ever be interested in co authoring a book on this for with me? And and he said, yes. And then it just went from there. And this is, this is our baby. And. I’m so, it’s, I’m very proud of it. I will say right off the bat, Ben, I don’t know, you know, who your audience is, how nuanced they are. The truth is we all need to hear this, right? No matter how great or perfect our diets are, we all need reinforcement and reminding even with hydration. But the, but my dream is to get this in the hands of people who have never picked up a health book before. Right? So. If you have a friend or a family member that you think would benefit from this, like, you know, I know me personally my, my own family, like, you know, I can talk all day long, but it’s really hard for me to give them advice. So these are for the people who just don’t know where to start. You know, this is, start [00:03:00] here, this is a great place to start.
Dr. Weitz: We all know the benefits of vegetables and phytonutrients, and we’ve heard all about it, but you’re right, a percentage of people don’t like eating vegetables, so I guess a smoothie is a way to increase your vegetable intake.
Dr. Cohen: Well, 100%. It’s not just smoothies though. And there’s, you know, there’s science in the book. There’s that, that study that talks about people who eat more than 30 different plants a week have better microbiomes. So wherever we can find the science, we put it in there. It’s not just, we can’t just eat smoothies, right? We have to chew. We have to have community sit down and eat. Um, but you know, We, the other sort of going back to what made me write this book, I think about there is a steak sauce, a very famous steak sauce that I love. And the only reason I love it is because it has horseradish in it. And I any vehicle for horseradish I’m in. And for years I’ve been using the steak sauce because I just, I love, love, love the [00:04:00] taste of it. And one day I looked at the label. I never, I don’t know why I never looked at the label and I was like, I’m gonna look at the label, which I should have never done because now I can’t eat it anymore. You know, four different kinds of sugars in it, a thousand other ingredients high fructose corn syrup. And I was like, you know, I only like this because of the horseradish. I can do better. So, the book also contains other ways of up leveling your nutrition any way you can, sneaking it in by making, you know, condiments, cocktails, mocktails, desserts, you know, surprising ways to use your blender, like pâtés and chicken salad.
And then the other thing we also do in the book, which I love, is we teach people how to roast a chicken, how to grill a steak, how to grill a cauliflower steak, so we’ve lost the art of cooking. You know, so it’s not just a blender book. There’s so much more in there. We even go a little bit into the psychology of how to make some habit changes in your life. We touch upon that and try to meet people where [00:05:00] they are. No judgment and most of all, no judging yourself, no beating yourself up. Just start, take a step, try to get more plants and vegetables in your diet wherever you can. And a great way to do it is with condiments. And a morning smoothie, so there’s a lot in there. And it’s an easy, fun read. The reason I’m being so, you know, I it’s always scary for me to talk to a bit of a health nut kind of thing, like yourself, because I always think like, Oh, I’m going to get the eye rolling, another blender book, that kind of thing, but it’s not, there’s more to it. And once again, we all need to hear it, right. Your audience needs to hear it. So, so there you go. There’s a full chapter on hydration also, going back to my first book, Quench, that you and I talked about a few years ago.
Dr. Weitz: I remember on this vegetable thing, I think it was Datis Kharrazian, I remember at a seminar, he talked about when you’re cutting up vegetables, when you’re making things, the part at the end that you don’t use, put it all in a bag, stick it in the freezer, and then you can add, that’s a great way to get like a variety of all these extra vegetables.
Dr. Cohen: Oh, we totally talk about that too. What vegetables you can use, you know, the tops or even the piths. You know, like so more, more nutrients are in the white of the watermelon than the pink of the watermelon. Right. You know, eat like, I don’t know why we like eat the whole strawberry, throw the whole thing in your mouth, including the greens on top. You don’t taste it. And there’s a ton of nutrients in there. But yeah, and especially throw it in your blender. Cause you
Dr. Weitz: won’t. It’s interesting. I can’t tell you how many vegetables I buy. We’ll buy carrots and take the top and throw it away. And, a lot of vegetables come that way. Beets come that way.
Dr. Cohen: Beet tops are great. Colin actually taught me like, why peel the your ginger? Make sure you wash it really well, but there’s no reason to peel ginger. Throw it in your blender,
Dr. Weitz: everybody always says to wash your fruits and vegetables really [00:07:00] well, but I wonder how many people do. I know I don’t. We go like this under the sink, and the guy washed it.
Dr. Cohen: Yeah, so we do give you in the book, we tell you how to wash your vegetables. It is important. There’s, there’s God, I remember this from medical school. We did this is going to be gross. I’m going to just tell you right now. We did an experiment where we cultured different things, like, you know, including like the bottom of our shoes to some, you know, fruits and stuff and the literal crap that grew. Well, sorry. It’s you know, so yes, we do need to, to wash better, but we also like, you know, we live in a grab and go, how much faster can we do this? So we get great tips on how to wash things in bulk, how to clean up easier. Like that’s also part of the book, just to make your life easier. And once again, I hate to, you know, I don’t want to keep sort of patting myself, but the book’s got it in there. It’s great.
Dr. Weitz: Really good. How do you wash fruits and vegetables? I saw you in your book, you [00:08:00] recommended using baking soda. I have a friend of mine, Suzanne Bennett, she recommends using powdered vitamin C in water. People have recommended using vinegar. There’s scrubbing things. There’s special soap at the store for cleaning fruits and vegetables.
Dr. Cohen: I used to use grapefruit seed extract as to wash vegetables too. I think baking soda is probably the cheapest way to do it, more than powdered vitamin C, although that’s not that expensive, but all of the above are good. You know, I gotta go back. I wrote a blog on this many years ago about do it yourself. Fruit wash or hand wash. You know, I can’t even remember what I had written on it. Do you just maybe remind me of that? I’m going to find that blog. Um, but yeah, it’s, those are all good ways of doing it. I’m sure you Google a recipe. There’s one online on how to do that. But you do have to, you know, you have to, you have to put a little bit of effort into it. Not a lot, but a little bit.
Dr. Weitz: Now, some people advocate juicing rather than smoothies. They say you get more [00:09:00] concentration of nutrients that way.
Dr. Cohen: Maybe you know, I don’t know. I don’t know. I think juicing, there’s a place for juicing but you’re missing out on the fiber, which none of us get enough of, so that is the real difference for me.
Dr. Weitz: And, and with the fiber, you getting a lower glycemic response as well, which is good.
Dr. Cohen: Yes. And also you’re feeding your microbiome that, that resistant fiber that we need, so there’s lots of reasons and honestly, none of us are getting enough fiber. That is, and that’s a real difference in my own way of thinking as a doctor. You know, coming from Dr. Atkins, who I initially worked for 28 years ago and not, there’s not a lot of fiber in the Atkins diet or the keto diet, so that change over the last 10 years of like, we really need to up our fiber and you’re, you know, you’re hearing more and more of it. I think a lot of us. Holistic people are really changing our minds about the fiber story and and really upping that [00:10:00] fiber is, is a big, is, it is a big point in the book that we make. So juicing and not getting the fiber.
Dr. Weitz: Right. How much fiber should people get a day?
Dr. Cohen: Yeah. I don’t know the number. I don’t know the answer to that. I think, I think, I
Dr. Weitz: think I typically hear the 30 to 40 grams a day. Uh, and the average person gets like 10 or 15. Yeah.
Dr. Cohen: Yeah. 30 is the one that is the number that comes to mind, but it might be different. And, and, you know, the part of that story that we need to be a little bit careful about too, is that if you’re not eating that much fiber, And you all of a sudden need all that much fiber, you’re probably going to get sick. You’re going to feel bad. You’re going to feel really moody and, maybe constipated. Do it slowly. If anybody’s going to start.
Dr. Weitz: And of course being an integrative practitioner like yourself and treating a lot of patients with gut problems and conditions like SIBO, there’s times when you have to restrict fiber.
Dr. Cohen: Absolutely. Absolutely. Absolutely. And that’s You know, that, that then becomes more often when you’re [00:11:00] treating somebody with SIBO, the issue then is reintroducing or on such restricted diets to expanding their diets is really important. Hard and difficult. So there’s, it’s, it’s a nuance. I, anybody who’s suffering with SIBO, please see, you know, an integrative or functional doctor. I think it’s I think they do the best with those kinds of things. And, and.
Dr. Weitz: One of the trickier things to do is some patients are happy to expand their diets, but some of the patients. Once they start feeling better, they, I have had a number of patients say, that’s okay. I’ll just stay like this. I don’t want to add anything. I don’t want to go back to feeling bad again, but I always push them as much as I can to expand the diet, to get back to eating fiber because you want that diversity of nutrients. You want to feed the microbiome. We want to rebuild. We don’t want to reduce. have a restricted microbiome, even if they’re SIBO scarred.[00:12:00]
Dr. Cohen: Yeah. Well, and inherently it’s going to, it’s, they’re going to get worse again. Like it’s, you know, and those are, those are even harder to treat than what they had in the first time. I, you know, I want to just, I want to tell you the story of and he allowed me to say this, my husband, who All he knows in this world is the Atkins diet because that’s the thing that made him feel the best.
You know, like he lost the weight, but the truth is the reality is he yo yos his whole life. He goes up and down a lot, 30 pounds, you know, up and down. And, and he thinks that when he goes off the Atkins diet, like food is a bad thing for him. Like, you know, it creates eating disorders in a sense, like you can’t think.
So I’m trying to also. you know, change that way of thinking. There is no diet talk in the book. There is no deprivation. There is nothing off limits because the truth is Ben, and you just, you know, you even just proved my point. We, all of us health practitioners do things that we’re not supposed to sometimes, right?
[00:13:00] You know, we’re not all perfect and we don’t want to be perfect. You can’t be in this world. And especially with diet. I, you know, I used to, Go out to dinner with Dr. Atkins. And I could say this ’cause he’s no longer with us, but he’d be like, and he was pretty famous at the time, and he’d be like, you order the dessert
You know, so like, we all do it and there’s a time and a place. You’re right.
Dr. Weitz: Yeah. I’ve, I’ve, I’ve been to dinner with other famous doctors who tell everybody not to eat certain foods and then, and then they help themselves to bread and things like that.
Dr. Cohen: Right. But if you up level your nutrition wherever and when, and most whenever possible, you’re, you’re, you’re going to be fine. You’re going to live a healthy, longer life. You know, the one thing we didn’t even mention the big thing, which I totally just forgot is, um, ultra processed foods. you know, trying to get rid of ultra processed foods in your diet. Like, you know, it’s about anywhere from 50 to 65 percent of our diets are made from [00:14:00] ultra processed foods, everybody. And so if we can, you know, gradually get that ratio, that number down, we’re going to be doing so much better off.
Dr. Weitz: It’s interesting. For years, the term was junk food or processed food. Somehow it became ultra processed foods.
Dr. Cohen: Well, it’s, it’s good because, you know, I think, um, think about this. I, I do recommend protein powders, right? That’s an ultra, you know, and they’re medical foods.
Dr. Weitz: It’s a processed food.
Dr. Cohen: Right. But that’s a good, healthy, you know, for most people. It’s
Dr. Weitz: processed, but not ultra processed.
Dr. Cohen: Olive oil is processed. You know, it’s, it’s mushed down. It’s processed. Yeah. So there is, there is a, um, category system, the Nova system. It’s not perfect. It’s okay. It’s good. It’s good enough on, on what that means of what’s ultra processed. So, you know, and we give, we give a good description and in layman’s terms, what to think about when you’re doing ultra [00:15:00] processed foods, like cereals. Breads, anything with ingredients that have a huge list of ingredients that you don’t understand. Those are all processed stuff.
Dr. Weitz: In, in your book, you make it, you make a distinction between additive and restrictive diets. And that goes along with kind of what you’re saying, which is, you don’t want people to have this eating disorder behavior.
Dr. Cohen: Yes, yeah, yeah, exactly. Like my husband, you know, he still thinks that if he eats a Mediterranean diet, because he’s having maybe too much, even, you know, rice or grains, you know, that it’s that he’s cheating, But the truth is he’s so craving some of those things.
And maybe if he did that, he wouldn’t be eating all the junk food because he’s not on the Atkins diet anymore. You know, like, cause I said, he yo yos and he has a sweet tooth more than anybody I, I, I know. So I, maybe if he did eat more, you know, carbs, more well [00:16:00] rounded diet, he maybe wouldn’t go to so many sweets.
And then when he goes off and, you know, so there is. It’s, it’s absolute. And this is, if this is the one thing I’ve learned in my 28 years of doing this type of medicine, um, I know that diets don’t work. They work for very, very, very few people. Um, and those people for the most part, aren’t that happy with their diets.
Dr. Weitz: You know, our metabolic systems are very complex. There’s feedback loops and, you know, you decrease one thing and then the body upregulates that. Production in the body. I was listening to, uh, Joel Kahn on his podcast was talking about some guy who’s eating, um, like 75 eggs a week and found out that his cholesterol went down because there’s an enzyme that when you consume a huge amount of cholesterol, the body says stop making cholesterol.
Dr. Cohen: So interesting. However, I can, I would be very curious. Um, I am [00:17:00] seeing more and more egg sensitivities in people because they’re eating, all they’re eating is eggs every single day. So yes, the cholesterol is one part of the story, but the other part of the story is, um, um, you know, diversity in your diet. Right. You know, I think that that really is a thing, and we need to cycle our foods. You can’t be eating the same thing day in and day out. Mix it up a little bit.
Dr. Weitz: Now, are you seeing this based on food sensitivity testing?
Dr. Cohen: Both. Both. You know, so, food sensitivity testing is a tool. It’s not perfect, but an elimination, uh, trial of an elimination diet is, there’s no better test. Right, so you eliminate a certain food for a period of time, reintroduce it, and your body will tell you whether or not it likes it.
Dr. Weitz: How long do you typically eliminate it for?
Dr. Cohen: I think a minimum of three weeks. That’s, that’s typically what I go for.
Dr. Weitz: Right. Okay. That’s pretty doable.
Dr. Cohen: Yeah. And I, I, [00:18:00] I’ll, you know, just to give some people, I’ll typically start with like the five most common things that I think, and I see up. So it’s eggs, dairy, all day, you know, uh, dairy, Um, Gluten, Corn, and Soy. Those five things are, are a great way to start with the, eliminating those five things for a matter of, and I, and I’m making this number up, but I would say probably more than 90 percent of food sensitivities lie in those five things.
So, eliminate those five things for three weeks, Reintroduce them methodically, one at a time and and do it for three days, right? So, if you’re dying for your eggs, reintroduce eggs, eat, eat your eggs once or twice a day for three days, and if nothing happens, Fabulous. Go on to the next one. And the other part of that is I often separate out dairy.
I’ll separate out cow’s dairy, sheep dairy, and goat’s dairy when you’re reintroducing, because I find that people, some people can reintroduce, sheep, And goat dairy, but still can’t [00:19:00] tolerate cow’s dairy. So like feta cheese is, you know, or goat yogurt or goat cheese. So, um, that’s a real simple down and dirty, not only will it, you know, 90, 90 percent of food sensitivities, my number, not scientifically formulated. But, um, I think a huge amount of gut, you know, gut issues could be, um, super helped by just that alone.
Dr. Weitz: Yeah, I, uh, I got real gung ho on the food sensitivity testing for a while and felt like I just needed to do certain, um, higher quality food sensitivity testing. And then I kind of got soured on it. Um, I, I definitely noticed that there were percentage of patients, just basically whatever foods you’re eating, those were the ones that were coming up positive. And sometimes they were like the healthiest foods. Like you shouldn’t eat olive oil and avocado and eggs and chicken. And, and, you know,
Dr. Cohen: it’s a, it’s a [00:20:00] tool. Um, sometimes I use it for ammunition. with a patient, you know, like here, look, um, but, uh, I often find that if somebody, and I’ll tell them this before they even do the test, if you’re sensitive to a ton of things, nobody is sensitive to that many things.
Dr. Weitz: That means you have a leaky gut, right? Your gut
Dr. Cohen: is messed up, you know, so if one thing comes up though, it’s screaming at us, that’s a really good test. That tells me that you’re going to eliminate that food and you’re going to feel better.
Dr. Weitz: So what’s your current favorite, uh, testing company for food sensitivities?
Dr. Cohen: Um, I use Vibrant Labs. Okay,
Dr. Weitz: yeah, yeah, we use Vibrant America as well.
Dr. Cohen: Yeah, it’s, it’s fine, it’s not perfect. I like it because it also does some of, you know, your, um, your leaky gut, what’s the test I’m thinking about? Zoomer. No, but your, your, your Oh, the
Dr. Weitz: zonulin.
Dr. Cohen: Yeah, it measures zonulin and a couple other markers that then give you a little clue as to some further things that you could or should do.[00:21:00]
Right. Yeah. It’s a good test. It’s not great. No, no, no food sensitivity test is great.
Dr. Weitz: Right. Um, what, what are, um, Talk about how, how making smoothies helps us macro, maximize our micronutrients and phytonutrients.
Dr. Cohen: Yeah. So, um, first of all, um, it’s almost impossible to put ultra processed foods in your blender, right?
Nobody puts cake in their blender. Nobody puts. So you’re only, you’re only putting real food in your blender, right? You’re putting fruits and vegetables and seeds and, you know, so it’s, it’s that in and of itself is worth everything, right? Um, and, and we just are not getting enough vegetables. So you can, You can put, um, spices and herbs in there, you know, so that it makes it really simple to get that 30 different plants in a week, number one.[00:22:00]
And, you know, I don’t know about you, but it’s rare that I have vegetables for breakfast, right? So whenever I make a smoothie, no matter what it is, even a dessert smoothie, I’ll throw some greens in there just to get those extra greens, you know, um, and, you know, plants are amazing. We have not even begun to to really understand or know the healing benefits of plants.
There is such wisdom, true wisdom in them from a health standpoint that we have no idea. You know, we as the medical community really have no idea. So, I mean, it just makes sense. You’re getting concentrated. greens in a, in a, in a blender, you’re putting things in there that you maybe wouldn’t eat for breakfast. So it’s just a simple cheat, you know,
Dr. Weitz: I get it. I’m an exception. No, I think I had five, six vegetables with my breakfast and I made up a big thing of egg white omelet with, uh, I had kale and two different kinds of mushrooms and I had onions and [00:23:00] I had avocado.
Dr. Cohen: So, so, so yeah, you don’t, you don’t necessarily need a greens. And that might not be you. You’re the person. However, the condiments and the up leveling wherever you can in your blender, the desserts. One of my favorite things in the book, we have a section called salad shooters. Um, so I don’t know, you know, when you have leftover salad, you put it in the fridge, hopefully you’ll eat, you know, saying I’ll eat this tomorrow. You never eat it.
Dr. Weitz: You throw it out. Yes.
Dr. Cohen: Try throwing it in your blender and drinking, you know, drinking it as a snack the next day. Sure. It’s a, it’s a hit and it tastes really good. Sometimes it’s not, you know, throw it away anyway, but what a great way to get a little extra and not waste food. So like, that was,
Dr. Weitz: I can’t tell you how many vegetables we throw away because we load up the fridge and
Dr. Cohen: I know, I know.
Dr. Weitz: Stuff always gets pushed in the back that you forget about.
Dr. Cohen: That’s the other thing, like the blender, you know, to, to lessen food waste. So, um, it doesn’t have [00:24:00] to be, it’s necessarily a meal. It could be a little afternoon pick me up or snack, a way to, you know, get those used. How many times do you put a cut pepper in the fridge in a baggie and don’t use it? You know, or your, your, you know, stuff that you don’t use in your salad.
Dr. Weitz: A million times.
Dr. Cohen: Throw it in. Yeah. Yeah, make a little blend. Sometimes it’s great. And if not, you wasted five minutes, three minutes of your time.
Dr. Weitz: Right. You talk about adding certain gut helpers to your smoothies. Can you talk about that?
Dr. Cohen: Um, yeah. So fiber is definitely one of them. Um, I’m trying to think what the section was. So
Dr. Weitz: I think you said fermented foods, resistant starch.
Dr. Cohen: Yeah, fermented foods is a big one. We have a whole nice section on fermented foods, um, which going back to what you said earlier, could be a little difficult for some people who, especially if they have SIBO or something like that, right, fermented food, but we really discussed a whole lot about fermented foods and how in other [00:25:00] cultures there, there are so much more widely used than they are here.
in the U. S., but what a great way to get, uh, good beneficial bacteria in your, in your body. Um, and, and that’s, that is a method of processing that’s good, you know, for example, you know, and it’s, it’s the original way of how they, um, Uh, what’s the word I’m looking for? How they kept food, um, stable and, and extended their shelf life.
What’s the word? Expired. You know, it doesn’t, I’m blanking on the word. Um, simple word. Uh, so fermenting was a way of how they kept foods stable and fresh for longer. Um, and for centuries it’s been, it’s been done. Um, and so, uh, really nice way of, of, um, Keeping foods longer. Um, but I wanted just a little, you know, pickles in the gross, in the food store have no, uh, they don’t add bugs to there. It’s just vinegar, right? So [00:26:00] most pickles are not a fermented food.
Dr. Weitz: Right. Even though they are. Yeah.
Dr. Cohen: Right. It sounds like it was
Dr. Weitz: probably the same with a lot of yogurts that claim that they have all this probiotics when, you know, the way they’re made commercially, they probably don’t have very much, or they may have strains that are not particularly beneficial.
Dr. Cohen: Yeah, exactly. Exactly. So, um, there’s a great cookbook. Donna Gates wrote the cookbook on fermenting foods. Okay. Fabulous, fabulous book on how to learn to ferment yourself. Um, if anybody is, is interested in that, but I do think that there’s some real good. Yeah. Benefits for fermentation, but also be careful if you’re not used to, to doing it.
Dr. Weitz: Yeah.
Dr. Cohen: Yeah. Yeah. I
Dr. Weitz: had some, uh, beet kimchi on the side with my eggs this morning and
Dr. Cohen: Oh, what a fabulous breakfast. I think you should wait. Tell, tell me your breakfast again, because I think this is a total learning point for everybody.
Dr. Weitz: I, I cut up two different kinds of [00:27:00] mushrooms. I had reishi and I had, um, I, I, I had, um, uh, what did I have? This morning I had oyster mushrooms, and then I cut up onions, and I cut up kale, and I put it in a pan with olive oil, and then poured it in a container of egg whites, and then added some avocado on the side, and also put a side of kimchi, and put a little hot sauce on top, a little jalapeno sauce.
Dr. Cohen: Gorgeous. Wow. What a meal. I bet if we counted the vegetables in that it’s, it’s like over 10 in our 30 a week that we’re supposed to be getting. 30 different ones a week. That’s incredible. Gorgeous.
Dr. Weitz: Yeah. Always try to do that. Maximize the phytonutrients and diverse. Why do you
Dr. Cohen: use egg whites? I’m curious.
Dr. Weitz: Uh, cause I’m stupid. I’m old school bodybuilder from, you know, the [00:28:00] eating cholesterol is bad. But, uh,
Dr. Cohen: it
Dr. Weitz: makes it easy for me. I, you know, I can just pour it in and I don’t have to take the eggs and chop, you know. Mix them all up. It’s, it’s ready. It’s there.
Dr. Cohen: I love that. That’s a cheat right there. I’m
Dr. Weitz: basically using the eggs to get the protein. Love it. You know, sometimes when I, I take some time and put some, uh, you know, blend up some regular eggs and pour them in, but.
Dr. Cohen: Yeah. I’m just curious what the thoughts are. Yeah, because I just to just to be clear that I think all, you know, eating eggs with egg yolks doesn’t raise your cholesterol, you know, it’s, it’s all the other things and in a rounded diet that counts,
Dr. Weitz: right?
No, I know. And I, I, we, we actually, I mentioned that study where this guy’s eating some extraordinary number of eggs a week, like I think it was like 72 eggs a week and found his cholesterol actually [00:29:00] went down because of some enzyme that down regulates, uh, cholesterol production, but, you know, still trying, everybody’s trying to maximize their cardiometabolic health.
Dr. Cohen: Yeah, yeah, no, it’s, and there’s nothing wrong with eating egg whites at all. I just was curious on people’s, you know, yeah, yeah. I will say though, you know, there is also some, um, research that, um, you, you could be deficient in biotin if you’re eating too many of the egg, egg whites.
Dr. Weitz: Yeah, I understand, but, and then there’s also the issue of choline, you know, the cholines in the egg yolks, and you got Stanley Hazen saying that choline’s going to increase your TMAO, and that’s going to increase your cardiovascular risk through another mechanism, but, you know, I think Once in a while None of Given the amount of supplements I take, which is about at least 30 twice a day, um, I’m sure I’m not [00:30:00] biotin deficient.
Dr. Cohen: I don’t even do that either. Um, but yeah, so the, I, I think, uh, yeah, you’re, you’re, you’re good. I just, you know, for, for people listening, just.
Dr. Weitz: Yeah, I’m constantly doing large arrays of, uh, blood testing and trying to maximize everything and getting everything to the optimal range and get my omega 3 level to 12 and get my, you know, everything. Yeah. Just playing that game.
Dr. Cohen: Yeah. I just came back from a conference, as you know, we talked about earlier, and Mark Hyman spoke at the end and he talked about his function health. program, which, um, you know, I think
Dr. Weitz: the design to undermine integrative physicians by having patients treat themselves, but okay. Uh, it’s so interesting.
Dr. Cohen: The person who spoke up in the audience was one of his doctors at the Cleveland health clinic for integrative medicine. So, however, however, Um, I do think that there’s something about putting the, you know, for the [00:31:00] people who can’t get to these practitioners.
Dr. Weitz: Sure.
Dr. Cohen: There’s something, you know, about being able to do these blood tests for yourself and having that information.
Dr. Weitz: Sure. It’s just you and I both know how complicated it is to interpret these and look at the whole milieu and look at the history and look at everything else.
Dr. Cohen: Yes. Yeah, I think, I think there’s a place for it. Um, and like you said, like you’re doing your own blood testing. Like, you know, how nice is that, that you have that luxury of being able to do that?
Dr. Weitz: A lot of people don’t. Right. But you know, because of all this consumer testing, I can’t, I don’t know about you, but I get. So many inquiries, emails and stuff from patients. This one level is a little low, this level is a little high. What does that mean? Oh my God! You know, am I gonna die because my, um, you know, monocytes is one tenth of a fraction below where it’s supposed to be, you know.
Dr. Cohen: Well, that’s why I think there’s always
Dr. Weitz: a place
Dr. Cohen: for us.
Dr. Weitz: Personalized
Dr. Cohen: medicine is still super [00:32:00] important. Um, and you know, if, uh, but I, I do, I still think that it’s, it’s, there’s goodness in being able to take charge of your own health, doing so.
Dr. Weitz: Absolutely. It’s important that people get access. Not everybody can afford to see a functional medicine doctor. I get it.
Dr. Cohen: Exactly. But I’m right there with you, by the way, because that was my question in the audience. I was like, I’m listening to him and I’m thinking. You know, this is the person who was the president of the Institute for Functional Medicine, trains doctors, you know.
Dr. Weitz: And it is to some extent undermining a little bit.
Dr. Cohen: I think so too.
Dr. Weitz: And by the way, I think Mark Hyman is great. And I’m happy that he’s going to get a big payday out of this whole thing. And I think he deserves it.
Dr. Cohen: Yeah, no, he’s put himself out there. He
Dr. Weitz: really,
Dr. Cohen: you know, yes.
Dr. Weitz: Yeah, I think he’s great. I appreciate everything he’s done for our profession, for me. And you know, I see where he goes to Congress and argues for Functional Medicine. [00:33:00]
Dr. Cohen: It’s the most important stuff. You want to talk about ultra processed foods and changing the system. He was right there at the forefront.
Dr. Weitz: There’s no better representative for our profession. I appreciate Mark Hyman. Yes. And I think his books are great, too.
Dr. Cohen: Exactly. Exactly. Um, but we’re, we’re still on the same, same wavelength as that. Yes. I love it. I love it.
Dr. Weitz: Okay. What else? What else? Anything else that we haven’t talked about? I’m sure you have some other things.
Dr. Cohen: Um, I, you know, there’s a whole chapter on hydration, which was my, which is my, you know, my, my whole thing, uh, about learning how to hydrate.
Dr. Weitz: Mention again, the title of your first book on hydration.
Dr. Cohen: It’s called Quench, um, coauthored with Gina Brea, um, written five years ago, still continues to sell, bestseller, done, has done really well. And I still get letters from that, how that [00:34:00] book changed their lives. Um, and it’s also. a very simple message, easily practical, easily implemented and very practical. Um, and, uh, learning how to hydrate is, is always the first step before you go on any, uh, diet or nutrition or even supplementation, you have to start with learning how to hydrate first. Um, and the good news is that can be done in one day, you know, but you have, it’s the one thing that I am a stickler on. Like you have to stay on top of your hydration. every single day, you know, that 80, 20.
Dr. Weitz: That means not just drinking water, but eating these water rich fruits and vegetables. So you get water in this other form that’s particularly beneficial, right?
Dr. Cohen: Exactly. Exactly. So, you know, the truth is both books are very similar in the message. One is, is. is just more in the blender kind of thing. The other one is, is hydration. But if you put them together, it’s the same, it’s the same [00:35:00] information, right? You’re, you, the, the bottom line, get more fruits and vegetables and plants into your diet. Um, and that doesn’t mean you know, being a vegan or vegetarian at all.
Um, it just means eating more, more additive, eating more plants and vegetables. And then the, the quench book does go into, um, different phases of water. It goes into more on movement. Um, fascia is a hydrating act. Um, you know, that there, there’s a lot more in that book that’s really focused on hydration and, and yes, drinking eight glasses of water a day is not necessarily the answer for most people.
Um, some people can do one glass of water if they were eating a super hydrating diet and some people need eight glasses, but it just depends. Everybody’s different. Um, I will say one thing about that, which I think we talk about in this book, I can’t remember now. The best thing you can do to know if you are optimally hydrated is to look at your urine output. Um, so we are meant [00:36:00] to pee every two or three hours while we’re awake. And if you’re not doing that, you’re not hydrated. And that’s, that is like that one message is really important. So anybody listening, make sure you’re doing that.
Dr. Weitz: And you should be having a good poo every day, potentially two or three times a day. That’s another key to hydration as well.
Dr. Cohen: Yes. Yeah.
Dr. Weitz: Yeah. Great. Great. So, um, your book is going to be out, um, probably by the time this podcast is posted, your book will be out and you’ll be able to get it wherever books are sold, I’m assuming?
Dr. Cohen: Yes. Everywhere books are sold.
Dr. Weitz: And I recommend going to a real bookstore if you can, like Barnes Noble, because we’d like to keep a few of the remaining bookstores still in existence.
Dr. Cohen: Yes. Please visit your local bookstore, ask them to carry the book. I would be forever grateful, um, because yeah, we need, we need those stores staying open. [00:37:00]
Dr. Weitz: And listeners can also get more information from your website.
Dr. Cohen: Yes. Which is great. DrDanaCohen. com.
Dr. Weitz: Great. Thank you so much, Dana.
Dr. Cohen: Thank you, Ben. Be well.
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 very much appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review. Thank you. As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health condition and want to prevent chronic problems, and want to promote longevity, Please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111 and we can set you up for a consultation for functional medicine. And I will talk to everybody next week.
https://drweitz.com/wp-content/uploads/2024/11/rwp-385-website.jpg350785drweitzhttp://www.drweitz.com/wp-content/uploads/2017/06/drweitzdsamplelogo-withtext.pngdrweitz2024-11-09 16:36:062024-11-11 20:20:28Fuel Up with Dr. Dana Cohen: Rational Wellness Podcast 385
Dahlia Attia-King discusses Whole Exome Sequencing 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
Join Dr. Ben Weitz in this episode of the Rational Wellness Podcast as he dives into the world of whole exome sequencing with Dahlia Atiyah King, founder and CEO of Panacea. Discover the latest advancements in DNA testing technology and how it can be a game-changer in the prevention of chronic diseases like cancer, heart disease, and neurodegenerative disorders. Learn about the differences between next-generation sequencing and commercial genetic tests like 23andMe, and how whole exome sequencing provides a more comprehensive analysis of your genetic makeup. Dahlia also shares her personal story of genetic testing and highlights the importance of accessibility and affordability in preventative health care. Tune in to gain valuable insights and explore how this cutting-edge genetic test can empower you to take control of your health future.
00:00 Introduction to Rational Wellness Podcast
00:30 Understanding Whole Exome Sequencing
01:26 Guest Introduction: Dahlia Atiyah King
02:44 Whole Exome Sequencing vs. Other Genetic Tests
08:10 Importance of Laboratory Standards
12:50 Personal Experience with Genetic Testing
24:17 Functional Medicine and Genetic Testing
27:44 Future of Genetic Testing
37:08 Addressing Patient Concerns and Final Thoughts
39:01 Conclusion and Special Offer
Dahlia Attia-King is the Founder and CEO of Panacea and she has a BS in Biology and Chemistry from the University of Miami. Panacea was founded with a mission to reduce barriers to access for clinical genetic testing so that people can get in control of their health and prevent disease. Panacea now offers residents of almost every state the ability to receive at-home clinical genetic testing called Whole Exome Sequencing and expert medical guidance in just a few clicks, empowering people to potentially save their own lives. The website is SeekPanacea.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.
Podcast Transcript
Dr. Weitz: [00:00:00] 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. Today we’ll be discussing something we’re probably not that familiar with, which is whole exome sequencing, which is a type of DNA testing. And this is another entry into the preventative field of trying to screen for chronic diseases like cancer and heart disease. We currently have a number of tests on the market for that. We have a full body MRI. We have a blood test for [00:01:00] circulating tumor cells known as the Galleri Early Cancer Detection Test. And, of course, we have all our biomarkers that we run as part of our normal functional medicine screens. But this new genetic test is another way to screen for possible cancer risk, given that up to 25 percent of cancers may have a genetic origin.
Today we’ll be speaking with Dahlia Attia King, who’s the founder and CEO of Panacea. She has a BS in biology and chemistry from the University of Miami. And her experience working for genetic labs exposed her to the reality that few patients were able to access Valuable Preventative Genetic Testing. She learned quickly that the lack of insurance coverage for genetic testing led to physician hesitancy to order testing. And these barriers [00:02:00] led her to develop her own company that could offer genetic testing at a more reasonable price that patients could order directly. So, her company, Panacea, offers whole exome sequencing, along with expert medical guidance. And this is another way to help us find out about risk for various chronic diseases, especially diseases like cancer, heart disease, and neurodegenerative diseases. So Dahlia, thank you for joining us.
Dahlia Attia-King: Thank you. Thank you for having me. It’s a pleasure to be here.
Dr. Weitz: So what is whole exome sequencing and why is it better than say 23andMe or Ancestry?
Dahlia Attia-King: Sure. So, before I get into the specific details about whole exome sequencing, let’s take just a step back and kind of understand the differences in general, among genetic testing. So that of course, you as providers can kind of know what you’re getting into when you’re talking about genetic testing. So there’s two major things that you have to consider when you’re sort of assessing a genetic test. Number one is what technology is being utilized in order to review the individual’s genes. And number two, What laboratories, what are the quality of the laboratories that are actually utilizing this technology and essentially delivering these results to you?
So when we talk about whole exome sequencing versus the type of genetic testing that we might get from 23andMe or Ancestry. We’re really talking about the comprehensiveness of the genetic review. And that is typically allowed by different [00:04:00] technologies. The technology that’s utilized by companies, by these commercial direct to consumer companies, is something called microarray. And what microarray tech does, it’s a very simple analogy, is a search and find mechanism, right? And if we’re writing a digital document, and we’re looking for specific words, word, maybe a word that we misspelled we would activate the search and find function and the document will automatically highlight where the misspelled word is, right? It’s kind of comparable to what microarray does. Microarray doesn’t actually read your gene. It doesn’t review your gene. It looks for a very specific variation in the gene. And if you don’t have that variation, then you kind of turn up. negative for that particular for that particular variation. The problem with that is you don’t always know. What you’re looking for, right, as the provider. Patients could [00:05:00] have all kinds of variations that are not very obvious, and if you don’t know what to look for, then you’re probably missing a ton of information. So microarray is really only useful when you’re very specifically looking for something.
Dr. Weitz: So in other words, what you’re saying is, my understanding, 23andMe picks out a set number of genetic SNPs that they’re looking for. Right. You know, maybe it’s 50, and that’s just what they’re looking for.
Dahlia Attia-King: Exactly. Exactly. I don’t know the number, so I don’t quote me on that, but that’s exactly right. There’s a predetermined list of things that they’re searching for. And they search for those things using that technology. And if those things are not present, then the patient is essentially negative for those things. It’s not completely useless. It’s actually wonderful. It’s a cost effective technology. It’s a quick technology, but it is not thorough. And so if you really want a [00:06:00] thorough analysis, of an individual genome. What you’re really going to want to utilize is a technology called next gen sequencing. Next gen sequencing is typically the technology that’s used in medicine, although microarray is also used in very specific cases. But in general, next gen sequencing is really the big daddy technology. What you, what next gen sequencing does is it literally reads. every letter of the genetic alphabet. It’s very comparable to me telling you, Doc, read me this book but don’t read me every word. Read me every letter. of every word in every sentence of every paragraph on every page. It is incredibly thorough and it’s very helpful when you’re not always sure what you’re looking for because it is a full detailed analysis.
So this type of technology, next gen sequencing, is really what allows for deep and thorough analysis [00:07:00] of an individual’s genes and their potential disease risk. Now taking it a step further, there’s different kinds of tests. That are utilized or utilize next gen sequencing. You could cherry pick and say, you know, you only want to sequence gene 1 and gene 2 and gene 3, right? That’s all you’re looking for. You could cherry pick a hundred genes and run next gen sequencing on a hundred genes, right? You can pick very specific genes that you’re reading each letter of the genetic alphabet for. But what whole exome sequencing does is it reviews all every gene, right? Your entire gene library from the first gene to the last gene. That’s 20 plus thousand genes. And the reason why that’s so valuable is because you’re not missing anything. You’re not leaving any stone unturned, right? And again, when you’re looking for a comprehensive review of an individual’s genome, you’re really wanting to do that full, [00:08:00] thorough search. Now, the other thing that’s really important to understand, which is kind of what I mentioned in the beginning, is the type of laboratory that’s utilizing this technology. Anyone can wake up tomorrow, buy sophisticated machinery that runs next gen sequencing, and call themselves a lab, and they sell whole exome sequencing to the public.
The difference, and the thing that’s really important that providers understand, is when you’re looking for true quality, reliable medical genetic testing, you really need to a laboratory that has TAP and CLIA certification. These certifications Basically ensure that the laboratory is operating at very high standards. These laboratories are the laboratories that are used by hospitals, by doctors and even the insurance reimbursements for laboratory testing typically have to come from CAP and CLIA certified labs. So again, when you’re looking for Quality, Medical, Genetic Testing, [00:09:00] What kind of technology are they using? Is it microarray? Is it next gen sequencing? And what kind of laboratory is being utilized? Is it a true CAP and CLIA certified medical laboratory? If you know those two things, then you can reliably order genetic testing from these laboratories or these institutions because you know they are truly using high quality tech and they are operating at the highest level standards when it comes to medical genetic testing.
Dr. Weitz: So what is an exome? So,
Dahlia Attia-King: Great question. I should have clarified that. So there’s two really like super comprehensive big tests. There’s whole genome sequencing and whole exome sequencing. Whole genome sequencing is, again, the reading of every single letter of your genetic alphabet. Every little thing. Whole exome sequencing is a little bit more specific. Your exome is [00:10:00] your full gene library. Now some people say, wait a minute, you just said whole genome, it sequences your whole genetic library, your whole genome, but whole exome does the same thing. Not quite. There’s actually genes in our genome, right? These are very specific information packets. They deliver instructions to the body. And then there is actually genetic information outside of those genes, outside of the gene packet. Those areas of genetic information don’t actually actually instruct the body to do something directly. So, it’s genetic material, it’s information, but it is not necessarily translated into useful information by the body, right?
So, genes are those packets that give it, give the body instruction, and then the genetic information outside of the genes really support the genes themselves and don’t actually, you know, give instruction to the body. So what we’re [00:11:00] focusing on with exome is just those gene packets, those genetic areas in your in your genome that instruct the body to do something.
And again, the reason why that’s so important is because most diseases are caused by variations in the gene packet, inside the gene packet, not in variations outside of the gene packet. So we only focus on sequencing the genes themselves, those information packets, and that is what whole exome sequencing is.
It’s more cost effective, it’s a lot more affordable than sequencing every little tidbit of genetic information, and it’s more juice for the squeeze, because again, you’re looking at the areas that are instructing the body to do something. And not any other areas.
Dr. Weitz: Is that additional genetic material that’s not part of the DNA? Isn’t that the epigenome?
Dahlia Attia-King: Not quite. Okay. Not quite. Yeah. The epigenome [00:12:00]
Dr. Weitz: is important, right? Those are the Switches that turn off and turn on our genes, right?
Dahlia Attia-King: Yes, and I so I’m not an expert in that area to be honest. I’m not a geneticist, so I don’t want to speak. But I think epigenome really mostly focuses on the the turning on and turning off like I think you mentioned of the genes themselves. And that can can be impacted by other things, right, the environment of the DNA and not the DNA itself.
Dr. Weitz: Okay, so, tell us about your experience when you ran this test on yourself, what you found, and then also if you can give us any detail on what steps you took afterwards.
Dahlia Attia-King: Yeah, absolutely. So I have a very ironic story with the founding of my company. Normally, I hear a lot of entrepreneurs they face a problem themselves and then they say, you know what, this is a problem I’m experiencing. I bet a lot of people are [00:13:00] experiencing this problem. Let me create this company or let me solve this problem. You know, and hopefully help a bunch of people.
I never considered. genetic testing as a problem for myself. I never even thought about genetic testing for myself, which is so insane. I worked for a group of laboratories, as you mentioned in the beginning, and I recognize how few people were able to access this potentially life changing, life saving test. And because of that problem that I observed, I decided to create a solution and make this testing a lot more accessible and affordable to people so that more people could get access to this information and potentially save their own lives. It wasn’t until I launched the company that I decided, hey, I could get genetic testing.
I’m the founder of this company. I would be a total fraud if I didn’t actually get this genetic test for myself. And so, I was patient number one, and I dragged my poor sister, my poor guinea pig sister into this as [00:14:00] patient number two. And ironically, we found out that we both have a genetic mutation that makes us nine times more likely to develop ovarian cancer than the average woman.
Mind you, my sister and I do not fit the traditional healthcare guidelines for genetic testing. We’ve even asked our physicians to If we needed to get genetic testing, and because we have no family history, we have no personal history of any related disease we really were sort of guided to not worry about it and not get genetic testing.
And so it wasn’t until we did it anyway, right, because again, we made this company to make this type of testing more accessible and affordable, that we realized that we both carry this, you know, kind of, hidden genetic mutation that makes us more at risk for this type of deadly disease. Now, what we’ve been able to do because we have this information is we’ve both been able to take it to our doctors and say, hey, listen, [00:15:00] we actually are at higher risk for developing this disease.
What can we do? And although ovarian cancer is one of those insidious types of cancers that really doesn’t any symptoms until very late stage there are a few things that can be done in order to hopefully catch the problem at early stages, or maybe even eliminate it completely. We get certain scans every year, of course, because, We have this risk that we wouldn’t have gotten otherwise.
In fact, this gene also increases your risk a little bit for a little bit more than the average woman for breast cancer as well. And so I get annual mammograms even though I’m under the age of the annual mammogram recommendation. I get mammograms, I get MRIs, and I get ultrasounds as well. So that we’re able to kind of monitor any, you know, any disease progression. And all of that is possible because of this genetic risk that I have. And that’s exactly what can be done for millions of other people that have these types of risks. This information [00:16:00] can empower you and allow you to identify any of these problems before they even become full blown problems so that you can hopefully save your own life.
Dr. Weitz: By the way, we talked off air about what is functional medicine, and so from a functional medicine perspective, apart from the scans to look for the beginnings of ovarian cancer, I would recommend that you look at your estrogen metabolism by taking a urinary estrogen test that looks at how you metabolize the estrogen, because depending upon whether you metabolize it along the four or the 16 hydroxyestrone pathway will determine to some extent whether you are at increased risk. And number two, you should be tested for environmental estrogens because there are many endocrine disrupting substances in the environment, like bisphenol [00:17:00] A, like pesticides, like phthalates, like, there’s a whole series of chemicals that. have an estrogenic effect and can also increase your risk of estrogen related cancers like breast cancer and ovarian cancer.
Dahlia Attia-King: That is great guidance and that is obviously your area of expertise and so I will leave all of that to you but that sounds phenomenal and even personally something I should probably look into so thank you for that.
Dr. Weitz: I do recommend that you look into that. So What are some of the diseases that patients, besides ovarian cancer might find on one of your tests? And and then it seems like the test is focused on cancer, heart disease, and neurodegenerative. Is that right? Or are those just the biggest most prevalent killers?
Dahlia Attia-King: Yeah, so genetic testing, medical genetic testing is really [00:18:00] as advanced as our scientific knowledge of genetics, right, and how our genes are playing a role in our disease. So the more we understand with scientific research the more these tests will be able to tell us. And so, to your point today, these tests really focus on those areas of knowledge that we sort of have a decent grasp on. And those areas are the areas of cancer, of cardiovascular diseases and conditions, and neurological disorders. There’s also a whole group of diseases that are sort of lumped into this group called rare diseases. There’s thousands of rare diseases, and they are just that. They’re quite rare. In aggregate they occur, I think, in, in 10 percent or more of the population but each individual rare disease is quite rare and could affect, you know, very few number of people. Those diseases can also be identified, I think, 80 percent of the time with with genetic testing. But the areas that I think will [00:19:00] concern the vast majority of people are those areas that are, you know, the big killers, right? The big problem problem makers. And so, scientific research is you know, sort of uncovering that one in eight cancers, is actually potentially linked to very specific identifiable genetic changes and in those areas, these tests are very helpful because those specific individuals will be able to understand where their risks are, again, before problems arise.
And they could reduce their risk and in a lot of cases even eliminate their risk completely. So yes, so cancer is definitely one of those spaces. And it tends to be one of the most attractive spaces because of how you know, our lifetime risk of developing cancer in the United States is almost one in two, right? So there’s basically a 50 percent chance in your lifetime that you will develop some sort of cancer. And so [00:20:00] having a risk assessment, Before you develop these problems, it’s incredibly, incredibly effective.
Dr. Weitz: What percentage of patients who get this test will have a negative result?
Dahlia Attia-King: That’s a phenomenal question. And actually the fantastic news is it is the majority of people. Most people will have a very boring test result and that’s what we want. We don’t want a riddled result, right? We want it to be as boring as possible. And the good news is that most people will actually be negative for the vast majority of mutations that science understands to increase your risk for disease. So it’s fantastic. And what we like to say is, you’re going to walk away with one of two things once you get this guy. You’re either going to walk away completely empowered because now you have information that will help you make smarter, more targeted decisions, and it will, you know, [00:21:00] potentially reduce your risk for developing any problems in the future. Or you will walk away with a tiny bit more relief, right? A little bit more comfort because you don’t have an increased risk. of developing any of these problems. So it is a win win situation with everybody you know, taking this test. But the good news is that the good majority of people will actually have very boring test results.
And no matter what your results are at Panacea, you get a one hour free post test session with a genetic counselor. And the reason why that’s so powerful is because genetic counselors are actually the experts. on genetic testing. In fact, they have more training on this than physicians do. And so, sitting down with a genetic counselor, no matter what your results are, is really helpful in helping you understand what your results mean and what your results don’t mean. And they also help you think about potentially beneficial next steps as well, and [00:22:00] what you should be talking about with your doctor. So, that’s something at Panacea that everybody gets, no matter what the results are.
Dr. Weitz: That’s great. I’ve really been enjoying this discussion, but I’d like to pause for a minute to let the listeners know that we have a special offer for those listening to this podcast. If they would like to order this genetic test through Panacea, they should go to the website seekpanacea. com and use the affiliate code Weitz15 and you will save 150 off your purchase. Now we’ll get back to the discussion.
Dr. Weitz: So, for practitioners who have their patients get this test, can they call in and talk to somebody from your staff to get some questions answered as to how they will work with their patients?
Dahlia Attia-King: Yeah, so, the genetic counselors that, that we work with are lovely and they will answer and [00:23:00] consult with the physician should the physician have any questions about any next steps or any, you know, they need any clarifying about the results themselves. Absolutely. So this is really a handholding experience, not only for the patient and the user, but also for the providers that, that might be helping the patients as well.
Dr. Weitz: Since a percentage of my listeners are functional medicine practitioners, how can this testing complement a functional medicine approach to patient care?
Dahlia Attia-King: Yeah, so again, I think what we’re all trying to do here is we’re all trying to reduce risk, and we’re all trying to do that by preventing Massive catastrophic problems from happening in the first place. I think disease prevention and as you mentioned to me offline Root cause based medicine, right, which is what functional medicine is is you know, a perfect pairing with this [00:24:00] type of preventative genetic testing. Our goal is to help individuals and providers really I understand where their risks are so that they can sort of continue a very targeted and personalize plan for for themselves and for their patients, because that truly is one of the best ways to identify an early problem.
And I mean, I hear it all the time, scientists and doctors talk about how you know, the real true problem with cancer is this, is when it’s discovered in very late stages, because that is when it really becomes a deadly issue. If you are able to discover cancer in very early stages, you really increase the risk, or increase the likelihood, excuse me, for you know, these types of problems to not be as deadly.
And so, what we’re hoping is to sort of put more people, into that early discovery category, or even the prevention category, where these problems don’t even happen in the [00:25:00] first place. And so with that mission of ours and the mission of functional medicine providers, I think we’re all really on the same boat here. We want to be able to utilize this technology to stop problems before they even start.
Dr. Weitz: Now, apart from these big diseases like cancer and heart disease, can your genetic testing also give us some guidance as to how patients metabolize their food, how they, you know, their propensity to gain or lose weight, or can it tell us anything about whether or not they’re more likely to do well with one type of diet over another or things like that.
Dahlia Attia-King: Yeah, so our testing specifically focuses on disease susceptibility at this time. We are obviously reviewing the entire genome and our laboratory partners. Obviously, they’re [00:26:00] Kaplan Clio, you know, certified laboratories. They certainly have the ability to run all kinds of genetic tests using all kinds of technologies. And in the future, we likely will be able to offer reporting on those specific things that you just mentioned. But to be clear, today, our whole exome sequencing is solely focused on inherited disease risk. That’s really the areas that we’re able to guide on. But stick around because we’re always adding different functions and different reports and are able to reveal all kinds of different information for our users and our providers.
Dr. Weitz: Now, what about for fetuses? Parents, you know, who are pregnant, are concerned about the propensity of their newborn to have certain genetic diseases. Can this test be done in that setting?
Dahlia Attia-King: So prenatal genetic testing is probably one of the biggest fields in genetics. And of [00:27:00] course, as parents, you know, we all want to do what is best for our child and our children. Today, prenatal testing focuses on very specific diseases. And whole exome and whole genome is not typically run or utilized in prenatal testing. I’m a little biased, obviously, but I believe, that’s exactly the direction or where the direction should be for prenatal testing. But believe it or not today, they only focus on very specific diseases.
We, we don’t do whole exome or whole genome in prenatal. But I think it’s certainly an excellent observation and an excellent question because it makes the most sense. And it also will set the child up for, you know, their health future, once they, you know, once you have an idea of what this child is at risk for, you can certainly start from very early stages and you know, help guide that child on a really healthy trajectory. It’s just not something that is being [00:28:00] done today. It’s wild to even think that we have this technology and we can use it in this way, and it’s actually not being utilized. So, hopefully we’ll explore that in the future.
Dr. Weitz: Are lifestyle interventions discussed by the genetic counselors with respect to some of these disease risks?
Dahlia Attia-King: In certain cases, yeah, absolutely. I mean, listen, in general, no matter what your genes are, I think the guidance still stands, right? Eat a healthy diet reduce your stress, be active, build muscle, right? All, all of these got these key guides or guidelines are important no matter what your genetic makeup is. But what’s interesting is if you actually Find that you have an increased risk for XYZ. That might be a really great boost into getting you, you know, into these lifestyle habits and patterns that you may have been flacking on or avoiding, right? And so sometimes it’s a great reminder that, you know, [00:29:00] in for us all to say, Hey, you know, we really do need to reduce our stress. We need to, you know, we need to sleep better. We need to do whatever. And so it could be a fantastic reminder. However, those things are important, no matter what your genes are. Right. And I don’t, I don’t think anybody would argue that. But yeah, that’s it.
Dr. Weitz: You know, the thing, unfortunately, is those of us who live in this world of diet and lifestyle and nutrition and what seems like a simple recommendation, you need to eat a healthy diet might seem a sort of a simple thing for maybe somebody who’s not in that world.
But once you get into that world, you realize that you have Ideas of what a healthy diet is. And you have people recommending eating meat only. You have other folks saying you should eat vegetables only. We have the ketogenic diet. We have the Mediterranean diet and they’re all [00:30:00] completely different. And, and so, we argue back and and forth and everybody has their opinion.
I have my opinion. And I try to use biomarkers to determine if people are doing well on a specific diet and if those biomarkers are not looking good on that diet. I use that as a basis for saying we need to try a different type of diet. But it would be nice if the genetics also could guide us as to, you’re the type of person you need who might do really well on a really low carb diet, even if it were, say, a ketogenic diet as opposed to somebody else who’s more likely to do really well on a, on a vegetarian lower fat diet.
Dahlia Attia-King: Right, absolutely. And we, we hear, we hear this all the time and I think That type of information could be very useful for people, obviously. And again, it’s something that, [00:31:00] that we can very easily sort of add on, right? We’re already looking at the genes very deeply. And there might be some different types of testing or, or technologies that might need to be utilized in order to drill down into those specifics that you’re, you’re referring to. And like I said, it’s very likely we’re going to do it. It’s funny because that area of genetics is not as. As, as studied, I should say in the scientific community, as much as the disease causing areas, right, of of genetics and so we sort of started out with the area that we have the best grasp on in, in, in science and our scientific understanding, but it’s certainly something we, we’re strongly considering and, and we could, you know, pretty easily add into our reporting abilities.
Dr. Weitz: Right. Okay. Can you give us any other examples of some patients who’ve run your test and discovered certain types of diseases so we have some concrete examples?
Dahlia Attia-King: Yeah, [00:32:00] so, clearly the, the, the areas of cancer are probably some of the, the, the most prevalent, I should say. We’ve had individuals that have an increased risk for colon cancer and that’s, that’s an interesting area because, Colon cancer is ideally one of the most preventable cancers because we have such good screening methods like colonoscopies. And the power of this type of testing is that it could alarm you to these risks before any of these recommended screening methods are actually recommended. There’s typically an age in which these screening methods are recommended. And if you have a genetic mutation. That puts you more at risk. You could start the screening methods earlier, again, to increase your risk or increase your likelihood of finding these problems or reducing your risk overall.
Dr. Weitz: And that would be especially important because recently we’ve heard about an increased risk of colon cancer in younger [00:33:00] people.
Dahlia Attia-King: Absolutely. And so, and colon cancer, your risk for colon cancer obviously, again, can be identified earlier in life, but it’s another really great area of where, you know, changing your diet, right, could help decrease your risk, even if you do have a genetic risk. A high fiber diet you know, They say try to avoid high fats and, and process, you know, meats, etc. Ideally, those things will reduce your risk for colon cancer, but especially if you have this genetic risk for colon cancer. But the best thing to do when you do have an increased risk for something like colon cancer is to start screening earlier, right? The colonoscopies. I think the recommended age for just got reduced from 50 to 45, for, for
Dr. Weitz: Yeah, but 45 is still pretty old when we’re having 25 year olds with it. So, if you got this test and it showed you had an increased risk, would that increase the likelihood of your insurance company to approve a [00:34:00] colonoscopy?
Dahlia Attia-King: Yes, so, yes, it does. And the good news is that there’s also a law called GINA and GINA is the Genetic Information Non Discrimination Act. And what that act does is it essentially requires the insurers to not drop you. as a member because of any of your genetic mutations that could be identifying these tests. And they also can’t hike up your premiums because of your genetic test results. And in most cases, yes, they do cover a lot of these services. Myself personally, my insurer does cover a lot of my screenings because of my genetic mutation. I wouldn’t have been able to get a breast MRI had I not had this.
genetic mutations. And my doctor obviously pushed for my insurer to cover these MRIs because of my genetic mutation. And I’m protected by Gina because now my insurer can’t drop me or change my premiums because of my, my genetic mutation. So that’s something luckily we, we don’t have to [00:35:00] worry about. And in, in most cases, or in, in some cases, maybe you will be able to, to get covered for these, these things.
Dr. Weitz: Now, I’ve heard you say that some of the patients don’t want to get these tests because they don’t want to get the negative results.
Dahlia Attia-King: Yeah, so one of the biggest hesitancies that we hear from people is they’re afraid. I don’t want to get this test because I don’t want to know. What, what if I do have an increased risk for colon cancer or breast cancer or, or whatever, I don’t want to know. And I understand that fear, of course, we, you know, it, it is always overwhelming to learn something about yourself that, that maybe is not that great, right?
But, the power of this test, and the whole reason it exists, is because it helps us change our trajectory. And it helps us get in control. of our past and our future. It would be [00:36:00] useless if these things were written in stone and you get this result and you literally have to sit there and wait to get sick, right?
It would be a useless task. Nobody would buy it. I would never endorse it. I wouldn’t buy it. I wouldn’t sell it. It would be just an absolute disaster. But that is not These tests give you an idea of where your red flags are, and because of that information, you can now be in control. You can now understand exactly how to target your healthcare with your provider and change the trajectory of your healthcare future because of this information.
And so again, this is, the purpose of this test is to empower you so that you can be better off with this information than without it. So fear is a very normal thing, but once you walk yourself through the reality and the logic of what this test can do for you, then it becomes a no brainer. Then everybody wants to do it because they realize how powerful it is.
Dr. Weitz: [00:37:00] That’s great. Okay, I think it’s time for us to wrap. If you have any final thoughts, otherwise tell us about how patients can find out about this testing.
Dahlia Attia-King: Yeah, so just as you said you can visit our site seekpanacea. com. That is where you can purchase a test within a few seconds.
Dr. Weitz: You want to spell that out exactly?
Dahlia Attia-King: Sure. Yep. So it’s seek, S E E K. Panacea, P A N A C E A, com, and that, like I said, that’s where you can purchase a test. We accept all major credit cards, and we also accept FSA and HSA, so if you have those insurance dollars that you need to spend, use them or lose them, you can certainly use them with our genetic testing. A lot of people do that, and they’re basically able to get this test for free, which is amazing. Thanks. And you also will be able to schedule your genetic counseling session once you purchase your test with us as well, but you can buy a [00:38:00] test within seconds online, and don’t forget to use Dr. Ben’s discount code, save you 150 on the test.
Dr. Weitz: Great. Thank you so much.
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 very much appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review. As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health condition and want to prevent chronic problems and want to promote longevity, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111 and we can set you up for a consultation for functional medicine. And I will talk to everybody next week.
Lara Zakaria discusses Hashimoto’s Thyroiditis 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
In this extensive and informative episode of the Rational Wellness Podcast, host Dr. Ben Weitz is joined by Lara Zakaria, the Foodie Pharmacist, to explore the complexities of thyroid health, focusing on autoimmune hypothyroidism, also known as Hashimoto’s thyroiditis. They delve into the prevalence and history of hypothyroidism in the U.S., the nuances of thyroid function, and the role of iodine. Key topics include the limitations of TSH levels for diagnosis, the importance of comprehensive thyroid testing, and the role of thyroid-binding globulin and sex hormone binding globulin. The discussion emphasizes a multifaceted approach to treatment, integrating gut health, stress management, adrenal health, and personalized medication strategies. Also covered are various thyroid medication options, dietary strategies for managing thyroid conditions, and the intricate relationship between iodine and thyroid health. Lara Zakaria shares insights on bio-individuality in functional medicine and introduces a one-month thyroid optimizer program. This episode offers a thorough understanding of thyroid health and individualized care protocols.
00:00 Introduction to the Rational Wellness Podcast
00:29 Understanding Hypothyroidism and Its Prevalence
02:11 History of Iodine Supplementation in the U.S.
03:30 Meet Lara Zakaria: The Foodie Pharmacist
04:09 The Role and Importance of the Thyroid Gland
06:01 Symptoms and Diagnosis of Hypothyroidism
07:23 Proper Testing for Thyroid Function
18:24 Autoimmune Thyroid Conditions and Their Management
26:02 Choosing the Right Thyroid Medication
26:55 Understanding Thyroid Medication Options
30:51 Addressing Medication Sensitivities
32:35 Impact of Biotin on Thyroid Testing
34:11 The Role of Iodine in Thyroid Health
41:32 Dietary Considerations for Hypothyroidism
46:15 The Goitrogen Debate
48:49 SIBO and Thyroid Health Connection
50:29 Conclusion and Contact Information
Lara Zakaria is an Integrative Pharmacist, Certified Nutrition Specialist and an IFM certified Practitioner. Combining her background in pharmacy and training in Personalized Nutrition, Functional Medicine, and herbalism, Lara designs personalized protocols that incorporate whole food, herbs, nutrigenomics/pharmacogenomics, medication history, and lifestyle modification to help patients achieve their health goals. Her website is LaraZakaria.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.
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.
Today we’ll be having a discussion with Lara Zakaria, the foodie pharmacist, about how to help patients with autoimmune hypothyroidism, also known as Hashimoto’s thyroiditis. Which is the most common autoimmune condition in the United States? I’m going to talk for a few minutes about the prevalence of hypothyroid, and I wanted to give you a little background about the history of iodine supplementation, [00:01:00] which kind of changed the landscape of thyroid conditions in the United States. So, the prevalence of hypothyroid in the U. S. has been increasing. From 2012 to 2019, the prevalence increased from 9.5 percent to 11.7%. The prevalence of untreated hypothyroid has increased from 11.8 percent to 14.4%. Greater than 78 percent of patients treatment consists only of T4, also known as Synthroid. In the body, T4 is then converted into T3, which is actually the active form of the hormone.
And hypothyroidism is nine times more likely in women than in men. Now, overt hypothyroidism is defined as elevated thyroid stimulating hormone. in combination with 3T4 below the reference range. Then there’s something [00:02:00] called subclinical hypothyroidism, and this is defined by elevated TSH, but normal 3T4.
So now I want to talk for a couple of minutes about the history of hypothyroidism in the U. S. So today, over 90 percent of those with hypothyroidism have Hashimoto’s, which means it’s an autoimmune condition not arising from an iodine deficiency. Prior to 1924, the main cause of hypothyroid in the US was iodine deficiency, especially across the northern part of this country and across Appalachia, where the soil was iodine deficient and this was known as the Gorder Belt. Iodine deficiency leads to enlargement of the thyroid known as goiter, and in extreme cases, this leads to [00:03:00] impaired neurological function, stunted growth, and physical deformities known as cretinism. But then, starting in 1924, a hundred years ago, we instituted iodized salt, and rates of goiter dropped to very low levels. Unfortunately, rates of Hashimoto soared. And in fact, this same pattern was repeated in other countries around the world. So that’s to set up the background a little bit.
Lara Zakaria, I hope I pronounced that properly, is an Integrative Pharmacist, Certified Nutrition Specialist, and an IFM Certified Practitioner. Combining her background in pharmacy and training in personalized nutrition, functional medicine, and herbalism, Lara designs personalized protocols that incorporate whole food herbs. Nutrigenomics, Medication History, and Lifestyle Modification to Help Patients Achieve [00:04:00] Their Health Goals. Welcome, Lara.
Lara Zakaria: Thank you so much for having me, Ben. There we go.
Dr. Weitz: So, what is the thyroid gland and why is it so important?
Lara Zakaria: Great place to start, right? Let’s set up the foundation. So the thyroid gland is a butterfly shaped gland that sits right at the base of the throat. So very often you’ll see imagery of butterflies. In fact, the blue butterfly has been adopted as the symbol for the thyroid gland. And it, its job is to produce the metabolic master hormone thyroid. And you know, not to sound melodramatic, but this is literally the hormone that is probably most responsible for activating or slowing down our metabolic process. It’s essential from every step of life, from conception to to gestation through childhood growth, making sure that everything, all, all the different cells and organs are growing healthfully. And as [00:05:00] we grow into adulthood, ensuring that we have a healthy metabolism, it’s lockstep with the way like our insulin hormones function, our other metabolic hormones function, and is responsible for, you know, the basic foundational stuff, heart rate, respiration rate, digestion, as well as some of the things that we consider superficial like hair growth, nail growth, skin texture, and quality. So very often we can easily assess that there’s something metabolically happening from some of the superficial function, and then when we start to see that metabolic decline, it starts to get more and more insidious and more and more serious. We start to see changes. in digestive function, in menstruation, in fertility, and then eventually we start to see things like outright primary hypothyroidism and outright conditions that really start to cause disruptions in metabolic function.
Dr. Weitz: So when they have outright hypothyroidism, what sorts of symptoms do you see then?
Lara Zakaria: So most people will present with fatigue, brain fog, energy issues. You’ll also see sometimes joint pain or difficulty recovering from workouts. That’s even if they can get themselves to do the workout. For a lot of people, it’s again, those superficial symptoms, changes in hair texture or hair quality, the rate at which their hair might be growing, their skin changes. It doesn’t have that. Luster to it as much. It might be drier or might even have to be so dry that it’s causing irritation or scratching changes in the nail bed quality, the length, the growth, and the strength of the nails, and a lot of these symptoms actually very closely mimic it, anemia, or iron deficiency. And so for some folks, that first step is often distinguishing whether they have an iron deficiency that might be causing some of these disruptions, because that’s a very important mineral, of course, or if this is caused by metabolic issues from [00:07:00] the hormonal dysfunction. The other piece of it is that we actually need iron as part of our process to make Thyroid. So the two are intertwined. So just because they have iron deficiency doesn’t mean it’s not impacting their thyroid and vice versa.
Dr. Weitz: Great. So let’s go into the proper testing for thyroid. Which tests should be run? Which tests do you like to run? And what do they tell us?
Lara Zakaria: Okay, so this is, this is a controversial topic because the guidelines recommend that we test the TSH. There are some recommendations to either get a T4, what’s called a reflex T4. In other words, a reflex T4 is if you test A TSH and it’s out of range, it’ll, the lab will automatically run a T4 or you outright ask for a T4, and most clinicians will recommend a free T4, meaning it’s unbound to protein,…
Dr. Weitz: And this is all to save an extra $10 for the insurance company.
Lara Zakaria: Well, to be fair, I’m going to run the list of the various [00:08:00] labs that I would recommend, but I would say that this is an okay starting point if we add the T4 at least, right? That’s an okay starting point. The problem with TSH on its own, one, the reference ranges on most labs are so wide, it’s very easy to miss an outlier that might cause that TSH to look like it’s normal, number one. Number two if you have a normal TSH, we’re not directly measuring the thyroid activity. We’re measuring the activity of the hormone that stimulates thyroid production. If there’s no issue with that part of the process but the issue is further down the line, we might potentially miss that. So if the issue is from converting T4 to T3 and we never measured a T3, Or even better yet, a reverse T3, then we’re missing the potential conversion issue, which is all, a couple of steps down from TSH production, right? So when you think about it, there, let’s, let’s back up a little bit, and let’s just do a quick refresher of the, the biology of thyroid production, right?
Dr. Weitz: Accepted range in conventional medicine for the TSH. Is it 0.5 to 4.5 or so?
Lara Zakaria: It depends on the lab. It can vary from lab to lab. The average that I see is usually somewhere between 0.5, maybe 1.5 on the low end up to 4 or 4.5 on the high end. That’s, that’s what I typically see on most standard lab testing. Some labs are going to vary because what they’re doing is they’re taking a population average. And sometimes they’re doing that local population. So if they’re doing it in New York or they’re doing it in California, there might be a variation on what that average looks like. So that’s why you’ll see slight variations on that. That said, that that recommended range is based on what a quote, healthy population could potentially fluctuate in their TSH. And that’s fair, but you’re taking an average, right? You’re not necessarily honing in on what’s optimal and you’re not necessarily honing in on all the various factors that can impact that average. Age, Gender, Inflammation, Nutritional Status. All these factors can [00:10:00] impact where that TSH might land. And then there’s bio individual differences of where somebody’s TSH might be.
Dr. Weitz: And we could argue that the average American is far from being healthy, so.
Lara Zakaria: That’s a very good point. What is defined as healthy, right? Right. Just because somebody doesn’t have TSH, maybe a diagnosis of hypothyroidism. They could call that healthy but they might have another physiological or metabolic condition that might alter again that TSH level and that function. So I think that’s, that’s a basic problem. So if we’re just relying on one marker in order to diagnose Transcripts What essentially could be multiple conditions, right, because there’s hypothyroidism, hyperthyroidism, autoimmune, there’s Graves, there’s Hashimoto’s, there’s subclinical. So there’s multiple things that could be happening, multiple reasons why those could be happening, but we’re only looking at one marker to try to identify. I think we’re putting a lot of pressure on TSH, frankly. I’m not saying throw it out. I’m just saying maybe that’s not enough and one good [00:11:00] basic step might be to add that T4 maybe I, I don’t know. I kind of like a total T4 with a free T4 as a basic starting point. ’cause then I know how much of that binding globulin might be holding onto T4 and how much of it is actually bioavailable. That gives me a clue as to what might be happening physiologically to the rest of the hormones, let alone to the T3 and everything else down the line. Now that said, we got to now convert T3 to T4, excuse me, to the active T3. That takes its own step. Then we’ve got to take that T3 and we’ve got to shuttle it over to the rest of the cells and they’ve got to engage with the cell receptors, fit that lock and key, so that we can then activate those cells and turn the metabolic process on.
A couple of things could go wrong there. We could potentially not have. Primarily enough T4 being produced. And we would catch that with a, with a T4 or free T4 measure. We could be [00:12:00] converting T4 to reverse T3 instead of to active T3. And again, if we’re not measuring reverse T3, T3 and free T3, then we’re not potentially catching that. We might have a lot of binding globulin. We talk about sex hormone binding globulin when it comes to testosterone and estrogen levels and how that could potentially impact hormones. But those same. Binding globulin, I call them Ubers. They’re like the Ubers of our hormones. Our hormones can’t just walk down the street on their own. They’ve gotta take, they can, they need a ride, right? Right. So they call the Uber. That’s the binding globulin. Thyroid has its own binding globulin, and very often the amount of binding globulin for thyroid MI mimics that of the sex hormones. So if there’s something that’s activating, increased. There’s more Ubers on the road.
For example, if somebody’s on estrogen therapy, that could increase their sex hormone binding globulin. That could also potentially increase their thyroid binding. So you’d have more bound thyroid than free thyroid. So again, measuring the bound [00:13:00] versus the free can be really helpful in identifying Is it a problem of too many thyroid’s not getting out of the car, or is it the problem somewhere in the conversion? Or, if I measure reverse T3, I can now see if stress might be, or inflammation might be, activating that conversion from an active T4 to a reverse T3.
Dr. Weitz: And for that reason, is it good to measure the thyroid globulin as well?
Lara Zakaria: You can, it’s a little bit harder to get. And so kind of, I’ll come back to this point about kind of choosing, choosing your own adventure based on the access, the lab that you’re using and the cost. But if you can, you, you sure can, but I think you can actually get enough information from just getting the bound and the free, but if it’s available and you, you want the extra data to confirm your findings, I think that’s. That’s reasonable. And then kind of going back to go down the line, you have now that T3, it gets in its uber, it goes to the cell site, it gets to the receptor, that key does not open the lock. Again, we talk about insulin resistance and we talk about [00:14:00] insulin resistance being an issue with the receptor activation and the acceptance of that insulin into the cell. Thyroid has a similar activity it has to go through. So if there’s an issue with the cell receptor sensitivity to the thyroid hormone, that’s also going to create another barrier for activating metabolism.
So when we can kind of get that full picture, when we can understand just from a hormonal perspective. TSH plus free total T four, free T four total, T three, free T three, reverse T three in my opinion. That would be foundational. And then from there we can start to get a little bit fancier. We can start to assess some of the nutrients that are involved in those steps. We can start to understand some of the we can look at autoimmune factors from there, if we wanna assess to see if there’s an autoimmune process that’s that’s creating the thyroid dysfunction. And then we can start looking at things like stool testing, hormonal testing, et cetera, to see if there’s these other factors that might impact a thyroid function.
Dr. Weitz: Well, given the fact that most [00:15:00] cases of thyroid problems are autoimmune, shouldn’t we automatically be measuring the TPO, the TGB, and perhaps the TSI?
Lara Zakaria: I think so. I think if you have a family history of autoimmune disease autoimmune diseases tend to run in clusters. So if we see them particularly on the maternal side, because they do, they are more prominent on in women than men. If you particularly see a history of it, I think it’s a good idea to at least, you know, annually, if not every couple of years, to run that autoimmune panel, especially if you already have either symptoms of hypothyroidism or hyperthyroidism for that matter. Or if you have a diagnosis of hypothyroidism. I have seen it over and over and over again, where somebody gets that diagnosis of hypothyroidism, they get, medicated or it’s either, you know, it’s either a borderline. And so they’re not medicated yet, or they get started on HRT for thyroid, but they never go back and recheck that [00:16:00] autoimmunity, right. They, they checked it the first time it was within range. But at some point, it pops up. So it’s a little, it’s a little deceptive. If it’s not triggered, and if you’re not in an auto, in an immune flare, you may not catch that autoimmunity. And so it’s really important, in my opinion, especially if you have a history of hypothyroidism, if, especially if your hypothyroid systems are not fully resolved with hormonal replacement therapy, to periodically check for autoimmune disease. Because as you said, Ben, it is the Hashimoto’s is the number one cause of hypothyroidism.
Dr. Weitz: Good, so that’s a good clinical pearl. You have a patient, they test negative for thyroid antibodies, so you decide they don’t have autoimmune thyroid, check it again at some point in the future because they may actually have it and those markers just may not have been elevated at that time.
Lara Zakaria: Absolutely, absolutely. And I would do all of the thyroid antibodies. I think we often stop at antithyroplobulin, but I think doing all of [00:17:00] them comprehensively is a good idea because that really gives us a better perspective because the way that that autoimmune presentation shows up, might be a little, again, it might be a little insidious and it might I’ve seen cases, Hashimoto’s is notorious for flipping between hyper thyroid symptoms and hypo thyroid symptoms. And I think that’s that presence of the variation in the way those antibodies are showing up. So I think it’s a good idea to sort of throw a wide blanket on it until you get a good sense of what their triggers are, what that process looks like for them. And that really can be so validating for patients that keep saying like, I don’t feel good.
Like I’ve been taking my medications. I’m so meticulous about taking and taking away from food. I still don’t feel good. That could be really validating to say, Hey, it’s actually not your thyroid. It’s actually your immune system. That’s causing some of that issue. Let’s address the immune dysfunction and let’s treat that root cause. And that usually really helps to keep them stable and they feel so much better. And those symptoms start to resolve.
Dr. Weitz: I’ll tell you what, why don’t we go into that first and then we’ll get into directly treating the thyroiditis. How do we address the autoimmune condition?
Lara Zakaria: Okay, so we’re going to zoom out now, right? Autoimmune disease, right? Autoimmune disease versus thyroid disease, right? So number one, I think conventionally we have, a lot of us have been trained that autoimmune disease is like a subset, the Hashimoto’s is a subset of thyroid disease. And I actually don’t look at it that way. I look at it as a different disease altogether. It’s a disease that impacts the immune system that happens to target the thyroid. Similar to how Crohn’s is an autoimmune disease, it’s an immune disease dysfunction that happens to target the thyroid. The colon, right? So I think that’s a really important distinction. It means that we still need to treat the thyroid.
We need to address the hypothyroidism, but we actually also have a responsibility to look a little bit more upstream and actually balance the immune system. And I’m seeing [00:19:00] the approach change significantly. I used to hear a lot from my patients saying, like, Well, my doctor said it is Hashimoto’s, but there’s nothing they could do about that. So I just keep taking my levothyroxine and call it a day. And I’m like, whoa, whoa, whoa, pump the brakes. There’s actually so much we can do. Number one, balancing the immune system with nutrition, making sure that you have all the basics when it comes to reducing oxidative stress. balancing the immune system, optimizing your vitamin D levels, your beta carotene and vitamin A levels, making sure your vitamin C is optimized. We can use things like quercetin, and we can really like focus in on that nutritional aspect. Antioxidants, things like EGCG and resveratrol all have been proven to to sort of balance that immune response. Selenium is really interesting. Actually, selenium and zinc, they’re kind of buddies, are really interesting because both have direct antioxidant activity. And that’s why they’re so central in both primary hypothyroidism and autoimmune hypothyroidism because not only are they part of the physiological process of making thyroid, they’re also involved in [00:20:00] the conversion and activation of thyroid and they have antioxidant activity as well. So they directly kind of impact that intersection between the autoimmune and the primary hormonal dysfunction.
And then other factors are gut health. That’s probably foundational. I would say that’s probably foundational for primary hypothyroidism too, but it’s especially important when it comes to autoimmune conditions, ensuring that we balance out any microbiome disruptions, any dysbiosis is addressed, any overgrowth is addressed, we’re addressing any intestinal permeability, and that we’re making sure that folks are balancing their make, they’re pooping every day, that they’re getting their, their stuff out on a daily, regular basis. They’re having healthy, robust formed stool every day is really, really important. Again, this is, sits at the intersection of both primary hypothyroidism as well as autoimmune, but really kind of like a foundational piece in my [00:21:00] opinion and for anybody who’s managing autoimmune patients. Another factor we kind of.
Glossed over is the adrenal piece and the stress piece. I always tell my patients, your adrenal glands and your thyroid glands are buddies. If your adrenal glands, we’re not keeping your adrenal glands happy. Your thyroid gland is going to tell us about it. They are two peas in a pod. So when we have thyroid disruption, we often see issues with catecholamine production and cortisol production and vice versa. If you are stressed and you’re not dealing with the stress primarily, you’re not going to see the benefits on your thyroid as effectively. So I think that’s a really important factor. So addressing stress, you know, foundational stuff, finding ways to manage our stress. We can’t completely avoid it right away from it, but finding ways to manage that and making sure that we are also accounting for cortisol dysfunction, high or low.
I very often find folks with thyroid issues tend to actually run on the low side and that their circadian rhythm sort of disrupts the [00:22:00] amount of cortisol that they produce and they’re sort of sluggish and dragging and don’t like have that energy in the morning. So if they’re telling me that, I definitely want to support their adrenal in one way to help to actually improve their adaptive response. If they’re super high stress, wired, having trouble sleeping, you’ve seen that elevation of the cortisol later in the day, then we want to neutralize and bring that cortisol down and then addressing sort of that catecholamine, the, the, the, the excess caffeine use because they’re trying to take advantage of that energy surge because they’re exhausted.
We want to make sure that we are addressing any low dopamine issues because they’re taking all that dopamine and they’re making epinephrine and norepinephrine instead. So they’re turning over those stress hormones very quickly and then doing all and then addressing how that’s impacting their gut function and, and all the other factors in terms of hormone balance.
Dr. Weitz: Right. And so let’s go into how do we treat the [00:23:00] Hashimoto’s? And why don’t we, would you rather start with diet and supplements? Or would you rather start with drugs? How would you like to handle it?
Lara Zakaria: Let’s start with the medication. Let’s start with the way it’s usually addressed. And then let’s use it with some of the, you know, all the good stuff that we can do more.
Dr. Weitz: Right. Okay. So we just give the patient Synthroid, end of the story, right?
Lara Zakaria: Yeah. That’s it. Call it a day. End of podcast. Right. So I will never, I, there’s a lot of also kind of chatter about, Oh, Synthroid is bad. Levothyroxine is bad. It’s synthetic. It’s, it’s fine. It, so many people do so well on Synthroid and there’s arguably some Hashimoto’s folks actually do better on Synthroid. And it just has to do with the way their body utilizes it and how it can convert it. So. If level, if you’re on levothyroxine, that does not mean that we have to discontinue levothyroxine. However, to the point you made earlier in the introduction, that’s only a T4. So if we’re not addressing conversion from T4 to T3, or there’s [00:24:00] additional dysfunctions that are slowing down that conversion, then we either have to optimize that conversion through nutrition and lifestyle factors. Or we need to then go in and add a T3. So it is possible, you know, we could do that as well through medication. You can do bioidentical hormones. That’s totally fine. You can also do it through traditional prescriptions. And I think it’s important to note that because for some people, the availability cost wise.
Some people can’t afford to do, you know, their insurance doesn’t cover it. They need to go with what their insurance covers. Number two, there are supply issues sometimes with some of these medications, but specifically the bioidentical hormones and the sort of older grandfathered bioidentical hormones that are available on the shelf, like R morthyroid, et cetera. And so that could be a challenge. Also, thyroid is a very narrow therapeutic index. The great thing about levothyroxine is it comes in a quarter microgram increment. So you really can hyper personalize a dose. And for people with Hashimoto’s, they might change [00:25:00] their dose on a day to day basis. They’re feeling a little bit too high, they might cut the dose down. So having that ability to adjust the dose by that fraction of a, of a microgram can really help them to, really empower them to make those changes very quickly. On the other hand, your armor thyroids, etc. Those don’t have a very wide dosing range. And so again, you might not feel good on them simply because it’s, you just can’t get that right. You know, like you put on a shoe and the half size up is too big and the half size down is, it’s kind of like that but more serious because you feel like. Crud, right? So, it’s, it’s I think important to kind of know that we need to choose the medication that’s going to work best for the patient and then work on it from there, right?
Whether we need to add a T3, that’s one option, or we can really focus on those factors that are going to improve conversion from T4 to T3. So, from, from a, from a conversion perspective, Stress and inflammation play a huge role. So if you’re managing somebody that’s on a [00:26:00] levothyroxine and you’re not addressing foundational aspects of stress management and you’re not addressing any other of the root causes of inflammation, that’s going to impact how well they can make that T3 and potentially might increase the reverse T3 that they’re making. In addition to that, Nutrients, Selenium and Zinc. I told you those guys are buddies and those are the star of the show when it comes to thyroid, but also vitamin A, vitamin E, and I would say antioxidants in general can be really helpful for that conversion piece.
Dr. Weitz: So just to clarify for people who are listening out there who are not really familiar with thyroid medication we’re talking about straight synthetic T4, which is known as Synthroid or Levothyroxine, as compared to what you’re referring to as bioidentical, which is thyroid from ground up pig’s glands, essentially, that contains T4, but also contains some T3 and even some T2 and T1. And so having a [00:27:00] balance of some T3 with the T4 is more of a natural type of sub of medication and may make it easier for the person to feel better because some of the T4 is already in the active T3 form. Or another option is you can add a synthetic T3 to their T4 if the person’s having trouble converting the T4 to T3 perhaps, right?
Lara Zakaria: Yes and no. What, what I’m saying is that, that different people will respond to different formulations, right? Because for example, in the the, I, the, in the versions, for example, like Armor Thyroid, or those are porcine derived to your point, there’s a combination of all the potential, it’s a glandular formula. And so there is a combination of T4, T3, and yes, even T2, which is less bioactive. And we don’t really talk about it as much as sort of the by product of T3 breakdown. However, we can’t always, [00:28:00] you’re not going to have consistency in the amount of T4 and T3 that are in those formulas. For some people who are hypersensitive, that variation from batch to batch or the wideness of that dosing parameter, the way that it comes in a capsule or tablet, it’s going to miss them. It’s either going to be too high, too low. We’re not going to get the Goldilocks out of it. We’re not going to get the just right dosage. In those cases, they actually, those folks might actually do better either on a customized bioidentical formula, a compounded formula that’s very exact and precise. Some people do better on synthetic and they don’t do as well on bioidentical.
And by the way, bioidentical in this case is not accurate. If it’s porcine derived, that’s not bioidentical, that’s porcine derived, right? Synthetic is actually closer to bioidentical because it actually looks exactly like the one that humans make. And then there’s the compounded that could be either porcine derived. They could also be derived from cattle instead of porcine. So if there is a [00:29:00] kosher or halal consideration, that’s also sometimes an option. And then there’s obviously synthetic instead. So there’s the, the, it really honestly depends. And what I, I too, there’s two myths I want to bust when it comes to medication and HRT when it comes to thyroid.
Number one, that the goal is always getting off of the thyroid HRT. I don’t think that’s necessary. I think some people have a reduced capacity to produce the hormones, and we need to supplement it, and if they feel good on it, that’s great. Like, that goal should be that they feel awesome, right? What we want to do is optimize it, and if they don’t need it, yeah, reduce the dose or eliminate it.
If it’s unnecessary, go ahead and de prescribe it. Myth number two is that bioidentical or animal derived is always superior to synthetic, and that’s not necessarily always the case. And true individualized and personalized medicine should actually respect what actually works best for the patient, and, and we should be kind of using [00:30:00] all of those options in our toolkit to make it fit for them, not only to make them feel great, but also, you know, what they feel is best for them, what their their own beliefs are in terms of what’s appropriate for their therapy.
Dr. Weitz: Yep. And then another issue that a lot of times we might want to deal with is prescription medications are typically have added additional ingredients like food dyes and coloring agents and a bunch of stuff that perhaps gluten even that we don’t necessarily want or that the person may be sensitive to.
Lara Zakaria: Absolutely. I think that’s a great layer to add to that. The bottles that we’re pulling off the shelf in a pharmacy if they’re coming from a standard manufacturer, are not going to have that layer. They’re not paying attention to gluten and they are using dyes. On one hand, it’s a safety concern, right one hand. The binders that they’re using are safe. They, we know that they’re not interfering with the [00:31:00] bioavailability of the thyroid hormone. Those colors aren’t interfering with the bioavailability of the tho thyroid hormone and arguably. really help us identify giving the right dose. So when we’re sitting there dispensing as pharmacists, the color usually cues us. Most pharmacists that work in community pharmacy could probably tell you what color goes with what dose because it’s so ingrained in our head because we dispense so much of it. And that could be a really helpful like seeing the color and go, Oh, that’s not the right color. Oh, I grabbed the wrong bottle.
On the other hand, if you have a patient who is sensitive to those, and I’ve seen it where patients will say, I don’t feel good when I take this brand, I feel okay. When I take this one, I don’t feel as good. And I’ve seen where pharmacies will dismiss those concerns. So on the other end of that spectrum is we need to also be really open minded as clinicians and hear out our patients and hear out their feedback and try to work with them to really find. Again, that ideal formulation that’s going to work for them.
Dr. Weitz: That’s great. I wanted to mention one issue that sometimes is not, is ignored [00:32:00] concerning thyroid testing, which is that depending upon the lab, if the person is consuming biotin, especially in higher levels. That can affect the way the test comes out. And how do you address that?
Lara Zakaria: Well, usually we just have folks discontinue their biotin supplements or B complex as sometimes we’ll contain a biotin. We’ll usually have folks discontinue. I usually recommend if it’s not something that you have to be on, like, if it’s not something like, if I don’t take this, I can’t function today. Go ahead and discontinue it before testing at least a couple days before. My general rule of thumb for my patients is if it’s water soluble, I’ll tell them two or three days is usually enough to flush it out. If it’s fat soluble, I usually kind of make the judgment call because it’ll take weeks for some fat soluble vitamins to really adjust. So from there, I’ll say, let’s say I really want to get an accurate vitamin D level. I rarely tell my patients to get off vitamins before I test it, but I might say, you know what, let’s take a break from the vitamin D for two or three weeks [00:33:00] and let’s just see what happens when we get your blood work done. Again, there might be very unique individual cases where that’s necessary, but to your point, very often those nutrients might interact with the way that the lab runs a test. And that’s really the reason we might recommend that we get off. It’s not so much the level, but the interaction with the testing method.
Dr. Weitz: Right. The biotin is water soluble. So two, three days.
Lara Zakaria: Yeah, exactly.
Dr. Weitz: Okay. So, let’s go into iodine. I mentioned a bit about the iodine. Some people advocate iodine supplementation. There’s a lot of thyroid supplements that contain iodine. Most multivitamins contain a modest amount of iodine. And then there are some clinicians advocating really high dosages of iodine.
Lara Zakaria: Yeah, I, I’ve seen cases where there was one clinician that had a patient go very high on the iodine, and at the same time, she has an MTHFR mutation, so they had them go [00:34:00] very high dose on methylated folate, and my suspicion is, is that is what triggered her severe Hashimoto’s. She had Hashimoto’s, that was very difficult to put into remission. So I think that’s a great warning that excessive amounts of iodine can be dangerous, that’s for sure. However, I’ve also seen cases where you have a Hashimoto’s or even a Graves disease and they do great on iodine. I think at the end of the day, there’s a couple of factors. One are they deficient in iodine? If they’re not deficient in iodine and you add more iodine, You’re at best going to have a net neutral reaction. At most, you could be triggering autoimmunity, and we’ve seen this in Hashimoto’s. Number two Iodine is a halide. Halides, like fluoride, chloride, and bromide, have a very unique chemical property that makes them want to attach to each other.
It’s actually kind of the magic between, with iodine and how we make thyroid has to do with this chemical property. It wants to attach and it is facilitated by the [00:35:00] presence of cofactors and enzymes. If you have excess amounts of other halides, like you’ve got exposure to chlorine from water, you’ve got exposure to bromide from formidated flour, you’ve got exposure to fluoride from fluorinated multivitamins or something like that, that could potentially knock out an iodine and create sort of like a wonky thyroid.
And in that case, that thyroid looks like a thyroid, but does not exactly behave like a thyroid. And in those cases, because it looks a little bit different, that could also potentially kind of confuse the immune system. So there’s also part of the, the theory is that the fact that these halogens are so much more available, so much more found so much environmentally more that they can actually knock out the iodine, outcompete the iodine.
So in some cases, adding more iodine can help it compete to create a better iodine better thyroid compound. That said, [00:36:00] I, I think that we have to be careful. Number one, the safest way if you want to add more iodine to somebody’s diet is, is to add it through food rather than add it through supplementation because the body will naturally then absorb the iodine it needs.
It’s going to compete with other nutrients in the food and it’ll sort of taper off. You’re not going to get the super high surge. Whereas if you supplement directly with iodine, it’s going to absorb more directly and that could potentially be excessive. That’s number one. Number two I considered actually topical application of iodine.
I’ve seen that really work well for folks, particularly if we, we need a little bit more iodine. We’re worried about overabsorption. Topical application can be really helpful. The trick is you don’t want the clear iodine, you want the one that has got a color. You stick it on the skin, a visible area, and if it absorbs, usually that means that person’s iodine deficient, and if it doesn’t absorb, that usually means they’re replete.
Again, it’s not like 100%, but it’s a very useful way to, to, to decide whether or not you need to be a little bit [00:37:00] more aggressive with your iodine therapy. You can do lab testing. Probably the best way to do it is looking at urine analysis. It’s a little bit of a pain in the butt to do, so it’s not my favorite and it’s, there, there’s not great information about what the targets should be.
So that’s not my favorite way, but if you can, by all means, especially if you could get multiple assessments every few months or something like that, that’s available, then that would be probably the ideal way to make sure that we’re not targeting too high on iodine, we’re not excessively supplementing, and at the same time, we’re not missing any opportunity to optimize iodine.
Dr. Weitz: Yeah, my experience is, iodine typically makes Hashimoto’s patients worse, but it is the case that a lot of drinking water is purified with chlorine, I know in L. A. we have chlorine in the water, they also add glycine. They, they also add fluorine to the water.
Lara Zakaria: Yep.
Dr. Weitz: So, and then a lot of people are no longer [00:38:00] consuming iodized salt, but are consuming Redmond sea salt or Himalayan pink salt, it’s the sea salt, etc.
Lara Zakaria: Not eating fish and not eating seaweed. And so they’re really, those are really the only two options when it comes to getting your iodine levels up. Yeah.
Dr. Weitz: Right. I know for myself, cause I, I have Hashimoto’s and I’m not on thyroid medication and I’ve been able to manage it nutritionally for the most part. But I tried the high dose 12 and a half milligrams of iodine and my TSH shot up to like 25. So yeah, it did not like it. It was very clear. Did not like it.
Lara Zakaria: Yeah. I, I usually so I’m very careful. I usually will give folks formulations that are like thyroid specific and I sort of choose. depending on the situation. My out the gate for a Hashimoto’s condition, I don’t, I’ll choose one that’s iodine free. However, I usually will add that on if we’re noticing either they don’t, they’re to your point, not eating enough sources of [00:39:00] iodine. Because at the end of the day, it’s not about like, they can’t have iodine, it’s not like an allergy to iodine, right? It’s excess amounts of iodine that will trigger that response. So, that totally makes sense.
Dr. Weitz: I know for me, increasing selenium and adding a lot more zinc and, and not consuming iodine made a huge difference.
Lara Zakaria: Absolutely. Actually, studies actually also show that selenium, selenium on its own, there’s studies that show selenium on its own can actually naturalize auto antibodies for Hashimoto’s. Combining selenium and zinc has also been shown. So again, specifically, I should say, especially if there’s a zinc deficiency, I think that combination is a magical combination. Right, yeah,
Dr. Weitz: I did the NutraEval and I was super low in zinc, despite the fact that I was consuming zinc. What about myoinositol? That’s kind of an interesting nutritional compound hypothyroid.
Lara Zakaria: Yeah, I, I wonder sometimes if it’s so much of a direct benefit or because myonocytal also has sort of a neurological [00:40:00] benefit to it. And so that might be part of the cat that again, that relationship between stress and adrenal function and thyroid production. But yeah, definitely another interesting option. I don’t necessarily always use it immediately, but it’s one of those things that is in the arsenal in specific populations. If there’s hormonal dysfunction. History, particularly in my women that might have a history of PCOS, or you know, if, if somebody, you know, kind of strikes me as that more nervous constitution, that’s usually a great add on.
Dr. Weitz: What about diet for patients with hypothyroid?
Lara Zakaria: So if there was going to be one diet, which I don’t believe that there’s really one diet for everybody. So let me, let me start off by saying that there is not one thing that works for everybody. But if there’s one thing that I could say that we have some evidence for is that eliminating gluten is generally favorable for folks, particularly with Hashimoto’s, possibly with people with primary hypothyroidism. There’s a theory that there is a molecular mimicry between [00:41:00] gluten and thyroid and that that might have been what instigated that autoimmune response. I don’t know that that has really borne out to be accurate, to be true. However, I think there’s a lot that could be said that comes with gluten containing diets that might be triggers for both the autoimmune piece and the hormonal dysregulation.
One would be gut function. You know, the microbiome we know that gluten itself can trigger intestinal permeability it’s for some people more than others, but even more so, so much of our gluten containing products, particularly wheat, have glyphosate with them. So, it’s hard for us to distinguish, is it the glyphosate, is it the gluten, you avoid the gluten, you tend to also avoid the glyphosate. And in that case, we know very significantly, can impact not only the gut piece, the microbiome, the intestinal permeability, the inflammation, but also directly impacts thyroid function. So I think from that, [00:42:00] from, from that perspective, if we’re struggling to sort of get it under control, you got a recent diagnosis, you, again, you’re, you’re medicated, but not feeling great.
I think it’s a great starting point to do a gluten elimination and see how that works. I’ve not seen any other evidence, either clinically or in the research, that sort of says, Oh, going on dairy free or removing eggs or that, you know, going keto or anything like that is directly beneficial for Hashimoto’s, but that’s going to be different for different people. If a person has a dairy reaction, then obviously removing the dairy makes sense for that person. So it might, in my practice, I might start with a basic elimination diet. At least those, the three big ones to me are going to be well I should say four. Gluten, Dairy, Soy, and Egg would be my top ones. And then I do that for at least four to six weeks, and then we do a reintroduction, a challenge of those foods, because I think it’s really important to challenge so [00:43:00] that we understand whether or not those foods were actually triggers or not. So I do a careful challenge. We identify if anything is still a trigger and or anything is questionable, and then we might continue to eliminate them if they turn out to be a problem, and then I come back in six months to a year, and we try to challenge again, just to make sure, because very often some of those sensitivities, they’re not true, they’re not true allergies, could actually clear up on their own when you do the gut work, you improve the microbiome, you address the intestinal permeability, you balance the immune system, very often they can reintroduce those foods back.
If not moderately, they can bring them back, you know, in a, in a healthy balanced way. Other than that, I really focus on those foundation, foundational nutrients, get their macros balanced, make sure they’re getting enough fiber in, and they’re getting tons of protein, right? So making sure we’re emphasizing that as a foundation.
Sometimes we go keto. If there’s a lot, there’s some evidence that keto can be really great as an anti inflammatory intervention. So if there’s a lot of inflammation, there’s other metabolic issues happening, keto could be a good way to [00:44:00] sort of clean some of that up, but that’s not appropriate for everybody.
So again, case by case basis. Once you get those macros in order, I’m really focusing in on bringing tons of fruits and vegetables in and bringing in all the specific nutrients, those antioxidants getting a lot of color. I talk to them about eating the rainbow and getting a variety of all those phytonutrients and polyphenols in because of the benefits that those are all going to have on the immune balance and on the gut microbiome.
I’m a big fan of the WALS protocol actually, so I, I do talk to them a lot about the WALS protocol and although she used it more for MS. I found it to be beneficial in my Hashimoto’s patients. So I sort of dial it up and down depending on what their specific needs are. And, and I think to your point, Ben, some people show up with Hashimoto’s and they’re very much a thyroid case. Like their symptoms are very much like hypothyroidism fatigue, you know, they’ve gone showing all those symptoms, but some people show up and all that stuff looks good on paper, but their autoimmune symptoms, their gut health, their adrenal function, they don’t. Hormone Health [00:45:00] is all, is all a struggle. And so we sort of positioned the diet depending on what we need to most directly support.
Dr. Weitz: When it comes to diet, do you think the concept of some vegetables as being goitrogens is something that we should pay attention to?
Lara Zakaria: I love this question.
Dr. Weitz: Is broccoli going to make my thyroid worse?
Lara Zakaria: Okay, goitrogens, when they’re cooked, go away. We don’t have to worry about them. So that said, there is something to be said about raw goitrogenic foods like broccoli that could be triggers for some. However, goitrogens typically are called goitrogens because they increase goiter. They are hyper, they create high amounts of thyroid production. So in an autoimmune case like Hashimoto’s, where you’re fluctuating between high and low, and if we still don’t have that under control and it’s triggering, just avoid the raw ones. Get it under control and you should be able to [00:46:00] tolerate cooked versions. But this is one of my pet peeves because those goitrogens tend to be those sulfa rich vegetables, right, your cruciferous vegetables, which are a powerhouse. They’re such a powerful food as antioxidants. They help us make glutathione. They reduce inflammation. They help with detoxification. They balance hormones. They are such a powerhouse. So this idea that we have to completely remove them from the diet is, misinformation. Cooks them to be safe. That’s probably easier on your digestion anyway. It eases some of that the, the, makes the fibers a little bit easier to digest as well. In fact, it improves the bioavailability of some of those phytonutrient compounds. When you see that broccoli start to steam up and it like gets super bright green, that’s when you know you’ve optimized those phytonutrients so they’re even more bioavailable. So that’s my suggestion. To be safe, cook them. If you’re in remission, if you are well controlled, then you should be fine, even if you have them raw.
Dr. Weitz: I, I, I’ve heard this one story on several podcasts where some woman [00:47:00] consumed like two pounds of raw bok choy for an extended period of time and died herself.
Lara Zakaria: Yeah, don’t do that. I, I don’t, I can’t imagine why you would do that, but don’t do that. Bok choy is delicious, but so much more delicious cooked with some garlic and some soy sauce, gluten free soy sauce.
Dr. Weitz: And, and, and poor broccoli is kind of a maligned vegetable because it’s a high FODMAP food. It’s a goitrogen….
Lara Zakaria: Poor broccoli.
Lara Zakaria: Don’t get me started on the high FODMAP thing too. Oh. Actually, that does remind me though you know, kind of going back to the making those connections and digestion, folks with Hashimoto’s and folks with primary hyperthyroidism are more prone to SIBO and digestive, I know, right? It just wants to, it wants to be part of the show, but folks with Hashimoto’s are at higher risk for developing SIBO and [00:48:00] IBS. And so to your point, so many of these things kind of, you know, they show up like, Oh, I’m going to avoid broccoli because broccoli is you know, is a goitrogen. Oh, I feel so much better off of it. Well, do you feel better because it was triggering your SIBO and we need to address your SIBO actually and get that microbiome in check and get your motility going? Because when you have low thyroid, your motility is going to be too slow. Slow motility increases your risk for SIBO. And that’s really the connection there.
Dr. Weitz: So there’s also an autoimmune connection too, because the latest research shows that SIBO has an autoimmune component.
Lara Zakaria: Yes, correct. And it has to do with the autonomic nervous system. And again, that connection back to the brain. And yes, absolutely. So I think, again, these kind of simplistic, just take this out, take out this food, and that’ll solve the condition. We need to start thinking a little bit more upstream, right? We need to start thinking about what is actually the foundational role. What’s the physiology that’s happening there? Where’s it going wrong and how do we address it? And we have to identify those bio-individual variances in people. Why one person might be more prone to one aspect versus somebody else that shows up a little bit differently. There’s definitely not one size fits all. Everybody needs their own bio individual approach. And we need to start thinking a little bit more with nuance when we approach it.
Dr. Weitz: That’s great. It’s been a great discussion. Tell everybody how they can get in touch with you and find out about what you have to offer.
Lara Zakaria: Amazing. Thank you, Ben. It’s been a pleasure being here. If you want to keep this conversation going, I spend a lot of time on Instagram and LinkedIn, so feel free to find me there. You could search my name or look for Foodie Pharmacist. That’s 2F, so Foodie, F O O D I E, Pharmacist. F, A, R, M, A, C, I, S, T. You can also come to my website, larazaccaria. com. And I do have a screening guide and a guide that talks about better assessment available on my website, as well as a collaboration with the Better Nutrition Program on a coached a one month thyroid optimizer [00:50:00] program that’s useful whether you have primary hypothyroidism or autoimmune hypothyroidism. It’s a great starting point. If you’re not sure where to start, you’re trying to identify what might be the area that you need to focus on on more, that’s what we built it for. And you get the four week program. It’s easy to follow in the app. Plus you get the added benefit of working with a coach as well.
Dr. Weitz: That’s great. Thank you, Lara.
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 very much appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review. As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would like help. overcoming a gut or other chronic health condition and want to prevent chronic problems and want to promote longevity, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111. And we can set you up for a consultation for functional medicine. And I will talk to everybody next week.
Dr. Tom O’Bryan discusses Demystifying LPS with moderator Dr. Ben Weitz at the Functional Medicine Discussion Group meeting on September 24, 2024.
[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
00:00 Introduction and Podcast Overview
00:27 Welcome to the Functional Medicine Discussion Group
00:45 Sponsor Highlights: Integrative Therapeutics and Vibrant America
02:34 Introduction to Dr. Tom O’Bryan
02:55 Challenges in Gluten Sensitivity Testing
46:06 The Importance of LPS in Inflammation
46:23 LPS and Its Role in Alzheimer’s Disease
47:24 Bacterial Translocation and Immune Activation
48:12 Personal Anecdote and Research Insights
48:46 LPS and Neuroinflammation
49:23 The Overlooked Impact of LPS
51:46 LPS and Sepsis: A Hidden Danger
52:38 Leaky Gut in Monkeys: A Comparative Study
54:59 Chronic Inflammation and Its Consequences
01:04:08 The Path to Sepsis and Organ Dysfunction
01:05:17 The New Model of Sepsis Treatment
01:09:06 Sources and Detection of LPS
01:13:45 The Role of Lipoproteins in Inactivating LPS
Dr. Tom O’Bryan is a recognized world expert on gluten and its impact on health. He is an internationally recognized and sought after speaker and workshop leader specializing in the complications of Non-Celiac Gluten Sensitivity, Celiac Disease, and the development of Autoimmune Diseases, as they occur inside and outside of the intestines. His website is TheDr.com. Please register for his award-winning docuseries, TheInflammationEquation.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.
Podcast Transcript
Dr. Ben 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.
Welcome everybody. I’m Dr. Ben Weitz, and this is another Functional Medicine Discussion Group meeting. Please tell all your friends about these meetings. We have great speakers and it’s a great opportunity to network and learn and usually get some free food.
So our sponsors for this evening are Integrative Therapeutics. The rep from Integrative is not here so, I just wanted to tell you about a few Integrative Therapeutics products. It’s one of the few professional lines of supplements that we use in our office and since the topic is gastrointestinal related a couple of their products that we use that are really great is the Motility Activator, which is a great way to reset the gut motility naturally.
And they also have the elemental diet dextrose free version. So, for patients who are stuck, that you’re not making progress with SIBO, with IBS, consider two weeks of the elemental diet to let the gut really rest and and that can be really beneficial. So I want to thank our other sponsor for this evening, which is Vibrant America.
The rep from Vibrant America is also not here. He’s on his way. But Vibrant America is a one stop shop for Functional Medicine testing. We use a lot of Vibrant America testing. They offer great panels. You can use it to replace all your standard panels as well as all the specialty panels, the special Food Sensitivity Panels, The Gut Zoomer. They have a whole series of those. They have great toxin testing. We use the Total Tox Burden, which is this urine panel that you get environmental toxins, you get mycotoxins, you get heavy metals, and they have great Lyme testing. They have great testing for chronic viruses, so, it can pretty much be a one stop shop for Functional Medicine testing.
Dr. Ben Weitz: And so we’re so happy to have Dr. Tom O’Bryan joining us this evening, he flew in just to speak at our meeting. Tom is, doesn’t need any introduction. He’s an incredible speaker. Thank you so much, Tom. Thank you.
Dr. Tom O’Bryan: Thank you. Hello. Before I get started, about Vibrant,… So, how many of you have [00:03:00] tested for gluten sensitivity comes back negative, but the patient feels better when they go off of wheat? Is that common? It’s the test. It’s the test you’re using. So, I’ve known this for many, many years, that sometimes you get false negatives with the testing that’s available. Whether it’s gliadin antibodies, transglutaminase, endomycem, they come back negative, but the patient reacts to wheat. It’s the test. So, I started really questioning the tests. And what I did was, when I draw a tube of blood, I took a second tube, out of the same venipuncture. I labeled it Joe Smith and sent it to the lab with the patient’s blood, ordering the same test. And when the results come back, three out of ten times, three out of ten times, you didn’t know which [00:04:00] one to talk to the patient about, the one that was normal or the one that really had a problem. That’s how frequently you will see how inaccurate your testing is, and if you don’t look, you don’t know. So we live in la la land with the tests that we’re using, thinking they’re accurate. They’re not accurate. It’s the technology. ELISA tests were developed in 1986. Is that 50 years now? Not quite, 50 years ago. They’re really helpful. And I’ve known this for many, many years, and so what do you do? As you may know, I cut my teeth in the world of gluten and wheat related disorders and celiac. I did 26 8 hour days in 2008, unlocking the mysteries of gluten sensitivity. 8 hours with me, 300 studies, Metagenics sponsored it. Anyone in the room back there? With [00:05:00] me back then, yeah, yeah. And in 2009, I did 28 8 hour days on autoimmunity. I’ve been, I’ve been doing this for a while. And when you do the double blinds, the second tube of blood, and you do it enough times, you go, oh my god. You’re,… it’s like the carpet gets pulled out. You don’t know what to say to people. You just go for symptom relief and hope for the best, right?
So in the world of celiac disease, there’s who I call the four horsemen. They’re the greats in the field. Alessio Fasano at Harvard, Stefano Guadalini, University of Chicago, Peter Green at Columbia, and Joe Murray at Mayo. They’ve written more papers that are easy to read and relevant to clinicians than anyone I know. And Joe Murray. He’s the one, he’s got leather patches on the back of his elbows for his sport coats. Bowties, that he ties, not clipons, bowties, horn rimmed glasses. He’s the geek of geeks. And his papers are so enjoyable to read because they’re clinician friendly, right? If you can read papers by Mayo, by Joe Murray from Mayo, you’ll appreciate him. Well, in January of 2016, Murray wrote a paper and said there is a new era in laboratory medicine. A new era. This is from Murray at Mayo, and it’s called Silicon Chip Technology. They can look at 6,000 antigens in one blood draw. What? With 97 to 99 percent sensitivity, 98 to 100 percent specificity, right on the money, every time. So, in 1990, 1995, if I were to tell you, in about 20 years or so, I’m going to carry this little black thing the size of my [00:07:00] wallet in my hand, and if I just push on it a little bit and run my thumb one way, or I, do it another way. And I push on a button. I can tell you within five seconds that the air particulate matter in Santa Monica right now is 38. It’s a good day to exercise outside. It’s not too toxic. Chicago’s 22. Costa Rica is 38. Alessandria, where I live, is 80. Don’t exercise outside today. I can tell you anything you want to know in the world because I’ve got the encyclopedia in my hand and I can access it in 5 seconds. If I told you that in 1990, you would have thought I was watching too much Star Trek. Right? It wasn’t in our paradigm. We couldn’t believe that’s possible. It’s possible. That’s silicone chip technology. Wake up.
The tests that you’re doing you have to check, because who’s getting screwed? [00:08:00] It’s the patients. Because you’re believing what you see in the results and you apply your protocols based on that and so many times…three out of ten…in my practice, 3 out of 10. So, that’s my plug for Vibrant. Because it was Vibrant that Joe Murray was talking about. That’s the technology. Silicone chip technology. It’s a game changer. There’s nothing like it. I’ve never seen anything like it. So, they’re sponsoring me here tonight. So that’s my plug for Vibrant, before I get started. It’ll change your practice when you do this and you do like, do five patients, it’ll cost you, you have to pay for the test yourself. You can’t bill the patient for it, but you’ll find out. Wow, one out of five of my patients gave me completely wrong information, or two out of five, completely wrong information. It’s like, holy [00:09:00] cow. Okay, let’s go. See if I can.
I’m really excited to talk to you tonight about this topic. I’m really excited. It’s a, it’s the talk that I’m giving on Saturday morning in San Jose at the Vibrant Longevity Conference. And I think I’m going to rock a few boats here and I’m looking forward to that. So many thanks to Ben for the invitation, you know, for being able to come here tonight.
This is my boss. I think the only way we’re going to change the direction the planet is going in is to raise a generation of children that think outside the box. They have to think differently because we think we’re saving the planet, but we’re driving SUVs, right? We think a certain way. So we need children that think outside the box. And the topic of this talk is really important for that. So that’s my son. And he’s almost four now. So I’m going to give you 12 premises tonight, 12 concepts, and I hope you’ll write them down maybe in your phone or a couple of notes to take so that you can think about them some more. This presentation is designed as a paradigm expanding, thought provoking engagement. I suspect there will be a few new concepts here for some. Allow ideas to percolate from these facts and write down your thoughts and questions.
In my career, when I found a paper that really captured me, I was like, what? I taped the front page of the paper to the ceiling in my bedroom. I did. And when I go to sleep at night, I go, oh, oh yeah, oh yeah. And sometimes I’d have thoughts about it during the night. I’d wake up, I’d set myself up, I gave myself permission [00:11:00] to think outside the box. You know, to just have it in my awareness. And then I would, oh yeah, and then I’d write little notes down. I got this little pad with a pen. You pull the pen out and a very soft light shines down on the 3×5 card. So you don’t have to turn the lights on in the room. You don’t get blinded. Right. And then in the morning I say, Oh, that’s right. Oh yeah. I groomed myself in topics that I didn’t, I wasn’t familiar with. If I read a paper and it is like, what? I groomed myself to think about that topic. I encourage you. to consider doing that with something that really grabs you. Put it on your refrigerator. It doesn’t have to go on the ceiling. Put it on the refrigerator. A graph from one of the papers, right? Because most clinicians don’t have time to read research. You don’t have time to do that unless you’re a geek and just love it. Like I do. It’s in all, three bathrooms in the house. There’s research papers and highlighters in all the bathrooms, right? [00:12:00] So when you find something that captures you, you dive in. You really dive into it. You learn more about it. And the result is, within a few months, you’re pretty competent in that topic. Much more competent than your peers, because you’ve read three or four papers on that topic now. because you read one and you look at the references in the back and then you order the papers or you download them off the internet and you’ve read two, three, four of those papers, you’ve got that, doesn’t matter what the concept is. If it grabs your interest and you allow yourself, you set yourself up to think outside the box, the result is you expand your consciousness, you expand your awareness on that topic that you’re interested in. Allocate one hour a week. For six months, just one hour a week to the topic. And in six months, you’ve got this. You’ve really got this down.
This is a [00:13:00] paper that everyone should read. All disease begins in the, quote, leaky gut. The role of zonulin mediated gut permeability in the pathogenesis of chronic inflammatory diseases. This is Fasano at Harvard, Professor of Medicine at Harvard, Professor of Nutrition, Harvard School of Public Health, the chief Pediatric Gastroenterology at Harvard, the Director of the Celiac Research Center at Harvard, the Director of Mucosal Immunology at Harvard. This guy has five titles. Any one title is a lifelong dream for someone at the top of their game. He’s got five. We think he’s going to win the Nobel Prize because it’s him and his team that identified the mechanism of zonulin in the production of Leaky Gut back in 1997. And they’ve written 400 papers now on that in the last 25 years. He’s always really careful of what he says, always, so that he’s not misquoted. You’ll [00:14:00] see a paper, and there’s eight authors on the paper, and the last one, Alessio Fasano, the stamp of approval from the boss, right? This paper, he wrote himself. I give you that history because The significance of the message from this great in the field. He’s a great in the field. All disease begins in the leaky gut.
This is a paper that needs to go on your refrigerator or on your ceiling and you digest this paper. He talks about the perfect storm in the development of chronic inflammatory diseases. He lays it out sequentially, you go, wow, well, what about, wow, wait, what about, Wow! And you follow his line of thinking and you get it. All disease begins in the leaky gut.
So, this is so very true, isn’t it? Now, what [00:15:00] does he mean? Well, if you haven’t read this book, this is from the 1950s, and it’s such a critically important book to read. It’s all about the adrenal glands and the impact of stress, and if you don’t know, you probably know, but a young man that unfortunately dies of trauma, a healthy young man, his adrenal glands are the size of a walnut. A young man who unfortunately dies of disease, his adrenal glands are the size of a peanut. So you think giving some nutrients for a few months or changing a diet is going to change that? How do you rebuild adrenal glands? One cell at a time. It takes years to rebuild an adrenal gland, but do you have any biomarkers of what you’re doing and the goals of what you’re trying to produce? You read Selye’s book and you start to get this big picture. Now I put the book here because of the quote in the book. I just love the quote.[00:16:00]
You’re all advanced clinicians here. You’re all advanced, but you’ve not done double blinds on blood tests yet. Right? Nor so naive to believe you could do so without intellectual effort. We trust our labs. We trust what we’ve been told. Wake up. So this paper tells us of why we have every autoimmune disease is going up four to nine percent a year, every single one of them.
Why? Well, the population has gone from, in the 1950s, we were at about 2 billion. Now, we’re at over 6 billion in 50 years, in 70 years, but look at the ratio of these. Look at how many of them, oops, let me back that up, sorry. There we go. The blue line are those over 70, the percentage of the population over [00:17:00] 70, compared to The percentage of the population under 70. We’ve got billions of more elders now. That’s a primary contributor that every autoimmune disease is going up 4 9 percent a year because there’s more people living longer who’ve had a lifetime of toxic exposures and their bodies are breaking down, right?
Societal triumph of longevity is plagued with debilitating morbidity accentuated towards the end of life. There’s a recognized gap between lifespan, the total life lived, and healthspan, the period free from disease. That’s my personal goal, is to extend the healthy lifespan closer to the total lifespan. I don’t know about extending life, I don’t know, I can try, you know, I hope so, I hope so. But, that quality of life, [00:18:00] healthy lifespan is, and when I say that to a patient, they all, oh yeah, yeah that’s what I want, well this is what you have to do. You have to figure out how you’re throwing gasoline on the fire and stop throwing gasoline on the fire.
They get that, and they have a goal that they understand what they’re trying to accomplish. Male life expectancy is almost 79, but the average healthy male life expectancy is 62. So for men, the last 16 years of their life are spent with disabilities. That’s the average. That’s the average. For women, they live five years longer. And their average is 20 years of disability. They’ve lost healthy lifespan. Do you get how profound this is? When you show this to a patient, They don’t want to be with disabilities. They want to extend total, healthy lifespan. And when you frame it this way, [00:19:00] when you get, you know, a couple of these studies and you just read them and you start thinking about it, you put the ceiling of your bedroom, you start thinking about it, you start applying those principles to your life and to your family. You start understanding some of the mechanisms that have to be looked at. One fifth of an individual’s life will be lived with morbidity. That’s a gruesome thought, but that’s the average. Yeah, right now. That’s the average. So, whoa, whoa. So now we address a tool in reversing this devastating direction, right? That’s our goal.
When do these eventually disabling diseases begin? Most of you will remember this paradigm shifting study that came out in New England Journal of Medicine in 2003. Melissa Arbuckle at the VA, she looked for people with lupus in her VA center. There were 132 [00:20:00] people diagnosed with lupus. Now, if you’re in a VA center, you’re a vet. If you’re a vet, you were in the Armed Forces. If you were in the Armed Forces, you had your blood drawn many times over the years when you were healthy in the Marines or the Navy. What most people don’t know, government’s been saving and freezing all of that blood since 1978. They’ve got tens of millions of samples of our service people’s blood. Well, Arbuckle knew that, and she asked for permission to look at the blood, the frozen blood of the currently diagnosed veterans when they were healthy in the Marines or in the Navy. She got permission and what did she find? She found that antibodies are present years before a diagnosis. Elevated antibodies. There are seven antibodies to lupus. Every single one of them was elevated five years before there was ever a symptom. So here’s the symptom. The zero line is normal and anything above is elevated. And all of the antibodies of lupus are elevated and there’s a predictable course of increase in symptoms.
Antibodies, increased antibodies. Why? Because they’re still living the lifestyle that’s causing the problem. They don’t know it’s their lifestyle causing the problem. Until they hit a threshold. Now they get symptoms, and within six months to two years, they get the diagnosis of lupus. And this is the summary of those seven questions. different antibodies and how they climb. And she put this together and she made it up. She said, well, you’ve got normal level of antibodies to your thyroid or to your liver, whatever your brain, whatever antibodies you’re looking at. There’s a normal level. And why do we have antibodies to our thyroid? Why is there a normal level of antibodies to cerebellum? Because the antibodies are part of the [00:22:00] process of autophagy. Getting rid of the old and damaged cells, making room for new cells. But elevated antibodies means you’re killing off more cells than you’re making. That’s just a basic 101 concept. Elevated antibodies are never normal. Well, let’s just wait and see. What are you waiting for? You know, there’s a problem. There’s some type of imbalance. There’s a problem. But first you have normal immunity. Then you have benign autoimmune. That’s what she called it. That’s elevated antibodies and no symptoms. Now you get symptoms. And then you get a diagnosis.
To increase healthy lifespan, we must address the imbalances when in the prodromal period. What does that mean? Well, the prodromal period is before clinical illness, before a diagnosis of a disease. That’s when you’ve got to address this stuff. That’s when it’s [00:23:00] the easiest to address. And as Fassano says, arrest and reverse the development of autoimmune diseases. You can arrest them, but you have to learn how to do that before diagnosis. That’s like, whoa, okay, okay. And you think about that, you get a couple of those studies because they’re paradigm shifting in your brain. When you understand the mechanisms that are going on, you start thinking differently. Focus on addressing the presenting symptoms successfully, and you are still likely to exasperate the comorbidities.
How do we address the mechanisms triggering comorbidities? That’s the key to expanding healthy lifespan. And how do we accomplish this during the prodromal period? Well, in God we trust, in all others require data. That’s Andrew Campbell, and [00:24:00] that’s a very good sentence. I like that sentence a lot.
So here’s what I did back in 2008, the full day seminars on gluten. And I talked about, back then, the serology. Identifying celiac disease or gluten sensitivity is ineffective in detecting those with silent or subclinical celiac disease. The sensitivity of endomycium, for example, is 100 percent if patients have total villous atrophy. But when they have partial villous atrophy, it’s 31%, meaning it’s wrong 710 times with a false negative. Wait, what? So you’re testing for celiac disease? If they don’t have total villus atrophy, you miss it seven out of ten times if you’re doing endomycium or transglutaminase. You miss it seven out of ten times.
And I taught that back in 2008. But still, so many are still using [00:25:00] Transglutaminase or Gliadin antibodies as the marker people have a problem with wheat. It’s wrong 10 times if you don’t have total bilis atrophy. If you have total bilis atrophy, it’s right on the money. And fecal antibodies, some docs are doing fecal antibodies against these antigens. Well, the sensitivity of Transglutaminase is 10%. The specificity is 98, but that it accurately identifies it, it’s wrong 9 out of 10 times. And for Gliaden, it’s 6 percent wrong, 9. 4 out of 10 times. Well, I do the stool test. Um, can I suggest you read a study on that? And I give them this link. It’s like, wait, what?
You know, what? So, here’s Vibrant. This is a paper that Joe Murray’s team put out [00:26:00] in January of 2016 that changed my life. Now we had tools that I could tell clinicians about that are 97 to 99 percent sensitive and 98 to 100 percent specific. Right on the money every single time. The only exception is is if they have low total immunoglobulins.
Then you can’t test immunoglobulins because they’re low, or if they’re on steroids. You can’t test immunoglobulins if they’re on steroids. A combination of lithography and biochemistry for peptide synthesis has opened the door to a new era in the identification of novel biomarkers of disease. This is Murray.
This is one of the godfathers of celiac, and he doesn’t work for Vibrant. He was as excited as everybody else to see this technology. The relative non invasiveness, broad availability, and versatility of the high throughput [00:27:00] peptide microarrays makes this technology well suited for incorporation into routine healthcare and provide a promising new tool for biomarkers.
And this is the Wheat Zoomer test because you zoom in on the problems. This is page one of the test report, and this is the part where they look at leaky gut. These are the biomarkers of leaky gut, and that was a brilliant business move on their part. I wish I had stock in Auburn, but there’s no stock available, but I wish it was.
I did. Because this is brilliant. They took the most comprehensive test. ever produced so far that I know of to identify leaky gut, and they put it in the wheat zoomer, and they made it affordable. It’s like 350 bucks or 400 dollars. Very reasonable. But now you have not only the antibodies to zonulin, actin, and LPS, but you also get zonulin levels. which [00:28:00] is just excellent. So where do we begin in educating our patients? Is there a root cause in the development of chronic inflammatory diseases? You know, I’m the kind of guy that doesn’t hold back. So if you’re talking about, well, this is the root cause of your disease, this genetics, it’s the root cause.
No, it’s not. There are many causes to disease, but there’s one root mechanism. There’s one. I suggest there’s not a root cause. There are many causes and we must refrain from using this type of language as it confuses patients and deflates their receptivity. When a root cause is addressed, and they still have symptoms, they lose faith in you when you do language like that. Right? There is a one root mechanism in the development of chronic inflammatory diseases, and speaking to this paradigm will guide and empower your patients to use more of your services. They hop on board with you when they understand. [00:29:00] I call it the Prime Directive. What’s the Prime Directive? Well, the Center for Disease Control tells us that 14 of the 15 top causes of death are chronic inflammatory diseases. Everything except unintentional injury is a chronic inflammatory disease. It’s always inflammation, without exception. Why are we not making this primary in our therapeutics for every patient?
This is the mechanism of This is a patient you pull in a chain and breaks at the weakest link. It’s at one end, the middle, the other end. It’s your heart, your brain, your liver, your kidneys, wherever your weak link is. And that’s determined by your genetics and your antecedents. How you live your life. You eat mercury twi or you eat tuna fish twice a week.
You got mercury toxicity. Right, because all, most of the tuna now has mercury, high levels of mercury, right? That’s an antecedent. So it’s your genetics and how you live your life that [00:30:00] determines where the weak link is, but it’s inflammation that’s the pull on the chain. That’s what’s pulling on the chain.
You have a BRCA1 or BRCA2, it doesn’t mean you’re getting breast cancer. It means if you pull on the chain too hard, That’s where it may manifest. If you have an ApoE4, it doesn’t mean you’re getting Alzheimer’s. But if you pull on the chain, and Dale Bredesen has given us so much information on that. Stop pulling on the chain. There’s 36 holes in the roof. Fix the holes in the roof. That’s Dr. Bredesen’s approach. Right on the money. But it’s to stop pulling on the chain. And when you talk to your patients like this, they get it. It’s not geeky science to them. You’re pulling on the chain too hard. You got mold in your house. I tested you.
You got mold. We have to get the mold out because it’s pulling on the chain. And that’s your daughter’s attention deficit or whatever the symptoms are. They’re presenting with every chronic, Disease is a [00:31:00] Chronic Inflammatory Disease. Every one of them. We were never taught to think like this. Get a couple of these papers, and just chew on them a bit.
And you’ll get as passionate in your own way about it as I am. I’m half Italian I’m a little vocal about it. Chronic Inflammatory Diseases have been recognized as the most significant cause of death in the world today. When your immune system gets activated, why is it getting activated, it’s got, it gets activated producing inflammation because it got this message.
We’re under attack, fight and defend. That’s why you get inflammation. So the question is, what is it your immune system is trying to protect you from? It’s that basic. It really is that basic. And then it’s all the sophistication of what tests do you do and how do you interpret the tests? What do you do when you find the results? of where the inflammation is coming from, what are [00:32:00] the environmental triggers. That’s the art of medicine, the art of healthcare, right? But the concept is just so basic. I don’t mean to insult anyone here, but we should all be living in that world of basics with our patients. This is precisely why I spent the last year putting together the free docuseries, The Inflammation Equation.
I went to seven countries, interviewed 64 experts on inflammation. Did anyone in here see The Inflammation Equation? No, oh my, oh, a couple people? Thank you. Yeah. It’s TheInflammationEquation.com. Please register, it’s free, and watch the first day. Just watch, watch the first ten minutes. And if you’re not hooked, turn it off and say, alright, whatever. Right? Just watch the first ten minutes. Terry Walls started crying when, when she saw it. She started crying. She said, Tom, this is right on the money. I’m doing a docuseries. And she [00:33:00] just finished her docuseries. She said, I’m going to do a docuseries. I interviewed her in the early days for this one and she decided to do hers on ms, and it just launched and is really great.
But in any event, please take a look at this because you’ll find that every single patient when they watch this, and I programmed this I language this. So that every day we say, now go back to the healthcare practitioner that recommended this event to you and ask them, where’s my inflammation coming from, or do I have mold sensitivities, doc, or, but we prep your patients to come back to you.
We’re not selling them anything here is to come back to you more educated. So you aren’t trying to convince them. to do a test. They get it. They understand that you have to identify the environmental triggers that are activating the immune system, trying to protect you, [00:34:00] causing the inflammation, pulling on your chain, and wherever the weak link is on your chain, that’s where the symptoms are manifesting. They get it. They understand that basic concept. Pull the chain and breaks at the weakest link. This drawing is so wonderful. When I saw this, I had to go interview that guy. And that’s David Furman at Stanford, also at the Buck Institute. He got the contract with NASA to figure out why are the astronauts aging so quickly in space? Because astronauts can never go to Mars. Never. The technologies They’re two and a half years and the spaceships are at Mars, but astronauts will die on the way. Now NASA doesn’t talk about that, but that’s what they found out. And what is it? It’s inflammation. Accelerated inflammation. So I talked to David about that.
I love this drawing because every patient understands this. Mrs. Patient, you’ve got a viral [00:35:00] infection and that activates your immune system, or physical inactivity, or obesity, or Dysbiosis, Diet, Chronic Stress Hormones, Not Regenerative Sleep, Xenobiotic Accumulation in your body. It turns the wheel, which turns the middle wheel, which gives you systemic chronic inflammation that manifests as Diabetes, Cardiovascular Disease, Cancer, Depression, Autoimmune Disease, Neurodegenerative Disease, Sarcopenia, Immunosuppression, it doesn’t matter what the symptoms are. This is the mechanism. This is what they’re teaching in Stanford Medical School right now. This is the mechanism. We all should be embracing this as a 101 primary as we’re working with our patients. You know, we first have to of course address their symptoms so they’re starting to feel better or at the same time, but to educate them. This is what we have to educate them on. [00:36:00] And we know that the nine well established hallmarks of aging are all linked to sustained chronic inflammation. Every single one of them, without exception. This also is from Berman at Stanford. How important is it to identify the triggers of inflammation?
If you want to extend healthy lifespan, this is how you do it. You stop the deterioration, deterioration, the antibodies, killing off cells, killing off cells, killing off cells, while they feel fine. They feel fine. They don’t know. No, I don’t feel bad when I eat wheat dock. I feel fine. But they don’t know that for every one person that gets gut symptoms, there are eight people that don’t, who test positive to weep. They get brain symptoms, or skin symptoms, or joint symptoms. They don’t get gut [00:37:00] symptoms, so they feel fine. They think they’re okay. From the blood immune of a thousand individuals, They looked at this and they, a deep learning method was based on patterns of systemic age related inflammation, and this is what they found out.
The resulting inflammatory clock of aging tracked with multi morbidity, immunosenescence, frailty, and cardiovascular aging, and is also associated with exceptional longevity in centenarians. The ones that live long have low markers of chronic inflammation. And here is an example. 79 centenarians, disease free, they’re all disease free, were compared to 178 people under 40 who had had a heart attack and 178 people under 40 who did not have a heart attack.
So they compared the three groups. All the [00:38:00] centenarians were free of major age related diseases. Disease free veterinarians had significantly lower levels of serum zonulin and LPS than young patients.
This is what it looked like. I’m going to talk about lipopolysaccharides for the rest of the night now. Look at the numbers. You want to live over 100? This is what it takes. This is, this is extended Healthy Lifespan. This is what it takes. Low LPS. Low Zonulin.
And that’s just the bar graphs that went along with the study for LPS and the bar graph for Zonulin. LPS levels were significantly lower in disease free centenarians than in acute myocardial infarction patients and [00:39:00] healthy young controls. Zonulin levels were significantly lower in centenarians. So when researchers, when geeks, say significantly, they’re, you know, that’s their word for, Holy cow, Batman, look at this!
You know, it’s just startling, the results. Permeability may cause endotoxemia, which in turn leads to inflammation and insulin resistance, atherosclerosis and hypercoagulation. Our data suggests serum levels of zonulin and LPS emerge as potential novel biomarkers of exceptional longevity. Extending healthy lifespans.
Now there are many factors to take in mind, and this is one of them, but this is a primary that I’m talking about for the rest of the night. You really need to get this one down, understand this one. Put it on the ceiling of your bedroom. What other biomarkers are you currently using to identify exceptional longevity?[00:40:00]
We’re not using them. So LPS is a biomarker of exceptional longevity. A very basic paradigm in functional medicine is test, don’t guess. You must monitor a patient to confirm successful redirection and or to identify roadblocks. And the summary of this study, I’ll let you read that, very powerful study. 79 centenarians. Everything should be made as simple as possible, but not simpler. The essential question is with inflammation, what is the immune system trying to protect you from? What’s it trying to protect you from? Here’s Tassano. Those are his titles. That’s the paper that everyone should read. All disease begins in the leaky gut. And just google it, it pops right up and you can [00:41:00] download it.
Can you go back? Go back? Yeah. This? Okay.
The activation of the zonulin pathway represents a defensive mechanism to flush out microorganisms, contributing to the innate immune response of the host against changes in microbiome ecosystem. Do you understand what he’s saying? Our ancestors, Mrs. Patient, you have the same body as your ancestor 10, 000 years ago, the same kidneys, the same immune system, everything functions the same. And before agriculture, our ancestors were nomads. They followed their herds for food. Food was the number one thing they needed. Top priority. Then shelter and safety. Right? But it was food. They’re walking around, they find something, they grab it, they sniff, they nibble, and they eat it. If there were bugs on that food, which there [00:42:00] often were, and hydrochloric acid didn’t kill it, and it comes into the proximal part of the small intestine, that’s where toll like receptor 4 is very abundant.
Why? Because it’s the sentry, standing guard. I think of the soldiers at Buckingham Palace, those big hats, you know, they’re just dormant as can be. But don’t mess with those guys. But they’re dormant. Toll like receptor 4 is dormant, until it’s scanning everything that’s coming out of the stomach. And when it sees a bug, what does it do?
Two things. Within five minutes, it activates increased production of zonulin, which opens the tight junctions. Water comes from the body into the gut to wash out the bug with the poop. That’s what leaky gut is for. It’s a life saving mechanism. It’s very cool. Excessive leaky gut is a problem, right? Two things. That was the first one. The second thing, It activates NF kappa B, the [00:43:00] major amplifier of inflammation in the body, within five minutes. All that happens within five minutes. I’ve got the videos. If we have time later, I’ll play the videos and you see what leaky gut is within five minutes. Wow! So, that’s the purpose of leaky gut.
Now, listen to Fasano. Among the several potential intestinal luminal stimuli that stimulates zonulin, Small Exposure, Large Amounts of Bacteria, and it’s Exhaust LPS, and Gluten are the two most powerful triggers. Most powerful. Not soy, not dairy, not lectins. Gluten. Why? Oh, wait a minute. Okay, so I didn’t put the slides in here as to why. Why? And it’s in that paper from Fasano. Gluten is misinterpreted. as a harmful component of a microorganism. [00:44:00] The protein structure of these peptides of wheat look like the outer shell of gram negative bacteria. That’s why every human gets leaky gut every time they eat wheat, whether they feel it or not.
Every human. Maureen Leonard at Harvard, famous gastroenterologist, did a literature review on that topic, and she published it in the Journal of the American Medical Association, and she said this occurs in every human, everyone, whether you feel it or not. Okay, LPS. It’s one of the main toxins responsible for inflammation from gram negative bacteria, which ranks among the most potent amino stimulants found in nature. How important is that? One of the most potent immune stimulators in nature. [00:45:00] LPS is the major molecular component of the outer membrane of gram negative bacteria. It’s the shell that protects the gram negative bacteria, serves as a physical barrier, uh, protection from its surroundings. This is LPS. That’s LPS. Drosado says it’s one of the two most potent triggers activating leaky gut. Leaky gut is the gateway to development of chronic inflammatory diseases. 14 of the 15 top causes of death are chronic inflammatory diseases. When you put this together, it’s like, holy cow, I never thought of it that way.
Critically important to address LPS. It’s an intrastructural component found in the external membrane of gram negative bacteria, as well as representing [00:46:00] one of the most powerful microbial inflammation indicators. Could they say it any differently to knock it into our heads how important this is? One of the most powerful, one of two that stimulates leaky gut.
Look at this, the title of this paper. Look at the title first. Microbiome derived lipopolysaccharide enriched in the perinuclear region of Alzheimer’s disease brain. LPS is recognized by Toll like receptor 4 as a marker for the detection of bacterial pathogen. and is responsible for the development of inflammatory response, is perhaps the most potent stimulator and trigger of inflammation known.
Could they say it any more clearly for us to pay attention to it? The most powerful trigger of inflammation known [00:47:00] causes a substantial increase in the production of cytokines, chemokines, and the synthesis of a broad group of lipid inflammatory meteors. So LPS is the outer shell, and in your body, it’s called endotoxemia, when you have elevated levels of LPS.
Because it’s endotoxin. We know that gram negative bacteria is in the passage of viable indigenous bacteria from the GI tract to extra intestinal sites such as the mesenteric lymph nodes, the liver, the spleen, the kidney, the peritoneal cavity, the brain, and bloodstream, under some stressful conditions.
Wait, wait, what? What? Did they just say bacteria from the GI tract goes to extra intestinal sites, such as the brain, the mesenteric lymph node, the liver, the spleen, the kidney, the peritoneal cavities and the bloodstream? Yes. And damage to the gut correlates with [00:48:00] how much the immune system gets activated.
Now this is, this paper, this paper, it came out in 2010. I called my friend Ari Vojtani. We were working together at the time and Tom, Tom, are you okay? I said, yeah, yeah. Tom, it’s 10 o’clock at night. Why are you calling? Ari, listen to the title of this paper. Compromised gastrointestinal integrity and pigtail mucocs is associated with increased microbial translocation, immune activation, and IL 17 production.
In the absence of infection, and we were talking for an hour or more about this, because I’ll show you why. In the brain, LPS causes inflammatory response, which results in the degeneration of neurons, synaptic loss, and finally, neuronal cell death. This process is mediated by [00:49:00] the production of inflammatory molecules.
Look at this sentence, amyloidogenesis caused by LPS is the most prominent phenomena in the cortical and hippocampal areas. Most prominent in the development of Alzheimer’s. Nobody’s checking for it. Nobody’s treating it. Most powerful bacterial activator of an immune response, creating the inflammation.
that pulls at the chain. Could they say it any clearer? Look at the title of this paper, Lipopolysaccharide Induced Model of Neuroinflammation, Mechanisms of Action, Research Application, Future Directions for Excuse. You put this one on your ceiling, and in a few months, you’ve got this. You’ve got it. But right now, it’s like, whoa, that’s all geeky stuff.
You know, for most people, it’s [00:50:00] like, well, but when you read it once, and then next week, you read it again. And then maybe the next week, you kind of look at it once more, what you’ve highlighted, you start to get it, and you get in the flow of what these people who spend their lives researching this are trying to tell us.
Because we’re the ones that are supposed to be taking their information and applying it to the patients. But we don’t even know about this. Did you know that LPS? is the cause of amyloidogenesis, the most powerful trigger. LPS can induce characteristics features of Parkinson’s by causing neuron loss.
There are papers reporting persistent changes in the brain and cognition upon single LPS administration, even 10 months after LPS injection. This is consistent with the very first report of neurotoxicity after LPS exposure. When a laboratory worker developed Parkinson like signs three [00:51:00] weeks after exposure to 10 micrograms of LPS from salmonella through an open wound.
And this just talks about all the different areas of the brain and how LPS affects different areas of the brain. Take a picture of this one if you want.
You’ve got five seconds, four, three, two, one. What’s the longer term body response to LPS migration into systemic circulation? Absolutely no one is talking about what I’m about to talk about. I’ve never heard anybody talk about this. LPS is the primary cause of sepsis. Wait, wait, what? The number one cause of death of elders in hospitals?
Sepsis? And LPS is the primary cause of it? [00:52:00] By an overwhelming systemic response to bacterial infection, sepsis is a life threatening multiple organ dysfunction resulting from a deregulated Host response to infection. What is a deregulated host response to infection? What does that mean? How and why is this primary cause of mortality for elders in the hospitals a multi organ condition? How does that happen? Damage to the gut epithelium results in systemic microbial translocation from the gut into the body that correlates with immune activation. So pigtail macaque monkeys, their guts are very much like human guts, and lots and lots of studies have been done over the years with using macaque monkeys, because they’re very similar.
Pigtail macaque monkeys always have leaky gut. They always do. Don’t know [00:53:00] why. The food they’re eating probably. Rhesus macaque monkeys rarely have leaky gut. So they looked at this and they found an average LPS accounted for 13 percent of the tissue of the gut in monkeys that have leaky gut. But in those that don’t have leaky gut, LPS was only 0.
274%. Meaning, if you have a healthy gut, you don’t get the migration and deposit. LPS into the tissue. 13 percent of the tissue is made up of LPS. Do you think the immune system ignores that? Absolutely not. We think, oh my gosh, lead toxicity, lead poisoning, oh my gosh, and it’s important, of course, to address that.
Well, the immune system’s [00:54:00] attacking lead, isn’t it, in there? Do you think it’s not attacking the LPS, the most powerful trigger of inflammation that we have? And this, this is the key, this one, when you understand what you’re looking at, you start drooling. This is stained for LPS. The dark brown is LPS. This is how much of the tissue in pigtail macaques with leaky gut.
The LPS is deposited in the tissue. This is when you don’t have leaky gut. So, what kind of a state of inflammation do you think this would be? As much as the immune system could possibly do. Because it’s constant, right? This is a constant assault of bacteria that is a primary trigger activating an immune response.
Right. But it’s constant. [00:55:00] Chronic low grade systemic inflammation. 14 of the 15 top causes of death are chronic inflammatory diseases. And this is the area of the colon that had LPS embedded in the tissue.
And they identified, they looked at these animals and they found LPS embedded in the peripheral blood mononuclear cells, embedded in the spleen, embedded in the axillary lymph nodes, in the inguinal lymph nodes, in the mesenteric lymph nodes, in the duodenum, in the jejunum, in the ileum, in the cecum, in the colon.
Do you start to get a sense of where sepsis comes from?
A lifetime of leaky gut? A lifetime of infiltration of LPS depositing in your tissue throughout your body? And then something takes them over the edge, [00:56:00] and that inflammatory cascade is out of control, the cytokine storm is out of control. But it’s all the OPS that’s been deposited in there over 50, 60, 70 years, that no one ever detoxed to get out, because they’ve never identified it, they’ve never thought about it. These data define the degree to which microbial translocation stimulates the immune system, locally and systemically. Did they just say immune activation in the absence of viral infection? Yes, they did. What does that mean? It means the endotoxin that’s already in your body is triggering that chronic systemic inflammation.
Does that mean what is already stored in the tissue activates a chronic systemic immune response without new exposures? Yes! So you clean up the diet, you heal the gut, but they’re still walking LPS storage tanks [00:57:00] from 50 years of this stuff. It doesn’t go away unless you take action to get it out of there.
Very recent studies have evaluated pro inflammatory potential of several different chemokines, cytokines, amyloid, beta peptides, LPS, either alone in combination. So they’re checking all different markers of inflammation there, have indicated that when compared, bacterial LPS exhibits the strongest induction of pro inflammatory signaling in human neuronal glial cells of any signal inducer.
It’s the most powerful, and every one of you are ignoring it. Excuse me? It’s time to wake up. Look at the title of the article again. Where do you think Alzheimer’s comes from? Not just LPS, of course, but this is fueling that inflammation so quickly.[00:58:00]
For example, exposure of LPS from the gram negative GI tract, abundant bacterioides fragilis, and we’ve all done stool tests and we get positives back on B. fragilis. It’s pretty common for me, maybe 10 15 percent of the patients will have this. It’s found to be an exceptionally powerful inducer of NF kappa B that triggers the expression of pathogenic pathways involved in neurodegenerative inflammation. So LPS, Bacterioides Fragilis, is an exceptionally powerful inducer of the major amplifier of inflammation. Puts a whole new perspective on They don’t have any gut symptoms, but they’ve got positive for Bacterioides Fragilis, but they’ve got depression.
Might not the inflammation that’s caused by this be contributing to their neurodegenerative inflammation, be contributing to their [00:59:00] depression? Absolutely! All disease begins in the gut. Remember the article by Pisano? All disease begins in the gut. And this is a primary mechanism to this. It’s fairly common to find Bacteria Fragilis on a stool analysis.
Now perhaps you’ll look with eyes that see a deeper potential significance to this finding. Perhaps test for inflammation in the brain, because B Fragilis is an exceptionally powerful inducer of NF kappa B that triggers the expression of pathogenic pathways involved in neurodegenerative inflammation.
Every patient I see gets a WeetZoomer and a NeuroZoomer Plus, minimum. I don’t care what they present with. And then I show them how inflamed they are. And then we talk about other tests, if necessary. The NeuroZoomer has anyone here done NeuroZoomer Plus? Yeah? A few people? Okay. It looks at 53 markers of inflammation in your brain.
53! [01:00:00] with 97 99 percent sensitivity, 98 100 percent specificity. It’s a new era in laboratory medicine. And I asked my friend Jill Carnahan, I said, Jill, how often, she was taking a drink of water at dinner, I said, how often do you get a negative back on a Zoomer Plus, Neural Zoomer Plus? She went, Never!
You never get a negative back on a first test. Until people understand, Yeah. What to do? Everybody’s brain is inflamed. Why? Because we all have this low grade chronic systemic inflammation that is the mechanism for 14 of 15 top causes of death and 20 percent of the blood in your body that’s full of inflammatory cytokines is in your brain at any one time.
So your brain is the organ that’s most affected by it, right? So you test the brain for inflammation. You do the NeuroZoomer Plus test and [01:01:00] you see how bad it is. Then you start protocols to turn it around. Mrs. Patient, this will take two years. This is what, what I think you have to do, but I wouldn’t redo the test for at least a year.
You can if you want after six months, definitely not before, but I wouldn’t spend the money until a year. It’s going to take a while to turn this around. You know, you, you just give it to them straight. And once you’ve educated them about pulling on the chain, it’s always inflammation, their mother died of dementia, and they’re scared to death, you say, okay, we have to stop the pull on the chain.
And this is how you do it.
Oh, we’ll just skip that. Endotoxin may trigger cellular biosynthesis, activate intracellular mechanisms of apoptosis, and induce strong activation inflammatory pathways with the consequent release of pro inflammatories. You can read it all. [01:02:00] But this is LPS. This is what LPS does.
Imagine for just a moment how inflamed a body must be with this low grade constant inflammation fighting LPS in so many tissues throughout the body. It’s stored in the tissue.
Does LPS in the tissue go away on its own? No! LPS deposits incrementally in the tissue over a lifetime, activating a continual low grade systemic inflammation. It is a primary mechanism in development of chronic inflammatory diseases. It doesn’t go away. You want to stop sepsis? My mother died of sepsis. I didn’t know this at the time. This is why I know this now.
This fact alone should change [01:03:00] the paradigm of how we address the topic of intestinal permeability and leaky gut. I encourage a much more comprehensive detoxification protocol of identify, remove, and treat. Refine, Restore, Recheck. Whatever your protocols are in those five categories, but you always recheck.
I don’t care how much better they feel and they don’t want to spend the money. You always recheck because you don’t want to hear three years from now, Oh, I went to see Dr. So and so and I felt a little better for a while, but you know, it didn’t last. You always recheck. What is the impact of LPS that passes through a leaky gut into systemic deflation?
Recheck. Oh, we did that already. There’s a marker that says, yeah, we did that. Okay, it looks like I’ve got that there twice. Let me see what happened here. Let me find out where we are here. [01:04:00] Oh, I see. I know where we are now. This is very cool. I’m going to talk to you about where sepsis comes from. Sepsis is a life threatening multiple organ dysfunction.
Resulting from a deregulated host response to infection. LPS is the primary cause of sepsis, an inflammatory syndrome characterized by overwhelming systemic response to bacterial infection. See, if I just told you these things, you would think I was a little fanatic, right? But it’s these guys that are telling, it’s all these studies that are telling you this.
And we don’t know this, but this is the number one cause of death of elders in hospitals. And we are treating for this. This estimate of the prevalence of sepsis is 31. 5 million patients per year, with 5. 3 million deaths. High income countries hospital mortality rates for general and severe sepsis are significantly elevated, 17 and [01:05:00] 26 percent respectively.
In the old model, sepsis was used as a unique clinical syndrome. Oh, what are we going to do about sepsis? Difficult to treat, but the obvious target for therapy. Well, obvious, they’ve got sepsis, you have to treat it. No, that’s the old model. In the new model, incorporates sepsis, but as a late stage syndrome on a continuum of endotoxin related diseases. The new map encompasses the entire inflammatory cascade, And it’s Clinical Manifestations. This is what it looks like. This is the new map. And it’s, I mean, this went on the ceiling for six months. Because there’s so much to this, that when you start to understand, it’s like, What? What will? Okay, that makes sense, I get it. Yeah, that makes sense. Okay. Yeah, I can see how that’s next. Oh, okay, I can see that. The systemic toxicity of gram negative sepsis is largely due to [01:06:00] endotoxin, an LPS component of the outer membrane of gram negative bacteria. And look at the date of these papers. This was 25 years ago, we knew this, but our sepsis experts don’t think like this, they still think the old way.
Well, let’s try a different antibiotic and see if that’s going to work. LPS causes a substantial increase in the production of cytokines, chemokines, and the synthesis of a broad group of lipid inflammatory mediators. The systemic inflammatory response syndrome triggered by the bacterial endotoxin LPS Affects many organs and may lead to death.
So that’s the systemic inflammatory response syndrome. We also call that co morbidities, right? Imagine LPS in your liver, LPS in your kidneys, LPS in your heart, and then [01:07:00] imagine why you get these co morbidities of functional problems, right? Because they’re loaded, they’re toxic, as toxic as can be.
Bacterial translocation often leads to a progressive and catastrophic condition known as Multiple Organ Dysfunction Syndrome. So that’s after you’ve got sepsis. So first you’re healthy, then you get leaky gut, now you’ve got LPS that’s come into circulation, and it starts to accumulate, you’ve got endotoxin, then you get Systemic Inflammatory Response Syndrome.
Low grade chronic systemic inflammation. Then you get sepsis within 20 years, 30 years, whatever it should be. Then you get multiple organ dysfunction syndrome. Then you die. The number one cause of death of elders in hospitals. And it’s a syndrome. [01:08:00] The appreciation that septic shock lies at the far end of a continuum of clinical manifestations of the inflammatory response to bacteria and endotoxin will direct attention to preventative measures to treat at risk patients.
It’s a continuum of exposure and accumulation. And if you address the excess serum LPS earlier in life, you can reduce the amount of LPS that accumulates over the years in tissue. throughout your body, including your brain, and thus reduce the constant inflammatory cascade at the base cause of practically all degenerative diseases.
Does that make sense to you?
Now, you know what these pictures mean. It’s like, oh my god Do you want to take a picture of a biopsy of your tissue [01:09:00] and see what it looks like? So, sources of LPS, where does it come from? Through the oral cavity, through the Excessive Pathogenic Intestinal Permeability, Lipid Wrapped Transcytosis, Dormant Bacteria in the Blood that Gets Activated, Organic Material and Particulate Matter, Air Pollution, Minimally Processed Vegetables, Peeled and Sliced and Threw in Open Wool. Those are the most common sources of LPS. Wait, what? Minimally Processed Vegetables? What does that mean? When you dice an onion, within four days the amount of LPS on the diced onion is equal to the amount of LPS on the diced onion. is toxic levels. Onions, carrots, because you peel off the protective coating and the bacteria in the air feeds on the food and it repopulates, repopulates. So all those little bags of [01:10:00] peeled carrots that you buy in the store, and sometimes they’re a little slimy. That’s all bacteria. It’s like, whoa. Yes. Oops.
Identifying LPS. Well, we know leaky gut, that there’s both paracellular and transcellular pathways getting into circulation, that LPS gets through both ways. We all know that. Based on the central of LPS and sepsis, recently several methods and numerous devices for its detection have been produced. At this moment, simple, speedy, extremely sensitive, specific test for endotoxin determination are established and commercially available. Well, I checked zonulin levels. But the lifespan of zonulin is 4 minutes to 4 hours. So, if it comes back positive, [01:11:00] good! You identified something. If it comes back negative, it’s very likely, could be a false negative. Because the lifespan is 4 minutes to 4 hours.
Um, at the end please. It’ll be easier. This fluctuation in blood levels was studied for a period of 6 days in ICU patients with sepsis, and values were varied by a factor of 2 to 10, day to day. They’re just all over the place, measuring zonulin, because the lifespan is 4 minutes to 4 hours. The half life of antibodies is about 21 days, so antibodies to zonulin are a much more confident marker that you can look at.
And depending on the laboratories you’re using, Whether it’s accurate or not is determined by the sensitivity and specificity. You ask your lab rep, tell me the sensitivity and specificity of this test. They usually don’t know. [01:12:00] Well, uh, uh, it’s a good test. Yeah, I know it’s a good test, but what’s the sensitivity and specificity?
Well, uh, uh, you don’t really know, do you? Well, no, I don’t know. All right. Can you call the lab director? Can you find out from the lab director and then get back to me within two days? Yeah, I’ll do that. Great. Here’s my card. And you’ll find they’ll give you gobbledygook. They won’t tell you. They won’t tell you.
They said, well, you know, compared to, no, no, no, don’t compare. Just tell me the sensitivity and specificity. They won’t tell you because it’s embarrassing. It’s in the 70 and 80 percentile range. Unless you ask Vibrant, 97 to 99 percent sensitivity, 98 to 100 percent specificity, published by Mayo Clinic in a number of papers.
It’s a new era in laboratory medicine. It really is a game changer. I mean, there’s nothing like it on the planet. I don’t know about the Far East, but I teach in Brazil. I teach in North America. I teach in Europe. [01:13:00] I always look at the labs at Braves. In seminars, no one’s got anything that compares to what Vibrant’s got. And that’s the test on the wheat zoomer for intestinal permeability. There it is. And we’ve all seen these before of how to interpret each marker when you’re looking at antibodies to LPS and gluten, zonulin, and Actomycin. This I put in because I felt that I couldn’t be here without telling you about this.
It’s not widely known that lipoproteins bind and inactivate microbes and their toxins, LPS, by complex formation. They grab on to them. And you know who gave me [01:14:00] this paper? Kilmer McCulley, the godfather of homocysteine. And this was Eight years ago, nine years ago, he gave me the paper that just caught my attention.
Complex formation between all lipoprotein subclasses, and both bacteria and viruses has been demonstrated by electron microscopy, enzyme linked immunoabsorptive assays, and column chromatography. High cholesterol and or high LDL. is protective against infection and atherosclerosis. This is like, wait, what?
What? LPS or endotoxin, the main pathogenic factor of gram negative bacteria, binds rapidly to lipoproteins, mainly LDL, and lipoprotein bound is unable to activate the secretion of various cytokines. This is backup for the immune system. It [01:15:00] grabs onto LPS. So that macrophages don’t produce cytokines and it escorts it out of the system.
This is, wait, wait, what? Staph aureus alpha toxin, a toxin produced by most pathogenic staph strains and causing damage to a wide variety of cells, is found and almost totally inactivated by human LDL. LPS that gains access to the bloodstream. From the gut, lumen is bound by various particles. The majority of LPS circulates bound to HDL, but also with lower affinity to other lipoproteins.
This paper was two, 2022, a couple years ago. Lipoproteins bind LPS and decrease LPS stimulated cytokine production. So to reduce the inflammatory cascade. Your liver makes more cholesterol to grab on to the LPS, to lock it up, so that the immune system doesn’t [01:16:00] have to produce more inflammation. Lp little a was as potent as low density lipoproteins in inhibiting LPS stimulated tumor necrosis factor.
This suggests that circulating Lp little a may be an important factor in determining the amplitude of response to LPS in humans. This is like, wait, what? What? I didn’t know this. I didn’t know this. It’s also been demonstrated that LDL inactivates up to 90 percent of Staph aureus alpha toxin and even a larger fraction of bacterial LPS.
Phagocytosis of LPS bound to lipoproteins also explains why LDL becomes oxidized. You ever wonder where oxidized LDL comes from? Well, it’s the immune system attacking the LDL. Why is it attacking the LDL? Because it’s bound to LPS. Since macrophages inactivate [01:17:00] phagocytosis pathogens by producing oxygen radical species promoting LDL oxidation.
LPS from chlamydia and also from several periodontal pathogens is able to convert macrophages to foam cells in the presence of LDL. Conversion of macrophages to foam cells by bacteria indicates that these pathogens contribute to the development of atherosclerosis. Oh, look at the title of the paper.
How Macrophages are Converted to Foam Cells. It’s a response to LPS, the most powerful inflammatory trigger in nature. Learn Think of all the quotes from the different authors that I showed you earlier about LPS. None of them say, well, it’s one of the things you should think about. It’s the most powerful. It’s the number one. It stimulates amyloidogenesis. It’s the primary stimulator [01:18:00] of amyloidogenesis. Now we see what it’s doing with cardiovascular. Compared with normal rats, hypocholesterolemic rats injected with LPS have markedly increased mortality, 8 fold, which can be ameliorated by injecting them with LDL. They don’t die. Compared with normal mice, hypercholesterolemic mice challenged with LPS, Or live bacteria have an 8 fold increase in lifespan.
Wait, what? What? This should be called the wait what talk. Wait, what? Could this mean that sometimes elevated cholesterol, total cholesterol, HDL, LDL, oxidized LDL, Lp, may be life saving attempts by the body? [01:19:00] Excess? Okay. Reducing exposures to the triggers of inflammation. Stop pulling on the trait on the chain so hard.
That’s the message to our patients, which then will reduce activation of the immune system, which then reduces the response of inflammation, which then reduces low grade tissue damage, which then reduces dysfunction symptoms and the development of disease. which gives us a higher quality of function, extending healthy lifespan.
That’s the test, the wheat zoomer, which includes the testing for LPS. That’s the LPS portion of that test, the most comprehensive test I’ve ever seen. Please consider watching this, at least the first episode. You know, it’s all free. And when you see how good it is, have your patients watch it because they’re going to come back with questions and [01:20:00] be more engaged with you.
That’s why I spent 13 months doing this. Was it so your patients will come back to you more engaged and you don’t have to try to convince them. to do a test to find out where’s the inflammation coming from. We’ve got to educate them to be partners with you in exploration to figure out where it’s coming from.
So if your desire is to address presenting inflammatory complaints wherever they are, Extend or create a higher quality of life. Read papers like this one of Fasano’s. We must address the gateway in the development of chronic inflammatory diseases. The gut and the accumulated endotoxin that’s developed over a lifetime.
And what happens when you start setting yourself up to think outside the box, you allocate one hour a week to this, you get it. You just get it. You say, wow, this [01:21:00] is really cool. So I hope you will dive in. To whatever part of this really grabs you, take care of yourselves. Make sure to tell those important to you how much you love them.
And thank you very much for your kind attention. Questions? Yes, please.
When you were talking about the 4 minute to 4 hour window testing, is that other tests other than Vibrant? Which has to be through vibrator. Some. So the concept of four minutes to four hours, is that with other tests or is that also vibrance? Oh, it’s vibrant. ’cause zonulin doesn’t last long.
It dissipates, it falls apart. So it’s, as far as I know, any lab that would be the case. How accurate or stool testing markers. [01:22:00] How accurate are stool testing markers for zonulin? I’ve not read the paper on that, I don’t know. But after seeing what the accuracy was for transglutaminase, and uh, uh, I’m not very confident, but I don’t know on that.
Question from the audience: How are you binding to the LPS out of the tissue? How are you binding the LPS out of the tissue?
You have to mobilize it. And then use some kind of binders. I use G. I. Detox from Biobotanical. Sorry, what? G. I. Detox from Biobotanical Research. Oh, by the way, I’m sorry, I forgot to tell you. Vibrant is giving you a 20 percent discount Tonight on any test that you wanna order and that’s 20% off wholesale.
So how, say again, how are you gonna do that? I think that’s the vibrant rep. Guys, I have coupons for everybody in the room and wants to order a [01:23:00] test for yourself for a left one. Come check you guys calling, get you signed up. Also, next week we have Longevity Summit. Well, Dr. Arkady is going to be there.
Everybody in this room has a free ticket if you want to go. You just have to make your way to San Jose, okay? Alright. Thanks, man. Sorry. Yes. Okay. Thank you. I’m so sorry. I’m just curious. I work with a lot of older women. You work with what? A lot of older women. Yeah. Okay. so much.
Oh, tremendously. Tremendously. They, they have a panel that’ll be coming out pretty soon, an autoimmune panel, as good as they’ll rock your boat. Wow. Uh, but yeah. Someone in Croatia who runs a health clinic there for upper end people. [01:24:00] found me, reached out to me and said, will you work with me? I said, yeah.
Okay. Okay. And I helped her with her problems. So she said, would you work with my clients? I have upper end clients, world famous athletes. I said, well, yeah, I don’t have time, but all right. But this is, they all have to do these seven tests. First, before I’ll talk to them. And then I’ll talk to them and interpret the tests and send them back to you.
I don’t want to do therapy. I don’t want to do that. So they all did seven tests from Vibrant. And it was startling. There were 26 people that I’ve done one on ones with. 19 or 20 of them have mold and didn’t know it. Mold metabolites that are sky high. Uh, every one of them. had organophosphates that were elevated. Many of them had heavy metals. Many, almost all of [01:25:00] them, have wheat sensitivity, almost all of them. Some had some dairy, some had lectins. But when you do the test, when you do the panel, and you’ve got all this information, you can say, boom, there it is. That’s the primary one. Right? And there’s secondaries, but there’s the primary. And then you educate them on how to reduce their exposure to whatever that is. Well, they’re going to continue to flourish.
You do 10 tests on patients, 10 patients with double blinds from Cyrex, and then you do 10 tests with double blinds from Vibrant, you decide. I only did three with Vibrant because [01:26:00] I knew already, but, and all three were right on the money–97 to 99%. So there’s a 2-3 percent variation, which is very acceptable in my book. But a 25 percent variation? It’s not acceptable. Yes?
What’s my protocol to decrease LPS? To decrease LPS, heal the gut. You have to heal the gut. And that’s about a 20 minute discussion in my book, right? There’s a really great article to read. The Italians put out an article three years ago, The Mediterranean Gluten Free Diet, and it’s got a pyramid. And I have every patient put that pyramid on their refrigerator. So that’s the basic guideline. And do you know what’s on the bottom? of the pyramid with the most water. Cause everyone’s dehydrated. This patient, pinch your skin. If it doesn’t go flat immediately, if you can see it go down, [01:27:00] you’re dehydrated, right? So is, and you don’t want to sit at the very top of the pyramid. Gluten free foods, whether it’s breads or muffins or don’t eat that stuff. It’s garbage. Right? So that’s a starting point.
For Liga, do I prescribe? No.
Identify the triggers of inflammation. Stop throwing gasoline on the fire. Identify the dysbiosis in the microbiome. Build a healthy, diverse microbiome. So you find out where the deficiencies are, you look at what foods increase those deficient beneficial bacteria. Most patients need an antibacterial protocol to clean out the pathogens, and then you teach them how to live a healthier [01:28:00] lifestyle with food selections.
No, no, I’ve never had to. When we retest six months or a year later, almost always they’re down in normal range. I use Biocidin for that. Biocidin. BioCyte. Yeah. Say again. Dose. Dose. Biocidin doesn’t like the way I do it. I’ve had lots of talks with Rachel, the president of the company, about this. Hey, this is how I’m going to do it. I give them the spray, and they go up their nose with the spray, and in their mouth. And it’s like, like that. Unless they’re recovering alcoholics, then I don’t use the spray. Because there’s a little alcohol in there, right? The drops, and the capsules. I give them all of them. Two [01:29:00] or three times a day. And, biocidin, yeah, biocidin capsules. The GI detox at night, Ben. Yeah. We have to get out of here. Yeah, unfortunately. Oh, the library closes today. I didn’t know that. All right.
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 very much appreciate it. If you could go to Apple Podcasts or Spotify and give us a 5 star ratings and review. As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would like help, overcoming a gut or other chronic health condition and want to prevent chronic problems and want to promote longevity, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310 395 3111. And we can set you up for a consultation for functional medicine. And I will talk to everybody next week.
https://drweitz.com/wp-content/uploads/2024/10/rwp-382-website.jpg350785drweitzhttp://www.drweitz.com/wp-content/uploads/2017/06/drweitzdsamplelogo-withtext.pngdrweitz2024-10-19 21:00:362024-10-23 07:40:08Demystifying LPS with Dr. Tom O’Bryan: Rational Wellness Podcast 382
The Holistic Kids discuss Avoiding Ultraprocessed Foods 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
In this episode of the Rational Wellness Podcast, Dr. Ben Weitz converses with the Holistic Kids, young advocates for health and nutrition, co-hosts of the Holistic Kids Show Podcast, and co-authors of a best-selling children’s book series with their mom, Medea Saeed. The discussion highlights their personal journey towards a healthy lifestyle, influenced by overcoming health challenges like allergies and eczema through dietary changes. The Holistic Kids emphasize the impact of eliminating fast food, dairy, and gluten from their diet while advocating for eating diverse vegetables and whole foods. They address the dangers of ultra-processed foods, the role of food industry advertising in shaping unhealthy habits, and the benefits of eating colorful, nutritious foods. They aim to educate and empower kids to make informed choices about their health, countering mainstream influences with a holistic approach. The episode closes with insights into the boys’ future aspirations in nutrition and functional medicine.
00:00 Introduction to Rational Wellness Podcast
00:26 Meet the Holistic Kids
02:19 Holistic Kids’ Health Journey
03:21 Dietary Changes and Their Impact
05:33 Making Vegetables Fun for Kids
10:21 The Importance of Real Food
12:59 The Dangers of Ultra-Processed Foods
15:14 The Addictive Nature of Junk Food
18:54 Advertising and the Food Industry
21:48 Investigating Health Organizations’ Funding
22:36 The Breakfast Myth Exposed
23:15 Cereal for Dinner?
24:42 The Rise of Artificial Foods
26:06 Impact of Artificial Dyes on Health
28:34 Addiction to Ultra-Processed Foods
31:06 Avoiding Junk Food at Social Events
35:03 Future Aspirations and Advice for Kids
39:57 Promoting Health and Nutrition
The Holistic Kids, Abdullah, Zain, Emaad, and Qasim are the co-hosts of The Holistic Kids’ Show Podcast. They have co-authored four best-selling books with their mother Madiha Saeed, MD, Adam’s Healing Adventureschildren book series which have been featured as Dr Mark Hyman’s Top 5 Picks. Their book The Teen Health Revolution: Unlocking lifestyle secrets to Optimizing the Mind, Body and Soul will be releasing in 2025. Their YouTube page is HolisticMom, MD.
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.
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!
Today, we’re going to have a discussion with the Holistic Kids. Holistic Kids. Oh, who, which three Holistic Kids are with us today? And what are your names?
Abdullah: I’m Abdulla.
Zain: I’m Zain.
Emaad: And I’m Emaad.
Dr. Weitz: All right, great. And so they’re the co-hosts of the Holistic Kids show podcast, and they have co authored four best selling books with their mother, Medea Saeed, Adam’s Healing Adventures [00:01:00] Children’s Book Series. And these have been featured as, there’s, there’s one of them as Dr. Mark Hyman’s Top 5 Picks. Their new book, which will be out next year, is The Teen Health Revolution, Unlocking Lifestyle Secrets to Optimizing the Mind, Body, and Soul. They spoke at the annual Institute of Functional Medicine conference in 2024, which is where I met them. The Holistic Kids Show Podcast is a completely run, kid run podcast, kids empowering kids. It’s a one of a kind podcast that has featured over 160 different experts from New York Times bestsellers, top physicians, Harvard professors, actors, White House correspondents, TV personalities, and even Dr. Ben Weitz, educating and empowering [00:02:00] kids of all ages to control their health and lives. The Holistic Kids are also the co creator of the first health course for kids by kids called Real Healing for Real Life Kids course. So welcome Holistic Kids.
Dr. Weitz: That’s great. So how, why did you become so interested in health? Tell us about your story.
Abdullah: Well, as you know, we go to school and we see all of our classmates. We see all of our friends and our, like, even sometimes family. And we see them all suffering. You know, Zan as, as well had, what did you had? 80 H? No, what? What? Eczema. Eczema, yeah. eczema. He had allergies. Mom had allergies, right? You had allergies. Mom, you had sinus allergies. He had allergies. I had, um, you know, terrible headaches, really bad dizziness. And we, and our [00:03:00] mom had a lot of, um, diseases as well. And we noticed that changing our diet, would keep us off going on the conventional way with taking kinds of medications. And eventually we started to eat better foods and we started to change ourselves, right? We started to feel better, you know, we started
Dr. Weitz: What are some of the major changes you did in terms of changing your diet?
Abdullah: We started to cut out fast food. We started to cut out the dairy, gluten. We used to eat it like all the time. Now we like barely, we don’t eat it as much. It’s more of a treat.
Dr. Weitz: It’s hard not to eat dairy and gluten, right?
Abdullah: But basically we, once we realized how much of a difference and impact it made on us, we were like, why don’t, why doesn’t, why don’t people know this? Oh, I have, I have, um, uh, AD, I have allergies now, it’s normal. Don’t worry about it. Like back, like [00:04:00] having a peanut allergy is seen as normal. Right. And it’s so weird to us. We were like, why don’t these people know this? Like people are literally feeding themselves poison. And they’re killing their own bodies. And these are our friends and classmates and the people around us.
Dr. Weitz: But it’s okay because we have a drug that can treat the symptoms.
Abdullah: Exactly. We were like, this is terrible. We need to do something. We need to have a change. And we want to bring this to kids in a way that they’ll understand. Because obviously back then we were like health, come on, right? And kids in general, right? They don’t really care about health. Yeah. Like Iman, how many kids in your school actually care about health?
Emaad: Like everybody hates health class.
Zain: Exactly. No one actually wants to learn or they don’t really care about their body because they’re like, oh, we’re kids, we’re immune to everything, right?
Dr. Weitz: But they probably care when they get a rash.
Abdullah: Yeah, you know, and it’s so sad because even when they do get [00:05:00] the rash, they’re like, Oh, I’ll just take, you know, antibiotics. But like, what do you mean by antibiotics? There’s better ways to do this. You just have to eat your arch nemesis, uh, vegetables.
Dr. Weitz: Your arch nemesis vegetables. Yeah. We have to get to the root cause and not just treat symptoms.
Zain: And that’s where really our journey started. Right. Does anyone want to add on anything? Yeah. Um, actually what’s sad is one in every second child has a chronic health condition and you’re not expected to live longer than their parents.
Dr. Weitz: There you go. So you guys want to change that?
Zain: Yes.
Dr. Weitz: So how did you get yourselves to start eating vegetables?
Zain: So it was all by the step by step process. Okay.
Abdullah: Like what our mom would used to do is she used to make smoothies and she would like, Like, um, uh, secretly put in microgreens, she would secretly put in like 10 different vegetables, and she would mix it with all these other fruits, and she’d put like stevia and stuff, and we could never tell. [00:06:00] Right. And so that was one way. Also, vegetables are fun to eat if you prepare them like a certain way, if you prepare them right. Right? So we would make vegetables, eating vegetables fun. We wouldn’t just eat broccoli, right? We wouldn’t just eat boring broccoli and boring carrots. How do you make broccoli fun? We would, sometimes we would steam it, like steamed vegetables. It’s
Zain: good.
Abdullah: We used to also use spices sometimes. Our mom was like amazing at turning, making vegetables fun. We’d have like a diverse amount of vegetables, like vegetables we didn’t even hear, like no existed. Right, Zed?
Zain: Also like if we’re like celery. We have something called Ants on a Log, which basically we put celery with peanut butter and, uh, raisins. Yeah, raisins. And that tasted like, we
Abdullah: were like, how did, how can we, how did we make celery taste so good? And there’s just this negative stigma around vegetables that most kids, uh, they buy into because that’s what people tell them. That vegetables are boring, that [00:07:00] vegetables make your life not fun. If you eat vegetables, you live under a rock and you’re depressed. This is more like most kids think, and we wanted to change that. And once we started to eat real vegetables and diverse vegetables, we started to see how fun that we can make vegetables.
Dr. Weitz: That’s great. How many, how many vegetables do you eat a day, do you think on average?
Zain: Ooh. So then there first there’s breakfast, yeah. And then there’s lunch. Uh huh.
Dr. Weitz: Do you have vegetables with breakfast?
Zain: Yes. Yes, we have. Yes. My mom makes like the smoothies.
Abdullah: Um, what are the smoothies? We have smoothies. So that has a ton of vegetables. She, she used to call them Hulk smoothies because they’re green, but then she’s like, Oh no, no, they will become stronger. You know, drink this. And she put in maybe some like banana or apple or something like that. And we drink it and it tasted good. Right.
Dr. Weitz: Cool.
Zain: And then lunch, every single, like when we go to school, I always prepare the lunches a vegetable, a [00:08:00] protein, and a carbohydrate. So we always get some type of vegetable.
Dr. Weitz: That’s great. A lot of kids are just eating chicken nuggets and, you know, they’re not having any vegetables at all unless you consider maybe french fries a vegetable.
Abdullah: They used to say, they used to say pizza has vegetables on it because of the tomato sauce. Correct. They’re like, I’m having a full meal because of, you got the bread, you got the cheese, you have the tomato sauce, which is a vegetable, you know.
Dr. Weitz: Oh yeah, when Reagan was president, they said just the ketchup on the burger was considered a vegetable.
Abdullah: I know, they’re, people are changing the idea of food so that it makes them feel better basically. Exactly.
Emaad: Yeah, we used to like, we sometimes like, in the morning we’d have like, um, sauerkraut, whipped cream, um, graffiti, and that’s all fair frame.
Dr. Weitz: That’s great, sauerkraut, feed your [00:09:00] microbiome, it’s fermented.
Abdullah: Yeah, cause there’s so many other fermented foods. that we love to enjoy. Like before we thought there was only pickles and then we realized you have sauerkraut, you have kimchi, right? We, anytime, right Emaad? Uh, anytime we feel like sick or like some we have a problem with our stomach, we’ll go and just, we’ll go to the fridge. We’ll have some sauerkraut because we, we know how it feels. We, the, the difference it makes, right Zen? Yes.
Zain: And it makes a huge difference. And like also with the different colors. Like you have to eat the entire rainbow. You can’t just like.
Dr. Weitz: You go, you guys are way ahead of most of the other kids. I would doubt many kids even know if they’ve even tasted sauerkraut or kimchi or know about eating the rainbow. So that’s great. What about activities? Do you guys play sports? Are you active?
Abdullah: Yes, definitely.
Dr. Weitz: What sports do you play?
Abdullah: Emaad, do you want to start?
Zain: What sports do you play?
Emaad: I play soccer and football.
Dr. Weitz: Okay.
Zain: I run, so cross country, track.
Abdullah: I play, you know, basketball, soccer. Uh, I also run in my free time. Or, I like to run. Um, and just go out in nature as well.
Dr. Weitz: That’s great. So let’s talk about the difference between real food and Fake food.
Abdullah: Okay.
Zain: So let’s just start with ultra processed foods. So although, do you wanna talk about what a ultra processed food is? Well,
Dr. Weitz: we like to call. Yeah, I mean basically we were talking about junk food, right? Yeah. That’s term, ultra process is a new term for junk food.
Abdullah: Yeah, no, for the nickname we give ultra processed foods like fake food because they’re not actually foods. Right. And, um, because. Children’s brains and bodies are made of food. I think it’s important to, you know, choose the foods [00:11:00] that we eat, like, and be mindful of those. So for us, the way we see ultra processed foods and the way it really is, it is basically just a formation, formulation of like ingredients, um, industrially produced ingredients that are put together to seem like, to make it look like a food, to make it have the food like shapes and textures Basically, instead of food, it’s industrially ingredients that have been created through industrial techniques. And that’s where the ultra and ultra processed food came from. Right. Right. And the thing that really blew my mind is I heard someone say, you know, ultra processed food is a science experiment and like they’re experimenting on us. We are the lab rats.
Dr. Weitz: That is true. And that’s why you see 14 different ingredients.
Abdullah: Exactly.
Dr. Weitz: There’s something wrong with that.
Abdullah: Like, I wrote, McDonald’s French Fries, 14 ingredients in [00:12:00] McDonald’s French Fries is way too much.
Dr. Weitz: Yeah. Yeah, those are super unhealthy. Not only are they, they, they take the potatoes, they soak them in sugar, then they deep fry them, they stick them in the freezer, they take them out, they deep fry them again so they can absorb more fat, they put salt on them.
Abdullah: My God, it’s crazy, right, Zen?
Dr. Weitz: Yeah.
Abdullah: Like, yeah. Also, what’s interesting is that, um, ultra processed foods, They’re basically reconstructed from whole food that was then reduced to a molecular level and then Reconstructed to look like food. I like to think it’s like pre digested food It’s already been through the entire system of being crushed and being smashed and then they just put it back together So that it tastes good and it makes us feel good, right?
Dr. Weitz: [00:13:00] Um, so how do ultra processed foods affect kids behavior and the way their brain works?
Abdullah: Well, ultra processed foods, they, they basically alter how the brain works and how the, um, and they harm the body because of the, they’ve basically been made addictive by these companies because if they’re not addictive, they’re addictive. Then people aren’t going to buy
Zain: or get them again. Right, Zen? Yeah. And also when we put junk food in us, we only get like junk behaviors, a junk body, a junk brain. Bad and fake foods destroy the balance of our gut microbiome. And with this, it leads to inflammation, like chronic inflammation imbalances our hormones, threatens our, our prefrontal cortex and destroys our ability to function optimally. Yeah. So it just creates a bad. [00:14:00] Life in general, like you don’t want to live a life that’s like Messed up.
Dr. Weitz: And they’ve actually, the food scientists have studied how to get people to eat the maximal amount of ultra processed foods. And there’s actually a concept they’ve come up with called the bliss point. And the bliss point is you just have the perfect amount of fat, sugar, and salt. So the person will just want to crave more and more and more of that unhealthy food.
Abdullah: Yeah, and then, like you were saying, when you add all of that fat and salt, you’ve essentially created an irresistible food. At that point, you know, they even have in the ads, they said you can’t have just one. Right, absolutely. They literally put it in the ads, you can’t have just one, you have to keep eating and eating and eating and eating. Because that’s how they were created.
Dr. Weitz: Right.
Abdullah: If, if you didn’t keep eating them, then they would [00:15:00] go back and yell at the scientists. Why didn’t you create it the way we wanted?
Dr. Weitz: Absolutely. They don’t want you to feel full and they want you to be eating it quickly. So you don’t even know how much you’re eating.
Abdullah: Also, what’s interesting is when I was going into like, how did these foods become so addictive? Because I was interesting. How do you make a food? That’s like just it’s because I was thinking of food as food from nature. How do you make something edible that addictive? So I went to the research and I actually realized that the way that ultra processed foods were made is that they activate the brain reward system in a way that is similar to drugs. It’s similar to nicotine. It’s similar to heroin. And what happens is when people they use like drugs like nicotine and heroin and alcohol.
Then they keep, they make these foods as addictive as them. And [00:16:00] there’s actually something in the field of drugs and addiction called the rate of delivery. And that is when, how fast the food goes through your body and it’s digested. It’s how fast it’s going to hit your brain. And that’s how fast it’s going to affect your body.
And, uh, I realized that because of the way that ultra processed foods were created, like, you know, how I said, um, they’re pre digested, and they go through your body fast, and like you said, they, you can’t, you don’t feel full, right? And because they go so fast through your body. Right. And actually, the faster they go through your body is the more addictive it becomes.
So I was like, oh my god, ultra processed foods are drugs based in LA. They’ve created, like, they’ve created them just like people have created drugs. And the same way that drugs work, is drugs work, or how all [00:17:00] depressed foods work. And I went more into this, like how do they do the research? Did they put, how much research did they put into developing this? Maybe it’s a coincidence, I don’t know. And I realized that the people that, you know, created Kraft and Nabisco and General Foods, they were owned by a company called Phyllip Morris. Right. Um, I don’t know about the company, but you’re probably, you know, you’re a little, you know,
Dr. Weitz: Phillip Morris was the company that made cigarettes and cigarettes is another example where they got everybody addicted and, and, and they just kept consuming more and more of it. And then tried to tell us that it really wasn’t unhealthy when it was killing us.
Abdullah: Exactly. And I went into this and I was like, okay, who’s Philip Morris? I went to research that. And apparently after they were exposed because they were selling, they were telling people, Oh, you know, smoking is fine. It’s fine. After they were exposed and studies [00:18:00] came out, you know, debunking them, they decided, you know what, let’s put our resources and into something else. And so they then bought Kraft, they bought Nabisco and General Foods, like I said, and Actually, the same scientists then used those methods of studying addiction and they then implemented that and created these ultra processed foods or these artificial foods. So the same, the same like strategies and research that went into making cigarettes super addictive went into making ultra processed foods addictive.
Dr. Weitz: Right, absolutely. Um, so, what happens when people eat these ultra processed foods is they’re no longer really in control. They’re just being controlled by the food industry.
Abdullah: Exactly. Like, you know, you look at advertisements. Advertisements are now a way [00:19:00] for these companies to basically control what’s happening inside the home. Nowadays, it’s crazy to me that advertising an addictive substance is now appropriate to advertise it, uh, to three year olds using a monkey and a tiger. Now it’s, now it’s like, it seems as normal to use an addictive substance as an advertisement with monkeys and tigers and other animals to seem appealing to three year olds and little kids. Right. And now it seems, oh yeah, this is fine, you’re allowed to do that. Like if it was, uh, cigarettes or drugs, it’d be, oh no, no, you can’t do this.
But with ultra processed foods. They say, yep, that’s completely good. They give the green light on that, right? You see people, you see the ad, you’re like, I want to buy that. Ooh, that looks good. That cereal, the colors that they use, it tricks their brain into thinking, I want that, right? Is that like, if you see, you know, you know, those ads, [00:20:00] yes.
Like the Froot Loops ads and, um, uh, what other ads? Like McDonald’s, like the, uh, Burger King ads, they, they, Like, they make the ads so that we want to keep on buying it, so it’s an entire scheme, basically.
Dr. Weitz: So, the kid shows are all filled with these ads for ultra processed foods, so the kids get overweight. And then the adult shows are all filled with ads for medications to try to help you lose the weight that you gain from eating the ultra processed foods. So, now all you have to do is take Ozembic and forget about eating healthy.
Abdullah: And it’s funny, it’s funny, Zan, you know, when, remember we were watching that one ad and it said side effects are death, you know, this illness, that, and the cancer, it’s pretty small letters. They have like a whole list of symptoms that are even worse than the original symptoms.
Zain: And then you just see like people, like happy people, like walking or [00:21:00] like swimming or just happy playing.
Dr. Weitz: Of course.
Zain: I don’t know the background, but like the music and then
Dr. Weitz: yeah, they don’t, they don’t see when they’re, uh, suffering from these, uh, chronic diseases like diabetes and they’re getting, you know, and they’re having to go through, um, dialysis because their kidneys are failing or they’re having to get their, um, toes and feet cut off from, uh, neuropathy from diabetes. So all these chronic diseases are, are killing us.
Zain: So. Who do we trust? Think about this. American Academy of Pediatrics? They take money from companies like Matt Johnson and Abbott. I know, remember, you were researching this for the book actually, right?
Abdullah: Yes. Yeah, so Zan was researching for the book, like, where do the money that, that, for a lot of these heart diseases, uh, heart disease organizations and all [00:22:00] of these other organizations, where do they go to?
And what Zan actually found was really interesting.
Zain: So, who do we trust? The American Academy of Pediatrics? No, they take money from companies like Matt Johnson Abbott. What about the American Diabetes Association? Koch and Cadbury give them donations. These are the same people that are making our recommendations. And I was like, what?
Abdullah: Like, I was, I was going into all the tobacco stuff and then Zan brought this entirely different part of it that you wouldn’t think would even exist. Like all, that’s why, you know, um, uh, the people, you know, the, the people that said that breakfast, you have to have breakfast, like breakfast is the most important meal of the day. Right. Guess who that came from? Uh, the cereal
Abdullah: industry. Exactly. Yeah. We were like, you’re telling us, because we knew by school, like everyone was saying, our teachers, that breakfast is the most important meal of the day. [00:23:00] It was ingrained into our minds that you can’t miss breakfast. And then we realized when we were doing this research, where it actually came from. Right, Zen? Right, Ma, did you know that the teachers say that breakfast was the most important meal of the day? Yeah, they
Zain: do it
Abdullah: in
Zain: shows and stuff.
Dr. Weitz: And then during COVID, a lot of people were staying home and, uh, a lot of them didn’t want to cook because they were too lazy. So I saw the CEO from one of the cereal companies on TV talking about how great it is that people are eating cereal for dinner now.
Abdullah: Cereal for dinner? Imagine having cereal for dinner?
Dr. Weitz: It’s just totally processed, loaded with sugar, and no vegetables, no fruits, no natural foods. It’s like a bowl of poison. Exactly.
Abdullah: And now it’s weird because it’s being seen as like, Oh, [00:24:00] if I had like five bowls of cereals, that’s more things. Okay. That’s good. That’s good. It seems normal now, right? If you don’t have, if you have anything like natural in the morning, you’re seen as like, what I can have, you know, I, I remember some person said, Oh yeah, I have toe. I have like toasted avocado on it. Avocado Toast, and I was like, what? We just eat cereal every single day. You’re having something that, like, exotic?
Dr. Weitz: Because Yeah, you go through the grocery store and there is a huge aisle with all these boxes of cereals. And you look at how much sugar is in them. It’s just horrendous.
Abdullah: Yeah, and the kids are now brainwashed. It’s become the new norm for people to eat these foods. Artificial foods. is now seen as food. I mean, if you thought about artificial food back in like the 1940s or something like that, you [00:25:00] would think of this as like some crazy invention, and now it’s become our daily diet. Everybody’s supposed to eat this. And, you know, several studies have actually been concluded that there’s an association between artificial food dyes and neurobehavioral symptoms in sensitive children, including hyperactivity, attentiveness, and restlessness.
And then people go say, Oh, you know, artificial foods are not that bad. I mean, come on, they’re not doing anything to our body. I’ve been eating it for 10, you know, 15 years. And people don’t realize that it’s affecting the future. Absolutely. And that’s why we really want to educate people because we are, you know, we are technically the future.
Dr. Weitz: And, and the, the group that makes out the US dietary guidelines recently said that there’s no proof that ultra processed foods are really harmful.
Abdullah: Wow, when we saw that we were like, [00:26:00] what, what are these people saying to me?
Dr. Weitz: Because they’re getting funding from Big Food.
Abdullah: Yeah, and also another thing that was really interesting is, you know, artificial dyes. Most people think, oh, they’re just like dyes, you know, you put in sprinkles and stuff like that. But artificial dyes can directly trigger something called gut dysbiosis. Correct. 95 percent of our neurotransmitters are made in the gut. That’s why we like to say that our gut is the second brain. And so, when artificial, um, dyes affect the gut, they then affect the neurotransmitters that are being made, which then affects our brains.
So, Nowadays, like, even in our schools, right, kids are becoming more crazy and crazy and crazy, right? Like, Raizan, in your high school, in my, like, uh, in middle school, yeah, in middle school, like, kids are crazy, right? Oh, yeah. And, like, kids, they’re so addicted to sugar and, like, [00:27:00] ultra processed foods. And
Zain: additives, you know, basically, the, the teachers bribe the, uh, the students with sugar, basically.
Emaad: And Jolly Ranch. If
Zain: they, if you, if you do this, you’ll get some candy. If you win, you’ll get some candy. If you get this bingo, you’ll get some candy and it’s always, they’re pushing kids to do it for candy and kids will do anything for candy. So,
Abdullah: yeah, that’s crazy. Kids will not like, I remember when I was in middle school, kids would have entire lockers full of candy because they needed, for some kids, they need candy to survive. It’s become from a want to a need, yeah?
Dr. Weitz: So, in our society, chronic diseases are the major cause of sickness and death, and over 70 percent of the population is overweight. [00:28:00] Why are we not doing anything about artificial ingredients and ultra processed foods that are contributing to this?
Abdullah: Does anyone want to answer that?
Dr. Weitz: Well, it’s all money.
Abdullah: You know, food additives make ultra processed foods taste better,
Dr. Weitz: right?
Abdullah: You know, they make them smell better, look better, be more addictive, and they last more on the shelves. Ultra processed foods, they’re addicted by design. And it’s, it’s, it’s worked. They, all of the money that they put in, all the research that they put, obviously, they’ve made something that is an addictive substance that people can’t resist anymore. And because of that, the global food items market It used to be worth, I think around 30, 38 billion in 2021, [00:29:00] but by 2026, the value of the global food additives industry is projected to be 56 billion.
Wow. 56 billion is now, it’s like, that’s the market for food additives. And one interesting thing I heard is if kids around the world would, uh, or kids in America missed, missed even one meal of ultra processed foods, then the food companies, uh, sales would plummet by 7%. If they just missed one meal, then their sales would go down by 7%.
So it’s all money. People think so, if, if it was so bad for us, why wouldn’t they tell us? If, um, uh, Smoking was bad for you. You think that Phil Morris was going to tell you, Oh, it’s bad for us. Bad for you. Don’t buy our product. They promoted it. They said, [00:30:00] no, all this research is bad. And these scientists, you know, they’re not trusted.
And the same thing is happening now. If, uh, right now they’re not, nobody’s going to stop the food industry because they’re making so much money. I mean, there’s, who’s going to stop them. Basically people have tried to loss, have to sue them. People have tried to talk, uh, tackle them and put them down and make them change the foods, but they’re not going to do anything because for them, we are money for them. We’re there. They’re probably, they are, we are the product basically.
Dr. Weitz: Right. And, and we’re sitting around arguing over whether we should eat a vegan diet or a Mediterranean diet. And meanwhile, uh, you can have, eat a vegan diet that’s all filled with junk fruit. So we should really be focused on the quality of the diet [00:31:00] and, and not just on the specific macronutrient content. So how do you guys stay away from ultra processed foods when, when you say go to another kid’s birthday party?
Zain: So we like to bring our own things ’cause um Oh, okay. We’re not going to eat their junk most of the time. You
Dr. Weitz: just whip out a bag with some cut up carrots or what? .
Zain: So basically, let’s say if they’re having cake, right? We will bring our own muffins or Oh, okay. Our own brownies. Okay. Like the real deal. You have the real deal or some cookies. And that really, we don’t really want that anymore because it doesn’t really look as appetizing as it did maybe 10 years ago. It makes us kind of even like nauseous and feel
Abdullah: sick when you see that food, right? Yeah. What do you do when you go to a party and that’s all they have? They just have pizza [00:32:00] and, you know, all this junk food.
Abdullah: Because we know, right, Emaad? We know that they’re basically just chemicals, right? Yeah. I mean, we just see, you know, a product, a substance, that people are eating and eating and eating. For us, it doesn’t seem appetizing anymore. Okay.
Zain: If they offer it to us, we say no. And we like to bring our own things, so we’ll have that.
Dr. Weitz: Oh, you guys got great willpower.
Abdullah: And that’s why we love to keep researching, because this information, right, it gives us power. And because we don’t want to be tricked into doing something we know is not good for us. At school, everyone is eating pizza, and yes, it still smells appetizing to us. It’s To us, it’s still actually disgusting. We don’t crave it anymore, we don’t want it. Uh, I know you might think that we’re lying, and it seems impossible. Because kids nowadays are seeing that they’re addicted to all of these kinds of foods. But, honestly, we can’t even stand the sight of it. Right? You know, when I was like 10 years old, I remember, Emaad, I think, [00:33:00] you brought like a Gingerbread house, oh
Emaad: yeah,
Zain: into the house, when he was in Kindergarten, they were decorating the gingerbread house, and luck could not stand it, so he like, completely like, threw it away.
Abdullah: I didn’t want this, you know, it’s like, it’s for me, I see them as drugs, you wouldn’t want drugs just like staying on, you wouldn’t want an addictive substance that’s dangerous for you. That we know destroys our body, that we know what it does to our brains. We know how it makes us feel. We don’t want that to, uh, I, I, it just didn’t feel right with me.
Dr. Weitz: So what do you guys do on Halloween?
Zain: Halloween, we just get, there are better alternatives to that candy. So
Emaad: it’s a brand that we like specifically use called Yummer. Do you
Dr. Weitz: guys go around and collect candy from other houses?
Zain: So it might be easier for us because we don’t actually celebrate Halloween. Oh,
Dr. Weitz: you don’t celebrate Halloween?
Zain: Yeah, we don’t celebrate Halloween.
Dr. Weitz: Oh, okay.
Zain: So it would be easier. We just like give it out.
Dr. Weitz: That’s one of our favorite pagan holidays.
Abdullah: No, but we still love anytime it’s Halloween. We’re like, Mom, um, everybody else is having candy. So we can, we have like our candy. Yeah. So we take, we get our organic, organic, natural, real. There you go.
Dr. Weitz: Cool.
Abdullah: And for us, that tastes even better than the other stuff. Because nobody likes to, nobody likes to know that they’re being tricked into doing something or that what they’re doing has been, you know, um, been advertised to them and basically like people don’t want to know that what they’re doing is being funded and their people are researching to trick them and make them do what they want to do. Right. So that’s why, you know, we also, we look through the ingredients and we see, okay, what does this do? What does that do? And then we make mindful choices because [00:35:00] we know their tricks. Right.
Dr. Weitz: So what do you guys see yourselves doing in the future?
Zain: So I have an interest in nutrition, so I’m thinking to become a, some type of doctor ish. Not like normal doctor. Right.
Dr. Weitz: And how about yourself?
Abdullah: Oh yeah, no, so I was thinking of going also into medicine and learning more about this and becoming in like, you know, educating more people basically.
Dr. Weitz: Right.
Abdullah: So you can
Dr. Weitz: become a functional medicine doctor, a naturopathic doctor.
Abdullah: I’m still thinking about it, which one I want to go into, but I know I want to work with functional medicine and the holistic way. Right. And how
Dr. Weitz: about yourself?
Emaad: I have no idea.
Dr. Weitz: How old are you?
Emaad: I’m 11.
Dr. Weitz: Okay. And how old are you? [00:36:00] 13. And you? I’m 16. Okay. There you go. So you’re, you’re almost applying to college soon.
Abdullah: Soon.
Dr. Weitz: Yeah. All right, great. So advice for other kids?
Zain: So we need to be more mindful about the food we eat. We have to use food as medicine to thrive, basically. So make sure it’s nutritious, helps our gut microbiome. It’s nutrient dense. Yeah, nutritious, nutrient dense. Yeah. Um, it helps your, like you said, gut microbiome, gut microbiome, insulin. Balance is insulin. Insulin and Balances blood sugar levels, all of this, and it’d be what we’re looking in, in foods. And it’s good for your body in general, basically.
Abdullah: And that’s all we want. We, we think this entire problem could become much better if kids actually read what they’re [00:37:00] eating, because the problem is not that kids know that it’s harmful for them and they continue to, Oh, I want to put these chemicals into my body. Oh, these chemicals that taste so good. No, they just don’t even, they don’t know what these foods are. So we just want kids, you know, to read ingredients because that’s what we used to do, right? Yes. When we started to do this, we wanted, we started to read ingredients. Um, uh, we started to think of food as like a molecular information that dictates our day to day, um, and long term function as natural
Zain: food because it has 5, 000 known biochemicals inside them. Like, that’s insane. That can really help us.
Abdullah: We think of food as like medicine, food as our fuel,
Zain: food as like dictates everything that we do in our life basically. Cause like food is like the single most powerful tool that impacts our brain, body, and our behaviors.
Zain: That’s great. It’s really important to look at food and especially like the good food and like eat it.
Abdullah: That’s why, you [00:38:00] know, that’s why we are so passionate about this because we know that we, that this food makes change, um, it can make a change to our bodies. We feel it, right? So we have more, we can even have more endurance than a lot of the people around us. Like I don’t play, I don’t, um, run track or cross country, but I already have a lot more endurance when I do run against other people. I’m like, Oh my God, they’re like exhausted. Like, how do you do this? I was like, I don’t know. This is, we just eat nutrient dense, uh, food. And the rainbow. Oh yes, we love to eat the rainbow.
Emaad: Speaking of rainbow, red foods contain lycopene that protects against cancer and heart disease. Orange foods help with hormonal health. Yellow foods is great to sustain nitrate, fiber, and great for the digestion. Green foods indicates biochemicals such as raffinate and sulfurophane, which raises the with um, boosts the circulation and lowers cancer. I love seaweed.
Abdullah: He loves seaweed. Like loves, loves seaweed.
Emaad: Loves.
Abdullah: That’s great.
Emaad: Iodine strengthens the immune system [00:39:00] and then blue and purple foods help the brain. Wow, that’s some very intense, uh, scientific information for us. Thank you. He
Abdullah: even compares it. He’s like, okay, this one has glucoraphanin and this one has iodine, iodine, which, which one we need. Compares, okay, I had seaweed before, I already got my iodine, so now let me get some sulforaphane.
Dr. Weitz: That’s great. I wonder how many 16 year olds would have any idea what glucoraphanin is.
Abdullah: Especially in my, in my, uh, 6th graders. Yeah. Well, you guys are way ahead of the curve and I applaud you for being knowledgeable and promoting health and that’s what this country needs. Tell people how they can find out about your podcasts, your books, and your course.
Abdullah: So, um, [00:40:00] Our subconscious world governs about 90 percent of our thoughts and actions. Training us to be positive is key. Especially as a teenager, I know negativity is basically our entire thing. But that is why we have to train our subconscious to be more positive. Because our subconscious is just neural pathways that need to be rerouted to become more positive. So we can look to see all the blessings in life, be grateful, be grateful, be grateful, be grateful. Know what we’re, uh, know that we’re not missing out, you know, see the things that we do have instead of the things that we don’t. With hundreds and thousands of edible foods on the planet, we need to look at the foods that we can eat instead of the foods that we can’t eat.
Zain: And our podcast is on, actually we interviewed you on our podcast, it’s on iTunes, Spotify, Apple Music, um, YouTube, like basically all the ones that you usually do. That’s great, and your books you can get [00:41:00] from, uh, Amazon, Barnes Noble, wherever they sell books. . Yeah. And then what about your course? It’s on your website?
Zain: Yes, it on website.
So, and the website is you definitely
Abdullah: check that out. The website is holistic kids.com.
Dr. Weitz: Well, thank you so much, guys, for joining me today and spreading the word about health and nutrition. Well, it’s our pleasure.
Zain: It’s our
Emaad: pleasure.
Zain: We need to empower kids. This is our mission. We need to empower the next generation. This is our purpose. Our purpose.
Dr. Weitz: That’s great that you guys already know what your purpose is. I, you guys are way ahead of the curve. Well, thank you. Thank you. It’s our pleasure. 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 very much appreciate it if you could go to Apple Podcast or Spotify and give us a five star readings and review. As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health condition and want to prevent chronic problems, and want to promote longevity, Please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111 and we can [00:43:00] set you up for a consultation for functional medicine. And I will talk to everybody next week.
Dr. Yousef Elyaman discusses Fatty Liver disease with Dr. Ben Weitz.
[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.]
Podcast Highlights
Dr. Ben Weitz hosts a discussion with Dr. Yousef Elyaman on the recent rebranding and significance of non-alcoholic fatty liver disease, now known as Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD). They explore its emergence as a leading cause of liver failure, affecting millions globally due to poor metabolic health. The discussion delves into causes such as insulin resistance, uric acid dysregulation, and oxidative stress. They assess diagnostic methods, including FibroScan technology and various laboratory tests. Dr. Elyaman highlights functional medicine approaches, focusing on dietary changes, exercise, and targeted nutraceuticals like berberine, curcumin, and omega-3s.
The episode underscores the importance of understanding and addressing systemic imbalances to combat this epidemic, offering both professional insights and pragmatic medical advancements.
04:17 The Evolution of Fatty Liver Disease Terminology
07:17 Causes and Mechanisms of Fatty Liver Disease
17:07 Testing and Analyzing Fatty Liver
21:46 Advanced Testing and Treatment Plans
32:47 The Role of Semaglutide and Ozempic in Weight Management
33:33 Modified Mediterranean Food Plan for Fatty Liver
34:41 Exercise and Its Impact on Fatty Liver
36:50 Nutraceuticals for Insulin Resistance and Gut Health
37:55 Understanding Liver Enzymes and Oxidative Stress
40:52 Supplements for Fatty Liver and Overall Health
42:36 Functional Medicine Approach to Fatty Liver
50:31 Final Thoughts and Course Information
Dr. Yousef Elyaman is a board certified Internist with a speciality in Functional Medicine. Dr. Elyaman is the founder and Medical Director of Absolute Health, a primary care functional medicine practice in Ocala, Florida. Dr. Elyaman also serves as the Medical Director for HumanN, a leading nutraceutical company, and as a consultant for Quest Diagnostics Laboratory’s Wellness Division. He’s teaching faculty for the Institute for Functional Medicine, specializing in their Cardiometabolic module. His website is AbsoluteHealthOcala.com. Dr. Elyaman offers a detailed course on Fatty Liver for practioners, The Functional Medicine Practitioner Essentials course on Fatty Liver.
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.
Podcast Transcript
Dr. Weitz: [00:00:00] Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to 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. Today, we’ll be having a discussion about a very important condition which had been known as non alcoholic fatty liver, but is now known as metabolic associated liver disease, I think. Is that correct?
Dr. Elyaman: Metabolic, yep, metabolic dysfunction associated fatty liver disease.
Dr. Weitz: Okay.
Dr. Elyaman: Actually, metabolic, now it’s Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD).
Dr. Weitz: But it’s a very important condition and everybody needs to know about it because this is going to be the leading cause of liver failure for millions of people around the world and we’re already in the midst of an epidemic of this condition as a result of our metabolic health, and we already know from recent research that over 70 percent of Americans are metabolically unhealthy.
Dr. Elyaman: Correct.
Dr. Weitz: So we have Dr. Yousef Elyaman here with us. So Dr. Elyaman, can you tell us about yourself, about your background a little bit and what you’ve been up to?
Dr. Elyaman: Yeah, I’m an internist, I’m a pediatrician. I belonged to the first graduating class of the Institute for Functional Medicine. I have my own practice here in Ocala, Florida. We have over seven providers, we have a insurance based functional medicine practice. We have health coaches. We have actually over 60 employees. I also am a faculty, teaching faculty for the Institute for Functional Medicine, so I do various talks across the world, actually, on functional medicine, on getting to the root cause. I live on a horse and cattle ranch in Ocala, Florida. Happily married, got seven kids. The oldest of 15. So, that’s about it.
Dr. Weitz: Yeah, that, that ought to keep anybody busy.
Dr. Elyaman: Oh yeah.
Dr. Weitz: So, tell us why fatty liver disease is so important. I teased the audience a little bit already.
Dr. Elyaman: Yeah, so you already kind of mentioned it, but But if you look at statistics, between 25 and 30 percent of people have fatty liver disease already. And that, I mean, you think about that means one in every four people have it. It is, not only can fatty liver lead to liver cirrhosis, meaning failure, and liver cancer, but the liver is the center of metabolism. All the stuff, in functional medicine, we’re learning about, like, Methylation issues, elevation of Homocysteine, inflammation, oxidative stress. Most of those things are happening at the level of the liver. So when the liver, when there’s a problem with the liver then the, and the liver isn’t functioning properly, it causes other issues. So, many, so when they have fatty liver disease, they have a high chance of dying from a stroke or a heart attack. They have a high chance of having high blood pressure just because of what the liver does. So it’s I think because it covers most of our or at least a quarter of our population, plus it leads to all kinds of other issues, we really do want to know about it.
Dr. Weitz: Absolutely. So, how do we know if we have fatty liver? How do we know if a patient has fatty liver? I’ll give you an example. I just talked to a patient and she had a CT scan of her abdomen and it showed [00:04:00] some fatty infiltration of her liver. Now, is that technically fatty liver or we need additional testing to really nail that down?
Dr. Elyaman: Yeah, we may need to do some additional testing. So now it’s called MASLD. So the S is with a is kind of pronounced with a Z. Right.
Dr. Weitz: So the condition had been called Non-Alcoholic Fatty Liver and now…
Dr. Elyaman: Yes. Now it’s called MASLD and actually it does sound a little bit cooler. I was very upset when the name changed and then it changed again because like I created a course on fatty liver. I have over 10 hours of teaching practitioners how to deal with fatty liver and it wasn’t called mazzled. I actually had to change the name of my course and kind of throw in fatty liver and mazzled but we can I know you, you were, you asked a follow up question but just…
Dr. Weitz: Yeah, let’s talk about the name and why it’s changed.
Dr. Elyaman:Yeah so the reason was, is that when you call something by what it’s not, like non [00:05:00] alcoholic, that it kind of doesn’t make sense to call it what it’s not. It turns out, it just, it didn’t. When the liver gets inflamed, one of the things that can happen is it can turn to fat. So what, that’s what they’ll see when they do a biopsy and under a microscope, they’ll see that the liver is turning to fat. So it was one of the most common causes back then of the liver turning to fat was alcoholism when or not even alcoholism when certain people, when they drink alcohol, different people have a different threshold, but that some people, it might be one drink a day, it would start turning that liver to fat. So they just called it by what it wasn’t, the most common cause at the time. Oh, non alcoholic. And then so naming it by what it’s not, kind of didn’t make sense. So now what it is. Metabolic Dysfunction Associated, because like you mentioned, metabolic disease, it’s associated with [00:06:00] metabolic disease, and metabolic disease is like driving this. And then the other part of it is steatotic, so metabolic dysfunction associated, steatotic is Latin for fat, and what people were saying is that. We were being stigmatized, or patients that had this were being stigmatized. Calling somebody fat or saying that, hey, this is fatty, is, was a little bit of a shaming thing. And also, even though they called it non alcoholic, people would go home, tell their family, and their family think, oh, you’re drinking too much. Even hough it’s non alcoholic, they’re like, oh yeah, it is alcoholic. So that’s where non alcoholic metabolic dysfunction associated, steatotic is the Latin word, and then liver disease. So that’s where the name came in. And then back to your case, you were talking about, you did, was it a CAT scan you mentioned?
Dr. Weitz: Yes.
Dr. Elyaman: Alright, so there’s a CAT scan, and the CAT scan shows that somebody has fat in the liver. Well, we know that they have liver, that they have fatty liver infiltrate, but various conditions can cause the liver to turn to fat. And that’s why, in order to make that diagnosis, you do have to rule out other conditions.
Dr. Weitz: Now, is there a difference between alcoholic fatty liver and metabolic associated liver? Is there a different mechanism of what’s happening? Because my understanding in metabolic associated liver disease is that as a result of having too much glucose in the system, that glucose is converted into triglycerides and then stored in the liver.
Dr. Elyaman: Yeah. So it’s interesting. There are about what, like digging in the research, about ten really common causes that of fatty liver disease. And because alcohol can cause the liver to start turning to fat, that’s just one of [00:08:00] the, one of the reasons for it, and because drinking alcohol is pretty common, they now, there’s actually a there’s a version of MASLD called AC, meaning alcoholic associated as well. So alcohol is a toxin and that toxin is causing the liver to start turning to fat. Now alcohol also,…yeah, alcohol will cause your homocysteine, which is that met, that level in the blood when that’s high, that means that you’re not doing what we call methylation properly. And methylation is kind of one of the ways that we break down different hormones and we detoxify. So that homocysteine can also go up, which can cause that liver to start getting inflamed and turn to fat. But like you were saying that, one of the primary causes in MASLD, take away the alcohol piece to it, is insulin resistance. But here’s what’s interesting about the insulin resistance. Insulin resistance. When you start taking lots of sugar and lots of carbohydrates, then the pancreas has to make up for it. It has to do something about it because we don’t want our blood levels to be filled with sugar. So the pancreas creates insulin, and that insulin is going to drive your glucose or your sugar into the cells. Now, what happens is that whenever our body gets too much of a hormone, like it’s just oversaturated, whether it’s testosterone and people are roiding up too much, whether it’s estrogen, what happens is those, the body just can’t handle, or the cells can’t handle it. So they start to get resistant to where you need more and more insulin for those receptors to work.
So now let’s go back to MASLD. People will have lots of sugar, and then they keep getting this, these spikes of insulin, and then they start getting resistant. And that, what would happen is now the insulin is not working, and they’re needing more and more insulin. That insulin resistance will cause an enzyme called hormone sensitive lipase, found in our fat cells to be overactive. And what that does it starts tearing up fat in the fat cell and start sending it to the liver. So now the liver gets overwhelmed not only with what they are eating, but also with all of these fatty acids that are like overwhelming the liver. So then the liver starts like trying to make, try, trying to repackage it. And it repackages it in something called VLDL and triglycerides. Now VLDL is what becomes LDL, which they usually call bad cholesterol, but we know in Functional Medicine that it’s not always bad. You actually need to have LDL, but it makes the [00:11:00] really tiny bad cholesterol. And the really bad, tiny bad cholesterol is what ends up causing clogging of the blood vessels or heart disease and a lot of the issues that we see. So from that mechanism, one of the primary mechanisms of MASLD is going to be that insulin resistance. Now you add toxins to the liver, you’re kind of pouring more fuel on it, and then that can make, can happen, that can add a little bit more. But what’s interesting is, those are just parts, there are so many other causes of mazzled, and if we just, we can’t just look at people that have fatty liver and are MASLD, and we’ve ruled out, and we can at some point, talk about how to rule out other causes to make sure you actually have the diagnosis, because I think that’s important. But there’s many other things that may be causing MASLD for our patients that, that we’re not picking up on. And we’re just saying, Oh, just lose weight. Like that’s not the answer.
Dr. Weitz: Or what are so many other causes?
Dr. Elyaman: Okay. So one of the other causes is an elevation of uric acid. So uric acid. Yeah, uric acid is a particle that’s found in the blood and it is usually associated with gout. So, really high amounts of uric acid in some people, because some people it doesn’t really cause that. They’ll get gout attacks where they get inflamed, painful joints. But that uric acid, if it’s elevated, it can actually cause other things. For example, it can cause fatty liver and it can cause the body to start storing fat. Now, the question is that why do we have this elevation of uric acid? And the answer is, so we think that it has so traditionally,
Dr. Weitz: So high uric acid is actually a metabolic issue, right?
Dr. Elyaman: Exactly. So it’s because of, so when we consume large amounts of fructose…
Dr. Weitz: Correct.
Dr. Elyaman: which is found in high fructose corn syrup. When it’s found, it’s also found in [00:13:00] in fruit juices. Then, and actually, you can get high uric acid from drinking alcohol, but what happens is that now the body, when it gets too much fructose at one time. Then the body has to use ATP to break it down or to process it. And that ATP, the A and the A in ATP gets broken down into and it increases uric acid. And then uric acid makes us start building more fat. It makes the liver not able to break fat down and it makes our body store more fat.
Dr. Weitz: So it’s not a coincidence. That fructose, which has a low glycemic index because it has to go through this circular route through the liver to finally get metabolized. And the exact same pathway is needed to break down alcohol.
Dr. Elyaman: Are you reading my mind or something here? No, not at all. I thought I was the only one that knew this stuff. No, it is not. It is not a coincidence. Yeah, no, it is not. It is not a coincidence. It is. It is. And what’s happening is this. If you look at the way we would eat, consume fructose in nature, it was kind of with you. There was fiber with it. There were other things, other. The different colors in the fruits and vegetables or phytonutrients had different healing properties. But in reality, if you look at our Stone Age ancestors, we had a mechanism to build or to acquire fat. So what would happen is that in springtime, we would get access to fruits. We would eat a whole bunch of fruits, because you never know, you don’t know how long that’s going to last. And then those fruits, one of the things that would happen, they would have sugar in them and sugar can increase insulin and make us gain fat. But then on the other side, the [00:15:00] fruits were caught, can cause uric acid to go up. And then the uric acid to go up would, would also then push us to store fat. And then what would happen is that winter would come. And when winter would come, then, unfortunately, a lot of vegans would change their minds really quickly, and then not, I mean, hey, we’re not in the Stone Ages, so you can, you can definitely be vegan and survive. But back then, what would you have access to? Nuts and seeds, and meats. And then, the nuts and seeds and meats, would then push our body into muscle storage and fat burning, to make us, kind to kind of change our body composition until spring would come again.
Dr. Weitz: Now why don’t bears die from fatty liver?
Dr. Elyaman: Oh. Because they’re too busy sleeping, man, not moving around. Bears are so that, that’s right. Bears eat. Bears.
Dr. Weitz: Bears eat the fruit.
Dr. Elyaman: Yes.
Dr. Weitz: To store fat to last through their hibernation. Right?
Dr. Elyaman: No, [00:16:00] absolutely. So actually this is just a theoretical thing or so. I’m sure the audience knows this is for entertainment purposes only, and don’t use this and whatever. But so if you think about it, human beings, we’re not supposed to…
Dr. Weitz: Make sure you check your bear for fatty liver.
Dr. Elyaman: Definitely check the bear for fatty liver. So humans, we are not supposed to store fat in our liver…
Dr. Weitz: Do you think Bobby Kennedy checked the bear in the back of his car for fatty liver?
Dr. Elyaman: I don’t think he, nope.
Dr. Weitz: Just kidding.
Dr. Elyaman: But I don’t think it happens in bears. I think it’s more of a human thing because we kind of overdo it a little. Like I, we didn’t really
Dr. Weitz: Human beings overdo things?
Dr. Elyaman: I know it’s shocking, but yes. Sometimes, some humans, not me. I don’t know what, I don’t, I would never ever overdo things, but some humans would overdo things, yes.
Dr. Weitz: Okay, I’m sorry for messing up your train of thought. I
Dr. Elyaman: did not at all. This is this. I love [00:17:00] this. This is how science can be fun. See, science is fun.
Dr. Weitz: I agree. I love science. So how do we test for fatty liver? How do we analyze people? What are the labs we want to look at? What are the tests we want to run?
Dr. Elyaman: Absolutely. So first of all, we’ve got to rule out other causes, right? So how do we rule out other causes? Well, we’re gonna we’re gonna get, one of the things we look at is a CBC or a blood count. And when you look at that CBC or blood count, you can look at what’s called the mean corpuscular volume or MCV. And if MCV is high, if the number is high, then that means your red blood cells are large. And what can cause your red blood cells to be large? B12 Deficiency, Folic Acid Deficiency, and also, in some people that drink alcohol can cause that to happen as well. Because it poisons the system, and makes your red blood cells larger. So, that would be a clue that there’s an issue with alcohol. With, that there’s an alcohol component to it, and that’s something you would talk to patients about and see, is this alcoholic fatty liver, or is it MASLD or is it a combination of both? The other thing that you can see when you’re looking at the blood count, is you can look at platelets. And your platelets are, if you’re and there is a test that you can do called a FIB4, and it’s really not a test, but what it is a calculation where they look at liver enzymes, your AST, your ALT, your age, and your platelets. And if your platelets are low compared to the, to, to what they should be based on what your liver enzymes are, then that can tell you that there is some fibrosis happening, meaning that there’s a hardening of the liver. Why? Because the liver is one of the, its functions is it makes a hormone called thrombopoietin. And thrombopoietin’s job is to go to the bone, to your bone marrow, [00:19:00] to tell your bone marrow to make platelets to help the blood clot. But if your liver is damaged, it can’t make it as well, and then those platelets are going to be lower. The other thing though, is that it could be a clue to alcohol as well. Because alcohol will poison your bone marrow and not allow it to make those platelets. So those are kind of some of those initial clues. So definitely a good history, find out if they’re drinking alcohol. You can do a viral Hepatitis Panel. And a viral hepatitis panel is to see if they have these chronic viruses that can infect the liver, like Hepatitis C, Hepatitis B, those are the common ones. You also can do something called an autoimmune hepatitis panel. And an autoimmune hepatitis panel is looking to see if you have an issue with autoimmune hepatitis. Autoimmune hepatitis is where the body is attacking the liver, it’s attacking itself. You can also get, and this is just kind of the initial, we have more of a functional medicine approach, of course we will look more. But this is just the initial test. So you check that Autoimmune Hepatitis panel and you can also check something called Alpha 1 Antitrypsin. And it’s a genetic condition and what happens is they can get problems with their liver and problems with their lung. You can also check an iron panel with ferritin because if you have iron overload, that can cause the liver to turn to fat. So that’s another thing that we would look at. And then you can also check copper levels. And if your copper is and it’s a little confusing, but if your copper is low, it could mean you have high copper, high free copper. So then you would follow up by getting a ceruloplasmin level, which is the carrier molecule for copper and a 24 hour urine copper. But bottom line, if you have too much free copper, that also can turn your liver to fat. And that’s the workup you do to rule out other causes. And then in the regular CMP, you’re going to look at something called an [00:21:00] alkaline phosphatase and a bilirubin. And if the alkaline phosphatase is high, then that’s kind of a clue that you have another liver issue…you need, you probably get to get them to a subspecialist…it’s not just the typical fatty liver or now called MASLD.
Dr. Weitz: What does it mean if the alkaline phosphatase is low?
Dr. Elyaman: It means that you have a problem with, you have a problem with kind of the bile flow. We call it cholestasis, so the bile ducts are kind of clogging up and the bile is not flowing properly.
Dr. Weitz: Ah, interesting. Okay. So, we’re gonna do those tests, and then what’s the next step if we’re suspecting that there might be fatty liver?
Dr. Elyaman: Yeah, so I, nowadays, we have readily available this amazing technology called FibroScan technology. And a FibroScan is an ultrasound technology, [00:22:00] but it’s specified. And what it can do is it can tell me two things. It gives me what’s called a CAP score and a fibrosis score. The CAP score is telling me how much fat is in the liver. And you’re supposed to have less than five percent fat in your liver. The fibrosis score tells me how much hardening is happening in the liver. And I can take those numbers without a biopsy because before you had to do a biopsy to know this. That’s the exciting piece. With non invasive tests, no biopsy, and based on that, I can actually tell the patient your liver is supposed to be less than 5 percent fat, you’re at a 37 percent fat, we need to get this down, we need to work on your liver. And I’ll tell you something, I have not seen people as motivated to make changes with, in their life, or in their lifestyle, in their habits as, I haven’t seen anything as powerful to make them, have, see them, have them make changes, as when you show them that there’s something going on with their liver.
It’s interesting, you’re like, oh yeah, your arteries are clogged up. Okay, we’ll try to make some changes. You tell ’em the liver and for some reason, they pay attention. But the FibroScan is a definite must that and the fibro, if you can. And the FibroScan also gives you a fibrosis, a hardening number. ’cause we want to see. Is the liver hardened? There’s another blood test. It’s kind of a newer test, but it’s part of the guidelines that you can look at called an ELF test. ELF. And the ELF test, when that’s high, that also can indicate that you have fibrosis or hardening of the liver. Why is that important? Because if you have hardening of the liver, that then step after that. So you go from fatty, you start getting hardening of the liver, to liver cirrhosis, and cirrhosis goes to liver failure. And that’s why to be able to pick up on that, and to be able to give them a number, and to be able to give them some things to do and see that improve, is a game changer.
Dr. Weitz: Now, it’s interesting that you get fat infiltration that leads to fibrosis. Why is that, how does that result from fatty infiltration?
Dr. Elyaman: Yeah because the liver gets all jammed up with fat, you can’t, and because of the mechanism behind it, because that insulin resistance can also cause some inflammation coming from fat cells, you can get something called oxidative stress, so you can get, you can get glycation, where, caramelization is happening in the liver, in the body. You get oxidative stress, so that’s where rusting is happening in the body. So, you have those things, you have that process happening, and you have the liver, man, you back that sucker up enough, and then you start getting inflammation, so it gets inflamed, and you start backing that thing up enough, it’ll start getting harder, and it’ll start getting that fibrosis.
Dr. Weitz: And a similar process happens in the vascular system, in the [00:25:00] arteries, in the heart, where you get oxidation and inflammation, and then you get hardening of the arteries, and you get fibrosis of the heart. And interestingly, you can have fatty infiltration of other organs besides the liver, right?
Dr. Elyaman: Right, and I’ll tell you what’s interesting. So I remember when I first started learning about functional medicine. First I was a skeptic, then I was a fan in awe, right? And I remember hearing people mentioning these pathways, and I’m like, how do they know so much? But it turns out that they’re the body is pretty similar, and there’s only a certain amount of ways that the body can go bad, which is why, you mention, just mentioning the process of fibrosis, you as a functional medicine practitioner can say, yep, that actually happens over here and over here. But that’s but yes, to your point, to your point the body has a finite amount of ways that it can go bad. And depending on where it’s, that process is happening, that’s [00:26:00] the disease condition that they’ll end up naming it or calling it.
Dr. Weitz: Right. Dr. Mark Houston is fond of saying there’s only three finite responses, oxidation, inflammation, and immune dysfunction that can result from an infinite number of causes.
Dr. Elyaman: Right. And you can call it three or you can call it 10, right? It depends on how you want to break it down and look at it. But yes, and Mark Houston is very famous for that. For mentioning, focus on these three things, right? Yeah.
Dr. Weitz: And so a lot of patients probably with fatty liver may have fatty pancreas, or fatty other organs.
Dr. Elyaman: Right, right.
Dr. Weitz: So what do we do when we discover that a patient we’re working with has fatty liver?
Dr. Elyaman: Right. So I’m going to want to, I’m going to want to now to take a deeper dive of their chemistry, right? So I’m going to, I’m going to want to get a something called the insulin resistance panel, where not only am I looking at those insulin levels, but I’m [00:27:00] also looking at I can get a score, an insulin resistance score, and I can see if, and based on that test, I can see if they, how much insulin resistance they have. I’ll tell you, there’s many…
Dr. Weitz: And is it, you usually get that from Cleveland Heart Lab?
Dr. Elyaman: Cleveland Heart, you can get it from CardioIQ. I actually, I’m a independent contractor with Cleveland Heart and CardioIQ. I actually work with them. I just I, it’s not released yet, but I gave them a talk on fatty liver recently. And so that’ll be coming out soon. But yeah, you can get it from them. There’s many specialty labs that you can get an insulin resistance score from. You can also you, another test, speaking of Cleveland Heart and CardioIQ, There’s a there’s a test called Small Density LDL.
Dr. Weitz: Yeah, we run that all the time, of course, yeah.
Dr. Elyaman: Right, now when you look at it from this aspect, insulin resistance causes in the fat cell the hormone sensitive [00:28:00] Lipase, to be overactive. Now you start to get, you start to get those fatty acids that are released into the bloodstream. Fatty acids going into the bloodstream go into the liver. In the liver has to do something about it, so it repackages it. But it, it repackages it into VLDL. VLDL can be Triglyceride rich or Triglyceride poor? Triglyceride rich VLDL is from that process that’s happening. Because there’s all these, all of these fatty acids. So you get Triglyceride rich VLDL. And this is why it’s important. As the VLDL starts turning into LDL, IDL and LDL, and releasing the Triglycerides. If it’s Triglyceride rich, you get lots of small density LDL, the one we look at as a risk factor for cardiovascular disease. Why is that important? For various reasons, and we can go into it later, but [00:29:00] various reasons, your triglycerides could look normal even though you have fatty liver disease, but one of the biggest markers of your fatty liver disease. So if you have fatty liver disease, if you look at this test, if this number goes down, your fatty liver disease is getting better. And that’s small density LDL. So I’m going to want to get a small density LDL. I’m going to want to get a uric acid. And I’m not going to go by the lab’s definition of high uric acid. The lab basically is looking for what is a risk factor for gout. I’m worried about metabolic disease.
Dr. Weitz: So 5.5?
Dr. Elyaman: 5.5 or less. You did it. You did it again. Stop reading my mind. Absolutely. I go 5. 5 in younger people. We actually want younger women. We’re thinking 4.5. So I’ll look at, I’ll, I look, I check a uric acid every time I do a lipid panel.
Dr. Weitz: It’s just part of my panel right? Yeah. If you do an advanced lipid [00:30:00] profile, which we always do, we always include uric acid.
Dr. Elyaman: Perfect. Yeah. We do the same at our office. So then I look at it. And I’m, I see the uric acid and I’m like, Hey you’re taking, this is too much fructose. You’re taking in too much sugar. So we do these tests, we check the iron, we check, so we check these things. And then we like checking a homocysteine because if it’s high, then they might need some methyl B vitamins. And then based on that, we will put them on some sort of a treatment plan. So you’re so let’s start with nutrition.
Dr. Weitz: By the way, I recently had a conversation with Mark Houston who informed me that your risk of coronary artery disease goes up with a homocysteine level of above 5.
Dr. Elyaman: Wow, well, I shoot for 7 or less because of that.
Dr. Weitz: Right, I do too.
Dr. Elyaman: Yeah, we’re in America, man. If I can get you to seven, man, I’m a winner.
Dr. Weitz: Exactly. It’s like trying to get everybody’s blood pressure to 110 over 70. You’re not likely to do it.
Dr. Elyaman: Yeah. That homocysteine can [00:31:00] be an ugly little thing. Like it causes atherosclerosis in the Bredesen protocol for those people. Like we do the Bredesen protocol in our office when it comes to dementia. Right. You want that less than seven. So that homocysteine is a important piece.
Dr. Weitz: Yeah, okay, go ahead.
Dr. Elyaman: So back to, yes, weight loss, in the beginning, weight loss should end up lowering fatty liver. Why? Because now your body’s metabolizing fat, right? It’s breaking it down. But you gotta be careful, because if somebody loses weight, and then they maintain that weight by eating garbage, eventually what happens is the liver will let go of a lot of its fat. And it will, the fatty liver will start, will reverse, and then they maintain the weight, but they’re doing all of the junk stuff that they really don’t want to be doing. Guess what? The liver can refill with fat again at that weight. [00:32:00] So that’s the thing, they’re just like, oh, just lose weight and you’re fine. No. So we got to look a little bit deeper than that.
Dr. Weitz: So what you’re trying to tell us is if you just eat less junk because you’re taking Ozembic. Yes. That’s not really a good solution.
Dr. Elyaman: Right. So, so less junk because you’re taking Semaglutide.
Dr. Weitz: Right. In other words, a person who doesn’t change their diet.
Dr. Elyaman: Ozembic probably has a lot of money to come after me, but I didn’t say it.
Dr. Weitz: Okay. Okay. So let’s just say somebody who loses weight by taking a GLP 1 agonist without a change in their exercise or eating healthier or doing any of those things.
Dr. Elyaman: Why don’t you just say Ozempic? So absolutely, that’s one of the biggest issues. So do we put people on semaglutide? Do we put people on Ozempic? We do, but we’re not going to just say, Take this shot and see you later. We’re saying if I’m putting you on this [00:33:00] as a tool, I’m putting them on it as a tool, already planning for when I’m taking you off of it. Because yes, you just eat less junk, then the body will release fat, and when the body starts to release fat, then the bo then the liver will release fat, and then you stabilize, you could potentially then refill that liver up again because of the nine or ten potential causes of MASLD. So what is, what was I getting to? What we want is not to just say lose weight and that’s it. We want to say, well, what type of a food plan, and I like calling diets food plan because it’s, this is kind of the, what you eat, right?
So what kind of a food plan will cause weight loss? I’m sorry a decrease in fatty liver, independent of weight loss. And what I mean by that is, is that they can stay exactly the same on a scale. but their fatty liver starts to go down. And that’s the [00:34:00] Modified Mediterranean Food Plan. And that’s in IFM, we call it the Cardiometabolic Food Plan. We have kind of our own version of that.
Dr. Weitz: Right. Yeah. By modified, it’s basically a lower glycemic version, correct?
Dr. Elyaman: Correct. So that’s eating, and that’s the thing, they’re having, they’re eating healthy fats, they’re eating they’re consuming olive oil they’re getting all the different vegetables in, they’re nuts and seeds. So things that certain conventional literature may not be endorsing, but they’re, nuts and seeds are high in fat, well you know what, they can be healthy if you’re not, if they’re not roasted and not salted. Right? So, but a modified Mediterranean food plan is really nourishing the body, and you can start to see that. The other thing is that if you can get people to exercise, you can actually decrease fat in the liver independent of weight loss. So if I can just get someone to stay exactly the same weight, But do some sort of exercise. Cardio does some [00:35:00] things and resistance training does others. Because what happens, you tell people lose weight or you’re toast, and then they’ll start to lose weight and then they’ll get hungry and they’ll gain a little weight and then they’ll start to feel like depressed.
So then they’re going to eat more, right? And their fatty liver gets worse. And no. So this is not, we meet people where that we’re at. Everybody’s on their own journey, everybody has their own things, but why don’t we try to increase more of these foods? And why don’t we add a little bit of a wok to your Doritos? And why don’t we, and why don’t, and why don’t we also get some resistance training in there? So nutrition is gonna be key, because we’re looking for not to lose the fat in it and then the fat pops back. We’re looking for a long term. And hopefully they will lose fat as well, and their body composition will change.
Dr. Weitz: Resistance training, I think, is crucial for increasing metabolic rate.
Dr. Elyaman: It’s huge. Yep.
Dr. Weitz: and not to mention preventing loss of muscle and loss of bone as we get older.
Dr. Elyaman: [00:36:00] Right. Resistance training is every, you know, every one of our patients should have some sort of a cardio plan, even if it’s just walking 20 or 30 minutes a day, how many patients have I taken off so many different medicines, just because they go, I can get them to go for a 30 minute walk a day. Then the resistance training, Something to something about stretch, maybe some sort of like stretch and body. I mean, listen you’re a chiropractor, so you won’t know about this stuff, but let me help you. So I’m like preaching to the guy. I read your mind, didn’t I? It was my turn.
Dr. Weitz: What else can we do to treat these patients? What about you mentioned diet, you mentioned exercise, what are some of the other lifestyle factors? And let’s go into nutraceuticals.
Dr. Elyaman: All right, so let’s talk about nutraceuticals. Of course, nutraceuticals are not FDA approved to treat any disease and we’re looking at imbalances, right? So from an imbalance [00:37:00] point of view, insulin resistance, there’s some go to nutraceuticals. One of them would be berberine. Berberine can help with insulin resistance. Berberine can help kill bad bacteria in the gut. And one of the things that causes fatty liver that we didn’t talk about is something called SIBO, Small Intestinal Bacterial Overgrowth. And that, what happens is that those lipopolysaccharides that are in the gram negative bacteria that overwhelm the gut can get absorbed and they can cause inflammation in the liver. So, berberine is a go to because it helps with that. Now, one of the tests that we look at is something called GGT.
Dr. Weitz: By the way, I just saw a paper, berberine has been shown to reduce kidney damage from high Uric Acid.
Dr. Elyaman: Amazing. Amazing.
Dr. Weitz: Berberine is amazing.
Dr. Elyaman: It is. It is. It is great stuff. It is. It is definitely the go to. So, the GGT is a marker. [00:38:00] We check it, usually, what practitioners usually look at GGT for is, if it’s high, it means that it’s your liver enzymes that are elevated are coming from your liver and not from, not from other tissue, or not from or your alkaline phosphatase, if it’s high, it’s coming from the liver, it’s not coming from the bone. But the reality is, is that if we really look at what GGT is looking at, it is looking, it’s a byproduct of glutathione, our body’s most powerful antioxidant, or rust buster. And when you see that GGT high, you know there’s oxidative stress happening.
Dr. Weitz: By the way, what number do you like to see for GGT and why don’t you throw in ALT and AST as well? Because depending upon the lab, the normal range changes. And I’m always trying to explain to patients, forget about the normal range because that’s just reflecting the average American.
Dr. Elyaman: [00:39:00] The secret to the optimal numbers they can get if they read my book. I’m just kidding. I don’t even have a book. All right. So if I have a book one day, no, you make a good point. There were population studies. So let’s look at AST and ALT. AST and ALT are, Those are those are the traditionally what we call the liver enzymes for women, you want your ALT to be 25 or less men 35 or less not what the lab says for a GGT I want to see it less than 35 better than less than 30.
So if my GGT so if my if someone’s GGT is in that higher end of normal or high, then I’m gonna think they have oxidative stress. So what are our go-to you? And that if they have insulin resistance and o oxidative stress, alpha lipoic acid may be helpful, right? Because it helps with glucose and it helps with that.
If they have high GGT, you can think about N acetylcysteine or NAC because that increases glutathione, but that’s not [00:40:00] fixing the problem, the underlying problem. But I’ll tell you there, there’s a study that was showing. that CoQ10, and I like the ubiquinol form, also can help when you have that elevation in GGT.
Dr. Weitz: Interesting.
Dr. Elyaman: Probably curcumin as well. Curcumin. Man, curcumin, like, everything you look at curcumin helps with.
Dr. Weitz: Absolutely. Curcumin.
Dr. Elyaman: As a matter of fact, probably this podcast is doing so well because you take a lot of curcumin.
Dr. Weitz: Absolutely.
No wonder I’m orange. No I don’t know. Sometimes no matter how I set up the lighting, my, I look a little orange or a little pink or something like that. And you never quite figure it out. But
Dr. Elyaman: it’s the curcumin. You’re probably having a lot of carrot juice too.
Dr. Weitz: No carrot juice. No, gave up the juice. So what other nutraceuticals are beneficial?
Dr. Elyaman: Yeah. So that just, you kind of, you take a look, you [00:41:00] see what the imbalance is. If you’re, so we talked about insulin resistance, we talked about oxidative stress and elevation in uric acid. So things like I actually work on the medical director for a company called Human N. They’re the ones that make Neo40 Professional and whatnot. And we actually designed a a capsule that has four ingredients in it that have been found to lower uric acid. One is, one is is Cherry, Tart Cherry Extract, which may help lower it.
Dr. Weitz: The other
Dr. Elyaman: one is Vitamin C, because Vitamin C may lower it.
The other one is going to be a, like a Green Tea Extract. The fourth one tart cherry, vitamin C. The fourth one is a surprise . ’cause I can’t remember. Or
Dr. Weitz: a 10 maybe .
Dr. Elyaman: No. It was yeah. Yeah. It’s a surprise. This is a, that’s okay. This is homework for the audience to look at. Okay. Uric acid balance.
Dr. Weitz: Yeah. We’ve been using either Uric X from Designs for [00:42:00] Health or a few other Nice. Other professional companies have uric acid products.
Dr. Elyaman: So low, so that’s kind of for the uric acid.
Dr. Weitz: Okay.
Dr. Elyaman: Oh, I’m sorry. The fourth ingredient was quercetin, because quercetin can lower it as well.
Dr. Weitz: Correct.
Dr. Elyaman: And quercetin can help with people that have allergies and people that have, so it can help, it’s a mast cell stabilizer. And actually, and people that have issues with kind of like fibro, a lot of times it’s a mast cell issue, so it can help with that. So the only reason I’m mentioning these other conditions is because in functional, you can’t, you can only take so many pills. So what we’re looking for is, What other associated conditions do they have? Let’s try to find that one supplement that will help with all of those things. So we talked about high homocysteine. So definitely with homocysteine, you’re going to look at your methylation, your B vitamins. Certain B vitamins need to be activated to what’s called the methylated form. So your B6 to P5P, your B12 to methyl B12, your folate to [00:43:00] methylfolate, your 5 phosphate you also, so all those four things, if you can get them in the already activated methylated form, then they may actually help lower homocysteine, and then, or with homocysteine balance, and then the, then there’s something called trimethylglycine, or betaine, and that also can lower it so sometimes we’ll do that.
Sometimes we’ll give taurine. Taurine is a cool one because taurine may help with work on GABA receptors to help people relax a little bit. And taurine may help with with regulate heart rhythm as well. And taurine is needed to conjugate bile acids. And one of the imbalances that cause fatty liver MASLD is you can have you can have this abnormal bile acid. That, that’s the cool thing about it. It’s not just there’s one imbalance. Most people, even functional medicine practitioners, they think, Oh yeah, fatty liver. It’s just like insulin resistance. No, dude, there is like so many different things. That, which is why, which is why, I don’t know why the [00:44:00] first course I made on my own was fatty liver. I think I started going down that rabbit hole, and then I’m like, no, this is so freaking important. I don’t care if the world doesn’t know it. I know it.
Dr. Weitz: Probably herbal bitters would be good for bioflow. Which one? Bitters. Oh yeah. Bitters is part of it.
Dr. Elyaman: Yeah. Bitters could be part, can, can help with bile flow. Cleaning out the gut because because what happens is if you have a lot of bad bacteria, you get these secondary bile acids that worsen fatty liver. Things to kind of help the composition. So phosphatidylcholine. I’ve seen amazing improvements in liver, in fatty liver content from putting people on phosphatidylcholine and there’s research to, there’s, there’s research to support that, not as robust as we’d like, but there’s research to support it and part of what it could do is it’s changing the composition and helping bile acids have less cholesterol in it.
Dr. Weitz: Right. That’s why when I have a patient with fatty liver I usually use a curcumin that’s bound [00:45:00] up with phosphatidylcholine.
Dr. Elyaman: Two for
Dr. Weitz: one. Two for one.
Dr. Elyaman: Yep. Yep. And sometimes we’ll give, we’ll end up, we’ll end up giving about 1800 milligrams of phosphatidylcholine divided twice a day. And we see great results.
Also the vitamin E Everybody’s different, but one of the things that happens in fatty liver is that people will start to deplete their vitamin E. They’ll also deplete glutathione. And the challenge with vitamin E is that the type of vitamin E that they usually get over the counter is D alpha tocopherol.
Yes. You see, there’s studies that show that taking, yes, exactly, right down. throw it down the drain, don’t even give it to your animals. Because what happens is that, that you look at the literature and what you see is that vitamin E may be amazing, but it also may cause all kinds of problems.
And one of the things we think is that because it depends on what the type of vitamin E, your vitamin E, there’s an alpha, beta, delta, gamma, [00:46:00] tocopherol, alpha, beta, delta, and a gamma tocotrienol, eight forms. And if you start taking that one form, you could block the other seven from getting in. Yes. Yeah,
Dr. Weitz: I’m big on the tocotrienols.
Dr. Elyaman: Since you’ve been reading my mind so much, I need to get you on my podcast, brother. I really need you. Yeah, very good. Yeah, so, so I think those are, there, there is a, there’s another supplement that I’ve been a fan of as well, and it’s called Tudka. And Tudka is, yeah, it’s the taurine bound ursodiol. Ursodiol is also, could be a supplement, but it also is a it also is a prescription that you can get, and there’s data that shows it may help with fatty liver. But Tudka is 1 C. step further. And what it really is like doing is it’s like, if you think of your bile as the oil of your car, it’s that treatment to the oil. So it helps improve [00:47:00] the quality of the oil. And it may also help. So for my challenging patients, they’re going to have, I like Tudco. I like Phosphatidylcholine. I like mixed tocopherols and tocotrienols. These are those challenging patients, but I don’t, I don’t think we should throw all of these supplements at people at once. Find out what’s the problem, work on nutrition, work on exercise, follow the tests, follow, and then maybe add a little something here and something there. You got to keep it interesting.
Dr. Weitz: You got it. Yeah, it’s easy to get excited and overwhelm them with too many supplements at one time. Right, right. Now, me, myself, I take about 30 twice a day.
Dr. Elyaman: That’s it. That’s the problem.
Dr. Weitz: I’m hedging my bets.
Dr. Elyaman: You read about it and you’re like, man, this is so amazing. I need this. And then you look at it. Yeah, we should probably just show a picture of our supplement cabinet. I have my own supplement cabinet. That’s [00:48:00] mine. And then I have the family supplement kit. I’m like, it’s nuts. Every once in a while I go into their supplement cabinet. But I try to, I, for patients, I, you, between three to five. And then you kind of give them the options. Never give, I never give more than three supplements at once, or I try not to. Oh, I missed one supplement. So actually, especially one supplement that that I like using to rebalance is going to be the Omega 3s. So we’ll check Omega 3 levels. And we try to optimize omega 3s as well.
Dr. Weitz: Yeah I think a multi, omegas, vitamin D with K, probably a probiotic. That’s baseline. That’s not even going into supplementation. That’s just essential.
Dr. Elyaman: That’s just replacing what we normally would have gotten if we lived in Stone Age times, right? We would have gotten our vit We would have gotten a bunch of greens, right? [00:49:00] And when in the spring, we would have gotten our Omega 3 composition would have been much better. We would have been getting sunlight, so our D would be, do it, we’d get the vitamin D. The greens we would get our vitamin K from. So yeah it’s the processing that’s happening. I agree with you. Those are my bare bone baseline as well. Just, this is like just normal. This is just replacing what normally is missing in everybody in our food.
Dr. Weitz: Right. If we were eating fruits and vegetables that were organic, that weren’t grown in soil, that was depleted of nutrients, and wasn’t over farmed, the same you know, foods grown over and over again, stored in frozen containers, shipped long distances to get to the supermarket, and Yeah.
Dr. Elyaman: And it’s not that hard. And you’d need a time machine, because even with all that, it could still be garbage. So, you go back in time, and then you harvest, and then you get back in the time machine, and I mean, that’s, that’s what we’re working towards, but till then, take those supplements. [00:50:00]
Dr. Weitz: Yeah, I got my time machine in the back.
I’m working on it. I got,
Dr. Elyaman: I have a little, a couple
Dr. Weitz: tweaks
Dr. Elyaman: to make, but I’m not there yet. I’m not there yet. I’m not there yet.
Dr. Weitz: Yeah, what’s happened in the experiment so far? You meet a few of your friends?
Dr. Elyaman: Listen, I can’t talk about it. I can’t talk about what happens in my backyard, okay? You want to come over? Come to Ocala.
Dr. Weitz: All right. So final thoughts about MASLD?
Dr. Elyaman: Yeah. Final thoughts. You know, now that we have, for those functional medicine practitioners, look up, look up the FibroScan and and figure out where you can get one. A lot of times you can get it for free at a research center because they’re researching different drugs for for fatty liver disease. There is a new drug that was the first FDA approved drug [00:51:00] Four fatty liver and the and it’s for, they have to have fibrosis, F two and F three. And it’s called ResMed, huh? It’s what’s, what we call, it’s a thyroid beta agonist. So if you look, I can see something about that. Yeah. It’s o only $4,000 a month . So if you are. Here’s the thing, so the thyroid hormone is, there’s different receptors throughout the body for the thyroid hormone. You have alpha and you have beta. The alpha is found in the heart, the beta is found in the liver, and then throughout the body it’s different, right?
So what this is it’s specific for beta, so it doesn’t increase the heart rate. So basically what you’re doing is trying to give people thyroid hormone without increasing the heart rate. Now, as functional medicine practitioners, we are checking advanced thyroid panels, and we are optimizing thyroid. We know, like if you look at the research, low T3 is a risk [00:52:00] factor for having fatty liver disease. Which is one of the other imbalances that cause fatty liver. Which is why I twitch a little when people say, oh yeah, that’s just insulin resistance. No bud, it could be toxicity and it could be thyroid dysfunction.
Dr. Weitz: You know what, real quick, could you just go through the 10 different causes of fatty liver? Because we hit some of them, but I don’t know if we hit all of them.
Dr. Elyaman: Let me try from the top of my head. Okay.
Dr. Weitz: Okay.
Dr. Elyaman: We did plan for this, right? , I think they need to know our planning. Did I think they need to know how much we planned for this. I texted you this morning. We both had like, work to do and then we just jumped on, right? So, exactly. So insulin resistance uric acid dysregulation iron overload is, it can be a cause. A discordance between your omega 3s and your omega 6s can be a cause methylation disorders and hyperhomocystinemia. Now this, these are parts of the process or [00:53:00] causes, but you can also have the Inflammation, Oxidative Stress can cause it as well. Small Intestinal Bacterial Overgrowth or Dysbiosis can be a cause of it. And also Bile Dysregulation. And also certain food intolerances. So like people, Some people, their fatty liver is caused because by celiac disease, like a subclinical celiac, then their problem is gluten. I think those are the major ones.
Toxicity, so toxicity can be a component, and there’s actually a condition called Taffled, or maybe it’ll be called Tazzled now with a new name change, and that’s basically, they are exposed to some sort of toxin. These are the people that don’t have the typical like metabolic syndrome factors and, but they have fatty liver and that would be tasseled as well.
So I think those are the main causes and those are the main things that we’re going to want to look at. And then based on your patient’s individual imbalance, [00:54:00] that’s what you’re going to go after. And that’s what you’re going to follow up on.
Dr. Weitz: That’s great. For fibrotic Liver, do you, are there any things that you use? I’ve used Modified Citrus Pectin.
Dr. Elyaman: Right, so, and Modified Citrus Pectin is helpful probably in all stages because a subclinical cholestasis is part of is part of the issue and it can help with growing good bacteria. So yes, but I’d say when they have that fibrosis, I’m going to number one, get their iron levels optimized. Their ferritin, I need less than 150. I’m going to make sure that they don’t have, I’m going to say absolutely no alcohol. I’m going to make sure that I’m going to look at like the, get homocysteine and all that stuff down. But I’m also, but I’m, I like Tudca. I like mixed Tocopherols and Tocotrienols 800 and Phosphotidylcholine, and that’s when we start hitting it really hard.
Dr. Weitz: What [00:55:00] about milk thistle? Glutathione. NAC. Oh yeah. You can mention NAC.
Dr. Elyaman: Yeah. Yeah. We can use some NAC I’ll tell you. So. If they have elevated liver enzymes based on the numbers that we mentioned, not based on what the lab says, then I usually am going to put them on a mix with Milk Thistle and NAC and just different things that are going it’s all put together in the same supplement and that’s just kind of a base.
Dr. Weitz: Like a liver support formula. Yeah,
Dr. Elyaman: just a baseline liver support. Right. And then you start hitting it hard with the one supplement prescriptions. Yeah.
Dr. Weitz: Cool. Great. So that was incredible. We covered a lot of information in an hour, Doc.
Dr. Elyaman: Nice. Yeah, I know. And I had a lot of fun with it. So that’s excellent. That’s excellent.
Dr. Weitz: So tell us about your course that you offer.
Dr. Elyaman: Yeah, so we have, so it’s still fairly new. We have the FMP Essentials, Functional Medicine [00:56:00] Practitioner Essentials. com, and the first course we launched was the Mazeld course, the Reversal of Mazeld course. It’s over 10 hours, taking a deeper dive in all of these different imbalances and kind of what we just went over, but the kind of, more of a systematic, all right, do these labs.
This is why I recommend these things. It kind of goes more in detail and elaborates more on what we talked about. And how do you and the beautiful thing about it is that once you’ve went through the course, you not only learned how to deal with fatty liver, but you also learned how to deal with diabetes and coronary artery disease and some of the because that’s the secondary benefit you’re going to get.
is how to deal with these functional medicine balances. So yeah, we would love to have it’s one of the things I’m very proud of, would love to, to have you there. If you guys want to keep in contact with me social media wise so across social media, I’m still learning the social media thing to be honest. I’m not like one day [00:57:00] I’m going to be more, better at it, but across the platforms.
Dr. Weitz: And one day you’re going to be Mark Hyman.
Dr. Elyaman: Yes. Well, I’m not there yet, but I’m coming for you, Mark. So at, I’m going to still stay in his shadow, right? Dr. Eman for myself at Dr. Eman. And then at FMP Essentials HQ for the, for our functional medicine practitioner essentials. And we’re right about to launch a mastermind for functional Medicine practitioners. We’re, it’s gonna, there’s gonna be a free mastermind that everybody can jump in and we’ll have our own kind of our own platform, social media platform. And then there’ll be kind of like paid tiers. So.
Dr. Weitz: That’s very cool.
So how about patients who want to have you help
Dr. Elyaman: them? Patients that want to have me help them? Currently, I’m not seeing new patients. Oh, okay. Yeah, so they might, if they live in Ocala, if they live in Florida, they can come check out the practice and see one of our providers and [00:58:00] that’s absolute health. Do they need to go to remote
Dr. Weitz: care?
Dr. Elyaman: We’re not doing remote care. No, we, there’s licensing. You got to get the license throughout.
Dr. Weitz: Okay.
Dr. Elyaman: So
Dr. Weitz: cool.
Dr. Elyaman: So you stay in California. I will stay in Florida and take care of the people here. The other 48 States covered and we’ll be good.
Dr. Weitz: Okay. Sounds good, doc. Thank you so much.
Dr. Elyaman: You’re welcome. My pleasure. Thank you for having me.
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 very much appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review. As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would help [00:59:00] overcoming a gut or other chronic health condition and want to prevent chronic problems, and want to promote longevity, Please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310 395 3111 and we can set you up for a consultation for functional medicine. And I will talk to everybody next week.