Advanced Biohacking and Longevity Strategies Clinicians Should Know with Dr. Sanjeev Goel and host 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

Enhancing Longevity and Healthspan with Dr. Sanjeev Goel: Exploring Functional Medicine, Biohacking, and Cutting-Edge Health Strategies on the Rational Wellness Podcast
In this episode of the Rational Wellness Podcast, hosted by Dr. Ben Weitz, the guest is Dr. Sanjeev Goel, a leading expert in longevity, biohacking, and health optimization. Dr. Goel, known as the Happiness and Longevity Doctor, shares insights from his practice near Toronto, Canada. The discussion covers the principles of hormesis, the difference between healthspan and lifespan, and strategies for longevity such as intermittent fasting, plasmapheresis, peptides, circadian rhythm alignment, and IV treatments. Dr. Goel emphasizes the importance of personalized, functional, and preventative approaches to extending both the quantity and quality of life. Listeners can learn about Dr. Goel’s methods and philosophies, and gain practical tips for incorporating these strategies into their own health routines.
00:00 Introduction to Rational Wellness Podcast
00:29 Meet Dr. Sanjeev Go: The Happiness and Longevity Doctor
01:07 Practicing Medicine in Toronto
01:32 The Role of AI in Medicine
01:54 Understanding Longevity Medicine
02:41 Healthspan vs. Lifespan
03:50 Challenges in Conventional Medical Care
08:03 Drivers of Aging and Longevity Interventions
09:53 The Concept of Hormesis
10:16 Fasting: Methods and Benefits
17:50 The Role of Protein in Longevity
21:51 Balancing Growth and Autophagy
23:18 The Role of Peptides in Longevity
29:19 Exploring Plasmapheresis and IV Treatments
32:18 Importance of Biological Rhythms
36:43 Conclusion and Contact Information


Dr. Sanjeev Goel is a physician, speaker, and leader in longevity and health optimization based in Canada. Often known as the “Happiness and Longevity MD,” he blends functional medicine, lifestyle medicine, and emerging longevity science to help patients extend not just lifespan, but healthspan and vitality. His website is www.sanjeevgoel.com and PeakHuman.ca and he hosts a podcast called Peak Human Labs, available on YouTube at @PeakHumanLabs

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 excited to welcome Dr. Sanjeev. Go. Dr. Goel is a physician, speaker and leader in longevity, biohacking, and health optimization. He’s known as the Happiness and longevity. Doctor, I’m glad you’re so happy. He blends functional medicine, lifestyle medicine, and longevity science to help patients.  Extend not just lifespan, but healthspan and Vitality. So, Dr. Goel, thank you so much for joining us.

Dr. Goel: Thank you so much for having me. I really appreciate it.

Dr. Weitz: Great. And you’re practicing in, is it Toronto, CA, Canada?

Dr. Goel: Yeah, just outside Toronto. One of the, you know, bedroom communities outside. Yeah.

Dr. Weitz: That’s great.  How’s practicing in Toronto?

Dr. Goel: It’s good. I mean, you know, I was just thinking that, you know, Toronto’s one of the hotbeds of many innovations and wellness medicine, you know, it’s one of the top, it’s also a good place there for that and a lot of innovation happening. That’s cool. AI is happening.  A lot of innovation happening from AI here in Toronto too, so it’s a place where things are happening for sure.

Dr. Weitz: That’s good. Is ai good or bad?

Dr. Goel: It’s a complicated question. You know, I definitely use AI and, but you know, I think in for our mental health and all that, there’s a lot of concerns I have about impact of AI on our health.

Dr. Weitz:  Right. For sure.  So what you led you into longevity medicine?

Dr. Goel: You know, I’m a family physician. I graduated, picked family medicine because I couldn’t decide on any particular part of the body to work on, and I just found it so everything, so interesting. And so I, you know, I was really trying to find the right answer.  And as a family physician I did many different things, you know?

Dr. Weitz: So what is the right answer?

Dr. Goel: Yeah, the right answer is that we have to give people the tools to go and understand their own bodies. The most personalized, customized treatments, I think are the best solution right now.  Right. And I think we have to rely on science and we have to rely on ai. And I’m very hopeful about the future, but that’s, but looking, we have to look in the body as a whole. And that’s why I think family medicine’s still by far the best option that way.

Dr. Weitz: Cool. So what’s the difference between HEALTHSPAN and lifespan?

Dr. Goel: Yeah I mean we obviously, the number of years aren’t as important if the, if those years are in suffering or in pain. And the idea of health span is to maximize the good quality years that we live. And I think a lot of longevity [00:03:00] physicians are all focused on that, on this aspect that is not just about the number of years, but the quality of of years that have been lived.

Dr. Weitz: So what does it really mean to be a longevity physician?

Dr. Goel: You know, I think a little bit of is again, a may be maybe a misnomer because it is we’re really focused on lifestyle and prevention of chronic diseases because these are the diseases that cause people to, to have shorter lifespan. So we’re doing whatever we can to help people maximize the health span and many people would recognize this as a lot of these things are just, you know, diet and nutrition and exercise and proper weight, lean body mass. What can we do to kind of, you know, improving mental health, not having depression, anxiety, all of these things together. One would call longevity medicine,

Dr. Weitz: right?  Unfortunately, conventional medical care really does not do a good job with this. Why do you think that is?

Dr. Goel: The incentives aren’t there. The, you [00:04:00] know, we get paid in Canada. We have a single payer system, which means that we get paid. People in the system get paid per visit. And what that basically incentivizes people to come to the doctor to just see us for whatever reason that is.  And that’s how, you know, doctors wanna spend a couple of minutes per patient, you know, maybe five minutes. And so when you’re incentivized that way you’re incentivized, see your patients regularly, and you’re not really focused on prevention and the long term solutions. So I think the system is structured like that, you know?  Yeah. We have, it is true, a sick care system. We’re very good at fixing bones and injuries and. Things like that. But we’re not good so much at the long term.

Dr. Weitz: So it’s kind of interesting that in Canada there’s a single payer system and it’s pretty much a sick care system with incentives not to really individualize care or spend a lot of time with patients.  And here in the United States. We have an insurance run system, and yet we have pretty much the same sick care [00:05:00] system where doctors are paid a small amount of money by the insurance company, so they’re incentivized to see a large number of patients and not individualized care and not spend a lot of time with their patients.  And it’s kind of interesting that they both end up in the same boat.

Dr. Goel: Same idea. I mean, if you want to call this your payers, the insurance companies who’s max in incentivized to pay less out. So they, you know, their interest is they’re not really focused again, on the long-term situation.

Dr. Weitz: You would think that a system like what Canada has, should be concerned about the overall health of the patients because. In the United States Insurance Company a is only concerned about maximizing the profit so they can have the stock go up so the CEO can get his bonus and for all they know next quarter or next year they’re not responsible [00:06:00] for your care.  So they have little interest in your long-term health, whereas in Canada, the system is going to be responsible for paying for your care for all those years, so you would think there would be a built in incentive to get people healthier so you don’t have to pay out for all this sick care.

Dr. Goel: I think there are, you’re right.  I mean, it’s not a com. There are some, and maybe there are some improvements from the Canadian system compared to the American system. You know, I think that, you know, let’s say like public vaccination and things like, which we know are very good benefits. We used to,

Dr. Weitz: we used to think that.

Dr. Goel: Yeah. So that’s, there’s the thing, so obviously, you know, we have, we used to get paid for doing physical exams, for example, just general physicals, right.

Repro that, because I think what’s happening is that there’s just so much pressure on the system. And there’s so much potential things that could be done and they have less dollars. So I think system is, you know, [00:07:00] and the first things that go are things that you do not see immediate gay gains. People don’t see immediate gains from like, psychological counseling, for example.  Right. So that becomes one of the things they remove, even though, you know, there’s long-term benefits providing mental health care to patients.

Dr. Weitz: Yeah, it’s really short term versus long term.

Dr. Goel: Right.

Dr. Weitz: Most of the benefits of diet and lifestyle and functional medicine are things that take a long period of time.

Dr. Goel: Yes. Yeah. And these governments are in for four years, so they’re only concerned about, you know, what happens in during the term and they get reelected again. That’s really what the issue is.

Dr. Weitz: So how do you manage to thrive in Canada? Are you outside of the system?

Dr. Goel: Yeah. I’ve decided to go outside the system because I just want to work with people who are motivated and want to get better and want to see me when they need to see me.  And, you know, that’s, I want to work with the latest technologies and you know, the, unfortunately that is, requires, you know, people to invest in their healthcare.

Dr. Weitz: Right.

Dr. Goel: And when it’s government paid, then people have a different mentality about how they use the system.

Dr. Weitz: Right. So what are some of the drivers of aging and what can we do about some of these?  I know there’s been some major papers written about, you know, some of the major pathways that are involved in aging. What’s your take on it?

Dr. Goel: You know, I like to, now I kind of say there’s three main things that I kind of tell people to focus on when they’re thinking about aging. First is that.  Hormesis, the idea that you know, what doesn’t kill you makes you stronger. So I think just that, understand that principle, we can then apply it to whenever we see potential interventions for aging and see does it actually make sense? So for example, you know, fasting, which is. In effect a stress on your cells when they have less nutrients around your cell will adapt and get rid of waste and become more efficient.  That’s proven. That’s a proven longevity intervention. Another thing might be exercise. So ESIS is one [00:09:00] principle I like to say, talk about. Second thing I like to talk about is, the, there’s the endless cycle of growth and death, which is happening all the time in our body. We need to understand that and not, and if we’re in tune with that then I think that’s also promote longevity because for, like, for example, some people taking growth hormone per for example, and I think that.  Taking endless amount of growth, hormones gonna make you live longer. I don’t think that we have the evidence for that. And potentially you might even live a shorter life. That’s because we do need cycles of decay and death to get rid of this make, to make space for the new. So that’s the second principle.  Understand the cycles of growth and decay. And the third one is in being in rhythm in harmony with your internal and external rhythms.

Dr. Weitz: Okay.

Dr. Goel: And I think when people live outside those rhythms, they have increased stress, which leads to shorter life.

Dr. Weitz: That’s great. We will make that the basis for this talk.  Well, let’s start with the hormesis. So when it comes to hormesis and putting stress on the body, yeah. And of course exercise is a stress on the [00:10:00] body. Most people think that yes, when you exercise, you build your body up. But really, in fact, exercise is a way to break your body down, but then your body rebuilds stronger, better, and, same thing with other things that put stress on your body. You mentioned fasting. Let’s go into some of the details about what’s the best way to fast. Some people recommend skipping a meal. It’s common to skip breakfast. There’s some dated indicate it’s better to skip dinner. Should it be done systemically or can it be done haphazardly? Is it better to just do a complete one day fast or a three day fast? And then some people are trying to make it less painful. So you just buy this box of food that’s low calories and you just do that. What’s your take on what’s the best way to do fasting?

Dr. Goel: Yeah, that’s a very good question.  I don’t think there’s an actual answer for everybody that’s exactly the same, and I [00:11:00] think people need to understand where they’re at, what their body’s like, what their health conditions are like to figure out what’s, what works for them. But we can go through some of these and I can kind of give you my thoughts on them.

Dr. Weitz: Sure.

Dr. Goel: But you know, I can tell you like somebody with me who’s relatively lean. If I was to start, you know, fasting for days on end or regularly I would, it wouldn’t necessarily suit my health, but but I think first let’s start with, you know, what we call intermittent fasting, which is relatively shorter periods of of fasting.  Anything from, you know, 12 to 16 hours a day, let’s say, would be, you know, I think generally, right?

Dr. Weitz: So that basically means you, you stop eating at a certain time and you don’t eat till, you know, maybe a little bit later in the day you have to have a later breakfast or you skip your breakfast.

Dr. Goel: Yeah.

Dr. Weitz: Which I think is ironic ’cause for so many years when we were coaching people about nutrition, about breakfast, you know, I’ve been doing this a long time for like 37 years. Yeah. And one of the mantras was you have to eat breakfast. It’s the most [00:12:00] important meal. Everybody skips breakfast and that’s why they’re fat.  So you have to eat within a certain period of time of waking up.

Dr. Goel: Yeah. Yeah I agree that, and I think that even for me, let’s say this morning, I only started eating maybe at around 11. And I’m hoping to finish by eight and then I’ll be done. But I think it’s, the evidence looks better to skip the evening meal.  You know, it just looks better. Right. But I think we can push the morning a little bit. We don’t need to have start at 7:00 AM Right. We can push that later. Me a little bit longer ’cause we wanna shorten the eating window. Right. And I think that’s the clear, that’s the part that we have the best evidence on is that just shorten the eating window to give your body time to you know, just have period without food, which I think is right.  The key principle, like, you know, you know, for some people it’s gonna work that they skip more of the breakfast, some people skip, it’s gonna work better for them to skip the meal in the evening. But you know, I think it’s just shorten that eating window don’t just be perfect. People are asking, you know, because it’ll be 16 hours or 14 to [00:13:00] 12, whatever I say, you know, just, we don’t have to be so rigid there.

I think just the principle and even you have people now doing, it’s called, I think eating in the morning and eating late later in the night, evening and then skipping the rest. Don’t eat anything during the whole day. Is another option, which sometimes could look better for, you know, for one’s lifestyle.  So I think we have a lot of potential options there. With regards to longer periods of fasting, they say that up, you know, up once you start hitting over two and a half days, then we get this rejuvenated rejuven or regenerative stem cell release benefit from fasting. So I think that’s hard to do but probably a very good thing.  Like you did, like you mentioned, there are some companies out there once called ProLon, which has a fasting mimicking diet five day. You eat whatever’s in the box and it basically mimics your fasting, tricks, your body into fasting. And people see they have a lot of relative health benefits for you.

Dr. Weitz:  And it does that because essentially it’s low calorie, right?

Dr. Goel: Yeah, it’s about six, 700 calories. [00:14:00] But I mean, it’s not that you could just do it yourself. I think they have kind of created the formula of a certain ratio of macronutrients that still doesn’t activate the, you know, the regular insulin levels.

So I think it has

Dr. Weitz: you know, I, it is hard to understand that, especially since there’s not a lot of protein there, which means if there’s not a lot of protein and you’re not eating a ton of fat, then most, it’s really carbs.

Dr. Goel: You’re right. I don’t know exactly how, why You’re right. What I wonder if it’s just a regular 600 calorie diet would work.  I don’t know what, how it’s working that the way they’ve done it. But I mean, the studies look pretty good. Their meta people’s metabolic parameters do improve, but maybe that would improve anyways if they just ate 600 calories a day for five days.

Dr. Weitz: Right.

Dr. Goel: Who knows? You know, and you know, they have.  Their bars are maybe have a little high fat in them and you know, but it’s it’s interesting. I don’t have a complete answer for that, but it looks like they have some research to back it up.

Dr. Weitz: [00:15:00] Right.

Dr. Goel: And then and then there’s the other alternate fasting of, you know, eating one day regular and then don’t eat the second day and then come back.  So I think it’s another type of way. And then there’s another one where you eat five days and fast for two days. So five and two. So there’s multiple different regimens and I think it’s, people gotta figure out what kind of works for them,

Dr. Weitz: right? Yeah, and you know, this is to sort of duplicate the fact that human beings for hundreds of thousands of years didn’t, weren’t able to regularly have a meal every four hours or whatever we do, or have three meals a day.  That schedule is really a modern thing. And so our bodies really are designed to go long periods of time without eating and it shouldn’t be a big deal.

Dr. Goel: Exactly. I think that that’s right. We, it is not everything so constant and I think we need to Yeah, appreciate that. Just like I said, there’s, you know, cycles of eating and not eating, and that’s part of, that’s part of how our bodies were designed and we should run away from [00:16:00] that.

Should accept that. And yeah I’m totally in agreement with you. I think that’s exactly what, how our bodies are meant to be.

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Dr. Weitz:  Now, part of that program we were just talking about is that it’s actually built into that system that we should eat a relatively low protein diet. And the thought there is, or the claim is that if we eat less protein, we’ll stimulate less growth.  And in the body that there’s certain pathways that stimulate growth and there’s certain pathways that stimulate breakdown, autophagy, you know, which is your second principle. And so the claim is that if you have too much protein or if you e even have a certain amount of protein, that you will increase IGF one and growth hormone levels.  And that potentially is negative for health because it may increase cancer rates.

Dr. Goel: Yeah, I mean, I think it’s a, it is a balance here so that we do need some amount of protein and and growth hormone. Otherwise, you know, that would be a problem as well. So, that’s why I like to say it’s, we should do things in cycles. But for sure carbs and and proteins. They lead to growth hormone release and through the ambulatory pathway.  And and when we’re fasting, then we have a different pathway and PK pathway that gets stimulated. [00:19:00] So,

Dr. Weitz: I have some questions about that. I haven’t found that to be true. Okay. I have a lot of patients who are eating a healthy diet, but yet maybe they’re having animal protein three times a day, and I don’t necessarily see any significant increase in IGF-1 levels.  They don’t necessarily have elevated IGF-1 levels. And so I’m kind of skeptical about that. And then the thought is that you’re supposed to keep the protein levels low so you don’t stimulate growth hormone. But then after you hit 60, then you’re supposed to increase your protein, so you don’t lose muscle.

Dr. Goel: So are you saying that, that maybe we don’t need so much protein. Is that what you’re saying?

Dr. Weitz: No, I do think we need protein. I think maintaining muscle is one of the keys to longevity, and I’m skeptical that we should restrict protein.

Dr. Goel: Oh, yeah. No, I don’t think we should restrict protein at all. No.

What I was just, no. I think that when we’re eating. [00:20:00] We are really a, we, our body is a protein delivering D device,

Dr. Weitz: right?

Dr. Goel: That’s one of the most important things that we need to take in there. So I think

Dr. Weitz: I agree. And so that’s why I am, I’m not a huge fan of programs that restrict protein.

Dr. Goel: No I’m not either.  I think I was just saying that when we’re fat, we should have periods of fasting, of which there’s no really no food or maybe only fats can come in during fasting. Right. But when we’re eating, when we’re eating regular, we should eat protein. It’s very, extremely important. And and maybe just some carbs to fuel our muscles and all that, but I don’t.

Dr. Weitz: Right. And we need all the phytonutrients and the fiber, et cetera. So.

Dr. Goel: That’s fair. Yeah. I, yeah, I’m totally, I mean, where that protein’s coming from, that could be conversation. Yeah. I mean, that’s, there’s, lots of people have different views upon that,

Dr. Weitz: but it’s interesting how there’s been this push pull in the longevity research.  For a while there was a lot of data that seemed to show that taking growth hormone and [00:21:00] taking testosterone and things like that, when that was a big part of the longevity you know, medical approach 20, 25 years ago. And and then one of the first studies that looked at reversal of biological aging actually used growth hormone as one of the interventions,

Dr. Goel: the trim trial.

Dr. Weitz: Yeah, but yet now it’s kind of fallen out of favor and there’s a lot more talk about, having less growth and focusing on autophagy and the breakdown process. So we get rid of broken down old cells and we recycle. Mm-hmm.

Dr. Goel: Well, I think it’s, this is the, I think you can never go away. It’s never one answer.  Right. Yeah. Yet caloric restriction has been shown to extend lifespan in various animals, even potentially humans. But this is where you need to focus on growth, and then you need to have periods where you have autophagy, but you can’t just have one or the other. That’s what I was just trying to say, is that right?  It’s never [00:22:00] that simple. It depends also what stage of life you’re in. And of course, lean body mass is critical. I mean, it’s one of the top things we’re doing in our practice is helping people build lean body mass. I would impact when people,

Dr. Weitz: I would point to that doctor from UCLA his name is escaping me, who was one of the first guys to really show that caloric restriction was associated with longevity.  Who was in that that. Place in San Diego where they ended up, he ended up having to be forced to eat a very low calorie diet and lost a lot of weight. What was his name? Rory Meels or something like that. [Actually Dr. Roy Wolford, who died in 2004 of ALS.]

Dr. Goel: Oh,

Dr. Weitz: at UCLA. Well, he ended up dying, like in his mid seventies, so Yeah.

Dr. Goel: Yeah, exactly.

Dr. Weitz: Didn’t work out so well for him.

Dr. Goel: No, it doesn’t. You can’t just have chronic caloric restriction and it wouldn’t be a very much of a

Dr. Weitz: right

Dr. Goel: look, talk about health span. It wouldn’t be a very high quality life.

Dr. Weitz: There needs to be some pulsing, we need a certain amount of growth through regeneration. So we rebuild our [00:23:00] muscles and our bones and it’s et cetera.

And our brain cells. It’s like

Dr. Goel: when you the game, you can’t work out every single day. Right. And I found if I just space it out, if I workout space out my workouts by two, three days, I have a better response.

Dr. Weitz: Right? So

Dr. Goel: same idea. I think we should eat. That high protein diet and proper calories and then space it out.

Give a little break,

Dr. Weitz: right?

Dr. Goel: Do it again.

Dr. Weitz: Now, what are some of the other interventions that can help with autophagy and longevity? Besides, besides diet and exercise that you use in your practice. What about things like peptides? What about you know, some of the other strategies?

Dr. Goel: You know, you know, we definitely do recommend peptides here.  You know, I run a BPC 157 supplement company, 

Dr. Weitz:  So is that oral or injectable?

Dr. Goel: Oral though I do also can have access, get patients access to injectables as well. But for sure oral is one of the few peptides that’s absorbed orally. I have seen it firsthand. People’s improvement in gut symptoms [00:24:00] improve.  People give all types of stories of, you know, musculoskeletal pain that improves with with this peptide. So, you know, we don’t have great clinical studies. But people’s experience tell us that these things are working. There are other peptides out there that I’m pretty excited about. One is the growth hormone receptor proteins.  So those are like epi and taal. And these basically stimulate your own pituitary gland to release growth hormone.

Dr. Weitz: Right?

Dr. Goel: Seem, they seem like they definitely work. And and then that, I think that, results in, in decreased visceral fat potentially increased muscle mass and you know, better quality of life.  There’s a couple other peptides that, one’s that, that I’m interested a lot these days in the thymus immune system peptides,

Dr. Weitz: the thymosin beta for and some of those,

Dr. Goel: yeah, peptides data is good for regeneration, but thymosin alpha is more of an immune system peptide may shift your body to less inflammation [00:25:00] and and there’s a Biore peptide called Dimin.  Because one of the things we saw in the TRIM trial was that, aging happens over our immune system and the thymus gla involutes around age 50.

Dr. Weitz: Meaning it shrinks.

Dr. Goel: It shrinks, yeah. So if we can help, that thymus can increase, which, what happened in that trial,

Dr. Weitz: right?

Dr. Goel: That one of the things we can do to really reverse and slow down aging.

So

Dr. Weitz: yeah,

Dr. Goel: it’s not just muscle mass, you know, immune system’s also aging. We need to decrease inflammation. So these peptides seem pretty promising, even though you may not notice anything immediately. But the long-term benefit of these peptides may be there. Right. We just unfortunately don’t have long-term studies, but they seem very safe.  And, you know, I would consider people to consider going down that road.

Dr. Weitz: Some of the companies come out with more oral peptides, and in some cases they’re taking fragments of TB four and some of these other peptides. What do you think about those?

Dr. Goel: I haven’t, I’ve talked to some of the peptide you know, [00:26:00] people are really knowledgeable in the space and they said, tell me that they’re not convinced these things are being absorbed orally.  Or maybe it’s a very small absorption and still injectable is still the way to go, though. I know people are doing some nasal sprays now. You’re coming now with liposomal sub, you know, sublingual version. So yes. Yeah, maybe these things are gonna get better. And I just saw, I was at the Antigen conference last week and there was a company out there was doing a patch through Iona Pheresis, which electricity

Dr. Weitz: right.

Dr. Goel: To see if the BPC and the NAD could come through the skin. Right. So there’s definitely, I think a lot of. Advance is happening here. Yeah. And I hope a couple years we’ll have better answers.

Dr. Weitz: Yeah. In the United States, of course the FDA has kind of cracked down on peptides.

Dr. Goel: Mm-hmm. Yeah, I heard about that.  So, you know, because, and if you know, these GLP ones are really peptides too.

Dr. Weitz: They are, yeah.

Dr. Goel: They just happen to be medications, but they’re also peptides. And you can see that the Trump administration is concerned about a lot of compounding pharmacies and [00:27:00] people buying red or tru tide. Well, you know, basically from a website and these pharmaceutical companies are saying, you gotta clamp down on this, so this is why.

Dr. Weitz: Wow. Because it cuts into their profits.

Dr. Goel: Yeah, exactly. Exactly. And this, you know, these LPs are very powerful, have made a massive difference in people’s health. Again, have used responsibly. I think they’re really game changers.

Dr. Weitz: Yeah. There, there’s some downsides, like loss of muscle, which seems to be pretty common.

Dr. Goel: We have to be very careful because people will generally lose some muscle. And like we’re saying, we’re, we wanna build lean body mass. So it has to be done carefully and be monitored.

Dr. Weitz: Yeah. The other thing I’ve seen apart from some of the side effects, which can be devastating, is that pretty much everybody who takes season and stops taking ’em regains the weight.

Dr. Goel: Interesting. Yeah I haven’t seen as much of that, but I’ve definitely seen that with a lot of weight loss strategies in the past. But I think people have to start I’ve seen people like start to understand this is the way to eat [00:28:00] and, you know, be, because they’ve been doing that for a while and they, I think their stomach almost shrinks to kind of be in this new way of eating.  And so maybe they build some new habits. So, but I think you’re right. It’s very possible that if you, people need to main stay on a main, on a certain dose. Like they can’t just come off it because it works centrally too. It doesn’t just work on the GI systems, work on the brain, right? And a lot of these things like we have sugar addictions where it seems to have an effect on addictive behaviors smoking, alcohol use, gambling.  All of these things seem to have the GMPs have an effect on that as well.

Dr. Weitz: You think that’s working through the brain rather than the gut?

Dr. Goel: No, both ways. I mean, for sure it does work on slowing down the gut system. So people have, you know, constipation, they can reflux. All this is because of slower transit time.

Dr. Weitz: Right.

Dr. Goel: But it’s also, there’s also a central mechanism for glp, it’s working on the brain. We don’t really clearly understand it, but it’s working on dopamine. Right. And the benefits we [00:29:00] get from,

Dr. Weitz: well, because of the gut brain connection, we’d assume anything that’s gonna have a significant effect on the gut is gonna have an effect on the brain anyway.

Dr. Goel: They’re connected. They’re so connected. Yeah.

Dr. Weitz: Yeah.

Dr. Goel: So one thing in some ways,

Dr. Weitz: right? So what are some of the other strategies to promote longevity besides peptides?

Dr. Goel: You know, I’m, i’m, I, you know, I do offer a treatment called Plasmapheresis in the office.

Dr. Weitz: Okay. Yeah, I’ve heard about that.

Dr. Goel: Super excited.

It’s

Dr. Weitz: I see, listen to David Haase talk about that. Yeah.

Dr. Goel: Yeah. He’s actually the one who taught me.

Dr. Weitz: Oh,

Dr. Goel: okay. I was. Stricken by Lyme disease or something about four or five years ago.

Dr. Weitz: Okay. To

Dr. Goel: go see him in Nashville had two plasmapheresis done, made a huge impact. So, really got me interested in this treatment.  And just for your listeners out there who are not familiar, but it’s like an oil change. You wanna consider removing half your plasma and replacing with saline albumin the new plasma that your body forms basically is that of a young person’s [00:30:00] plasma,

Dr. Weitz: right?

Dr. Goel: So it has a temporary rejuvenating effect and we’ve seen, you know, a lot of.  We’ve seen a lot of studies look showing that, I mean, definitely in animals. And there was a famous trial of Alzheimer’s patients where they did this every month on Alzheimer’s patients and they showed that reversal of mild Alzheimer’s and stabilization of moderate Alzheimer’s over a year, which is pretty impressive.

Dr. Weitz: Yeah.

Dr. Goel: So, you see a number of doctors now offering this type of treatment and you know, I’m pretty excited about that. That, that one of the few things that can actually reverse aging, I think.

Dr. Weitz: Right?

Dr. Goel: Yeah.

Dr. Weitz: How about some of the other IV treatments?

Dr. Goel: You know, we do offer all the full gamut of IV treatments here at the clinic, but you know, exosomes and stem cells regeneration, right?

Like that seem, you know, potentially could have some benefits. Again, we don’t have full studies, but they, these things are powerful. We have used. I mean, we see the impact of exosomes, let’s say if somebody injects them into their scalp for their hair, like we’ve seen for sure, we have [00:31:00] seen improvements there.

Dr. Weitz: Okay.

Dr. Goel: So we know it’s doing something. What

Dr. Weitz: about systemically when people

Dr. Goel: inject? Yeah. I don’t think we, I mean, I don’t have enough data to tell you that it’s having impact.

Dr. Weitz: Okay.

Dr. Goel: Exactly. It has an impact. And yes, I would do it all myself. You know that. I think that’s for someone who’s, biohacker type. I think it, you know, and has the financial means. I think it’s definitely worth doing, going down that road. But we don’t have good enough studies on this. And you need to, people need to pick a good product, you know, company that’s supplying the right product, make sure it’s tested and all this because these things sit in a gray zone.

They’re not yeah.

Dr. Weitz: Yeah. And there’s a lot of controversy. What is the best product and you know, why have some of the results been disappointing? How do we make a battery? Do we have to have a larger, like do we have to grow the do we have to grow the stem cells till there’s a larger number or.

Dr. Goel: Yeah. And then, you know, it depends on which stem cells did you pick? Like what type of stem cells were they?

Dr. Weitz: Right, right. Are they coming from a newborn? Are [00:32:00] they coming from your own bone marrow or your fat cells or where else?

Dr. Goel: Yeah. That, you know, that’s a good point. Are they expressing the right growth factors?

We don’t exact, you know, we don’t know each company’s sales will do something slightly different.

Dr. Weitz: Right.

Dr. Goel: Depend on, you know, what their been where they came from.

Dr. Weitz: Right. And the third thing you like to emphasize in your practice is biological rhythm, which I’m assuming you mean like the circadian rhythm and

Dr. Goel: Yeah.  I think teaching people to be aware of their rhythms, I think we don’t live in that type of society that’s so concerned and it’s not become part of awareness, but understanding the impact of light. On our body, the light rhythm, you know, 24 hour rhythm. Understanding that there’s seasonal rhythms to our body as well.  You know, here we have a very bad winter in Toronto. It changes what you should be potentially eating what your activities should be like. You know, we obviously have mood changes that happen, so we know that the body does. Change in response to the external [00:33:00] environment and our internal environment.  So just like we were talking about fasting, making sure we’re trying to be in tune with our system. I think it’s very important because as soon as the body’s outta system out of alignment is increased stress, which is chronic stress, which we know is linked to all types of diseases, right?  People are working, shift workers die earlier from heart disease, have increased rates of cancer. People are jet setting here and there. Or putting their in circadian rhythms in, in disarray,

Dr. Weitz: staying up all night tweeting and then falling asleep in your meetings.

Dr. Goel: Yeah. We have a commander in chief doing this.

We can

Dr. Weitz: only

Dr. Goel: help that example. So I can’t just, I can imagine what his health must be like. Is it because, you know,

Dr. Weitz: so, what are a couple of keys for respecting our circadian rhythm? What are some of the things that we need to focus on?

Dr. Goel: Yeah, like I mentioned with the light exposure, like right, so, you know, making sure we get bright sunlight in the morning, putting on blue light [00:34:00] blockers in the evening.  That’s, I think, very important. People try it. Stay away

Dr. Weitz: from screens

Dr. Goel: and yeah, from screens. Like if people might think this is nonsense, but if you just try it, you’ll be surprised how effective it is. And so again, just like slowing things down in the evening, you know, if you wanna get ready for sleep.  ’cause sleep is critical. Yes. And if you need to, you need, it doesn’t sleep. This doesn’t just begin at 11:00 PM your body has to prepare for it hormonally, and your mind has to be prepared so that when you get into the bed, you just fall asleep in a second and stay asleep for the next seven hours.

Dr. Weitz: Right?

Dr. Goel: So it’s, it requires, you know, some coordination of your whole body system. So, light would be there. The next thing I would say would be food. And activity and trying to just align them to make sure that, because again, each one of your cells, especially GI tract, has their own clock. So if you start eating and the clock begins as if it’s morning for that organ pancreas, stomach, you know, intestines, all of that.  So, and then like I was mentioning, even testosterone for example, let’s talk about that as also daily rhythm as well.

Dr. Weitz: Yeah.

Dr. Goel: And you know, peaks in the morning, cortisol peaks in the morning to get you outta bed, then starts to go down,

Dr. Weitz: right?

Dr. Goel: And growth hormone peaks, you know, in the nighttime to help you with restorative repair.  And if you eat right before bedtime, you actually suppress your growth hormone. So the body’s built for this that, you know, we don’t eat in the nighttime. Growth hormone gets released, growth hormone leads to a deeper sleep. It causes kind of a repair for the night. And yeah, I think these are the type of simple things that one could be doing for for alignment.

Dr. Weitz: Right, and having a certain amount of growth hormone, as we mentioned, is important because we have to make sure that we maintain our muscle as we get older because falling is such a threat to survival, especially as you get older. And we gotta make sure we [00:36:00] maintain our bone strength as well as our muscle strength.

Dr. Goel: I agree. I agree. Like the number one reason someone’s gonna pass away is from falling down, breaking their hip and dying from a complication hospital.

Dr. Weitz: Yeah.

Dr. Goel: Like that. That is how we see it. That’s how our grandparents, whatever, like they passed away. So I think those are the things we need to focus on.  And I guess being, building lean body mass is one of those ways you could prevent yourself from falling and as soon as you become bedridden within two weeks, you lose, I know what they say, 25%, 30% of your muscle mass.

Dr. Weitz: Yeah, it’s incredible.

Dr. Goel: So it is basically the death sentence. If you have a fracture at an elderly age, very difficult to recover.

Dr. Weitz: Yep. Alright, great. So, I think we’re going to wrap right here. Been nice talking with you. How can patients who are watching this find out about getting in touch with you?

Dr. Goel: Sure. They can reach my Instagram. Okay, Dr. Sanjeev Goel they can reach my [00:37:00] website, sanjeevgoel.com. And name of our entity, like our clinic is called Peak Human or at peakhuman.ca.  So those are all the different ways,

Dr. Weitz: right? I think you have a podcast as well.

Dr. Goel: Podcast called Peak Human Labs Podcast. We interview other, you know, people who live a peak human life and give us, you know, some tips and tricks for the how to do that.

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

Dr. Goel: Thank you so much.

Appreciate it.

_____________________________________________________________________________________________________________________________________

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 Podcast 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.

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Check out this episode!

Dr. Taylor Krick discusses a Functional Medicine Approach to Autoimmunity 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

Managing Autoimmune Diseases with Dr. Taylor Krick: Personalized Functional Medicine Approaches
In this episode of the Rational Wellness Podcast, Dr. Ben Weitz speaks with Dr. Taylor Krick, a chiropractor and host of the Autoimmune Doc Podcast. Dr. Krick specializes in autoimmune and chronic inflammatory diseases, offering a functional medicine approach enriched by his personal experience with Hashimoto’s thyroiditis. They discuss his discovery of the condition through lab work, its impact on his career, and the comprehensive steps he takes to manage autoimmune diseases in his patients. Dr. Krick explores gut health, explains the five R’s of gut therapy, and underscores the role of personalized care plans. They also delve into specific cases, lab testing, and the importance of patient education in achieving long-term health outcomes. The discussion highlights key functional medicine strategies and the latest trends in managing complex health conditions.
00:00 Introduction to Rational Wellness Podcast
00:30 Meet Dr. Taylor Krick: Autoimmune Specialist
01:37 Dr. Krick’s Personal Journey with Hashimoto’s
03:27 Understanding Thyroid Antibodies and Autoimmunity
07:36 The Importance of Gut Health in Autoimmune Diseases
10:48 Case Study: Managing Autoimmune Patients
15:52 Gut Protocols and Testing
19:49 The Role of LPS and Inflammation
26:48 Reinoculate and Repair: Probiotics and Gut Lining
27:38 Phases of Gut Healing: Simultaneous or Separate?
28:24 The Importance of Retesting and SIBO Breath Testing
30:38 Debating the Value of Various Tests
35:47 Case Studies: Patient Progress and Thyroid Health
47:11 Mold, Mast Cells, and Functional Medicine Trends
49:11 Conclusion and Contact Information


Dr. Taylor Krick is a Doctor of Chiropractic and educator, focused on autoimmune and chronic inflammatory disease, and the host of The Autoimmune Doc Podcast. His office and website is Washington Wellness Center.

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.

Today on the Rational Wellness Podcast I am going to be speaking with Dr. Taylor Krick, a clinician and educator focused on autoimmune and chronic inflammatory diseases. He’s the host of the Autoimmune Doc Podcast. Dr. Krick is a chiropractor like myself, and he brings a unique perspective to caring for patients with autoimmune diseases and otherwise combining a functional medicine framework, along with his personal experience having managed his own Hashimoto’s thyroiditis. So, Dr. Krick, thank you so much for joining us today.

Dr. Krick: Absolutely. My pleasure. You know, I gotta admit, when I look back at some of your recent episodes, I’m humbled by the company that I’ve in, you know, it’s a lot of the Mount Rushmores of the wellness world that you’ve interviewed.  So I’m honored to be a part of it.

Dr. Weitz: Thank you. Thank you. And I’m always honored to get to interview some of those people like Dr. Bland, who I admired for so many years and continue to admire his amazing intellect even at his age now. So, as I was reading about your bio, I understand that you have an experience with Hashimoto’s thyroiditis, which is an autoimmune condition that affects the thyroid.  And so can you talk about your experience with this and how this led you to become focused in your work on autoimmune diseases?

Dr. Krick: Yeah. Well, you know, the last part that you just said, Dr. Weitz is, excuse me is what I would say is the most important part, is what it led me to, you know, because it led me to learning about functional medicine, learning about autoimmunity, learning about my own condition, but also how it can help everybody else?  And I would honestly say my Hashimoto’s, you know, I say this with all you, you know, luck or whatever, but it’s been well managed. It hasn’t been a big problem in my life. So it was more of an uncovering for me and more of a discovery of, hey, you have this condition. Let’s learn everything there is to know about it, or as much as I can, obviously I’m always still learning, but it led me to learn functional medicine.

Dr. Weitz: So how did you discover that you had Hashimoto’s?

Dr. Krick: Well through lab work. I first discovered it in my dad. I found it in my dad first. He had no signs, no symptoms, perfectly healthy. Now my dad ended up passing away, so that story has a bad ending. But for the Hashimoto’s, it was not affecting him at all, and he didn’t know it at all.  We were just running routine labs. When I first started getting into the chiropractic world, and especially the lab testing world, like many people, my parents were some of my first, you know, patients, and I ran labs on him and said, hey, you’ve got this thyroid condition. He was like, wow. Had no idea.  I feel fine. Hadn’t been to the doctor, hadn’t been sick, any of those things, and then found it in myself too, and found the antibodies and my thyroid levels were perfectly normal, which is really common as you know in the autoimmune Hashimoto’s world. My thyroid levels were great.

Dr. Weitz: So when you say that, tell us about your thyroid.  What was your, did you have an elevated TSH?

Dr. Krick: No. Perfectly normal. You know, in the upper ones maybe or hovering around two. I don’t remember what it was, but just completely unremarkable. You know, you and I know that there’s the lab ranges. Like at LabCorp or Quest or whatever. And then there’s the functional ranges too.

Dr. Weitz: Sure.

Dr. Krick: Which are a tighter, and it was just right in those ranges. And same with my T4, my T3, my, you know, reverse T3.  I did a full thyroid panel, you know, initially, and everything checked out well [00:04:00] except for the thyroid antibodies. So just uncovering that again, led me to learn more about autoimmunity, the testing, the different, you know.  Presentations of autoimmune, whether it be for

Dr. Weitz:  How high were your anti, how were, or how high are your antibodies?

Dr. Krick: They’re, I still have positive antibodies present, so they’re not, you know,

Dr. Weitz:  And are they TPO or TGB or both? 

Dr. Krick:  I had both. I had both of my dad. Yeah. Which I would call like double Hashimotos, you know, both of those as you know, are diagnostic for Hashimoto’s, but it I did have both of those.  One of those has gone in and out of normal once. But they’ve come down. I haven’t checked them recently. I’m actually,

Dr. Weitz:  Well how high was your TPO?

Dr. Krick: Maybe? Oh gosh.

Dr. Weitz: Over a hundred. Over 500.

Dr. Krick:  Over a hundred. I would say. Over a hundred. Yeah. It wasn’t astronomical. You know, I’ve seen ’em up in the thousands many times, but

Dr. Weitz: Right.

Dr. Krick: It wasn’t that high. And that’s also. And I don’t remember the numbers, quite frankly, so I don’t track it that often. I track it once a year. So, but with [00:05:00] those numbers, but that’s also where I learned with Hashimoto’s, the antibody levels don’t matter as much with other autoimmune conditions. The antibodies do dictate the amount of attack or, you know, with Graves or with other, you know, autoimmunities.  But with Hashimoto’s, the antibodies are just a flag for the thyroid. But I think the TPO was in the hundreds, mid hundreds, and the TG was. I don’t remember nowhere near as high, but. I don’t remember what the number was. I’m trying to remember now. 

Dr. Weitz:  But yeah, I think they do matter, but not if they’re a little bit elevated.  In other words, if it’s over a thousand, that’s different than if it’s 150.

Dr. Krick: Yeah. Well, and Dr. Kharrazian has taught that they don’t really matter for that condition. But for others they do. But I’ve seen people with two thousands, three thousands, you know, and they feel completely fine. And I’ve seen other people whose TPOs are in the, you know, thirties or forties, and their life is a wreck.  So I think there’s a lot of other variables. I think that every number matters. I think if it’s higher and it comes down, it’s a good sign. Or if it goes up, it could be a bad sign. So I think that every number matters, but they’re [00:06:00] not always an indication of the inflammatory response that’s happening.

Dr. Weitz: Right.

Dr. Krick: Yeah.

Dr. Weitz: But they are an indication that your body is attacking itself.

Dr. Krick:  Exactly. Self tissue antibodies are self tissue antibodies and it’s not a, not necessarily a good thing to have.

Dr. Weitz: And another factor we know, is that if you have one autoimmune condition, you’re more likely to have another.

Dr. Krick: Exactly. Exactly. Exactly. So I think that even if somebody’s got, you know, I’ve seen people with, you know, alopecia that, you know, they’ve lost a lot of their hair. And that might not come back. You know, I see a gentleman that’s in his seventies, I don’t think his hair’s coming back, but it’s like you don’t want it to turn into another condition.  You don’t want to turn into another connective tissue disease or lupus or RA or anything else. Because that process is occurring, we know it’s more likely to continue occurring.

Dr. Weitz:  And in your case, did you take any steps to try to lower your antibodies?

Dr. Krick:  I’ve taken a lot of steps, but I stopped caring about them as much and started caring about my other more functional markers, I would say like inflammatory [00:07:00] markers, liver enzymes you know, gut things.  You know, looking at gut things and looking at more like what are levers I can pull because it’s not again, I think the antibodies matter, but there’s not, like, here’s the supplement for that. I know that people have lowered them with red light and lowered ’em with different, you know, supplement protocols, but there’s no one clear answer.  So I’ve decided to look at other things. That I feel like are levers to pull, especially gut wise. Yeah. And vitamin D and we know Omega check, you know, those are things that I’ll check,

Dr. Weitz: right.

Dr. Krick: To just say, Hey, where are these levels at to help manage the autoimmune progression or manage the inflammatory, you know, burden, I would say.

Dr. Weitz: One of the reasons why looking at the gut is so important is because we know that for inactive T4 to be converted into active T3, the intestines and the liver are two of the places where they’re gonna be converted.

Dr. Krick: Yeah. And I think that, you know, even if again, you start as maybe a generalist.  I think you circle in on gut as just being [00:08:00] so important for everything. Yes. You know, you read about it in the literature. First off, it’s all, all over the literature, whether it’s for Alzheimer’s or it’s for autoimmune. Certainly it’s all over. Then you also just see it clinically and it’s for all those things like you just mentioned, like hormone conversion.  Histamine degradation, which is a really, you know, important piece of my practice too, as far as an action step and a mechanism and explaining to people, you know, what the gut’s role in that is. But it’s so much more than just, you know, your digestion and your, you know, your bowel movements. It’s so much more.  And it’s a lever to pull. I use that term often because we’re just looking for levers to pull, to optimize physiology, and there’s just a lot that can be done with the gut. I see a lot of people that have come to me and it’s either, you know, a lot of times like, well, why has it to anybody worked on your gut?  And I’m a little bit surprised, you know, I’m usually the fourth, fifth. Practitioner, the people have seen like, well, why hasn’t anybody worked on your gut? Or how do you know you’ve cleared this parasite? Or what about, you know, [00:09:00] these things? Has anybody discussed this with you? And a lot of times it just hasn’t been covered yet.  And I’m surprised, you know, people have done hormones or they’ve done, you know, even they’ve done, you know, ozone or blood irradiation or other, just, you know, novel things. I would say. But they’re missing some of the low hanging fruit in the gut. Right. Is what I see.

Dr. Weitz: Yeah. Some you would like, would regard some of those clinical strategies at as advanced strategies.  Really should be. Make sure you have all the basics in place like diet and gut health and making sure you have optimal levels of nutrients and things. Make sure you’re exercising and sleeping and managing your stress before you go to some of these advanced clinical options.

Dr. Krick: Yeah, and I would even say, again, going back to my personal case, I’ve really.  And it, for better or worse, I think it’s for better. But I’ve really zoomed out on a lot of, you know, you can get lost in the details and on the [00:10:00] fine weeds and things like that. And the more people that I see who are really suffering and struggling and sick, they’re usually missing some really big piece, like there’s mold exposure or they haven’t addressed the gut or something, but.   I’ve become more of a generalist for myself, and I think even with my kids and things like that I’ll do some occasional lab testing and occasional supplementation and things like that, but it’s more like, let’s make sure that the foundations are good, whether it’s our diet, our exercise, our just wellbeing, you know, with our kids and screens and things like that.  We’re not a zero screen family, but every once in a while it’s like, okay, we need to pull back on this, or we need to focus on this. Aspect of their health, but it’s about more for me and just the age of my kids too. I’m using that as an example, but it’s just more about getting those foundational things in place and everything else will kind of fall in line a little bit better, I think.

Dr. Weitz: Right. So let’s talk about how you manage a patient with autoimmune disease. Let’s say a patient comes into you, why don’t you give us an example of a patient that you’ve seen recently with some [00:11:00] autoimmune disease, and then how did you talk to ’em? What things did you focus on in their history?  What kind of testing did you do?

Dr. Krick: That’s a great question. You know, first off, I’m going to answer it, but the hard, the reason it’s hard to answer is because everybody’s personalized. In my office, everybody’s customized. I don’t have like a program that everybody goes through. Sure. Per se. So some people come to me, I always joke with binders full of labs.  Duffel bags full of supplements. And then you kinda start with thinking a little bit like uhoh. Like what? What hasn’t worked? What all has this person tried and why hasn’t it worked? So approaching that person might be different than somebody who’s, let’s say, a standard American with, let’s say, so like two people that I saw yesterday, for example, one is a 27-year-old with thyroid autoimmunity who had been diagnosed with hypothyroidism, had been put on a med, and it was really,

quite frankly, jacking her hormones up and her endocrinologist told her this, and they got her off her meds. This is before she [00:12:00] met me. So all this is part of her history. She’s still 27 years old, but she’d had a lot of labs, she’d had a lot of testing, she’d had a lot of things. Versus another person that came to me yesterday who’s, let’s say maybe 68 years old or so, who has diverticulitis, who’s never done a thing.  So for that person, we’re starting from stage zero as far as education and understanding of some of,

Dr. Weitz: okay, why don’t we start with that patient, the patient with diverticulitis.

Dr. Krick: Okay. Yeah. So for,

Dr. Weitz:  First of all, explain what diverticulitis is.

Dr. Krick: Okay. Diverticulitis is any itis. Is inflammatory. Right? Right. And diverticulitis is inflammation of the diverticuli in the gut, which is like the little folds and pockets.  You know, it’s almost hard to explain and understand the concept of the gut and the folds, because if you unfold the whole gut. I’ve heard it said it covers two tennis courts.

Dr. Weitz: Right.

Dr. Krick: I’ve heard that. That might be updated to one tennis court or one and a half tennis court, but whatever.

Dr. Weitz: It’s something like that.  It’s a lot. 

Dr. Krick: It’s massive, right? I don’t really care, but it’s, the surface area is unbelievable and those little diverticula, those little folds can become inflamed and little things can get stuck in there like little, you know, like diverticulitis sort of recommend and not to eat nuts and seeds and things like that, that can get kind of stuck in there because they can inflame the gut. And so it’s a gut inflammatory condition. It’s not the same as Crohn’s or ulcerative colitis, but it’s a gut inflammatory condition. So for this person we did some gut testing, you know, and she had already had diverticulitis. I forget all the history pieces, but that includes colonoscopies, that includes some, you know, treatment, probably with some steroids or things like that, you know, but she was wanting to avoid her next flare.  She’s been dealing with it for seven years. And I’ve helped her daughter with some mold related issues. I helped her son-in-law with some issues. He was the first one I met, but it came through kind of a referral tree, as is often the case. But, so we did some gut testing and so we did a stool test. We did, or organic acid testing.

Dr. Weitz:  Okay. Which, which stool test did you do?

Dr. Krick:  I did a GI map.

Dr. Weitz: Okay.

Dr. Krick: I [00:14:00] do a GI map, you know, and not for any particular reason. You know, I’ve seen ’em all. In fact, the other person whose case we might be going through. She came to me with some GI effects testing from Genova. And so you know, I always say that Ford says they’re better than Chevy says they’re better than Toyota and they’re all about the same.  Now obviously each one has their selling points and each one will say they’re better than the other, but every practitioner has their preference. But

Dr. Weitz: sure,

Dr. Krick: that’s just the one that I’ve come to enjoy. But then we did an organic acids test from Mosaic. Okay. I’m a big fan of organic acids testing. It’s not everybody’s favorite. And same thing with, you know, hair tissue mineral analysis, different tests that some people like don’t like. But I like organic acid testing quite a bit, and we can talk about that if you want, but, and then we did a food sensitivity test.

Dr. Weitz: Okay.

Dr. Krick: That also had a gut barrier panel on it.  That was from KBMO. I do Cyrex testing as well quite often, but the KBMO is a finger prick, so that was maybe one of the reasons why we did that. I also, too, while we’re talking about these cases, I see about half [00:15:00] of my clientele are in person. And they drive in from different places in central Illinois.  And then about half are nationwide, worldwide, international. So one of these people that I’m talking about was in Colorado. One of these people was local. So, and that sometimes it doesn’t dictate my care, but sometimes it dictates the logistics of getting somebody a supplement or if they’re in, you know, Canada or Australia or things like that.  Just custom sometimes matters. Sometimes it’s harder to get things to Canada than it is to like Dubai. 

Dr. Weitz:  But well basically anything outta the United States pretty much takes full script out of the picture.

Dr. Krick: Yeah, exactly. And I and we also, you know, again, for international clients, we’ve got different vendors like that, but we house all our own supplements in house.  So we’ve got a supplement store that people can walk into and shop at. Or we send all our, you know, functional things and protocols and things out to people, but it’s a whole nother thing to just keep track of too. But, so we did this test and you know, you asked me about my labs. I’m really good at remembering people’s labs, but [00:16:00] I don’t remember exactly what she had.  I’m gonna actually pull it up in front of me, but we put it on a gut protocol and that’s obviously an oversimplification, but I put almost everybody with gut things. On some degree of gut protocol, and what I mean by that, Dr. Ben is the like a five R type of protocol. So the five R’s, if somebody out, there’s not familiar with it.  Every gut is treated through this five R protocol, but everybody’s R’S are different,

Dr. Weitz:  Which was originally started by Dr. Jeffrey Bland

Dr. Krick: And originally the four Rs, then it became the five, but, and there’s also a five R’s of cellular healing, which I enjoy, but not as many people know about that. The five R’s a pretty universal functional medicine framework that people use.  Yeah, but it’s R number one is remove. Remove anything that’s not supposed to be to remove any bad bugs. Remove any parasites, Remove any h pylori. This woman had h pylori. She also had quite a bit of bacterial overgrowth. I’m looking at her labs now to remind myself because I blend together and she had a lot of, iGA reactivity, which is an [00:17:00] immune reactivity, and there’s different, you know, ways to measure the immune system, which is super relevant to our conversation about autoimmunity. You know, there’s the IgG antibodies, which tend to be more blood IgM as well. And then IgA, which is often done through saliva or through the stool.  Which is our mucosal immune system. We’ve got a, a separate and segregated immune system.

Dr. Weitz: So these IGA antibodies, this was part of this KBMO panel?

Dr. Krick: It was part of the GI map.

Dr. Weitz: The GI map,

Dr. Krick: okay. And it’s part of the KBMO panel too.

Dr. Weitz: So on the GI map you basically get the gluten marker right.

Dr. Krick: And the elevated, just straight up the elevated ig.  Exactly, yeah. That’s what she had. Okay. And then in her KBMO. All her IgAs were normal. They and I kbm O. There’s four IgAs, two candida and IgGs, but to candida, occludin, zonulin, so leaky gut markers, tight junction markers and LPS. [00:18:00] So for her IgAs were normal on that one, but her LPS antibody was elevated on IgG.  And I explain this in a lot of detail and show people what this means and stuff, but basically I say LPS is very inflammatory, and it’s a sign of dysbiosis, but it’s very inflammatory. It just drives inflammation.

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Dr. Weitz:  For those who are listening who might not be following LPS is lipopolysaccharides.

Dr. Krick: Yeah. Yeah.

Dr. Weitz:  And these are endotoxins. Yep. That are secreted by bacteria [00:20:00] especially. If you’re involved in a program where you’re trying to eradicate the excess bacteria or the bacteria that aren’t supposed to be there, and as those bacteria die, they leach out these endotoxins like LPS that causes inflammation in the system.

Dr. Krick: Yep. Or if you’re not doing a program, then sometimes it’s just there and it’s just inflammatory. And

Dr. Weitz: Yes.

Dr. Krick: And, but LPS, you know, I won’t say the word, but Dr. Steven Gundry always says. I don’t curse, but I call these little pieces of, you know what, because LPS is just inflammatory and

Dr. Weitz: right,

Dr. Krick: they use LPS in, you know, mouse models and things to study inflammation everywhere.  If they want to study inflammation of the brain, they inject LPs into the brain. If they want to study inflammation of the joints, they inject it into the joints. It’s just highly inflammatory. So that’s what we were,

Dr. Weitz: Dr. Tom O’Brien gives this awesome presentation about how LPS is like a major factor in almost every chronic disease.

Dr. Krick: Well, and again, going back. To, you know, my evolution as a [00:21:00] practitioner, you start learning, okay, I got this Hashimoto’s, you start reading Tom O’Brien books, you start reading the, you know, I did, you know, hundreds of hours of research on the Cyrex website. You know, just the Cyrex white papers and Dr. Vojdani and reading, you know, everything that he’s ever put out. So I, sometimes I’d measure Cyrex antibodies to LPS too, but you just learn about this. But the takeaway of LPS, even if you’ve studied it. You know, unlimited amount. The takeaway is that it’s inflammatory and it comes from dysbiosis and those are generalizations, but they’re true too.  And it can also come from water damage buildings, which is interesting. But she had this reactivity to LPS. She also had these bacterial overgrowth in her gut. She had some histamine, you know, sensitivities as far as some of her foods. And so I put her on this five R protocol. And you know, again, as a generalization.  I always say sometimes we need to pull weeds and sometimes we, we need to. 

Dr. Weitz:  So what did you do for the remove phase?

Dr. Krick: We did remove, that’s remove, that’s pulling [00:22:00] weeds. We did Biocidin and Olivirex.

Dr. Weitz: Okay.

Dr. Krick: And I think that’s it. I use a lot of Biocidin vir, some of my favorites. We’ll use other, you know, herbal nutrient antimicrobials.

Dr. Weitz: Oregano oil.

Dr. Krick: Yeah.

Dr. Weitz: Of like that mean.

Dr. Krick: Yes. A lot of the things that I use too, Dr. Ben, are blends. So I use all those things, but a lot of those are in some of the most famous, you know, blends for antimicrobial. So Biocidin being one of the more famous antimicrobials, handrin is out there. You know, there’s others I don’t in different brands.  For antimicrobials, I’ll use HPLR sometimes for Apex, ’cause she also had h Pylori. And she also had some yeast levels too on her oat test. Now, that’s one of the reasons why I like doing all three of those tests for a gut because sometimes what shows up on the oat for yeast and fungal things isn’t what shows up on the map, and sometimes it’s vice versa.  And then sometimes both of those might be clean and somebody has the antibodies, [00:23:00] which is. You. You know, it doesn’t always necessarily indicate that it’s present, but that it has been at some point.

Dr. Weitz:  Yeah, it’s interesting. I think there a, if I was to pull functional medicine practitioners, I would say there’s pretty much a consensus that stool testing is not the most accurate for candida and fungal overgrowth.

Dr. Krick: Yeah. So what would you say if I asked you that same question about parasites?

Dr. Weitz: Well, it, it ranges. I mean, we have, there, there’s a whole bunch of practitioners who say everybody has parasites.

Dr. Krick: Exactly.

Dr. Weitz: We don’t even need to test, which for me is going too far.

Dr. Krick: I completely agree. Well, it’s not to say that we don’t.  But it’s like everybody has viruses. We got 400 trillion viruses in our body. That doesn’t mean we necessarily need to go kill ’em. All

Dr. Weitz: right. Exactly. Actually, something that hasn’t been accurately tracked yet is the microviome, which one day we’ll know about. And like the GI map mentioned certain viruses, but [00:24:00] there’s probably a series of viruses that are a normal, healthy part of our gut that we’ll call the microviome that hasn’t really been fully elucidated yet.

Dr. Krick: Yeah. And that’s fascinating just to note. And I would say out of, you know. Thousands of GI maps I’ve done. I don’t know that I’ve ever seen the virus show up on there.  You know, I’ve seen probably everything else and I don’t wanna say never because it’s, but it’s very rare, you know? But I’ve just heard the same thing with parasites, that sometimes they show up, sometimes they don’t show up. My opinion is similar to yours, I think, is if they show up, we’re shooting at.

Dr. Weitz: Right.

Dr. Krick: But if they don’t show up, let’s shoot it. The things we can see because

Dr. Weitz: I, I agree with that. Yeah.

Dr. Krick: Very rare that a test is perfect. And even some of the antimicrobials in Biocidin are good for h pylori. They’re good for candida, they’re good for kleb, they’re good for different parasites. It just might matter of how we eradicated it yet or not, or how do we know?  Sometimes you get a false po false negative test, I should say. But. Yeah, [00:25:00]

Dr. Weitz: that’s one of the great things about using herbs to eradicate some of these critters is that they have broader spectrum than say, antibiotics or antifungals.

Dr. Krick: Exactly. They might not be, you know, sometimes, yeah, I completely agree.  They might not work as quick. Sometimes you gotta be a little more low and slow than like your seven day round of antibiotics, but Right. The more broad spectrum and

Dr. Weitz: less likely to damage the microbiome.

Dr. Krick: Exactly. Or have other, you know, unintended side effects. Exactly. So that five Rs remove is where we use Biocidin Avirex and Right.

Dr. Weitz: Sometimes

Dr. Krick: it’s about, you know, the tools that we use. Sometimes it’s also about teach, in my opinion, teaching people how to use them. You know, so how to stair step up with their killers, how to do divided doses and things like that. But that’s what I use for that. R one. R number two is replace. Replace anything like stomach acid, replace anything like digestive enzymes.

And you know, again, you can measure that to determine how big of a need that [00:26:00] is. Right. Individual person. So

Dr. Weitz: you use the GI map partially for that to see if the pancreatic enzymes are low. If,

Dr. Krick: exactly. And what I do personally is a lot of times I might not tar unless they’re really low. I might not do that right away.

I don’t wanna say like, we wanna save an ASCE up our sleeve, but I might save that and a month later. Somebody, because I’ll usually follow up with people monthly and if they’re having, you know, they’re not making progress or hitting a plateau, they’re having food re activities, we might add a digestive enzyme or we might have ’em start doing like an IFM, I’ll share the IFM at home stomach acid testing with them.

Okay. And have them test their stomach acid and start with one and two and three and see if how they tolerate stomach rather. Right. To see if we need to bring that on. But I’ll use that GI map to see if, you know, if that’s on the radar or if it’s not. Then R number three, the re inoculate probiotics.

It’s probably the most easy or obvious one. We use probiotics, we use prebiotics, we use postbiotics and then [00:27:00] R number four repair to the gut lining, you know, leaky gut, things of that nature. You know, there’s a lot of things that could fit into each of these sections. You know, a lot of things that could be used in the pro probiotics or re inoculate phase with regards to, again, the postbiotics prebiotics, butyrate, fiber.

A lot of things that could go into repair. You know, even vitamin D could be classified as a repair thing. Glutamine is almost always

Dr. Weitz: zinc.

Dr. Krick: A repair protocol. Zinc. Yeah. Even, you know, I got one sitting right here, DGL that would just kind of sit on my desk, but more for soothing the gut lining, you know, if somebody’s got an ulcer or any gastritis symptoms, which I see quite often.

And

Dr. Weitz: do you do the replace and re inoculate and repair at the same time, or you make them separate phases?

Dr. Krick: Kind of depends. Kind of depends on the labs. Kind of depends on the person too. If it’s somebody that I think is not gonna be overwhelmed by being on 10 things at once, you know, overwhelmed from a compliance standpoint or overwhelmed from a budget [00:28:00] standpoint.

You, you know, sure. Then I’ll do ’em both at the same time. Or if the labs are really bad, like a lot of weeds to pull and a lot of seeds to plant, then it’s pretty easy to, I don’t wanna say persuade, but it’s pretty, pretty easy to show somebody, Hey, these are really high. We need to pull these weeds.

These are really low. We need to plant these seeds. But it kind of depends on, on, you know, the person. Great question. Great question.

Dr. Weitz: And do you find that sometimes the remove phase ends up being a lot longer than you were planning it to be?

Dr. Krick: Yeah. Yeah. And I’ll say that’s another, you know, I’ll answer that with another I don’t know, version of the answer.

But in my office I don’t always retest. I would say I base it on how the person’s doing and how they’re feeling, because I see a lot of people that three months down the road, they’re like, I feel great. I don’t wanna spend 400 bucks again, I feel great, thanks for helping me. And I say, okay, but hey, if we retest, a lot of times we’ll find that the stuff isn’t completely gone.

You know, people feel better because we’ve reduced it a lot, reduced their [00:29:00] pathogen burden, reduce their fungal burden, whatever we wanna say. But it’s not like it’s perfect. So a lot of times a retest and kind of another, you know, phase of like raising some lows, lowering some highs is often a really good idea.  But yes, I do think that.

Dr. Weitz: Do you do SIBO breath testing as well?

Dr. Krick: I don’t. I don’t. I’ve never been a big fan of it, you know, and just, that’s my personal opinion. But I just saw somebody that kind of opened my eyes that she was, she failed to a breath test many times, but her GI map was low bacteria, you know, there was no real overgrowth on there.  So I think you can have dysbiosis in all these different areas. What I found, like when those tests became popular and I was working with a lot of SIBO stuff, you could kind of tell by talking to the person. Do you have a sibo? Tell me about the foods that you bloat from. Oh, I can’t eat broccoli. I can’t eat a lot of these FODMAPs.  I can’t eat a lot of these fibers. I’m trying to eat a really healthy kind of, you know, plant heavy diet and it just bloats the smush outta me. And they might get, you know, bowel [00:30:00] changes or whatever. But to me that was like, okay, you probably have SIBO and I’m never diagnosing what they have anyway.

Like you are probably on this spectrum. Let’s avoid these foods. Let’s treat your gut with a five R protocol and yeah. What’s your take on that?

Dr. Weitz: I like to see both breath testing. Yeah. We use the Trio Smart a lot and you know, I’m pretty sold on it. I’ve had a number of conversations with Dr. Pimentel and he’s been on the podcast. I’ve seen. Yeah, I saw that. You know, I organized this meeting of functional medicine practitioners and we’ve had Dr. Pimentel come and speak a number of times as well. And so. I like to do the SIBO breath testing as well as the GI map on the GI map. Do you also add zonulin and have you experimented with adding the bile salts and the short chain fatty acids?

Dr. Krick: I have not short answer. I have not. I’ve seen a lot of those on a lot of other, you know, people’s assays and things, you know, on the [00:31:00] Genova test or otherwise, but I have not, my understanding with the zonulin is. That it’s a variable marker throughout the day. And that’s what

Dr. Weitz: doc it, it depends who you talk to.

I know. I mean, you know, if you talk to Dr. Barsi, he’s gonna exactly tell you that I know Dr. Barsi very well too.

Dr. Krick: Exactly,

Dr. Weitz: but, and but I, you know, he’ll say, you gotta look at the antibodies. And people say, you gotta look at the, you know, what’s in the bloodstream. Other people say, well, the relevance is what’s happening in the gut, so why not look at it in the gut?

Dr. Krick: I tend to, you know. I’m not super encamped in any you know, camp. Let’s say, you know, super entrenched, let’s say I’m not in any camp. You know, same thing happens in the mold world. It’s really prevalent in the mold world. You know, Dr. Campbell says, you gotta look at the antibodies. That’s the only way the urine testing is completely worthless, but there’s hundreds if not thousands of practitioners that use these tests with success.

I’m more [00:32:00] about like, what helps the patient get well, right? And so I tend to, and I would just say. I tend to suspend disbelief.

Dr. Weitz: Right.

Dr. Krick: You know, I also don’t muscle test, but people do. Yeah. People like it, and if it works for the person. Right. Great. I’ve got a buddy here in town who’s a chiropractor who’s done it for 30 years, and sometimes people that we see together, I’m like, Hey, if you want to take your subs to him and he wants to help you choose between this probiotic and that probiotic, great.  As long as he doesn’t say, you don’t need probiotics, then we’re on the same, we’re on the same page. But I don’t know. I’m always open to be persuaded otherwise, but I don’t do, you know, same thing with hair, tissue mineral testing. Some people swear by that. It’s not something that I’ve ever learned from many of my mentors, but I’m not opposed to it.  And if somebody brings me a stack of labs, I’m not like, oh, this one’s worthless. I’m just, they’re all puzzle pieces. You know, and I like seeing puzzle pieces, but I do [00:33:00] weigh budget and I do weigh things like that when I’m making my decisions of what’s gonna help the person. Yeah, I might experiment with some of those.

Dr. Weitz: Absolutely.

Dr. Krick: What about you? I, do you find those useful on the map? Like the bile acids? ’cause I’m super intrigued by that one. Specifically,

Dr. Weitz: we have started to run it more often and it’s interesting. We have patients who have issues that, you know, overlap with their gut problems. Found out one patient had this bile acid issue with her liver that she didn’t know about.

And it’s, you know, I like looking at the short chain fatty acids as well. ’cause that’s an important marker. Still not sure always what to do with the results and so we don’t do it all the time. But I am starting to run that add-on as well. I always do the zonulin. I really like having the zonulin as a general marker of the health of the gut and, you know, yeah, I find it to be pretty.

[00:34:00] Repeatable. I don’t find it all over the place.

Dr. Krick: Okay. Yeah. I recently had a guy who did a split sample. It wasn’t split actually, but it was like one on a Monday and one on a Tuesday, which I would just love seeing because

Dr. Weitz: Right.

Dr. Krick: You see the repeatability. They weren’t identical. They were really, you know, close and had the same major players.

But I am super intrigued by all those things because, you know, I talk about sluggish gallbladder and bile acids and you know, do we need bitters or tudca or other things like that? Right. But it’s so it’s, and it’s interesting too with labs, because sometimes we’re looking for, well, what do we need to do clinically?

Dr. Weitz: Right.

Dr. Krick: But sometimes labs are also just to educate the person of what’s going on. Yeah. And we don’t wanna waste their money, but it’s like the more markers that can give evidence to say, Hey, this is what’s going on. See this marker. It’s out arranged. This is what it means in the interpretive guide. This is what you got going on.  That helps them conceptually understand what they need to do to get it under [00:35:00] control. So it’s interesting when all those different factors play a role. ’cause it’s not like in the medical system where we’re just trying to give a diagnosis. Yeah. We’re not we’re trying to educate, we’re trying to, you know, give action steps and things like that.  But yeah, I’m intrigued by those. I do use the

Dr. Weitz: the guy to talk to is Tom Fabian of DSL Labs.

Dr. Krick: Yeah. He’s

Dr. Weitz: the guy

Dr. Krick: saw his a name on your lineup recently, I think.

Dr. Weitz: Yeah. He’s really good at helping you with the science to understand some of those things like that.

Dr. Krick: Yeah, well that’s actually even I’m gonna keep that in mind because I’m looking, like I’ve mentioned, I think it was off air that on my podcast I’m gonna do more interviews and that’s a good example.

I’ll have to reach out. ’cause we do a ton of GI maps, you know, and so,

Dr. Weitz: yeah.

Dr. Krick: I’m always intrigued to learn about the testing and the science.

Dr. Weitz: Yeah. Cool.

Dr. Krick: Yeah.

Dr. Weitz: So, and how is that patient doing? Or this is

Dr. Krick: somebody started. Okay. Back to those. Yeah, back to those two people, I

Dr. Weitz: guess. Yeah. And then let’s go over the second case.

Yeah. Wrap after that.

Dr. Krick: She’s doing excellent. Long story short, she’s feeling really [00:36:00] happy. She’s feeling really good in more ways than one, you know, not just got, but in more ways than one. As far as you know, it, mentally and energetically and things like that. And it was kind of the gist of our appointment.

You know, I had two of these yesterday, which is, was always like really great. The gist of our appointment was like, I’m really happy with how I’m doing and I don’t have any problems that I wanna solve right now.

Dr. Weitz: Except the ai I looked at said that you’re, everything you said is wrong.

Dr. Krick: Yeah. I’m

Dr. Weitz: just

Dr. Krick: kidding.

They don’t go to that, but yeah. But she was just really happy with no problems with social. No,

Dr. Weitz: actually, sometimes it’s funny, they go to AI and the AI like says everything that you told them to, so they feel

Dr. Krick: Yeah.

Dr. Weitz: Confirmed by it.

Dr. Krick: It’s before that. Or if I give people the right search terms.  You know, if you give people the right search terms, I think they’re gonna find that what I’m doing makes sense because. I think it makes sense and it’s just, you know, each practitioner has their own little nuances and their own tools and their own brands. Just like every carpenter, you know, one [00:37:00] might use Milwaukee tools and one uses DeWalt tools.  They can both build you a good deck. You know, we got our different tools that we use, but it tends to work. And the more you look at the literature, the more you take a lot of seminars, the more you learn from different gurus as you’ve had. You know, even on your episode, it really comes back to this like.

Overall, you know, generalist theme of like, fix the dysbiosis, fix the guy, get the vitamins and nutrients, decrease the toxin load, decrease the pathogen load, and things tend to work out. Now again, very general, but that person was just really happy with her care. Now I’ll tell you, you know, there’s some interesting stories with the people that she was even referred by.

Her daughter was one that I mentioned who’d had a mold experience and her son-in-law who’d had a mold experience too. But, I dunno. I digress with both of those two. But she’s doing really well and just happy with her guy. And I said, our biggest goal, I said, you’re out of your flare. Your diverticulitis flare.

You’re not flaring currently our biggest goal is knowing that if you feel like that inflammation starts [00:38:00] coming on even a little bit, it’s important that we know how to squash that out. And I told her a story too, Dr. Ben, that, you know, I tell a lot of stories, do a lot of drawings, and again, for the educational piece that’s so central to my.

My clinic. But I told her a story about this girl that I saw with Crohn’s Disease who was also doing great. She came in and she said I’m doing really great. My mom just thought I should check in with you to let you know how I’m doing. And so we’re just kind of checking in and, but no real problems to solve.

But this girl said she said, I don’t have turmeric and resveratrol when she feels inflamed. And she said, when my gut feels inflamed, I just take these two and it goes away. I was like, good. That’s how you extinguish that fire. But she said, but how long do they last? Because they’ve been in my fridge for a long time.

I said, that’s good too. That’s a sign that you don’t need ’em all the time. You’re not having to extinguish the fire. So I told this woman from yesterday. Now if the fire creeps back up, we wanna squash it out so it doesn’t turn into a flare. So you don’t have to go in and get a [00:39:00] scope or a steroid or something like that.

We can prevent these flares and we can catch them coming on the other person. Whose case I was telling about is a young girl, very knowledgeable. You know, a lot of these people today they’ve heard podcasts like yours, podcasts like mine. They’re super knowledgeable, sometimes to a fault of like, they know too much, but that’s a good thing.

I mean that in, in a loose way, but sometimes they know too much. But she. Thyroid is one of her issues. So yesterday we were review, we just did a short lab review reviewing her thyroid markers ’cause her thyroid is all over the place before I met her and they got, even her endo was like, you need to get off this med.

And I see that a lot where, you know, even somebody’s seeing, let’s say a natural, more naturally minded practitioner, but they’re like trying to tweak the T four, trying to tweak the T three, trying to tweak the different thyroid hormone levels and they’re just all over the place and the person feels like crap.

She was losing hair, she had a lot of anxiety. And things of that nature when I met her. And so [00:40:00] the overall theme of yesterday was that her thyroid numbers are normalizing. They’re not great for 27 years old. They’re not great, but she said, this is the first two labs I’ve had in a row where they’re pretty close to the same and they’re trending in the right direction.

So the takeaway from yesterday was like, let’s look at ’em again in January and make sure these trends continue. But so far we’re on a good trend now. She also, this person has a goal of a future family. So we’re talking about, and I know her husband, I see her husband as well, but she, that we’re talking about her cycle and all these different things, and I can go into more detail.

I don’t wanna ramble, but that’s what we’re always talking about, I’d say is all the puzzle pieces. You know, I always tell people if I’m doing a puzzle with my kids. We dump all the pieces out and flip ’em over, face up. So we’re talking about how’s your stress, how’s your anxiety? How’s your cycle? How’s your gut?

And she said, we’ve been working on our gut for a good [00:41:00] long while. Let’s say she did some parasite cleanses, she had some blastocystis, different things. But I kinda said, even as the call began, I said I’m guessing today. We’re pausing on your gut and not doing that because we’ve been doing that for the last several months.

And she agreed and she said, my gut is just doing really great. My bowel movements, my foods, my digestive symptoms, you know, bloating and other things are just doing really well. But the bulk of our visit yesterday was on her new thyroid labs. So I, I don’t wanna keep rambling, but that’s just No.

Dr. Weitz: Yeah, go ahead. What about her new thyroid labs?

Dr. Krick: What did you

Dr. Weitz: say?

Dr. Krick: Two of the people? Yeah. So her T three, so she’s got, she got real interesting thyroid labs too. But she has low rever. I don’t know. These are all real interesting. Again, you’ll know this, but she had low reverse T three. She has really low thyroid binding globulins, and she has really low thyroid hormone levels.  But she’s 27. She’s young. She’s thin. So [00:42:00] metabolically,

Dr. Weitz: so the free T three and the free T four, is that what you’re

Dr. Krick: referring to? The free. The free are. Okay.

Dr. Weitz: Okay.

Dr. Krick: The free are. Okay. Which is the active form in the available form, you know.

Dr. Weitz: Okay. So,

Dr. Krick: so those are okay, like 2.9, I wanna say free T three, which is pretty unremarkable, wouldn’t really catch my eye.

But her T three had been like, I think at one point it might’ve been in the forties. It was in the sixties, now it’s up to 79, which is still low, but it’s trending in the right direction. And so my theory, and you can tell me what you think about this, but the binding globulins are all really low because they want free, you want free hormone, you want free available hormone.

Correct. So the binding globulins are all low. So a lot of those, you know, packages aren’t on the Amazon truck they’re actually delivered, so you can use them. But the, there’s not a lot of actual hormone, there’s not a lot of hormone productions, and that’s what we’ve been working on for the last, you know, four or six weeks was doing some thyroid glandular type things [00:43:00] and doing some co-factors for thyroid hormone production to see if we can’t support the natural.

Thyroid hormone production

Dr. Weitz: things. Things like Iron, Selenium.

Dr. Krick:  Exactly.

Dr. Weitz:  Vitamin D

Dr. Krick: and ol Yes. Yeah, she’s on three products from Apex, all three of, I don’t only use Apex, but it’s one of my brands. But one’s called Thyroid Flam, which is a anti-inflammatories for the thyroid. So it has like an nool Google selenium.  It is more for thyroid inflammation. She gets this inflammation here. She calls it a frog in her throat,

Dr. Weitz: ah,

Dr. Krick: frog in her throat. When she gets anxious, she gets this swelling and inflammation around her thyroid area. So she’s on that one. She’s on a thyroid glandular that has also some pituitary, glandular and maybe, I don’t think it has adrenal glandular, just pituitary.

Maybe a couple other co-factor things. And then she’s on a. Antioxidant cream. I use my fingers, like if you’re listening on the audio, you can’t see it, but it’s a cream. It’s a [00:44:00] lotion, so you can rub it directly over the thyroid. It’s an antioxidant cream glutathione, and superoxide dismutase, but you can rub it directly on the thyroid for that kind of thyroid puffiness.

So we’re looking to see the signs and symptoms. Thyroid inflammation coming down. We’re looking to see that. She feels that less often, less frog in the throat less thyroid,

Dr. Weitz: you know, there’s some good data showing that using red light therapy directly over the thyroid

Dr. Krick: Exactly.

Dr. Weitz: Actually is beneficial.

Dr. Krick: And the antibodies too. I mean, many people have seen their antibodies go into remission. I’ve tried that. I didn’t notice any change. I didn’t, maybe, you know, there’s not, there’s a lot of different red lights, a lot of different laser, there’s a lot of different durations and things. But I’ve tried that many times.  Same thing with. I don’t know that there’s data on this one, but cast oil is another interesting thing that even like Queen of Thrones makes a thyroid, you know, it’s almost like a little mini sleep mask and my opinion it would not be pleasant to sleep with something around your neck. But I haven’t tried that one.  I’ve done the cast oil packs and some of those things, you know, people use it on their eyes [00:45:00] too but yeah, I agree with the red light and I think that’s something that her and I have discussed, you know, ’cause one of the things I’ll do. Just discuss with people, let’s say, and I’ll tell people sometimes I’m gonna throw down 10 things and see which three you pick up.

Dr. Weitz: Yeah.

Dr. Krick: And you might not pick up the first three, or you might pick if the three you pick up aren’t working, I might say, Hey, why don’t you try these three? But that’s what we would do. And so she’s also doing, you know, we started doing, she did some vagus nerve stimulation, so she’s really liked that her anxiety and her stress response.

Or probably the biggest thing that we’ve nudged the needle on. Now, did you

Dr. Weitz: use a device or what did you use?

Dr. Krick: We use a 10 device.

Dr. Weitz: Okay.

Dr. Krick: TENS device. Yep. And I’ll sometimes have people do gargling, gagging, you know, other you know, device free things. But we use a TENS device on the ear. I have almost everybody, you know, start doing that or pitch it to them.

But her stress response was something that calmed down or gut is something that’s improved. Her thyroid levels are starting to trend a lot better. And I think our next topic is gonna be [00:46:00] hormones and hormone balance. Just for her, you know, goals of future family. I see a lot of people that you know, are just of that childbearing age, let’s say.

They come to me, not for fertility, is their reason. I’m not that specialist, but a lot of times it happens for people as we get their gut in check, we get their detox pathways opened up, you know, whatever we wanna say, we get their nutrients, you know, balanced. And then it just kinda happens if that’s, you know, the goal for somebody and what they’re trying for,

Dr. Weitz: right.  I love that vibrant micronutrient test. That’s a really good test for assessing nutrient status.

Dr. Krick: Yeah. Yeah. And I’ve come to use more vibrant, you know, testing, I would say. I’m, you know, I’m excited to pick your brain about your tools that you use for these things, because even, you know, with your story, with your bone and your non-union and stuff, I’m sure those micronutrients are necessary for bone health.

Dr. Weitz: Absolutely, a hundred percent.

Dr. Krick: And I also [00:47:00] too, they’re necessary, they’re important. All those things we can say, but you can’t absorb ’em without a good gut. So absolutely it’s not to say that the gut is everything, but the gut is so foundational. But yeah, those are a couple of the cases that I saw yesterday and you know, also saw like an IGA nephropathy, which is a pretty rare.

You know, more rare than Hashimoto’s, let’s say. But just some interesting things too. I see a lot of mold, which I’ve mentioned, and I know you’ve had, you know, different experts on the podcast about air quality and other things, but it’s, I don’t know if you agree, but it’s wild to live in the world that we live in.

Yeah. And to hear the stories and it’s like. It’s wild, but yeah.

Dr. Weitz: Yeah. Well, definitely mold and mast cells seems to be the topic of the day. It seems like everybody’s talking about it now.

Dr. Krick: Yeah. Yeah. And I would say that they, those things blew, you know, especially the mast cells really blew up in, in the COVID era.  But I feel [00:48:00] like the people were similar before, you know, we just, there’s a new understanding of mast cells, but there’s mold toxic people, you know, chronic fatigue and autoimmune and otherwise, you know, 10 years ago. But it is a hot topic, but it’s also too, you know, it is trendy. Yeah. So it’s a hot topic.

Dr. Weitz: Yeah, no, you feel like there is a trend, like everybody had, you know, adrenal fatigue and everybody had hypothyroid and everybody has chronic fatigue and everybody and

Dr. Krick: parasites have had

Dr. Weitz: parasites and now everybody has mast cell and.

Dr. Krick: But I think it’s interesting that mold is like a, it’s in the Old Testament, you know, it’s a biblical concept.  It’s been around forever as a problem, but more and more people are uncovering it as a problem. But I think of just like everything else that we’ve talked about, you know, again, as a generalist, it’s like, yeah, that’s a problem, but what else? And it’s not a problem for everybody. You know, even in one family, it’s not a problem for everybody, right?

And the world is not a mold-free place, right?

Dr. Weitz: It

Dr. Krick: never will be.

Dr. Weitz: Right?

Dr. Krick: So [00:49:00] understanding those concepts is how you could take it from being a little too crazy with it. To be in, like realistic. It’s an antigen, it’s a driver. Right. But those stories are always fascinating.

Dr. Weitz: I agree. So, let’s bring this to a close.  Tell our viewers and listeners how they can get in touch with you and find out more about you.

Dr. Krick: Yeah. So you could follow my podcast, the Autoimmune Doc podcast. You know, I’ve told Dr. Ben that I’m, I look up to him for his frequency of posting. Mines nowhere near as frequent, but I’ve got a, you know, 70 or so episodes, a fraction of what you have, but just educating on these concepts.  You know, some of ’em are just me talking. Some of them are me interviewing an expert. Dr. Ben’s gonna come on my podcast soon also, so you’ll find that episode on there. I also have a YouTube channel that’s under, it’s actually now under Autoimmune Doc Podcast as well. My clinic is called Washington Wellness Center, which has confused some people because it’s not the state of Washington.

It’s

Dr. Weitz: right

Dr. Krick: Washington, Illinois, which is a small town [00:50:00] outside of Peoria, which is my home, my hometown. But wash, WASH, wash wellness center.com or on Instagram, autoimmune Doc. But any of those places are good places to follow and hear are the education. You know, my, my thing is again, that when you educate people on these concepts, you know the concepts that we’re talking about, the concepts of functional medicine, the concepts of gut healing, toxicity, then the action steps.

Make a lot more sense because like we said, there’s a world of action steps out there. It’s like, do I need a hyperbaric oxygen in the ozone or do I need, you know, to kill parasites or do I have heavy metals? And it’s like all those are maybes. How do you know what you need and putting those into a stepwise fashion.

But anyway, that’s kind of the focus of my social media is just education first. It’s not a lot of sales or anything like that. It’s actually none. We should probably be better at that, but that’s where you could find me.

Dr. Weitz: Sounds good, Taylor. Thank you and [00:51:00] I’ll talk to you soon.

Dr. Krick: Awesome. Thanks for having me.  Appreciate it.

____________________________________________________________________________________________________________________________________

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 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 wanna 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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Check out this episode!

Reed Davis discusses Functional Medicine Lab Interpretation 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

Understanding Lab Test Interpretations and Functional Health: An Interview with Reed Davis
In this episode of the Rational Wellness Podcast, host Dr. Ben Weitz discusses the intricacies of functional lab test interpretations with Reed Davis, a clinical nutritionist and the founder of Functional Diagnostic Nutrition. Davis explains his approach to functional lab work, including the use of saliva, urine, stool, and blood tests to diagnose a wide range of health problems. He emphasizes the importance of looking for underlying causes rather than just addressing symptoms, and shares insights on the role of hormones, gut health, and environmental toxins in overall wellness. The interview also touches on the effectiveness of various dietary approaches, stress reduction techniques, and the significance of a holistic health strategy in achieving optimal health.
00:26 Guest Introduction: Reed Davis
01:24 Functional Lab Testing Overview
02:04 Saliva Testing for Hormones
06:06 Endocrine Disruptors and Toxins
08:29 Case Studies and Success Stories
15:24 Comprehensive Lab Testing Approach
28:14 Metabolic Typing and Diet
31:30 Understanding Sympathetic and Parasympathetic Dominance
32:15 The Cree Indians’ Diet and Health Transformation
34:48 Diet Compatibility Across Different Cultures
35:36 Determining Your Metabolic Type
37:55 The D-R-E-S-S Protocol for Health
39:21 The Importance of Supplements
41:18 Reid’s Journey into Functional Medicine
46:43 The FDN System and Its Impact
52:19 Becoming a Functional Diagnostic Nutritionist
54:58 Conclusion and Contact Information


Reed Davis is a clinical nutritionist and founder of Functional Diagnostic Nutrition. Reed is known as one of the most successful and experienced clinicians in the world today, having provided functional lab assessments to over 11,000 people for hormone levels as well as adrenal, digestion, detoxification, mucosal barrier, pathogenic, bone density and diet related health problems.  He has certified hundreds of FDN Practitioners worldwide and with FDN, specializes in teaching about Functional Health Coach Training.

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 this is Dr. Ben Weitz and this is The Rational Wellness Podcast, and our topic for today is lab test interpretation with Reed Davis. Reed Davis is a clinical nutritionist and the founder of Functional Diagnostic Nutrition. Reed is one of the most successful and experienced clinicians in the world, having provided functional lab assessments to over 11,000 people for hormone levels, as well as digestion, detoxification, mucosal barrier function bone density, diet related health problems.  He certified hundreds of FDN practitioners worldwide and he teaches about functional health coach training. Reed, thanks so much for joining us.

Reed: Well, thanks Dr. Ben for having me here. Happy to help out anytime.

Dr. Weitz: Great. So, when it comes to labs, what are some of your favorite lab panels that you like to run, and what companies do you like to use?

Reed:  Sure. Well, for years and years I’ve been running what used to be called alternative labs. Now they’re more known, more widely as functional lab work. So I use saliva, urine, stool, blood when necessary. A lot of people actually, though they’ve already been to a physician, let’s say, and told their blood work looks normal.  And that was something that occurred to me 26, 27 years ago when I started. So I started using these alternatives, like for instance, for the saliva testing of the hormones. I now use a company called FluidsIQ. FluidsIQ, that’s all one word. And they’re out of Toronto, Canada. Okay. They have a US distributor.  They ship all over, including to some of the states that it’s hard to get lab tests into, like New York and Rhode Island and some of these places there. So they’re really good company Fluids iq. I use them for saliva testing of the hormones. By the way, our panel, I’ve gotten the labs to add markers as we’ve learned what’s important here healing wise.  So their hormone test, for instance, has, it’s not just the cortisol and DHEA four point, you know, with the sex hormones. It’s got estrogen and progesterone, testosterone, but it [00:03:00] also includes melatonin. And so that’s an indicator that’s often very important. So. You know, if you can do a test at home that’s real simple and kind of not real expensive it’s, there’s a fee of course, but you can get melatonin added and any other markers would be great.

So, you know what we had them include secretory, ICA. Now that’s from saliva. So at the same time you’re submitting your hormone panel. You can get your melatonin, you can get your secretory IGA or SigA that tells us about your immune system. So we’re looking at whether it’s overactive or underactive, and it tells you something about a person.  And oh, by the way, when someone has stress and cortisol or DHEA, you’re outta balance. You’re more catabolic. Your sex hormones go outta balance. Which is all on there. And then your melatonin, because the circadian rhythm is off. So we want to look at [00:04:00] that and hey, while we’re now,

Dr. Weitz:  There’s been a lot of critique of saliva testing for sex hormones as not being accurate.

Reed: Yeah, I’ve heard that. You know, but mostly it’s by the companies that don’t do it. So, you know, there’s over 300 white papers written on the accuracy of saliva testing for hormones. The trouble that a lot of practitioners might have is that there’s not very much hormone in saliva, but the cool thing about it is if it’s made it through the saliva glands into your mouth, that’s real bioavailable hormone.  So it’s not attached to anything. There’s no binding of any of it. And so, some practitioners are using dried urine, for instance, right? 

Dr. Weitz:  Like DUTCH testing, for example.

Reed:  There’s zero white papers on that. The only papers, the only research you can find on that test is written by the people who do the test, the [00:05:00] manufacturer or lab people.  So a, again, there’s over 300 white papers written on the accuracy and effectiveness of saliva testing. So, you know, I don’t really like to get into the debate because I know plenty of people who use the dried urine and I think it’s an okay test. I trust the lab too, but there isn’t even a fraction of the research done on that test. Now, the gold standard’s probably wet urine or even blood if you’re doing hormone

Dr. Weitz:  Blood, is really considered the gold standard I think.

Reed:  If you’re doing replacement, it is. And so, we don’t really do replacement, like we’re not prescribing hormones. We’re trying to find out what’s wrong with a person.  We, we would be more inclined to ask, well, why are your hormones out of balance and not just blaming it on age or something like that. So we and that way we can kind of help the person. The goal is to have them live themself out of [00:06:00] the trouble they’ve lived themself into. Right. One of the things that sometimes,

Dr. Weitz:  One of the things I’ll sometimes put hormones at a balance, and some of the labs now are starting to test for this also is endocrine disrupting substances.

Reed: Yeah, for sure. So we use for that, the vibrant total tox test for one thing.

Dr. Weitz:  Right? Yep.

Reed: Yeah, you’re probably familiar with that. And there’s other, yeah,

Dr. Weitz: I like that test.

Reed:   It’s what do you like so much about it? No, you’re interviewing me.

Dr. Weitz: Well, I love the fact that it’s looking at so many different forms of toxins.  It’s got environmental toxins, it’s got heavy metals, it’s got mycotoxins and I found it to be very helpful and accurate. And so, yeah, you know, I just tested a patient last week and she had very high levels of of gadolinium. And, you know, it’s one of the few tests that includes [00:07:00] gadolinium.  And we started talking about it and it turned out that she’d had three MRIs with contrast of her brain because she’s having brain problems and we, there’s actually warnings from the FDA that gadolinium tends to build up in the brain. And now we have a test showing that she has high gadolinium levels and she had no idea that she was being exposed to a heavy metal.

Getting these MRI scans.

Reed: That’s fantastic and reminds me recently, ’cause I’m older, you know, I was gonna get a scan for a standard checkup by my urologist and he wanted to use a contrast gadolinium. I said, no, I don’t want you injecting any contrast. Just take the MRI or your CT scan or whatever, do the best you can, you know, and right.

Dr. Weitz:  And by the way, this a patient who has MS and she’s having a flare and

Speaker 3: yeah.

Dr. Weitz: And then she also had high levels of [00:08:00] mycotoxins and then we talked about it. And she has a air conditioning unit that’s leaking water and she knows she has mold and the air conditioning unit’s throwing it all around her apartment.

Reed: It’s really helpful to run these labs to, and to try to be a good detective, you know, to find out what’s really going on with the person, their environment. Things. I’ve been finding it just fascinating. First test I ever ran was in 1999 and it was actually a food sensitivity test. Okay. Those are really great too.  I, by the way I’m full disclosure, I use Oxford Biomedical, they run the Mediator Release test, which I find to be the best for almost everybody.

Dr. Weitz: Oxford Biomedical, I’m not familiar with them.

Reed: Yeah, well, you know, you might wanna jot that down or use your note taker or whatever. Because it, I’ve been using it for all these years.  The first time I used it, and this is not typical, but not uncommon either. So I’ve had a lot of success stories, just like this lady comes in the office for chiropractic. She had sore neck and I was walking her back. She was on about her eighth visit and hadn’t really talked to her about much else at that time.  And she was walking back to the treatment room. And Ben, you know, we would do a little trigger point therapy and put a heat pack on a patient before we did the adjustment. I wasn’t doing the adjustment, so I would kind of triage the whole thing. And I’m walking this lady back and I could see she’s really sad.  Just tell what’s wrong. Oh, it’s this weight Reed. I’m 40 pounds overweight because I’m on medication for the hives and I’m, I wanna butt in. Right? But she goes and, she goes, I went to the doctor the other day and I told him how unhappy [00:10:00] I was, how frustrating it was to be 40 pounds overweight because of this darn medication for the hives you have me on.  According to her, she he said, lady, you can be fat or you can have the hives, take your pick. So wait, so now I really wanna butt in now. Nope. She goes and she goes, I told him how depressing that was and he said he’d be happy to write me a prescription for antidepressants.  So, you know, from the hives to being overweight because of the medication and how frustrating that was.  And now he’s prescribing or willing to prescribe antidepressants. Finally, I got my word in edgewise and I said, Hey, first name. How come you never tried to find out why you get the hives or would you like to, or something to that effect. Her head turned around so hard from staring at the floor to looking at me, I thought she wouldn’t [00:11:00] need her adjustment that day. It was like, what? I said, yeah, you know, let’s test, let’s run. I don’t know what, we’ll find

Dr. Weitz: you know, big pharma has figured out that’s not gonna sell so many drugs. So now every time you see a drug commercial on tv, and by the way, if you watch any tv, every freaking commercial is a drug company, is people taking these injectable medications that cost thousands of dollars a month, but every time they take it, they’re dancing and singing and everybody’s happy and it’s the greatest thing in the world.  And you’re like, sign me up for this injectable medication for autoimmune disease.

Reed: It’s amazing. And. Back then there was biologics, but this was just like a steroid, you know, just to keep the hives down. And you’re right, i, those commercials there, there’s birds singing and there’s butterflies flying around and everything, making it look good, even though they kind of under their breath tell you that could cause, you know, serious diarrhea [00:12:00] and, you know, like death.  

Dr. Weitz:  Oh, yeah, exactly. You know, and impotency and,

Reed: oh, yeah. Yeah. So I simply said. Hey, let’s let, maybe we could find something. And she took home a test kit, got the test kit completed. I finally got the results. Takes a little while sometimes for people to get it together, but this is by the way, out of pocket ’cause insurance didn’t cover it then 25 years ago and doesn’t cover it now for whatever reason.  It’s insane that these wonderful tests aren’t covered by insurance. A lot of ’em. So she was willing to pay, obviously. And when I went over her results, we changed a few things. As I recall, it was really the food sensitivity test that worked. But she was sensitive to some foods she was eating every day.  Got her off those foods. She told me later, she said, Reed, within nine days I was calling the doctor. I told ’em I’m [00:13:00] not taking this medication anymore because I found out why I get the hives right. I found, I mean, what a concept, you know, find out why you get

Dr. Weitz: the hives. Yeah. I mean that’s one of the fundamental principles of functional medicine is trying to get to the root causes and keep asking, why do I have this problem instead of just treating the symptoms

Reed: and it, yes, and it’s the same for like the saliva testing of the hormones.  We’re not looking for the kinda results would have a. You know, titrate medication, you know, like hormone replacement. You could do it, but that’s not why we do it. So I, my group, the Functional Diagnostic Nutrition Group are always, we’re strictly underlying causes and conditions. No prescribing, no drugs.  It’s we do use supplements, but a lot of other things like lifestyle, diet, rest, exercise, stress reduction. 

Dr. Weitz:  So give us an example of a patient who had some hormone imbalance and how did you treat it? 

Reed: Yeah, well, we try not to treat it. We try to indicate to that person, Hey, look, you’re all stressed out.  Stress throws the cortisol and DHEA off and the next domino to fall is always the sex hormones. So people with these sex hormone problems, you can use supplements. There’s adaptogenics and lots of things that make you feel better. You could even use a little estrogen or progesterone or what have you.  You can get a lot of that over the counter these days. But we would be more inclined to find out what the stressors were. And that’s the true detective work. And you know, of course people are eating wrong and they’re not sleeping and they’re working too hard and all these things that do stress them out.  But handling stress has always been our secret to success, you know, and along with, of course, eating right, going to bed on time, exercising and taking your supplements. And so I did. I, there’s so many [00:15:00] cases. And as a matter of fact, well, this would lead into another story. We had a lady coming in who was all of that overweight, fatigued brain fog you know, can’t sleep and you name it.  A very unhappy person who’s working with us for several weeks. And we did not just hormones, but ’cause I never just look at hormones. It’s like, I won’t guess what their problem is. I run five labs in every person, which is,

Dr. Weitz:  What are the five labs you run?

Reed:  I run the saliva test of the hormones, which includes melatonin, SigA and now we’re adding insulin to it.  

I look at the mucosal barrier. So I look at zonulin…

Dr. Weitz:  Insulin via saliva? That’s interesting. I haven’t heard anybody mention that.

Reed: Totally. Yeah. And because it’s so convenient. And remember, these are just windows. These aren’t always diagnostic tests. We’re not trying to diagnose and treat, we’re trying to find out what are the healing opportunities.  So that’s a better word [00:16:00] for us than diagnosed, I think for chiropractors, for health coaches, for, you know, these allied practitioners. Most people coming in don’t want another diagnosis and prescription. They want to know what’s really wrong with me. And that’s what started my career in 1999. I wasn’t a doctor.  I had a lot to learn. I had nothing to unlearn, but case after case of looking for those underlying causes, I found hormones are obviously very helpful. And I learned on saliva and I’m, I’ve stuck with it, although I’ve tried everything else. So, so,

Dr. Weitz:  So the five tests, the first one is salivary hormones….

Reed:  We do a urinary metabolic wellness panel, which is Indican for digestion and protein breakdown.  And also it indicates dysbiosis doctors used to run 40, 50 years ago, doctors were running a urinalysis in their office. They weren’t always sending everything out. And they would look at Indican, which is a measurement of dysbiosis and improper [00:17:00] protein breakdown. That’s important. So, but the same test has urinary bowel acids on it, which tells us you have congested liver.  So detox,  

Dr. Weitz:  So is this like an organic acids profile? 

Reed:  There is one organic acid on it. That’s the 8OHDG, which is a and we used to use lipid peroxide. We’re looking for oxidative stress, liver function, and of course the digestion dysbiosis all in one simple urine collection.  That, that’s pretty remarkable. So we use the saliva, that urine collection for those markers we use,

Dr. Weitz:  What lab do you get that urine collection from?

Reed:  That’s also FluidsIQ. Fluids iq. It is called their metabolic wellness panel. I helped ’em develop it because that’s what I learned on again. And the lab I learned on was BioHealth Diagnostics.  You might’ve heard of them. The owner, scientist, research lab geek, my buddy Tim Bill is Dr. Bill. Tim has died and the business has gone out. So I had to get other labs. Hey, I need, this is what [00:18:00] I need for my people. So we’d run the saliva test, fluids iq, it’s called their Stress and hormone panel, plus the add-ons.  They have the metabolic wellness panel, the Indicin lipid product or 8OHD guanine and their UUA. That’s a direct measurement of liver function. So that tells you a lot about a person why you feel so crappy. Here’s why not diagnosing and treating how to get rid of the symptoms. Here’s why you feel so bad, and here’s the things you can do to correct it.  By the same same type of test also from fluids. Iq, fluids IQ is their mucosal barrier assessment, which is a finger stick. Now, a finger stick allows you to do this at home too, very inexpensively. There’s no blood draw required, so you just poke your finger, you drip it out onto a blotter, it dries you, send it into the lab.  Very convenient, inexpensive. That gives us, first of all, zonulin, or zonulin, as Dr. [00:19:00] Gonshor says. He’s French Canadian, so a smart guy. Really brilliant guy. Zonulin is a marker for leaky gut, as you know. But along with it, we’re looking at the histamine and the diamine oxidase, those, and the ratio between those two because they’re going to give you a picture of what’s happening in the gut along with the endocrine and the, you know, from the urine test. You get this really nice picture of how healthy or unhealthy the gut is, and everyone seems to know about leaky gut, but to actually be able to, if you know the anatomy and physiology, you can see what’s going on with these markers, the histamine and the DAO, the diamine oxidase and the ratio.  And you can also predict what’s gonna happen. So histamine and

Dr. Weitz:  So histamine and DAO would be one way to try to assess the presence of mast cell activation syndrome, correct?

Reed:  Well, that and just any kind of histamine.

Dr. Weitz:  Histamine [00:20:00] intolerance, yeah.

Reed: Yeah. And it could be from eating histamine foods, but mostly it is from histamine being produced by the body in reaction in response to something.  And so something unpleasant to the body. And so, but the how well it respond, it’s responding if DAO is high. Then the system’s working the way it’s supposed to. If DAO is really low, well, histamine’s high. Hey, you have a problem. You’ve got k cryp hyperplasia, it’s called where the villi are flattened out.  You’ve got other things going on and you can tell how much healing is required when you look at this all again, it’s kind of connecting the dots. So this constellation of healing opportunities, we mentioned the hormones from saliva, which gives you SigA also you, so if that’s high, you’ve got bugs, while you look at the metabolic wellness panel and that Indican tells you, yeah, serious dysbiosis.  Now it’s gotten worse when you run the Mucosal barrier assessment, which has the zonulin, leaky gut and the other markers there. They’re telling you a lot about the health of that person and how much work it’s gonna be to heal, not just take your medicine. So the other tests we use, so those three are by Fluids IQ.  Now we use DSL’s GI Map for a stool test. Just find that’s still the standard. I’ve looked at everything else. I wish they did it the old fashioned way with Microscoping and tri-chrome staining and where the human’s actually looking at the stool.

Dr. Weitz:   Do you try to find more parasites?

Reed:  Well, they can identify things and you’re also culturing that you would used to do a stool culture.  You look at what kind of fuzz is growing on different Petri dishes. It’s, I think it’s more, it’s better for me as a natural healer, you know, to look at what’s really going to not just have some machine tell me, oh, here’s this, and this. But still the DSL has some the GI map has some [00:22:00] functional markers on it for digestion and it’s kind of a cool test.  It’s considered the standard today. So we use that and we also use that Oxford biomedical food sensitivity tests. Those five labs give you a lot of information when someone’s coming in. And if it’s okay, Ben, I’ll just elucidate a bit. So we’re different in that we’re not medical doctors trying to diagnose and treat one thing.  You got your, at your, you know, you’re a gastroenterologist, you’re your endocrine. And so on. So we’re looking at the whole person with a holistic approach to healing, trying to identify a whole constellation of healing opportunities because people that come in and I’m gonna give you the phrase that I used, that’s, I think, critical.

So people come in and they’ve got multiple causal things. You know, there’s they’re, again, they’re tired, fatigued, overweight, they can’t lose it. They got and you can tell they got bad [00:23:00] digestion, bad skin, you name it, bad attitude, moody irritability. And so, so they’ve got this whole constellation of things going on.

Some of them, and you know, this way upstream, you know, where the symptoms aren’t really pointing the finger. So we, what the phrase that I came up with? We’re looking for root cause. Yes, but you’re never gonna find one. There’s multiple root causes. And here’s the other thing you don’t hear a lot of places, Ben, is they’re having an effect on each other.

These multiple causal factors are crashing into each other, causing new problems. Very hard to measure. Some of them, by the way, and I teach a course in lab work I know a little bit about that. You can’t measure everything. So you need this constellation of healing opportunities. You need to you know, connect the dots, so to speak.

Explain that person. The most important thing I learned in the office. [00:24:00] Remember I started in a chiropractic wellness center. Running labs. Running labs, the and it’s, you know, that there isn’t one cause, there’s no one root cause. By the way, the University of California, San Diego did a study and said the original root cause might not even be there anymore.

So all these things crashed into each other, creating new problems you can’t even measure some of them. I call it metabolic chaos. And that is a, actually a phrase that I coined and it’s what my practitioners that I teach understand it’s metabolic chaos. You don’t want to just, oh, you’ve got IBS and you’ve got, you know, endocrine disruptors and you’ve got toxicity and you’ve, you have metabolic chaos from multiple causal factors.

So there’s a way to straighten it out, which is the other half of the business. And first half is figuring out what’s wrong. The step in between. You’ll love this and you know this ’cause I learned it [00:25:00] in that wellness center clinical correlation. Does this explain why the person in front of you feels so crappy?

And you know, so the practitioners that we teach, and I know you get it, metabolic chaos, right? You know, who else gets it? Mrs. Smith and Mrs. Jones who are sitting in front of you with all these complaints and they’ve been told by everyone else that it let’s they pick one thing. It sounds like thyroid.

It sounds like, you know, irritable bowel, it sounds like a parasite or we don’t use the sounds like method. You know, we don’t actually don’t wanna know what it sounds like. We wanna know what’s really wrong. That’s why I run five labs in every person and I used to do it one at a time, Ben, but I finally had a couple clients years ago, 20 years ago, say, Reed, why didn’t you just run all these labs at once?  You know, because every time I come in, you’re running another lab. That’s how it went when I was [00:26:00] learning. I was learning well, hormones, immune digestion, detoxification you know, oxidative stress, obviously energy production. You can run labs for all these things. I had to learn the hard way. And then of course there’s nervous system balance, you know, auto, the autonomic, I mean, in, I learned that from chiropractor.

Dr. Weitz:  You ever run micronutrients?

Reed: I have run micronutrients. I find them a little confusing because you don’t know if it’s a quantitative deficiency or qualitative, you know, a lot of people are eating that food. They’re not breaking it down and absorbing it. Right. So you’re not getting it in, into the system

Dr. Weitz: where you could test it.

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Dr. Weitz:  What is your general approach to diet and what sorts of dietary programs have you found to be the most effective?

Reed:  You know, the only one I found that works is the one that, it was called metabolic typing.  William Walcott’s, the founder of the, or the 40 years he’s done the research and I love that because it treats everyone as an individual. Is that the fast, slow?

Dr. Weitz: Is that the fast and slow oxidizers?

Reed: Yes. There’s fast and slow oxidizers, but there’s also autonomic dominance, sympathetic and parasympathetic that plays into it according to his system.  And I’ve done the test, the metabolic testing test. [00:29:00] I haven’t done it in a couple years, but I’ve done it over the last 26 years, probably 15 times. And I always come out the same. I’m a parasympathetic dominant and there’s a diet for that balances you out. You don’t wanna be overly parasympathetic.  Everyone knows about sympathetic dominance. It’s. That’s hell. But parasympathetic dominance is also a problem. And so,

Dr. Weitz: I’m actually not that familiar with parasympathetic dominance. Most people are so stressed. You don’t see too many people that are parasympathetic dominant. What is the parasympathetic dominant person like?

Reed:  Well, you know, the parasympathetics if you think about the tribal aspects there’s your warrior tribes, like in the jungles of South Africa or South America, you know, you got people that they live in the jungle. Everything around them can kill them, including their neighbors. So they’re very sympathetic dominant.  They’re just always on the alert. They’re in fight flight most of the [00:30:00] time. But you take your let’s say your Eskimos we’re always considered very parasympathetic. They can see for, no one’s gonna sneak up on ’em. They can see in a thousand miles in every direction, and they just eat a lot of meat and fat.  Very little carbohydrates and things. And so they’re parasympathetic dump. They’re just peaceful, relaxed people. They’re very steady. And I know this is true about me. I’m pretty hard to rile, you know, I have a calmness and it’s ’cause I’m in parasympathetic. They also, they call it the rest and digest. And so you’re very, you know, fast digestion and things like that.

So there, there’s a lot of physical characteristics and psychological traits, both along with your dietary likes and dislikes that matter. And so you can figure out the diet that’s right for you and fast and slow oxidation and in between is another great indicator. But sometimes [00:31:00] the nervous system will dominate the oxidative system.

Dr. Weitz:  So what do you do with, what do you do for a patient like yourself who’s a overly parasympathetic dominant?

Reed: I mean, you balance, you got, I got to not get too parasympathetic. You get kind of catatonic. Listen, every mother would understand this. If you look at the one kid can’t sit down, you know, he’s always bouncing off the walls and outside and playing and things like that.  Because he’s, you know, sympathetic dominant. And it doesn’t matter if he’s fast or slow. Oxidizer really, he’s a sympathetic dominant. The other one can’t get off the couch because everything. And so that one’s outta balance. Parasympathetically, you gotta feed that youngster more meat and fat because it just helps balance out.  It gives him more energy according to his type, you know, his dominance. And so. [00:32:00] You give a parasympathetic too much carbs and sugar and stuff like that, and they literally can’t produce energy.

Dr. Weitz: Oh, so it’s kind of like being a slow oxidizer. Yeah, exactly.

Reed: They’re very compatible. You feed them like a fast oxidizer.  So, I have a quick, real quick story. My cousin is a priest up in Canada. He was, he’s retired now, but he he must have been a bad boy in the priesthood. They sent him north to the to the Hudson’s Bay where his parish. We had two Cree Indian VI villages and the Cree Indians were known by the early settlers as they could work all day long.  They would hop around the rocks up and cross the ice and things like that. Very good hunters and trappers. And they had endless energy. They, that’s how parasympathetics are by the way. They’re like turtles. They can just go and go and go. So, you know, you just imagine you, it makes a lot of sense.  Your sympathetics more like rabbits, right? They get, they burn out, [00:33:00] they need to rest. They burn, they eat, they burn out and need to rest. Parasympathetics go all night. And so these Cree Indians who are basically parasympathetic, fast oxidizers when they were eating salmon and killing caribou and only eating seasonal fruits, nuts, seeds, what have you.

Blueberries, I remember ’cause I went up there a few times. They’re very healthy and happy and active and things. So when I asked my priest cousin, Hey, what are your native people there do for if they get sick? Like, do they go to a medicine? Man? So you know what he said? He goes, well, I’m their medicine man, you know, meaning the spiritual medicine man.  I said, no, if they get sick. And he said, read, they’re all sick. They’re all going to the clinic all the time. And why is that? Because they brought in, as they built, dug these mines and, you know, basically Euro came in and started bringing their donuts and their [00:34:00] spaghetti and their pizza and their stuff with them.  And when the native people started eating the crap, they completely fell apart, became huge consumers of alcohol and. Crap and depression. And

Dr. Weitz: like the story about the Puma Indians who were all alcoholic and diabetic and obese.

Reed: Yeah. He said, read, they’re all sick. And it’s because they stopped trapping and fishing.  And except for a few, you know, I mean, he went fishing and caught giant salmon and whatever. But the, when the diet changed, so that to me is evidence that they’re eating not according to their true metabolic, genetic, metabolic type. It’s very easy to see. And what’s really interesting to about this diet thing is, it’s such a great question.  So that’s the Cree Indians, which are like almost Eskimos, not quite that far [00:35:00] north but almost the natives of the Andes. Mountains down in South America who live above 8,000 feet, don’t eat hardly any meat and fat. They eat corn and potatoes, and yet they’re perfectly happy and fine. Why is that?

Well, it’s because they’re slow oxidizers and sympathetic dominant. You know, they can live that way. You give that diet to an Eskimo, it kills them. You give the Eskimo diet to a they’re called Kean, the Kean Indians, and they die. It’s just, so where are we? We’re, maybe we’re in the middle. So there’s a way to find out there’s no one diet right for everyone.  You have to find out the diet that’s right for you. Do use a questionnaire

Dr. Weitz: to figure out if you’re a slow or fast oxidizer.

Reed: There’s some, no, I’ve seen that test and I, if you’re having success with it, keep doing it. If it’s really working for you. The only layer you’d add is the sympathetic parasympathetic ’cause that can outweigh the oxidative [00:36:00] rate.  But ox start with oxidative rate. Eat the, according to the diet, which is gonna be a con the ratio of fats, carbs and proteins. So, a true fast oxidizer is gonna eat about 70% fat and protein. And a slow oxidizer would be kind of the opposite. They can eat a lot of vegetables, a little meat, and they’re fine.  So if you’re getting the test is in your energy level, your, sense of satiation. If you eat breakfast and an hour later you’re hungry or craving that wasn’t the right breakfast.

Dr. Weitz: And also, so, so how do you d how do you determine which type of diet is right for each person?

Reed: We do the mt diet.com.

So I just said, if everyone go to mt diet.com, have ’em take the test that tells you what type you are and give, so that’s an

Dr. Weitz: online yeah. Questionnaire.

Reed: Yeah, it’s, well, yes. And it sounds like, oh, that’s a questionnaire. It’s subjective. No, it, that’s very [00:37:00] objective. Questions like to your eyes dilate or does your skin turn red with certain foods and food groups, things like that.  So it’s very objective. It has been run for, it was run for many years next to an objective test, oxidative rate and things. And but that. Objective test is out the window. ’cause this test is cheap. It’s online and you can do it and get the results like within 24 hours or something. So I send everybody to mt diet.com and you know, there’s lots of education and things on how to eat, right.  Can’t tell you how many people I changed their breakfast and they couldn’t believe, oh boy, now I can make it to lunch without having to snack or crave or get tired or, you know, have less mental acuity. And, you know, you actually, life should be fun anyway. Right? Right. You eat right. If you eat right, you’re doing good.

So the other thing now, because there’s the investigation that [00:38:00] you’re very familiar with, you’re a good functional medicine practitioner. We were, we look at, the hormones, the immune system, digestion, detoxification, energy production, and the nervous system, the balance I just mentioned that spells heden, H-A-T-T-E-N.

And so it’s easy to remember. You can test for other stuff, but that’s, those are the, what I learned in all those years, running thousands of labs on thousands of people with the basics to start a foundational what lifestyle program? The D-R-E-S-S. So that’s the diet, metabolic timing, rest, which is, you know, not just sleep, but it’s resting your emotions and soul, so to speak, even during the day.

Diet, rest, exercise goes without saying, but that’s different for everyone too. I’m 72, I can’t do what I did at 40. I, that would kill me. [00:39:00] So, so, yeah, you just can’t do the I did jiujitsu and kickboxing for years till I got so hurt. I can’t do it anymore. And so diet, rest, exercise appropriately.

Then of course the D-R-E-S-S. So diet, rest, exercise. The two S’s are stress reduction and supplementation. I’ll start with supplements. You got to substitute What’s missing from food. You know, food doesn’t have all the nutrients in it anymore. The soils are depleted. You gotta take supplements, vitamins, minerals and ci, fat acids, antioxidants, trace elements, phytonutrients.

You, you need that genetically. It’s how we were born to be. And then stress reduction is huge ’cause it’s mental, emotional, psychospiritual, physical aches and pains. So kinda stress I have. It’s like I’m in pain a lot from injuries. Motorcycle. Kickboxing and stuff. I’ve had stem cells in both shoulders, both [00:40:00] hips, low back, neck, mid back, left knee, you know, so I keep trying to get outta pain and stuff, but there’s stress.

You have to reduce stress. Again, if it’s mental, emotional, like, you know, I haven’t worked for anyone but myself in almost 50 years. But a lot of people hate their jobs. They don’t like their relationships. They got money problems and stuff. So you have to reduce stress. You gotta know a few things.

Dr. Weitz:  What kind of an exercise program are you doing now these days?

Reed: Believe it or not, Pilates. Okay. And, you know, chiropractic and some aerobic, you know, I try to. Walk and I hike and I use my son takes me, you know, he taught me the summer how to do wake surfing, you know, and stuff like, right.  So, so just staying active is good enough for 72-year-old. And Pilates is really core strength, you know, so you, they say every old man has one good punch in him and [00:41:00] you better stay out of the way of it, you know, you better stay outta the way of it. ’cause if it comes, it’s coming hard. Right. You know?  But the diet, rest, exercise, stress reduction and supplementation, and I was talking about stress reduction. The chemical stress is the final. And I actually was in environmental law before I jumped into this business. I was saving the whole planet and decided, you know, after seeing enough dead fish and birds what about people?

So I literally just changed jobs, you know, I was healthy, but I didn’t want anything sneaking up on me. And a friend of mine’s dad passed away in 1999. And he, they, everyone said he was perfectly healthy. He was perfectly healthy. And then he drops dead and I go, no, you haven’t been, something snuck up on him, you know, that.

So I went to work for my son’s chiropractor. I just, I changed jobs like that, you know, he was in the middle of getting seven varsity letters in four [00:42:00] different sports, you know, from going to this chiropractic wellness center. I listened to those doctors in there and I was jazzed and I asked, could I work?

You know, Hey, I want to change jobs and work for you. That’s what started my whole thing, you know, Tony, what was it, 26, 7 years ago, I studied hard. I ran a lot of labs on a lot of people. 10 years I worked there and I sorted out the system. H-I-D-D-E-N-D-R-S.

Dr. Weitz: So, so when it comes to supplementation what supplements do you take daily?  What are some of your favorite supplements?

Reed: You know, I, I take a multivitamin which is, you know, all the. A, B, c, d, E, you know, all the things that you need. That’s supposed to be in food that isn’t. Also a mineral supplement. So the standard multi minerals are good. So vitamins, minerals. Now, when it comes to essential [00:43:00] fatty acids, you have a lot of choices, but probably the fish oil, crill oil, things like that work really well.

I stay away from seed oils like the plague, you know, I eat a lot of olive oil actually. And things like that. So then you’ve got your antioxidants, which are some are in the vitamins. The d and e. What are,

Dr. Weitz: what is some of your favorite antioxidants?

Reed: I’d say vitamin E, vitamin D vitamin E.

What form of vitamin

Dr. Weitz: E do you

Reed: like? You know, a mix Toco

Dr. Weitz: probably best mix the Carrols. We also have Tocotrienols. 

Reed:  These days. Yeah. All that stuff.  You know, I don’t have a brand of my own or anything like that. People say I should, I started long, long time ago and I studied nutrition, started working at the wellness center.  I went right into a, the boss was taking a diplomat program in nutrition for chiropractors and said I could go along [00:44:00] if and work on her patients in between, you know, school. And I had to jump on that, you know, so I, I learned a few things about nutrition supplementation and also learned that you can’t supplement your way out of bad lifestyle.  You can’t just take your same way. You can’t just take your metformin and eat a line key lime pie if you’re diabetic, you know, like, you know, you can’t medicate or supplement your way out of a bad lifestyle. So, you know, the whole dress program covers its holistic, there’s specialty

Dr. Weitz: and are there specialty antioxidants that you like?  A lot of people are taking berberine, resveratrol, quercetin. There’s a whole bunch of ’em out there.

Reed: I try everything that comes out and every supplement manufacturer, because I have 5,000 practitioners I’ve trained now, they think it’s gonna be a gold mine for ’em. They send me stuff, [00:45:00] I have stuff even just here on my desk, you know, that just people send me stuff.  And then my wife is also kind of an expert. She’s always got me trying things. So, I think food is your best source. I keep saying I’m going to eat right, and only make up for what’s missing those foods. So I eat all grass fed beef. We eat strictly organic you know, farm fresh farmer’s market type vegetables.

Again, you know, my advice is to marry someone who really cares about us. You know, and have them, you know, look at labels for you and shop for you and stuff like that. I do use a metabolic typing diet. Mostly I eat high levels of protein and fat and only good fresh carbs. I love vegetables and stay away from breads and things that make you fat, raise your blood sugar.

They aren’t good for my digestion anyway, and I don’t do dairy to too much. I’ll eat little cheese here and there, [00:46:00] but I haven’t had a glass of milk in 25 years or more. And so I try to find diet, but as terms of a, of an ex antioxidant, there’s some we don’t think about, like melatonin, believe it or not, is made in your gut.  Most of it’s made in the gut. It’s a great, yeah, absolutely antioxidant. So you find strange ways to, yeah. 

Dr. Weitz:  The integrative doctors who specialize in cancer are using two, 300 milligrams a day of melatonin, which is surprisingly good. Benefits.

Reed: Yeah. Might make you a little sleepy, but heck, you know, you’re recovering from cancer.  Who cares?

Speaker 3: Mm-hmm.

Reed: If you’re sleepy, right. It doesn’t. So, there’s the whole secret to FDN, what I call what we do. It’s just a name I came up with when I taught my first class back in 2008. I had to call it something. Until then, I was just nutritionist [00:47:00] and body worker working in a clinic who also ran labs.

I didn’t need a name. I just, only reason I developed the FDN system was for our patients, my clients, and our patients in that office. I had never thought I would teach Ben and. One day I got a call from this lab director. He said, who the hell are you? I go, I’m Reid. You know I work here. You know that.

He goes, no. I mean, who the hell are you that you run so many labs? I said, I don’t know. I just, I like it. He goes, no, Reid. He goes, you run more than our top five doctors combined. So whatever you’re doing, you should be teaching it. And the truth is, I was just so excited to be helping people run in labs, run labs, the right labs, and then interpret them individually so that you’re not, there’s no cohorts walking in your office.

They’re individual people. And so you treat ’em like that. And I got [00:48:00] some pretty good results and established this repeatable pattern what to look for and then how to teach that person. You know, it was really. Like I said, when I started I had a lot to learn. I had nothing to unlearn and I couldn’t diagnose or treat.

The doctors there would laugh. Ha. We can diagnose and treat. You have to actually figure out what’s wrong with them and teach them how to fix it. ’cause you know, you’re not supposed to treat either. If you don’t have a medical license, you can’t diagnose, you can’t treat. How the heck are you gonna help people run labs, figure out what’s really wrong, and teach ’em how to live themself out of.

What they live themself into primarily. Yeah.

Dr. Weitz: It’s amazing actually how many people are caught up in that whole diagnostic thing. You know, I get patients all the time going I, I’m trying to figure out what I have. Do I have this, do I have that? And, you know, yeah, sometimes I tell ’em, you know what, let’s call it [00:49:00] Mary.  It doesn’t matter what you call it. The bottom line is what’s going on that’s causing that problem? And what can we do to change your physiology to make things better?

Reed: That’s right. That’s right, Ben. There’s a lot going on. We call it metabolic chaos. That’s what’s going on. And the people who we had both types walking in the office, which you’re very familiar with back in the day, either they had fibromyalgia or they didn’t know what the heck was wrong with them.  It, this, I don’t know what they’ve had this diagnosis and that, you know, a lot of thyroid and hormone imbalances and you name it. But really it was, there’s a lot of causal factors. We try to take it all into consideration, and again, you can live yourself out of this, these chronic downward, spiraling, stress related conditions.

You know, it’s not good if you drive by victim, you know, you got shot. You’re not gonna call your nutritionist. Right, [00:50:00] right. You know, if you get off a off a plane from West Africa with a temperature of 105 and bleeding from your eyeballs, you don’t call me you don’t even go see your chiropractor.

You go get urgent care and get outta the woods, you know, then you can do some of what we work around the edges of some of those diseases until the, they don’t need the medicine anymore. That’s what it’s supposed to work.

So, what now you’re in Santa Monica you said, right?

Dr. Weitz: Yes,

Reed: sir. There are no sick people around there, is there?

Dr. Weitz: No. We’ve got our masks and our gloves, so we make sure we don’t get any germ exposure.

Reed: Yeah, I just bet. I just bet. So. Well, you know, the, what we try to teach Ben is that everybody should be in control of their own health. You know, like, that’s what blew me away when [00:51:00] I first started. I started studying anatomy and physiology and biochemistry and on and talking to the people coming in the office mostly for pain.  They were coming in for pain, right. And well it was the chiropractic office. Yep. Yeah, the chiropractic wellness center. We had acupuncture, massage, and. A bunch of modalities, you know, and things. But it was me doing the lab testing that developed this system that’s now f the n 26 years later.

But I couldn’t believe the people coming in had been to six or eight practitioners or 10 and weren’t better yet, you know, as a consumer and planet advocate, I’m just an advocate. I di I couldn’t, I said, you must be getting ripped off because how could you go to 10 people and not be better yet?

And the other thing was, why are you putting your health in someone else’s hands? So now if you need a chiropractic adjustment, you can’t do that yourself. [00:52:00] But the other stuff, you know, a lot of it you are in control of. And that’s our main theme is that, you know, you gotta watch out for yourself and your family.  So my whole education system is based on that self-directed, you know, once you get the labs run and find out what you’re supposed to do, then you’re supposed to do it.

Dr. Weitz: So how long does it take to become a functional diagnostic nutritionist?

Reed: Yeah the course is, it’s basically, I like to say, look, it took me 10 years to learn what I could teach you in 10 months or less.  It’s a self-paced course. And so, I’m not here to push the course, but it’s fun. It’s a lot of learning. For chiropractors, they’ve had some of the anatomy and physiology, but it’s a great refresher and and pick me up, you know, ’cause there, there’s a logical way to handle everyone coming in your office.  Now if you’re just doing sort of neck pain, back pain, which you’re not, but a lot of chiropractors are still [00:53:00] just neck pain, back pain. And they’re getting I don’t wanna say the word, but they’re getting messed around by, you know, the big franchises and stuff like that. ’cause how can, if you’re doing neck and back pain, how are you gonna compete with the average $17 adjustment that, that these.

These franchises are do plus you gotta be open seven days a week from nine to, you know, not nine to five, but from, you know, seven to seven. It’s unbelievable. What’s happened to the pain based chiropractor, you know, they’re getting squeezed and that’s a nice word for it. Word.

Dr. Weitz: Well, that’s been happening for years and years with all the insurance stuff.

Reed: Oh, that’s horrible. Yeah, I did it back in the day. The three Ds of insurance delay, deny and discount the three Ds every time you open up, you know, back then it was all you gotta open up, you gotta mail it in, you gotta open up the [00:54:00] envelopes, you get your your eops and it’s like they’re chopping you in half or they’re and that’s, if you ever get the eop, you know, if they ever even send you the check and then discounting you and.

Denying some Oh yeah. 

Dr. Weitz:  These days you’re lucky to get 30 cents on the dollar.

Reed: Yeah. See, so, so the wellness business is different. It’s all cash. That was the other thing that, that why I left that office after 10 years was I was doing better financially than any two doctors combined there. Just doing my own practice.  You know, I used to run the office and everything, right. And I couldn’t anymore. I was just out lecturing and getting new clients or patients you would call ’em. Right. And doing lab work now, that’s all I do and all I teach and that’s great. So let’s, chiropractors would do more of it. They could really expand if they would do what you’re doing, you know, do wellness.

Dr. Weitz: Right. So let’s bring this to a wrap. How [00:55:00] does how do our listeners find out about the functional diagnostic nutrition, where they go?

Reed: Yeah, well, we put a URL together for you guys. I’m just making sure I get it right. So it’s FDN training.com/ra. Rational Wellness. Okay. Rational Wellness. No. So F FDN training.

I, this name I came up with is Functional Diagnostic Nutrition. It was fancy. I was teaching my first class ever. Oh, that sounds great. Now I’m stuck with it. You know, the original 20 people, whoever took my course, wouldn’t go away. You know, it just, what about this? What more and more they wanted to run the labs.

It was a two day workshop. Now it’s a 10 month program, so you really learn it, do it on yourself, experiment, practice, and everything. And it, so, FDN we’re known affectionately as f dn training.com, rational [00:56:00] Wellness. And, that’s what I would, where I would send your listeners, if you wanna put that in your show notes or something, that’d be great.

Dr. Weitz: Okay. And if they use that code, they’re gonna get a discount. There’s nothing for

Reed: sale. They’re really, it’s just information. They okay. Yeah. There’s just get some information on it. Okay. Yeah it is a free booklet. I’d have to like, you know, I have a crew that kind of puts my notes together for me.  Okay. Yeah. It’s a behind the scenes access to our proven functional lab methodology, so we go through some cases for you.

Dr. Weitz: Okay. Sounds good. To help

Reed: your people.

Dr. Weitz: Well, thank you so much, Reid.

Reed: Hey, thank you. It is good to talk to you, Ben. Real pleasure. You got a great show there. And I know you’re helping lots of people up in Santa Monica and now across the planet, this wonderful worldwide web.

Listen, you’re not as old as me but Hightech for me was pagers and fax machines.

Dr. Weitz: Oh, yeah, I remember all that. I’m [00:57:00] 67, so I’m not too many years behind. Oh, man. You look good. Thanks, man. You look

Reed: great. Yeah.

Dr. Weitz: All right, so we’ll talk to you anytime. Okay. Thank you. Sounds good.

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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 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 set you up for a consultation for functional medicine and I will talk to everybody next week.

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Check out this episode!

Dr. Amir Vokshoor discusses Spinal Disc Replacement Surgery 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 Advances in Spine Surgery with Dr. Amir Vokshoor
In this episode of the Rational Wellness Podcast, Dr. Ben Weitz sits down with Dr. Amir Vokshoor, a board-certified neurosurgeon and chief of surgery at Providence St. John’s Health Center. They delve into the intricacies of back and neck pain and discuss the range of surgical options available, from traditional fusion surgeries to the latest advancements in spinal disc replacement. Dr. Vokshoor shares his journey into neurosurgery, the challenges associated with spinal disc issues, and how modern interventions like AI and neurofeedback are shaping patient care. The podcast also highlights the importance of pre-surgical and post-surgical rehabilitation, the evolving role of AI in medicine, and the innovative work at Dr. Vokshoor’s NeuroVella Brain Spa.
00:42 Understanding Back and Neck Pain
02:46 Meet Dr. Amir Vokshoor: A Journey into Neurosurgery
08:57 The Role of Intervertebral Discs
19:25 Innovations in Spine Surgery
29:52 Cumulative and Acute Trauma
30:12 Success Rates of Cervical Disc Replacement
30:53 Challenges with Multi-Level Disc Replacements
32:44 Patient Recovery and Activity Post-Surgery
34:23 Professional Athletes and Disc Replacement
38:15 Sacroiliac Joint and Surgical Options
41:35 Importance of Prehab and Rehab
44:59 AI in Spine Surgery
48:25 NeuroVella Brain Spa and Comprehensive Care
51:27 Contact Information and Closing Remarks


Dr. Amir Vokshoor is a board-certified neurosurgeon with more than 20 years of experience and Chief of Surgery at Providence St. John’s Health Center in LA, Dr. Vokshoor is internationally recognized for advancing minimally invasive spine surgery, spinal disc replacement, and motion-preserving technologies. His website is DrVokshoor.com. His Instagram account is drvokshoor. Use the Discount code BEN for a discounted consulation and MRI with Dr. Vokshoor.

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, on the Rational Wellness Podcast I generally speak about functional medicine topics, though I am both a functional medicine practitioner and a musculoskeletal chiropractic doctor. And today we’ll be speaking about back and neck surgery as an option for patients who fail conservative care, like chiropractic or physical therapy.  The most common forms of back surgery are microdiscectomy for disc herniations, laminectomy, spinal decompression, and spinal fusion, which is allowing to stabilize the vertebrae, but the newest procedure, spinal disc replacement surgery only accounts for a relatively small percentage of surgeries, only 1% of back surgeries and less than 14% of neck surgeries, suggesting that there’s been a very slow adoption of this procedure despite first being approved in the US in 2000.  Back and neck pain are very common, and while most cases of back pain will eventually resolve. Recurrence is common and a significant percentage of patients go on to have chronic pain.  Outside of traumatic injuries or conditions like cancer, most back and neck pain results from degenerative conditions and postural issues, including intervertebral discs that break down, tear or bulge or herniate out, spinal joints that become damaged, spinal nerves that become compressed or stretched, bone spurs, and shifts in spinal alignment. Surgery for patients with back or neck pain is particularly effective for radicular pain, which is when you have pain that radiates down an arm or a leg. But most patients who have back surgery will likely still have some future episodes of back pain, which is why surgeons like Dr. Vokshoor, who is our guest for today, have continued to search for better surgical methods since as minimally invasive surgical procedures and spinal disc replacement surgery.  Dr. Amir Vokshoor is a board certified neurosurgeon with more than 20 years of experience. He’s chief of surgery at Providence, St. John’s Health Center in Los Angeles. He’s internationally recognized for advancing minimally invasive spine surgery, spinal disc replacement and motion preserving technologies. In addition, he’s also the founder of the NeuroVella Brain Spa.

Dr. Weitz:  Dr. Vokshoor, thank you so much for joining us.

Dr. Vokshoor: Thank you, Dr. Weitz.  Thanks. Thanks for having me.

Dr. Weitz: So welcome to our podcast, and perhaps you can tell us about your journey and what made you decide to become a neurosurgeon.

Dr. Vokshoor: I love the name of the podcast, by the way, it really speaks to keeping a rational mind around health situations. Health events is extremely important and you know, I have a long journey, but basically it boiled down to I loved brain anatomy and neuroanatomy in medical school, and I loved the orthopedic aspects of bone and nerve health in the spine where they joined. So something about the segmentation of the spine, something about the way it was being treated really attracted me to learn as much about it as the [00:04:00] neuro and orthopedic structure and the function of the spine, but brain anatomy and how it connects to the spinal cord and how it’s like the central governor of all of our body energy really spoke to me. And, you know, we can go into details another time about exactly what led to becoming a neurosurgeon, but in a very short recap is I walked into the wrong operating room as a third year medical student, and there was a glistening white membrane, and it was the septum pellucidum of the third ventricle [of the brain].  And I, that week I had my first neurosurgical lecture by Dr. Paul Musilar about subarachnoid hemorrhage, and then we had another lecture about how drugs affected the brain. Right there, you know, walking in to the wrong operating room, looking at this white glistening membrane with a single vein behind it.  It looked like, oh, is that the eyeball? You know, and I was a student, so the nurse says, be very quiet. That’s the center of the brain. And right there I was like, oh wow. And something like came over me and I was like, you know, in the same week I’d heard about brain physiology, brain anatomy, here I was seeing brain surgery in person, and it really spoke to me.  And neurosurgery has really been a privilege in my life to be able to learn and practice and also try to see beyond its limits and where we go, where we fall short as neurosurgeons. So I have the, you know, utmost humility for the fact that, we have some very sobering conditions that we do not treat and we cannot treat yet very effectively.  Brain cancer being part of it, but even things like dementia, deep depression you know, there, there are chronic pain, there are things that we…

Dr. Weitz:  Yeah, a lot of neurogenerative conditions like Alzheimer’s and Parkinson’s… 

Dr. Vokshoor:  Exactly, precisely. So we haven’t made a meaningful dent in the treatment of those diseases.  And that’s why I want to continue to push the envelope forward in every way we can. And in the small way that I can, the NeuroVela brain spa is my answer to bringing you know, physiology and anatomy, which is our expertise, to psychospiritual levels and using meditation and frequency medicine and things of that sort in a way of biohacking affecting your nervous system in a positive way,

Dr. Weitz:  And we’ve been incorporating a functional medicine approach taught by Dr. Dale Bredesen, who’s been publishing about how that can sometimes be effective for patients with Alzheimer’s. 

Dr. Vokshoor:  Indeed, I’m a huge fan of Dr. Dale Bredesen. And I’ve spoken with him specifically about his methods and, you know, it’s like a breath of fresh air to really be like, okay, can we actually in our lifetime make a dent in these devastating disorders?  I, we formed a nonprofit research organization after my father contracted Alzheimer’s. It was almost like my gut reaction to the [00:07:00] ineptitude that we had exercised with billions of dollars poured into research dollars, you know, chasing wrong wrong data and, you know, erroneous data formats and bad, badly done research.

Dr. Weitz: Unfortunately that’s still going on. We’re still looking at amyloid plaque as the cause of Alzheimer’s and trying to come up with another drug to remove it. And now some of the researchers have switched from amyloid to tau as if that’s going to be the magic answer. And unfortunately, they’re not really asking the question is, why is this amyloid and tau proteins present in the first place and addressing that is going to be a really important part, even if part of the answer is getting rid of it

Dr. Vokshoor: Exactly. Exactly. I a hundred percent on board with that. And I feel like the amyloid, you know, I tried to picture this as a neurosurgeon, as my father is undergoing this ravaging disease inside his brain that, okay, you know, he has these myelin sheath that are perfectly connected, and then they get little potholes inside them, and those are the amyloid plaques.  And what these drugs are doing is just filling the potholes without really treating the disease. So we don’t know what’s causing the potholes, we’re just kind of trying to clear ’em up and that’s, you know, that’s why we haven’t really made a dent in it. Yeah.

Dr. Weitz: We think that part of the problem is that the amyloid is protecting the brain against inflammation and toxins and even infections, because now that we know that the brain is, that the brain blood barrier is not as tight as we thought it was.

Dr. Vokshoor: Indeed and there’s, you know, there’s great theories on infectious ideology and there’s definitely in Parkinson’s there’s an intestinal component that’s being investigated.  So I definitely feel more excited than ever that we are going to see some drastic discoveries come to fruition.

Dr. Weitz: Yeah. So, we’re going to talk about spine surgery and a lot of it’s about the disc. Maybe you can explain to us what is the intervertebral disc, what’s its purpose, and then what can go wrong with the disc.

Dr. Vokshoor: Yeah, so the intervertebral disc my most favorite subject matter because it really affects our structure, our physiology, and our psychology so effectively when it’s not functioning well. And so it’s basically this very low vascularity or avascular shock absorbing structure that’s between our vertebra, which act like brick supporters here actually happen to have a model here. So, you know, this is a glass shaped model, but basically the vertebra act like the bricks and the discs are these shock observers between the vertebra. And and then in the back we have the spinal joints, which are two on either side. So we have, you know, 7 cervical, 12 thoracic, 5 lumbar that are illustrated here.  And then sacrum, which is really a unified bone of 5 segments. And then the coccyx, the tailbone, which is a unified bone of 4 segments, or somewhat unified bones of 4 segments, is absolutely fascinating the way these structures come together and between each of the disc. Especially the ones that move for us, there is a working functional disc and in the neck you can imagine the shock absorption that goes on the extreme dynamic movement that goes on is due to the, you know, just the magic of C1/C2, which by the way, C1/C2 don’t have an intervertebral disc because they’re really specialized. Interesting vertebra. And you know, I would say our super subspecialty is in neurosurgery is knowing C1/C2 anatomy, you know, better than any other, especially surgically. And and then between two to seven we have cervical intravertebral discs in the thoracic spine.

Those distal move a lot because there [00:11:00] is a rib cage, but they do move. And as you know, there’s definitely some dynasty to that system as well. And sometimes in the thoracic spine, like our scapula, our shoulder blade motion is dependent on how mobile your thoracic spine discs are. And this is where the dynamic part of the system becomes really useful for hacking into it and decreasing pain and suffering.  And in the lumbar spine, we have shock observers between L1/2 and S1. Those essential discs are not only giving us shock absorption and structural integrity, they’re also giving us our curvature. So in the lumbar spine and the cervical, as a matter of fact it’s this parenthesis appearance of the of the lumbar vertebra.

This lordotic appearance, we call this lordosis of the spine, and you may have explained this to, to your audience at other times, but this structure, the structure of the disc in the lumbar spine being [00:12:00] a little wed shaped or lordotic is essential for a sense of. Uprightness wellbeing and painless motion during physiologic loads and due to trauma, wear and tear or sometimes infection or other ideology, the disc loses its height, loses its structural integrity, and begins undergoing this four stage generation to being completely gone, being bone on bone, sometimes filled with a little air, air particles or air VAEs, which is usually interesting to my patients. My patients are like, how did air get in there doc? And I’m like, good question. We’re still investigating that. ’cause some people think it’s a bacterial source. Some people think it’s just part of the degeneration, kind of a grade 4 degeneration of the disc, but these shock absorbing discs when they herniate out of their usual area, they can hit a nerve. So the spine is supposed to protect our [00:13:00] nerves, but if the disc herniates out of its original place, when a nerve is exiting the spine, the, it can be pinched by a herniated disc or a ruptured disc.

And we can certainly go through that terminology. But, that by itself usually causes arm pain or leg pain pretty severe. If it’s extruded and large, it causes massive pain. But if it’s, if it separates itself from the body completely and it’s just sitting there, this free fragment, what we call a free fragment, sometimes the body can chop that up really quickly.  And there’s always this controversy like, should we do early surgery, no surgery. Or wait and do surgery. And it’s a, it’s always a little bit touch and go. And, you know, I have a lot of conversations with the patient’s primary care or chiropractor or whoever referred ’em to me. And we always go through this workup of saying, okay, is there any nerve damage?

Is there a foot drop or is there [00:14:00] something that’s. Causing potentially permanent damage, and those cases were very interventional. Being a neurosurgeon gives you this immediacy to your mindset that, okay, nerve is under compression. We have to go take care of it. But if the weakness is mild or absent and there’s just a lot of pain, sometimes the body completely takes care of it.

You can avoid surgery, and it’s a, it is, it was antithetical to the size of the disc and the a disc fragment that could occur. But we see that in my 20 plus year career, I’ve seen that a lot. So being a conservative surgeon, my favorite thing to tell those people is, you’re probably going to pass this episode just fine with a steroid pack and maybe an injection and maybe some other types of medications and ice, et cetera.  But in your lifetime, if this shock observer becomes incompetent, means becomes bone on bone, then you may benefit from a disc replacement. And [00:15:00] I can get one of those models as well to show you guys. So, basically it’s an implant that then tries to replace the disc completely with. A, a metallic on plastic implant that moves, like the original disc does not absorb shock as much, at least this generation of the implants.  And it it doesn’t have I would say. Always the ability to give you the complete motion and flexibility back. Right. Especially in shock absorption.

Dr. Weitz: Okay. Before we go on to explaining the artificial disc, I want to make a couple of comments that I think are, yeah, you talked about the posture and the fact that we normally have this backwards curve in the lower back and the discs are aligned for that.  So the disc actually encouraged that backwards curvature, and I think one of the, problems leading to back problems that is often unrecognized is posture because we sit in chairs and people often sit with their [00:16:00] lordosis reversed. In other words, your chairs are soft. Your back actually curves the opposite way and studies have shown that sitting with your back slouch for as little as 20 minutes can cause the distal bulge or posterior ligaments to loosen up. And so I think one of the prevent preventative things is really important for people to be aware of that and to use some sort of lumbar curve. I specifically use these lumbar pillows that go directly.

To support that curve, and I think that’s super important for us to be aware of that if we want to keep those discs healthy and in the right place, we need to support that lumbar curve while we’re sitting. When you stand your back automatically arches and then precise. Second point I’d like to make is when patients have these discs that become damaged and bulge or herniate, what happens is that the immune [00:17:00] system attacks these discs because it’s seeing this piece of the disc in a place that’s not supposed to be, basically sees it as a foreign body like a bacteria or a virus and it attacks it, it sends these types of immune cells to gobble it up. It sends chemicals that create pain and. So a lot of the pain related to these disc problems is really just related to that immune process. And even without changing what’s happening with the disc, if you get that chemical process, that immune process, to calm down, then you’re, a lot of times the pain will go away.

Dr. Vokshoor: Indeed. No, I’m glad you mentioned those things because yeah, we didn’t go over the other things that happened. The chemical milieu of inflammation and then the macrophages actually coming and chopping up the fragment. Both of those being painful processes you’re absolutely correct.

Dr. Weitz: And over time, you know, [00:18:00] one of the thoughts is that the macrophages can come in and gobble up that part of the desk. It might actually resolve itself. The problem is how long is it going to take and can you withstand the pain till that happens, because it can be a long process?

Dr. Vokshoor: Yep. Yeah. We’ve, you know, we’ve seen trial after trials showing that, you know, surgical arms and non-surgical arms can be equivalent, but the surgical arms had like faster patient satisfaction scores and things of that sort because they get out of pain a little easier and they can go back to work and become functional a little faster.

Dr. Weitz: And there was a time that a procedure was being done to try to enhance the ability to gobble up those discs. They were injecting papaya enzymes into the spine, and that would dissolve the disc. Unfortunately, sometimes it would dissolve some of the nerves as well. Yes.

Dr. Vokshoor: Indeed. Thankfully those days are over.  We have a lot better tools. But that’s that, that’s an era from the past where we’re [00:19:00] experimenting with how do we change the chemical milieu there. Now we do numbing medicine shots or corticosteroid shots. And there are other techniques to, for the peripheral nerves to feel a little bit better.  I’ve even seen some chiropractors do like hydro dissection and things of that sort to just make the final pathway of the nerve feel a little better. All these things are meant to try to decrease the inflammation and make the nerves feel better while that actual healing goes on. Right.

Dr. Weitz: And so, the disc replacement is a replacement for fusion surgery, which is done much more commonly.  Can you explain what is fusion surgery, when is it indicated, whether the pros and cons of it? And then after that let’s get into the artificial disc.

Dr. Vokshoor: So, yeah, so discogenic pain is a huge participator in our overall disability score all across the United States and the world. So discogenic back and neck pain take away more productive hours of our [00:20:00] workforce than almost anything else.  And when you have disc pain, you just don’t feel well because the foundation of your body is unable to hold you up and have you doing most of your daily activities without pain. So in those cases, when the quality of life is so severely affected, then we actually contemplate, okay, what if we change the shock observer out for a new one?  And traditionally. We have had to put a, basically a bone wedge inside the area of the disc, the defect that’s caused by the disc being gone. This was initially done in the cervical spine successfully for by Dr. Klau and Dr. Smith Robertson Robinson. And those were little tiny dowels that they would put inside the neck discs.  Those were pretty successful, except we realized that a percentage of those patients continue to have problems at the adjacent level discs. So because the fusion did [00:21:00] such a good job eliminating motion, then the other disc would work harder and presumably wear out a little faster.

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Dr. Weitz: I’ve really been enjoying this discussion, but I just want to take a few minutes to tell you about a product that I’m very excited about.  Imagine a device. That can help you manage stress, improve your sleep, and boost your focus all without any effort on your part. The Apollo wearable is designed to just to do just that, created by neuroscientists and physicians. This innovative device uses gentle vibrations to activate your parasympathetic nervous system, helping you feel calmer.  More focused and better rested among the compelling reasons to use the Apollo wearable are that users experience a 40% reduction in stress and anxiety. Patients feel that they can sleep. Their sleep improves up to additional 30 minutes of sleep per night. It helps you to boost your focus and concentration and it’s scientifically backed.  And the best part is you can get all these benefits with a special $40 discount by using the promo code Weitz. W-E-I-T-Z, my last name at checkout to enjoy these savings. So go to Apollo Neuro and use the promo code Weitz today. And now back to our discussion.

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Dr. Weitz:  Let me just jump in real quick, so, yeah, whenever you’re going to bend or rotate you, each of your vertebrae are going to participate in bending a certain amount. And so if you talk, think about the five lumbar vertebrae and now you fuse L4/L5, you’re still gonna bend over to tie your shoes. And now the disc at L5/S1 below the area that was fused, or the disc above it, is going to be under a lot more stress because instead of say each of those levels participating five or 10 degrees some of the other levels have to move more to allow you to still be able to tie your shoes.

Dr. Vokshoor: Precisely and so if you think about how the spine was designed originally. It’s supposed to give you coupled motion. So at each segment you have a disc between two vertebra and two joints in the back, but they’re also talking to their buddies and they’re sharing the load. So if there are five of them sharing the load, it’s less load on each one of them than on one.  So if one of them checks out. There’s more load on the other four if two of them are fused. There’s mo more load on the other three, and this happens in the lower back, happens in the mid back, [00:24:00] happens in the neck. And that phenomenon of adjacent level degeneration has been well, well studied. So thankfully in the recent years, I would say at least 10 years, we have the advent of being able to replace the discs.

With mobile discs. With mobile devices, not just fusing them with a wedge of bone or a wedge plastic or a titanium implant. And in the lumbar spine, we went through this tiny little hiccup where the initial disc implants didn’t work that well. They would move too much, they would move too little, they would spit out, they would do they were hypermobile, et cetera.  And sort of very first generation implants. I mean, we can go way back. But there they were, thought they were thought of as these little balls first, and then the early two thousands we had, 

Dr. Weitz:  They were like metal ball bearings?

Dr. Vokshoor: Right, right. That was the original thought. And you know, they actually did okay for a while, but they weren’t studied very well.  We didn’t have this incredible system of doing very good [00:25:00] randomized controlled trials. So in the early two thousands I believe Johnson and Johnson actually put a very good effort in creating the cite disc and teaching everyone how to do it, et cetera. But the device was just not that good. It was a little hypermobile.  It was a French device company that initially came up with it from CTE Hospital in France. It just it just didn’t work out. So again, the fusion bandwagon, which is sort of like the equivalent of, you know, big pharma in our industry they were like, see, like this stuff doesn’t work.  And we were so hopeful. We were so hopeful that we can finally do what orthopedic surgeons do on the hips and knees every day. They say, here is your hip back, you know, with motion. Thank you so much. I brought you some models just in case we wanna review them. Thank you. Okay. So, so in, in essence, you know, the first generation lum artist that didn’t work gave rise to much better engineering, much better design.  So finally we have an implant now called the pro disc l that has been [00:26:00] approved for up to two levels in the lumbar spine and it’s a very stable device and it moves. And it gives you your curvature back. And so it’s the best device we have in order to replace the discs that are abnormally degenerated in the lower back.

Dr. Weitz: And what is that made of? And then how does it allow motion? And then how do you keep it in place?

Dr. Vokshoor: So it has these, so here’s the device. I hope we can zoom in on it to see it. So this is the actual device, okay. And it has these little fields that go into the vertebrae to keep it in place. Okay? But center, the center of it is indeed a polypropylene or plastic.  And the end plates, the ends of it are metallic, so the ends of it me mend with the bone, almost like fused to the bone above and below, and then the plastic part moves in the center, which is, you know, for the first time we’ve been able to mimic some of the physiologic motion surgically, [00:27:00] which is so exciting.

Dr. Weitz: And does that plastic wear out over time?

Dr. Vokshoor: No. So these are high grade polypropylene that have withstood 20 million cycles of fatigue. So they’re like medical grade plastic, so they don’t wear out in a human lifetime. Interesting. Yeah. Yeah. And the part of the body that has had a really good blessing from artificial disc replacement is the neck that didn’t even go through that hiccup from the very first generation of artificial discs, the neck.  Reacted much easier, and it’s a very natural area to restore motion. And I would say we’re probably the most frontier arthroplasty surgeon as far as disc replacement in the neck because every time you’re putting a disc replacement in the neck, you have to make sure that the joints in the back of the neck are not too arthritic.  And the neck has really interesting. This is a model of the cervical spine, another glass model. [00:28:00] And this is an example. A disc in the cervical spine.

Dr. Weitz: Okay.

Dr. Vokshoor: Where it’s also has the metallic end plates and the plastic in the center. And what’s fascinating about the cervical spine is that it’s a five joint complex.  It’s a disc in the front, two little UNC or vertebral joints on either side, and then two facet joints in the back. Huh. So that’s what really gives us all of this dynamic motion is an absolute. Fascinating structure to study from a design standpoint. And so the disc replacement in the neck can be used to reanimate three of those five complexes.  Huh? So, so if the joints in the back of the neck are not. Fused on their own or severely arthritic in a way that the neck just doesn’t move correctly, which we can check with x-rays and CAT scans. If it hasn’t fused or if it’s just a little bit arthritic, you can still get a disc replacement in the neck.

[00:29:00] And even if you have abnormalities of the, those two other side joints called the unco-vertebral joints, which are right on either side of the disc right there. So it’s really fascinating. So in, in my practice, we’ve been able to reanimate motion segments that, you know, in the in early arthroplasty days would be deemed impossible to give someone motion back.

And it’s absolutely fascinating to see how life wears out something and how you can reverse that. I call it the the spine rejuvenation surgery because you literally get years of life back after your spine has decided to, you know, look this way because of a degenerative cascade or trauma or car accident or playing football as in high school, like, being a truck driver.  I mean, I’ve seen it all. Some of it is. Cumulative trauma of life, and some of it is acute trauma due to an accident or something of that sort. Both of those can lead [00:30:00] to the same place, and this replacement has been our mainstay of giving people motion back, which is so extremely exciting.

Dr. Weitz: What do the studies show about this success rate?

Dr. Vokshoor: So we now have seven and even 10 year data from the cervical disc replacement. It shows not just equivalence, it shows superiority to the art of to the previous fusion, especially more than one level. So, if you imagine the cervical spine is supposed to move, let’s say you have three levels that are.  Abnormal and de herniated and degenerated yet, let’s say you need a three level disc replacement. Can you imagine what a three level fusion would do to the moment arm of a flexible neck? Sure. So, so as you get more into, you know, like higher age groups and more levels, degenerated. We need even better technology.  ’cause like currently, FDA is o only approved up to two level disc replacements. And some of that is because [00:31:00] the research studies are expensive and the companies that make these discs don’t have the bandwidth to put yet another randomized controlled trial to get a three level approval or four level approval.  So unfortunately we get into a sticky situation where. The insurance doctor is telling me, no, you can’t do more than two levels artificial discs. And we have to either do a hybrid construct, use a fusion, or simply tell the patient we can only do two at a time because of your insurance. Which is an absolute travesty in my humble opinion, that American healthcare has to even go there, you know?

Dr. Weitz:  So yeah.  Unfortunately this topic comes up a lot. Yeah, and I think so many consumers don’t realize that insurance companies really call the shots in the healthcare system in our country.

Dr. Vokshoor: And so, we need to really band together and get the FDA to study multilevel disc replacement as an option.  And I think that will happen. But currently, you know, even though our practice is known for. Even three or [00:32:00] four level disc replacement in the lower back and the neck. Currently we, based on FDA guidelines, we stick to one to two levels in most circumstances, unless it’s an extreme circumstance. And we’ve seen incredible results.  So compared to fusions, the cervical disc replacements are not just equivalent, but superior. The lumbar spine data is a little bit more. Dicey. I wouldn’t say it’s as clear cut. Most of the reason for that is the initial hiccups in lumbar disc replacement are also included in that data. So, you know, I, a lot of my colleagues say disc replacement just doesn’t work that well in the lumbar spine, and that’s just not true.  In my experience, that’s absolutely not true.

Dr. Weitz: So what are the after, let’s say a patient has disc replacement in the lumbar, what are the limitations? Can a patient go back to sporting activities? Can they do heavy weight lifting?

Dr. Vokshoor: So I would say my goal is to [00:33:00] have you at a hundred percent by three months.  If you know, kind of extrapolate, that means 50% in six to eight weeks. That means 25% in, you know, two to four weeks. So it’s like we do want this gradual increase of your activity. At the same time, depending on how long your symptoms were going on, how tight your muscles got as a result of your disc degeneration, how much of intervention we have to do to restore the height and the lordosis of each disc.  There can be longer. Recovery periods, and we have to be very realistic about that. I feel like, you know, you have to form a bond with your patient. You have to say, this is a marathon that we’re gonna traverse and you’re gonna be happier as a result of doing it in the long run, but we have to respect your physiology.  Some people he’ll super fast and are lifting Weitz and one week in the gym, that’s usually they’re younger, their muscles are more, more able to adapt, they recalibrate easier. Some people are, you know, a [00:34:00] month out and they’re still having some stretch nerve sensation in the back because we have stretched the spine to give it your original height.  You do get taller as a result of the operation most of the time.

Dr. Weitz: So, it may take some time, but they can go back to. Playing tennis, playing golf, lifting weights? They don’t have to worry about this thing coming loose or moving?

Dr. Vokshoor: We have professional athletes that are doing the highest level intensity.

Dr. Weitz: You can go back to professional athletics?

Dr. Vokshoor:  Yes, absolutely.

Dr. Weitz:  Can they go back to football?

Dr. Vokshoor: Yeah, I mean in the cervical spine there’s some recommendations as to what levels and for what cause you had it. So the cervical spine you’re protecting the spinal cord at all costs and spinal cord events, especially with settings of high head contact sports, are something that the physician has to consider I’m very sensitive to. Brain and spinal cord injury. So those are a bit [00:35:00] individualized, but in a lumbar lower back disc replacement, going back to any level of high intensity activity is definitely doable.

Dr. Weitz: Cool. Yeah, I think I remember one of the professionals, I think it was Darrell Johnston, he was like, a fullback for Dallas and I think he had a cervical fusion and went back to playing

Dr. Vokshoor: exactly. Exactly. And we always hear about the ones that, you know, that had a difficult time, you know, like had redos Yeah. And like Peyton Mannings of the world, et cetera. But no. Clearly I think the dynamics have changed and I think now we can finally restore spinal motion.  Yeah. To way it was supposed to be.

Dr. Weitz: Yeah. I think Tiger just had to have another fusion surgery.

Dr. Vokshoor: Yes, I did. I did hear that as well. And I think you know, it’s that’s why your index surgery matters so very much your index surgery,

Dr. Weitz: meaning, meaning if you get a fusion, you’re not then gonna be able to get a disc replacement.  Once you get that, you’re pretty much at the end of the line, right? 

Dr. Vokshoor: You can get a, you can get a fusion if it’s absolutely indicated due to instability or just severe arthropathy, or things that are, things that make a fusion absolutely necessary are gross spinal instability like a fracture, dislocation.  Sure, you know, but you can get a disc replacement above that fusion in the future. That needs to be considered. Right. But I think the, in by index surgery, I mean, no bridge is burned, so you can’t unuse a spine. Right. Right. But you can always go to a fusion from a disc replacement. 

Dr. Weitz:  Yeah. That’s what I was, that’s what I was trying to say.  Yeah. Exactly. So why isn’t this procedure being done more frequently?

Dr. Vokshoor: Yeah, so in the lumbar spine you do need access to a surgeon. So in Los Angeles, we enjoy having like the best of the best in class access surgeons, which are vascular surgeons that help get to the spine, to a minimalistic approach from the, from a belly incision, you know, very small belly [00:37:00] incision.  That’s, you know, done very routinely in LA, New York, other parts, but not, and not all throughout the country. And and in the cervical spine. I think it is being adopted more and more. There is insurance blocks and there’s also this like, learning curve of the surgeon’s comfort level. What I was talking about, reanimating different parts of the cervical spine.  I think that by itself, you know, I am now, I would say at this sweet spot of. Calling myself, you know, a masterclass competent surgeon. But that takes a while to develop and you have to be honest with your abilities. And I think every surgeon should be honest with telling the patient in my hands, this is the safest procedure for you.  And I think that’s the most important thing. So I think there’s an evolution of understanding. The pathoanatomy and the structural characteristics of each disc, each bone end plate, and then making the intraoperative decision to correct the [00:38:00] anatomy perfectly. And this is where I think the cervical spine is like a Swiss watch.  You’re, you know, you’re the more gentle but methodical you are with your methods, the better chance you have of restoring emotion with a cervical disc replacement.

Dr. Weitz: There’s one more set of joints we haven’t mentioned, a set of spinal joints that I want to ask about. What about the sacral lilac joints?  Is there a way to surgically repair a sacro lilac joint and still preserve motion?

Dr. Vokshoor: That’s a fantastic question. You know, the sacroiliac joint is a very important joint because it transfers the. All the load of the lumbar spine to your hip joints, right? So it’s like this, it’s like this interface joint that’s ever so important.  And even though it doesn’t move much, it moves in a very certain way. It’s actually that. 

Dr. Weitz:  And as a chiropractor, we [00:39:00] move it all the time.

Dr. Vokshoor: Exactly. So I love the term nutation, which right is what it does. And you know, lately there’s been this surgical procedure called sacro, sacroiliac joint fusion for the treatment.  Let me just stick it like a rod in there. For the treatment of atypical sciatica. I’ve been studying this procedure for some time. I spent time with some of some pelvic surgeons during fellowship and early years post training to really figure out whether sacroiliac joint is the way to go in those atypical sciatic patients.  And I remain skeptical as to the surgical fusion ability to eliminate that. Pain and I may be in a minority in spine surgeons and I certainly have a lot of respect for the data that’s come out in randomized controlled trials that show some benefit to sacroiliac joint fusion. But I would actually rather go the chiropractic route for a pure isolated sacroiliac joint problem rather than a surgical route, and this is coming from a surgeon that loves doing surgery. You know, and I love, you know, getting people out of pain and decompressing nerves. I think diagnostic injections in a sacroiliac joint are very nuanced and where you can get the injection or some people try different ablation maneuvers.  I think all of those things are of value. I do think in certain deformities and scoliosis cases, et cetera, when you’re having to fuse the spine, then the sacroiliac joint needs to be considered as going bad next. If you haven’t included it in your construct, it could go bad really rapidly.  There’s also conditions like ankylosing spondylitis and other conditions like that where the sacro ileitis is so severe that any motion of it is gonna hurt. In those cases, I think there is surgical solutions such as SI joint [00:41:00] fusion, but in most normal, atypical sciatica cases that I see. I send them to a soft tissue specialist rather than a surgeon to treat those pains.  And, you know, and this is an ongoing debate that I’m happy to expand to, you know, people that may disagree with me. ’cause I think one of the most important things we need to. B, as you know, clinicians slash scientists is honest with our outcomes, our real world outcomes, and in my practice I haven’t seen that much benefit from treating atypical sciatica with an SI joint fusion.

Dr. Weitz: How important is rehab and prehab if possible?

Dr. Vokshoor: So, so glad you mentioned that. Yeah. I would say both prehab and rehab are ex almost as important as the surgery and you know, like hip mobility, if you’re gonna do something to the lumbar spine at L five, S one, L four five. Regaining hip mobility, assessing hip mobility, even [00:42:00] having, even knowing about how the word a patient’s hips are in relation to the lumbar spine during standing, during sitting using dynamic x-rays and scoliosis.  X-rays is really important. Rehab should be multifaceted. Multimodal, so mentation, nutrition, exercise program, sleep hygiene, pain control. And the flexibility of the spine all need to be assessed and optimized prior to surgery.

Dr. Weitz: How important are pre and post surgical nutrition to ensure proper repair and recovery?

Dr. Vokshoor: Yeah, I mean we’ve had, so one of the, one of the only things that in artificial disc has been very challenging is patients that are older and have osteoporosis. So if you have osteoporosis, even if you’re on supplements you may have defects in your bone or weaknesses in your bone that may surprise your surgeon during surgery or afterwards.  There can be settling [00:43:00] of the implants, et cetera. So it’s really important to have good bone and nerve health. Both preoperatively and then continue that postoperatively. And there are some of the hardest tissues in the body to heal is your bone and your nerves. So I think to have a good grasp of that, to get hormonal control, physiologic control of your bone and nerves health.  Prior to surgery is absolutely essential. And, you know, we can go into a whole didactic about the microbiome and what your intestinal flora are you know, essential for, and your healing, your mood how the brain connects with it. So, yeah, absolutely. It’s a huge part of my practice is to figure out.  Where the weaknesses of someone’s entire physiologic picture is, and then using best in class experts to optimize those prior to an intervention.

Dr. Weitz: Yeah, I know all about bone healing. I actually had a traumatic femur fracture at the end of 2023. Had surgery [00:44:00] at St. John’s and afterwards ended up having a non-union.  And, was facing recommendations for additional surgery, but found a way to get it to heal without that. Wow. In my case, that’s surprising. I used the combin. Yeah. For some reason after the surgery, there was a gap. And how did you heal it? I used the combination of, well, first of all, high dose vitamin D, MK four.  I used Forteo injections daily for five months. Human growth hormone two IUs, five days a week, and a bone stimulator.

Dr. Vokshoor:  Wow. Excellent.

Dr. Weitz:  I did that for five months and now I’m a hundred percent. 

Dr. Vokshoor: I love it. I love it. That’s, you know, that’s a fantastic example that Yeah. You know, physiology, there’s structure, there’s function, and there’s psychology.  All three have to go well together for a spine surgery to, to succeed. Yeah. So, yeah. Glad you healed up.

Dr. Weitz: Thanks. How [00:45:00] is AI playing a role in your care?

Dr. Vokshoor: Yeah, it’s actually you know, I use an AI assistant almost daily now for almost every visit that I do as well as every note that goes into the chart.  There’s an AI way of making sure that the note contains the essential format. But what’s what I, where I’m really excited about AI is. You know, the outcome from spine surgery has been quite variable. And sometimes a study comes out that’s done under perfect conditions. ’cause those conditions are so controlled that, you know, they’re like, this device works because under these perfect conditions, we got it.

You know, 90%. Positive outcome, but in the real world that is not observed all the time. So one of the best services of AI in research engines and registries is actually putting all that data together and telling us accurately how successful intervention can be so we can inform the patients. [00:46:00] That’s occurring in deformity surgery right now, where, you know, Medtronic and a couple other major vendors and have come up with innovative ways of saying if we give someone spine criteria, their curvature, their height, weight, bone density, et cetera, all this information through X-rays and other imaging modalities to an AI engine, can they recommend to us the best intervention.

So the first generation of those things are about. As you guessed it, spinal fusion surgery. But I look forward to that being applied to every spinal intervention, including soft tissue care, chiropractic care, injections micro endoscopic approaches and things that are much less invasive. And of course, disc replacement.  So. Our measurements of X-rays have been static in the spine for too long. With ai, we could make those measurements, real world measurements, and there’s a DY dynamic portion of the spinal [00:47:00] motion that will be studied better with AI because there’s a lot more information going into it. You can get a static lordosis.  Or you can say you’re this degree of lordosis and sitting, this degree of lordosis standing, this degree of lordosis and running, this is what the hips are doing. All of that information could be in, in a very smart AI engine, and then inform the patient and the practitioner to make the best decision.

Dr. Weitz: Is AI gonna take your job anytime soon?

Dr. Vokshoor: As a neurosurgeon, I’m not that worried, but I have seen it do some amazing things in I work with some urologists in our hospital where we do tumor work. You know, getting the tumor in the, in retroperitoneal areas. I’m only there to protect the nerves and get it off the nerves.  But the robot is pretty amazing and I think in neurosurgery within our lifetime. I mean, you know, in, in Neuralink it’s already able to create a bur hole. But it’s not able to do other little finer [00:48:00] things yet. I don’t, you know, I don’t quite know, but I’m not as scared of some other people are.  I think I, I’m a believer that we need to use technology for good use. Just like what happened to radiation therapy. What happens to almost every great innovation? I mean, every great innovation has pros and cons. And in the right hands it will be used for improving people’s health, and that’s truly my belief.

Dr. Weitz: Great. Did you want to talk a few minutes about your brain health centers?

Dr. Vokshoor: Of course. Yeah. I really appreciate the opportunity to talk about NeuroVella Brain Spa, which was my sort of. My answer in saying, okay, how? How are we not providing a comprehensive care for some of our patients, especially chronic pain patients?  So we have this traumatic event called surgery. We know that it’s going to happen on this date. Why aren’t we not studying the effects of this trauma on the nervous system pre and post to improve the entire [00:49:00] ritual, the entire journey, so to speak. So the surgical journey, is being studied very intensely at the NeuroVella brain spa.  And then, you know, I also thought about the vacuum that happens with patients that are suffering from concussion, depression, dementia, even early dementia, that they have nowhere to go. Literally, there’s a vacuum in healthcare. And so the thought was, I think humanity is gonna need deans. Brain centers where they have a responsible neuroscientist, neurosurgeon, or a team of experts that say these are technology biohacks that work such as certain frequencies sound light.

We have so much now at the brain spa, we have, you know, we’ve dabbled into the world of neurofeedback to try to really re rewire the brain through the way that the network can relearn there. They’re sort of habits and there’s some incredible [00:50:00] frequencies of vibration and sound and light that work on the nervous system.  So that’s in a nutshell what the Brain Spa is doing. Very non-invasive neurotech with a meditative. Component that doesn’t doesn’t have to get, you know, super spiritual, but it definitely borders on the psychospiritual health as well. And there’s a whole other, you know, wing of it that’s being developed, including psychedelic research, psychedelic assisted therapy.  And that’s where, you know, that’s most likely where we’ll be going in the next few years under some regulatory control and research.

Dr. Weitz: You want to get even better results. We’ll put the patient through a full breent type functional medicine protocol, get rid of, you know, balance out their nutrients or hormones, get rid of the various inputs into neural inflammation and then put ’em through the various inputs into promoting a healthier [00:51:00] brain, and you’ll get even better results. 

Dr. Vokshoor:  A hundred percent

Dr. Weitz: agree with you.

Dr. Vokshoor: I think that’s the brain spa is it is based on electricity, chemistry, and plasticity. Right. And you just mentioned the chemistry part of it, you know, that it what are the markers of neuroinflammation?  Where is your PTA, where’s your, you know, other markers that we could potentially, you know, improve? So a hundred percent.

Dr. Weitz: How can listeners and viewers get in touch with you? What’s your contact information?

Dr. Vokshoor: Yeah. So our I, you know, I love input from the audience and please do follow us and subscribe.  And I love this, the Rational Wellness podcast, and I think, you know, you’re bringing a very important service to the audience. Thank you. I’m at dr vhi.com. D-R-V-O-K-S-H-O-O r.com. I’m also at Dr. Vhi at Dr R-V-O-K-S-H-O-R on Instagram, Facebook, LinkedIn. And our office number [00:52:00] is 808 9 9 0 1 0 1.  And yeah, I look forward to hearing from the audience and being of service and your audience can, plug in a discount code for our yeah, I was just gonna

Dr. Weitz: mention that if you use the code BEN my first name and you get a consultation and an MRI with Dr. Vokshoor, you’ll get 20% off the fee. Indeed.

Dr. Vokshoor: Yes. Code BEN

Dr. Weitz: code, Ben,

Dr. Vokshoor: use it. That’s great. Thanks. And we’ll get a discount. Hey, thank you so much for having me.

Dr. Weitz: Yeah, very nice to meet you.

____________________________________________________________________________________________________________________________________

Dr. Weitz:  Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would very much appreciate it if you could go to Apple Podcasts 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 set you up for a consultation for functional medicine and I will talk to everybody next week.

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Check out this episode!

Dr. Pejman Katiraei discusses Neurodevelopment Disorders in Children 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

Uncovering the Root Causes of Pediatric Neurodevelopmental Disorders with Dr. Pejman Katiraei
In this episode of the Rational Wellness Podcast, Dr. Ben Weitz interviews Dr. Pejman Katiraei, a board-certified pediatrician and integrative functional medicine expert. They discuss the increasing prevalence of neurodevelopmental disorders in children, such as autism and sensory dysregulation, and explore the interconnected systems contributing to these conditions, including gut health, immune imbalances, and environmental toxins like mold. Dr. Katiraei (Dr. K) explains how he evaluates and treats children using a systems biology approach and highlights the importance of addressing environmental factors to improve quality of life. The episode provides insights into specific tests, detox strategies, and the role of microglia and mitochondrial health in managing these disorders.
00:29 Meet Dr. Pejman Katiraei: Pediatrician and Functional Medicine Expert
00:53 Understanding Neurodevelopmental Disorders in Children
02:50 The Role of Mitochondria, Immune System, and Gut Health
06:06 Environmental Toxins and Their Impact on Children’s Health
11:20 Microglia and Neuroplasticity: The Brain’s Immune Protectors
16:43 Early Signs of Neuroinflammation in Infants
25:20 The Connection Between Gut Health and Neurodevelopmental Disorders
29:41 Energy Efficient Homes and Mold Issues
30:05 Building Standards and Mold Problems
30:36 Health Impacts on Children
31:01 Alternatives to Drywall
31:41 Environmental Standards and Mold Testing
32:42 Impact of Climate Change on Mold
33:25 Testing for Mold Exposure
34:36 Case Studies and Clinical Suspicion
44:08 Effective Detox Strategies
53:47 Conclusion and Resources


Dr. Pejman Katiraei is an Integrative Pediatrician and his Santa Monica practice is called Wholistic Kids and Families.  He got his undergraduate degree from UCLA and he obtained his osteopathic medical degree from Western University and completed a pediatric residency at Loma Linda University and he has also completed two fellowships in integrative medicine.

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. Pejman Katiraei. Did I pronounce that correctly?

Dr. Katiraei:  You got it perfectly.

Dr. Weitz:  Alright. A board certified pediatrician, an integrative functional medicine expert who specializes in uncovering the root physiological drivers behind the behavioral and neural development disorders in children.  Our focus today is on the interconnected systems that contribute to neurodevelopmental disorders, regression, sensory dysregulation, including gut health, immune imbalances, mast cell activation, mold and environmental toxicity, mitochondrial dysfunction, and neural inflammation. We’ll explore how Dr. Katiraei, if it’s okay, I’ll call you Dr. K–I’ve heard a lot of others call you that…

Dr. Katiraei: Pejman is fine too. I’ll be both.  We’re all just people.

Dr. Weitz:  Whatever you prefer. Evaluate children how he evaluates children through a systems biology lens, and how addressing hidden physiological burdens can dramatically improve function, behavior, and quality of life. Dr. Pejman Katiraei, Dr. K, is a board certified pediatrician.  He completed undergraduate work at UCLA. I also went to UCLA and then obtained his osteopathic medical degree at Western University. He completed a pediatric residency at Loma Linda University, and he stayed on as a teaching faculty for over four years. He’s completed two fellowships in integrative medicine and he’s got nearly two decades of clinical experience helping children with severe learning and behavioral challenges, and he’s in private practice in Santa Monica. Dr. K, thank you so much for joining us.

Dr. Katiraei:  Thank you for having me. It’s a delight to be here.

Dr. Weitz:  That’s great. So we’re seeing an epidemic of neurodevelopmental disorders and pediatric mental health challenges today.  What do you think are some of the factors that are driving this?

Dr. Katiraei: You know, it’s certainly a hot topic, right? And there are a lot of people asking questions and obviously no one knows the exact answer. I think when you step back and say, what is underlying a lot of these neurodevelopmental, behavioral challenges that children today have and it’s everywhere. And you know, a lot of providers, and I don’t know if you’ve seen it but a lot of providers that I talked to have seen even in the last five years, that there’s been a spike in the prevalence and severity of these neurodevelopmental challenges.  So when we step back and say, well, what the heck is driving this? You get down to basically, in my opinion, three core systems that, that are kind of the pillars of either allowing fantastic and optimal mental health to be there versus a lot of challenges. And that is the mitochondria, if you want to consider them a system, the immune system, and then the gastrointestinal tract. To me, those are the three pillars that when they become disrupted or distorted in whatever way, they then create multiple cascades of events in physiological abnormalities that then lead to, you know, presentations that look like [00:04:00] autism, right? Where the child is having difficulty socializing.  And you know, one of the challenges I have is a lot of times I see children given that label. But they’re able to make eye contact. They’re able to talk to you like they’re able to interact. But when you ask the parents, well, why did they give your child this label? They say, well, you know, he struggles socially because in school or other environments, he won’t interact with the kids.

Sometimes he does kind of little strange things. And you know why I bring this up is the challenges that are now presenting in the children have become. In some ways so complex that we just keep coming up with new labels. Right? And it seems like every year or two, there’s like some new label that we are coming up with or a diagnosis to explain what these kids are having.  But when you step back and say, why do these children behave the way they do? It boils down [00:05:00] to usually there’s a lot of neuroinflammation, right? Inflammation in the brain that is causing weird abnormalities and how they perceive the world. So you get sensory distortions where the child is overwhelmed by loud and crowded environments.  They have issues with clothing, they start having restrictive eating where they become very picky. On top of that, because of certain other chemical abnormalities you get changes in sleep patterns, you get changes in appetite. So there are oh you get changes in, in all of these different systems that then show up in a odd way, where then families say, well, what is going on with my kid?  And someone gives them that label. If we say, well, what drives that inflammation in the nervous system, right? If that inflammation in nervous system is one of the key factors, which I believe it is, and my entire practice is literally around identifying [00:06:00] this inflammation, figuring out what’s triggering it and taking care of it.

Literally that’s pretty much all I do. We get into environmental factors, right? Certain environmental chemicals and compounds and so forth could drive that, but also the gastrointestinal track, right?  You, you know better than anyone, and I’m sure most of our audience knows, like when the gastrointestinal track and microbiome become unhealthy, that triggers a whole lot of inflammation within the nervous system and.  Because the mitochondria are the stabilizers or essentially the foundation of cellular health, which then influences everything else. You, it kind of combines into that. And then if we take a step further back and say, well, what the heck is then causing this sudden rise?  That is where this, you know, as one of my friends, Patty Lemer just brilliantly put in a book, and her entire book is literally around this called  The Total Toxin Load.

Dr. Weitz:  I’ve had her on the podcast before, Yes.

Dr. Katiraei: And that, that’s the whole premise of her book, the Total Toxin Load, which is, you know, over time we have just kept pouring more and more toxins into the buckets of these little kids. And then I believe COVID was, if you want to consider it a toxin, it derailed the mitochondria.  It damaged the gut. It triggered neuroinflammation, so it basically caused the bucket to become even fuller. And then my experience is in these kids whose buckets are ready to overflow, but maybe not there just yet, you add the exposure of mold or dampness. That just causes the bucket to completely overflow, causing these children to then have this, these weird constellation of findings in all kinds of different, developmental, behavioral, and learning domains.

Dr. Weitz: And this increase in these environmental toxins helps explain why we didn’t see this number of kids decades ago.

Dr. Katiraei: Yeah. Yeah, absolutely. 

Dr. Weitz:  It’s something unique to our present environment.

Dr. Katiraei: Yeah. And you know what’s been interesting is, you know, with me, I’ve been taking care of kiddos with mold for, you know, close to a decade now, and what I can tell you is the resiliency that kids have against these additional exposures, even in the last four or five years has changed, you know?  Seven, eight years ago, the amount of exposure and using mold as an example that had to be there to make the kids sick was actually significantly higher than it is now. Where now if there’s any moderately significant amount of contamination in the home. And why I bring up mold is, I mean, you think about how much [00:09:00] time kids spend indoors and if you have a chain smoker, imagine a chain smoker living in your kid’s wall, right in their bedroom or living room, wherever they are.  And this chain smoker is constantly puffing out smoke, except the smoke is a super biological toxins that derail the mitochondria, trigger inflammation in the gut, disrupt the microbiome, trigger inflammation in the nervous system, so it becomes this perfect additional load on all of the other susceptibilities, if you want to say that are there.  That then triggers the issue. But the amount of chain smoking, biological toxins that now needs to be there to cause your bucket to overflow in comparison to even six or eight years ago is significantly less because sadly, these kids have buckets that are way too full.

Dr. Weitz: Yeah, so the point you’re making, or one of the points you’re making is that it’s this cumulative load.  That you have a toxin, you have something [00:10:00] else, maybe a food sensitivity, you have stress, you have all these different things that contribute to stress on the nervous system and it’s like a bucket when that bucket overflows. And so if you could empty out part of that bucket and maybe the bucket’s only half full, you can withstand some sort of stress from an exposure to an environmental toxin. And it might not trigger anything. But if your bucket is filled close to the top, any extra bit of stress on the system is going to trigger changes.

Dr. Katiraei: Yes, a hundred percent that that’s exactly the case.

Dr. Weitz: And so it’s environmental factors that seem to be so important, but what do we say to the traditional pediatricians and researchers who say that these neural developmental disorders are caused by prenatal brain development differences that can be seen as early as the second trimester, that you can see changes in neuronal patterns in the brains of these kids, and therefore, these environmental factors really are not that important.

Dr. Katiraei: It’s a great question, and I think to answer that, we need to ask what shapes neuroplasticity, right? What? Regulates and shapes and controls neural circuits. And that’s the microglia, right? The macrophages, the immune, primary immune protectors of the brain. The microglia literally shape and prune and control neuroplasticity and that has been like really well established in the science.  And for everyone out there, if you literally just go type in to Chat GPT, grok, whatever you want to use, microglia. You know, neuroplasticity, microglia, neuro, [00:12:00] you know, synapses, et cetera, et cetera. Like this is something that has been really well established in the science. So then if you say, well, if that’s true, and I believe that is something that has been, you know, kind of proven beyond any doubt, if that’s true, then what the hell pisses off the microglia to then cause them to start having the weird abnormalities that then cause the circuit disruption. Right. Right, and that is when we ask, well, what would activate the microglia? Right? The microglia have two states. They have the M2 state, which is kind of chill, right? They’re regulated. They are really, in that case, in that state, they’re like the caretakers, right?  They’re tending to the garden. They’re appropriately pruning a branch here appropriately, pruning a branch there. They’re helping the circus form appropriately. When they shift to the M1 phase. And that is like they’re having a psychotic [00:13:00] break and now they’re taking a hacksaw or a chainsaw and literally just slashing shrubs, you know, tree cutting down trees, like they’re just slashing and burning the garden and everything is a big hot mess.

What would cause the microglia to shift from one phase–Caretaker– to psychotic break arsonists destroy the garden, and that is some kind of typically infectious or microbial trigger because of toll-like receptors and all of these, you know, funny little pathways. That trigger this change. And what we know is when there is some kind of maternal inflammatory or infectious event, the risk of a child having increased, you know, neurodevelopmental challenges of whatever sort, including a SD, is significantly higher.  So once we start putting this together, then it brings us down to, well then what would trigger these microglia? [00:14:00] And that boils down to a handful of microbes. It turns out certain toxins, even air pollution can trigger microglial activation. It’s when you start looking at the material and then the data, you’re like, oh my God, how?  How in god’s good earth could air pollution and the particulates from air pollution, which do get into the placenta, right? Trigger that on top of that. It turns out that mycotoxins and certain microbial compounds that are released in these damp environments absolutely pass through the placenta, absolutely can trigger microglial activation. and can start that process of neuroinflammation before that poor little baby is born.  But. Clinically what I find in, so,

Dr. Weitz: So let me just stop you for a second. So I think the point that you’re making is that what is seen as genetic factors [00:15:00] leading to these conditions actually can be environmentally triggered even though they happen in the womb.

Dr. Katiraei: A hundred percent. And you know, if you just logically look at this, and a lot of people have said this like, genetics don’t change over decades.  They don’t even change over a hundred year time spans, right?

Dr. Weitz: But it’s interesting. Why do these researchers often say, oh, this shows that it’s genetic? Because it happens before the kids are out in the world getting exposed, but they’re getting exposed to environmental factors even while they’re in the womb through the mother.

Dr. Katiraei: Yeah, a hundred percent. And like this is the part that I think is unfortunate, right? You have a, we have a community of scientists that. For whatever reason are selectively only looking at part of the science. And if you just, I mean, literally anyone nowadays, you know, with any of these generative ais, could literally go do their own research.  And once you start digging [00:16:00] into the literature, it’s insane. Like, it’s all there. And plenty of data to, to really support how various environmental factors can absolutely change the neuroinflammatory response in a newborn.

Dr. Weitz: Yeah. It’s interesting you bring up the glial cells. I’ll be having a discussion with David Perlmutter in a month about his new book, which is about the glial cells.

Dr. Katiraei: Yeah. It’s huge. It’s huge. And I mean, they have become my primary focus in this population of kids. And, you know, it’s become my obsession to understand them and understand what triggers them and then also understand what we could do to help. But one of the things that I see is the babies are born.  The first sign of neuroinflammation is actually what I see as severe colic, and the literature also suggests that if a child has severe colic for [00:17:00] long enough period of time, the risk of developing a SD later on goes up two to 300%.

Dr. Weitz: Now, what do we call severe colic?

Dr. Katiraei: So severe colic there, there’s regular colic where the baby cries for a few minutes here and there, easy to console overall doing well. And then there are the kids who literally just could not be consoled for the life of them. The parents have to drive them around. They’re rocking them, they’re holding them, they’re bouncing them, they’re putting ’em on the dryer to help them calm down.  Right. And it’s not to say that if your baby has coic, they’re doomed. Right. It’s, there’s a pattern that I see over and over again in the consultations that I have with these families. So baby has severe colic where they will sleep for an hour or two, wake up crying, have to be held, have to be fed, and then instead of regular colic, that usually goes away after two to three months.  This persists well into five, six months of age. So it’s a very unique pattern that is different [00:18:00] than the conventional regular baby colic where they fuss and cry.  Usually these babies also start developing some degree of reflux. And that is, so the colic is the first sign of neuroinflammation because that is triggering changes in the microglia, and that changes part of the child’s response to the environment.

But also the elevations in histamine start causing abnormalities in that child’s circadian rhythm. And elevations in histamine is like taking 15 shots of espresso, except you’re a newborn, right? You just cannot wind down. You can’t calm down. And we see this in the older kids with a SD and like this is the part that’s so fascinating.  If you look at colic and you look at the disturbed and like sleep cycles of older children on the spectrum and some with pans, they actually look. Pretty much exactly the same. It’s just one is showing up in the newborn period. One is showing up when that child is [00:19:00] older, but it turns out it’s the same physiological event.  And how I know this is in a handful of kids that have had this early on, when I use certain compounds, natural compounds, to reduce histamine, to reduce microglial activation, the kids start sleeping again. So.

Dr. Weitz: What triggers the histamine increases the increase in mast cell activation. Is that a, is that an effect?  Is that an underlying driver? What, how does that end up happening in this cascade of events?

Dr. Katiraei: So in myopic view and I will admittedly admit that I, I am very biased here because this is the world that I live in.  What I see is environmental dampness, so water damaged buildings as being one of the most significant contributors to this.  Now, is it. The only contributor is that in all kids, obviously not, there could be multiple other things that could be [00:20:00] chronic infections that are there, there could be multiple other things, but,

Dr. Weitz: Heavy metals, other environmental toxins,…

Dr. Katiraei: Yeah. But the pattern that I see is, especially when there’s dampness.  The other thing that shows up right after, or almost at the same time is pretty severe reflux. And when I say that the babies, they’re health, normal babies will spit up, right? The little bit of formula comes out or milk comes out and they’re fine. Then there are kids that have such severe gastrointestinal inflammation, and this is the first sign of their gastrointestinal tract becoming disrupted, that they start refluxing and it’s like half the feeds that they have come up, they’re fussy, they’re crying, they’re in pain, and we start seeing early signs of food intolerances. So mom has to cut out dairy, mom has to cut out gluten later on when they’re trying to feed the child. The child [00:21:00] is now intolerant to certain foods so they can’t eat all the foods. And that is the first sign of now their gastrointestinal tract becoming disrupted because we know intestinal permeability leads to food intolerances. Right. And why I bring this up is these patterns start showing up.  The kids start developing sensory things. They start getting overwhelmed and loud, crowded environments. They become picky and they won’t eat all the foods. And this kind of goes on, the children sometimes start developing ear infections or other respiratory infections or eczema. So eczema being the gut, respiratory infections, ear infections being the inflammation typically from the environment.

And obviously those antibiotics are not helpful. And then this pattern keeps going and keeps going. And then usually somewhere between a year to a year and a half. some kind of other trigger or burden or [00:22:00] stressor. It could be COVID, I’ve seen that, it could be an antibiotic, it could be a host of other things, and we’ll leave that for our audience to figure out what those other things may be.  But then there’s that straw that breaks the camel’s back and physiologically, the parents see all of a sudden a significant regression or significant worsening, where before the child was fussy, they did have some sleep issues. They were a little difficult to console, but they were still babbling.  They were still making eye contact. They were still engaging. And then those things disappear. And what I believe is that is the moment where the gastrointestinal tract loses the whatever remnant of integrity that it has, and there is, it passes a certain threshold, and that is when endogenous microbial compounds. It could be various Clostridium mark compounds. It could be lipopolysaccharides. We don’t really know, but it seems that there’s a moment when the gut really falls apart.  And that causes a secondary wave of microbial toxins.  And when we look at what is really good at disrupting the microglia and activating them through their toll-like receptors, that is lipopolysaccharides in various microbial compounds, right?  They are probably the most capable and potent toxin in triggering the microglia. And what I believe and what I see is the children’s guts fall apart that releases all of these toxins that causes another wave of even more inflammation in the nervous system, which then causes these poor children to essentially lose whatever milestones that they have.

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Dr. Katiraei:  So you’re talking about the fact that the gut has this lining, a mucosal lining that. Prevents toxins and certain other substances that we don’t want getting directly into our system.  It’s a barrier. That barrier gets broken, becomes more permeable. And then these toxins, including bacteria that dye. Give off toxins called lipopolysaccharides, and there’s a host of other toxins cyto, lethal distending toxins, and those toxins that get into the system then [00:26:00] create this inflammation.  So the breakdown of the gut wall, that increase in permeability is one of the factors.

Dr. Weitz:  Now somebody who’s listening to this discussion. Who’s a bit of a skeptic might say, well, there’s all these kids with these problems. Could they really all be getting exposed to mold? Is there really that much mold around?

Dr. Katiraei:  So the answer is yes. Okay. And again, I’m not saying that this is the only explanation, right, right, right. There, there could be a host of other things, like you pointed out the metals Lyme and Lyme co-infections can certainly be even from in utero, right? It could be passed on congenitally, so there could be other things, but I don’t see those other things as being as capable of triggering a lot of ENT inflammation, so the recurrent sinus issues, the recurrent ear infections, the recurrent respiratory infections. I typically don’t see that with these other [00:27:00] factors and those other factors don’t seem to be as capable of disrupting the gut the same way as these DAM environments.  And just to give you a tiny context. When you look at, where do most of our modern antibiotics come from? They come from molds, right? They come from mycotoxins. Right? So, and that, that’s just and sill being the first one. Yeah. Yeah, exactly. So yes they, it can, and then when you look at. This is from the U-S-E-P-A, if anyone wants to go look it up, one in three homes in the US are known to have water damage, and this is, you know, from probably a decade plus ago. With the building standards or lack of that we have now. And when you think of what is embedded in every single home in the US drywall, and then you ask, well, why is that a big deal?  Until you a look at, well, what is drywall made of? Drywall is made of calcium [00:28:00] carbonate with heavy paper, and then that heavy paper has literally mold spores embedded in it. So essentially what we have done is create. Every single home to be a chia pet, right. You just add water, you get mold, and it’s one of the misnomers that I think as a community we have not done a good job in, is when we say mold, it’s actually not mold.

Mold is the smallest part of the equation. The toxins that these more toxin, genic molds create the mycotoxins. They’re a small part of the problem. I believe, and Dr. Shoemaker’s been talking about this for decades, is the bacterial component of the dampness, the gram-positives. The gram-negative bacterias are actually the ones that are most dangerous because they’re producing in the environment.  Forget about in the gut, in the environment, they’re producing the lipopolysaccharides, they’re [00:29:00] producing. All kinds of different microbial particulates, microbial volatile compounds, and a soup of other biological toxins that we inhale that get absorbed into our bloodstream and affect our system, you know, throughout the as they go around and circulate.

Dr. Weitz: Interesting. And in addition, one of the things we’ve done in building homes is trying to have homes that are more energy efficient, and that means making sure they’re sealed. By sealing the outside of your home, you don’t have the breathing ability, you don’t have air circulating between the walls.  And if some moisture gets into that area, you’re gonna have mold building up much more quickly than if the home was more permeable, if there was air circulating. So making these airtight more energy efficient homes is another factor in this. [00:30:00]

Dr. Katiraei: A hundred percent you nailed it. And you know when you add that with now, sadly, more shoddy building standards. I’ve had homes, you know, expensive homes, like multimillion dollar homes. Two years out they’re starting to have issues because a window didn’t get flash plop properly. One of my best friends, their home, the balcony wasn’t flashed properly, so every time it would rain, the water would go from the balcony into the walls.  Into the ceiling, and then it created literally more than half the home, and that was like a 2-year-old construction. So it’s that. And then again, if we add the bucket of these kids are already full, so their ability to handle any additional toxic load is significantly less than what we had 20 or 30 years ago.  Forget about, you know, even five or 10 years ago, the picture starts coming together and then when you put it all together, it’s like. Oh it’s actually no wonder why so many kids are struggling. [00:31:00]

Dr. Weitz: Interesting. I, is there a better substance to use in drywall? Is there alternatives out there?

Dr. Katiraei: You know, it’s something that actually one of my friends he is working with the Department of Defense to see if they can start developing such.  So there, there are certainly people that are starting to look at this and ask the question of. You know, what can we do? Because sadly we know military housing is notorious for having, you know, water damage. And I see that also with a lot of rental properties, right? They’re just, no one is investing the money or time to keep up these homes, right?

So a little leak here, who cares? Or it is not a big deal. It’s not a big deal. And then our environmental standards, the lack of certification and really, maintaining a high level of accuracy with our environmental assessments, that’s another problem, right? Well intending people who have been trained to think one way come in, they take literally one or two [00:32:00] samples from inside the home.

They take a sample from the garden, and then they say, well, garden has more mold than they inside of the house. Therefore, there is no mold. Therefore, there is no problem. Have a nice life. And you just think about that logically, like, wait, what? But literally that’s what we’re doing. It’s not that we’re breaking it down to the species, right?  It’s not, they’re saying, oh, there’s a, to a small pike, a spike in this toxic tox inogenic mold that wasn’t really there outside there could be a problem. They’re not doing this. Literally, it’s total mold outside has to be. More than inside. And that equation, simple equation is all they’re using to say if there’s a problem or not.

Dr. Weitz: And then look at all the floods you see in the news all the time and these hurricanes and these other environmental factors related to climate change that are leading to that’s gotta drastically increase the risk for mold. [00:33:00] Absolutely.

Dr. Katiraei: Absolutely. There, there’s one study that I know of where they, they looked at certain areas that were affected by climate change and hurricanes, and the prevalence of mold in those homes was about 45% with, I believe somewhere around 20, 25% having severe contamination not just a little bit like severe significant contamination.  So, yeah, absolutely.

Dr. Weitz: So. What kind of testing do you like to do for your patients?

Dr. Katiraei: I wish there was a perfect test that I could say, oh, this is the test we can a hundred percent rely on all the time. Right? There is no such thing. And that’s another fundamental issue. What I do like to do, I mean the first thing I believe is we have to piece together the picture, right?  If a child was born, they started having colic. They started having reflux. They had a bunch of ear infections, or child was doing fine, right? They were doing fine [00:34:00] until three or four years old. But then weird things started happening and that correlates with when the family moved. Or the child started school because 20% of schools have mold as well.  Right. So it doesn’t have to be in the home. I’ve seen it in the schools. I’ve seen it in a parent’s car. So if the child started having issues, at a certain point we need to ask, well, what could that have been? If the suspicion is there. So as we piece the story together, and that’s part of what I do with every single family.

We spend an hour, sometimes hour and a half piecing together the story of how did this all come together. And I’ll give you an example. There’s this dear family that I was talking to, both parents or physicians. Their beautiful boy, when he was around 14, they moved to a new home. New home. And within about a six month to a year time, he started developing all of these issues. Severe ooc, d, severe anxiety, can’t even leave the [00:35:00] house. Mom is literally trapped in the home because his separation anxiety is off the charts. He doesn’t sleep like literally. They have to give him Ativan. And even with that, he doesn’t sleep well, like severe issues.  And it turns out that is when they moved into their home. And, you know, as I was talking to them, they were like, yeah, you know, we did see that the, you know, some of the things buckling and there, there have been some leaks and, you know, et cetera, et cetera, et cetera. So first of all, the clinical suspicion has to be there.  Once that’s there, what I like to do, if we can draw blood, is use immune reactions against the molds to see if that child has had exposure. Are these tests a hundred percent accurate? Absolutely not. Generally speaking, are they more accurate than other tests that we have? I would say yes. So

Dr. Weitz: like for example urinary mycotoxin testing.

Dr. Katiraei: Yep. So you like urinary mycotoxin testing? I [00:36:00] know my dear mentor, Dr. Nathan, you know, recommends this, and I believe in adults, they’re a very useful tool. You can get false positives from the foods that you’re eating, right? So if you eat too much gluten, dairy, peanuts, et cetera, you can get false elevations in the little kids.  Why I stopped using them. Is when kids become really toxic, it seems that they lose the ability to push the toxins out into the urine. Ah, so I had interesting plenty of kiddos where like horrendous levels of confirmed contamination, like to the point where the family had to move out kind of stuff.  You results look completely normal, like to the point where it’s like, oh, there’s nothing going on until it’s like, oh my god this home needs to be condemned kind of stuff. So. That’s why I’m not a big fan of the urine mycotoxins in the kids. Urine organic acids, which is kind of checking the biochemistry.  And certain companies like Genova, Vibrant, Mosaic do check for fungal [00:37:00] markers, and there are plenty of people that question how accurate these fungal markers are. But basically this is like the fungus and the molds leave their own biochemical footprint. And these urine tests are looking to see if those footprints are there.  50, and I know these are tests that are used in the functional integrative community all the time. At least 50%, maybe a little higher, close to 60% of the time, a child can have significant exposure. And these urine tests don’t show signs of fungal imbalance. So if any family out there listening, if they’ve ever done an organic acid and outside of their aose.

The tartaric acid, or some of these other markers were elevated, even if it’s tiny elevation, that tiny elevation could be a sign that the child has had exposure, and that exposure changed the fungal makeup of their gut resulting in this abnormal result. So with all of that [00:38:00] said, you know, the tool that seems to be most helpful right now in assessing exposure to me is immune reactions in the blood against environmental molds or against environmental mycotoxins, mold, toxins.

Dr. Weitz: And which company are you using for that?

Dr. Katiraei: So the only company that holds the patent for the mycotoxin antibody testing is my Myco lab. And their testing is actually pretty accurate. About, I’d say 10, maybe 20% of the time you get a false negative. And I believe the reason for that is the immune suppression that these children have, because if the immune system is suppressed, it’s not producing antibodies appropriately, which some of these kids have.

Dr. Weitz: And mold tends to lead to immunosuppression.

Dr. Katiraei:  Yes, sir. Absolutely. Absolutely. So if you’ve got that right and you check the immune system and the immune system doesn’t show a reaction, it’s not because the child wasn’t exposed, [00:39:00] it’s because the immune system is asleep at the job. And with the, there’s another company called Allot Tests, A-L-L-E-T-E-S-S, and I have no financial affiliation with either allot tests I like because.  It’s a little bit cheaper. So if finances are tight mic, my micro lab, I think is a better test when families can’t afford the $400. That’s a two. The all test is a $200 test that looks for IgE reactions against molds, which are very uncommon. So for those families that have had their kids’ allergy tested and the doctors are like, your kid doesn’t have mold, you know, have a nice life only five to 10% of the time, I see those being positive.  And there’s a study that. Demonstrated pretty much the same thing. They check for IgG, so that’s the delayed immune re response. The cool thing with allot tests is they also check for iga a against some fungus and molds. And why that is [00:40:00] helpful is if you see an IGA reaction, that means that fungus is irritating some mucosal surface.  And in theory you can say, oh my gosh, there’s probably some degree of colonization or fungal dysbiosis driving that. That was a lot.

Dr. Weitz: Yeah. No, that’s good. And and then if you suspect that there’s mold, toxins, mast cell issues where do you start?

Dr. Katiraei: The first thing is to really understand what’s going on in the environment.  Because if you don’t, and let’s say there is ongoing active exposure, right? And typically how that shows up is the child’s nervous system is on fire. Like that example that I gave with that young man. In those cases, [00:41:00] typically. Regardless to what you do, the child will continue to be inflamed. And it’s like playing a gap game of whack-a-mole.  You try something, it kind of works only to fail later. So understanding the environment and helping to control or address whatever exposures there is pretty significant. And the analogy,

Dr. Weitz: you mean if there’s mold in the home? Yes. Trying to correct that if move out if you have to or get it ameliorated.

Dr. Katiraei: Yeah and you know, sometimes it’s just one. Done leak somewhere, right? It’s one bathroom that’s leaking into one area. And I’ve had families where there, there’s one family. Their beautiful young lady, 14-year-old, severe pans, like off the charts, anxiety, couldn’t leave the house nauseous, tired, like literally couldn’t function.  It turns out that the laminate flooring that was in her bedroom and in part of the living room. And laminate is [00:42:00] basically plastic, right? So it traps moisture. It hadn’t been properly installed, and literally there was visible black mold under that laminate flooring. Family ripped the floors out, cleaned it up, and within three or four weeks of just getting rid of that they didn’t even touch the rest of the home.

Literally by just getting rid of that, she’s already doing a thousand times better. She’s going out, she’s painting her nails. She’s got, she got a haircut for the first time in a few years. She’s hanging out with her friends. She’s chipper and I bring that up because. I think this is an important note to touch on.

This isn’t doom and gloom. Oh my God. I mean, part of why I’m driven to have these conversations and take care of these families is the beautiful transformations that become possible, right? Where we think like things like a SD or whatever else are just lifelong conditions. Well, they are lifelong conditions if you never take [00:43:00] care of where the source of the inflammation and dysfunction came from.

But when you do and you help the child’s system start rebuilding itself, dramatic and really beautiful things come. I have multiple, you know, kids that I can think of right off the top of my head with severe level three a SD and like the poor kids who couldn’t function headbanging self-injury.

Couldn’t go anywhere. Couldn’t take him to the restaurant, couldn’t take him to the church. Freak out every time they go out. Took care of the exposure, did a few things to detox them, and now they’re going to church, they’re going to restaurants. You know, are they totally normal? No. But has their quality of life improved dramatically?

Absolutely. And this is the most wonderful part of this conversation where it gives families. The possibility of finding some explanation for why their kids are struggling and gives them something that they can take an action on to take care of it. [00:44:00] And that is to me, you know, the wonderful part of this, there’s hope, there’s healing, there’s profound transformations that are possible.

Dr. Weitz: So what kind of detox strategies have you found to be effective?

Dr. Katiraei: So before I, I detox to kids. I first stabilize them because I find when they’re not in a stable place and they’re still acutely inflamed, everything becomes significantly harder. So with the stabilization, I use certain. Supplements like DAO enzymes in ric and I’ll sit.  There’s a substack that I have out there that has all of this spelled out if you want to include that. So

Dr. Weitz: DAO enzymes are an attempt to stabilize the histamine mast cell factors.

Dr. Katiraei: Yes. And by reducing the histamine in the gut, that allows the gut immune system to calm down because histamine acts as a pro-inflammatory agent within the gut.  There’s a compound a [00:45:00] supplement that has PEA polymethyl, if I’ve said that correctly. PEA actually is a really wonderful mast cell stabilizer within the gut and within the nervous system. Luteolin, which is something Dr. Theo her has talked about a lot and done wonderful research on, is another wonderful compound that also helps stabilize the mast cells within the gut and nervous system.

So I usually start with just those, some zinc and d. And see if I can get things to calm down. And why I don’t do anything right off the bat is sometimes, especially if there’s citric acid or other flavorings or other compounds, those additional compounds actually become triggers to the immune system. So you muddy the waters up.

Once that is on board one of the things that I’m finding to be really helpful, and this is something Dr. Fry has been talking about, richer Fry has been talking about for eons, is [00:46:00] using big doses of folinic acid and certain other B vitamins. It turns out that when you don’t have enough folate in the nervous system, your ability to break down histamine is also compromised.

So pushing some of these vitamins in a gentle yet. Significant fashion sometimes helps reset that. B six is really helpful. And then with that, I bring in some magnesium three eight, which also can help these children calm down because it activates gaba. So I do a few of those things, watch and see how the kid does.

And with this hopefully processed foods, food colorings, you know, all the junk gluten, dairy are also controlled. If the child starts doing better, which I’d say 60 to 70% of the kids who have the mild degrees of immune activation due and the 20% that have the severe sometimes need more heavy duty things like peptides or keto OFin or chromin [00:47:00] or more.

Intense levels of immune regulation, but once the kids start doing better, that’s when I think binders could be super helpful. Right. But one of the things that’s fascinating about binders is if we ask, what are these binders binding? Right? And not to say that they wouldn’t and cannot be binding mycotoxins and certain other things within the bile, but what I believe.

The binders do is they actually start binding the lipopolysaccharide. So, so all of the toxins that are within the gut, right, produced by the bacteria that were leaking through, right, that we talked about early on, that triggered the next wave of inflammation. If you look at chlorella. Citrus pectin, activated charcoal bentonite cholestyramine for those that have used the pharmaceutical that Dr.

Shoemaker talks about. If you look at all of these and others, every single one of these [00:48:00] is to some extent, either highly capable or moderately capable of binding the bacterial toxins that are in the gut. And what I think happens is when we use these. Yes, they do bind whatever mycotoxins that are floating around and other things.

But what they also do is while the dam is still leaking, they basically start trapping the toxins that were in the gut and preventing them from going into the circulation, which helps these kids start doing better.

Dr. Weitz: Interesting. What about using something like serum bovine immunoglobulins because those are known to bind to LPS?

Dr. Katiraei: I love it. I absolutely use those a lot of the time. N-acetylcysteine, once the kids are doing better, is fantastic because it reduces oxidative stress and starts boosting glutathione. One of the things that. I have become a huge fan of [00:49:00] is the AOL antifungals sometimes even Nystatin, which is, you know, non-absorbable produces dramatic changes and that is.

If you look at what else is triggering the inflammation from within the gut, it’s the fungus, right? The fungus go out of balance, candida goes out of balance. They become another trigger for inflammation, and by just controlling them, sometimes you’re able to downregulate the inflammation. But what’s so fascinating about Itraconazole Fluconazole.

Is these azos have really powerful and rather remarkable anti-inflammatory properties. So they’ve been looking at them in cancer research and all kinds of other things, and through multiple PA pathways, they actually start downregulating the inflammatory response. Especially within the nervous system, and I, for one, am convinced that they are probably one of the most useful [00:50:00] anti-inflammatories for the nervous system.

And I’ve had kids where we start them slowly, but we titrate them up. And within two to three weeks of being on these antifungals when it’s done properly, so you don’t just throw it in, you know, kid is still living in mold, their diet is garbage, right? You can’t just throw it in and do a Hail Mary and hope it helps you get everything plugged in.

When the time is right and it’s used for the right child at the right time, it’s sometimes weird how helpful it is. Children that were aggressive, irritable, struggling to make eye contact, struggling to connect, sometimes literally within a few weeks, they calm down. They’re much more able to regulate their sensory issues, calm down.

They’re able to connect more and. The there, one of the most beautiful things is it seems that by downregulating, the microglia. [00:51:00] These azoles start changing dopamine pathways, serotonin pathways, oxytocin pathways, and why? The oxytocin piece I bring up, we know that’s fundamental for human connection.

I’ve had several kids and I experienced this myself, so I can say firsthand that this. This seems to be true because I witnessed it in my own nervous system. Oxytocin starts working when inflammation calms down, and the ability for a human being, myself included, to be able to connect with others and be able to experience.

That flavor of life, if you want to say, right? It’s like going throughout your entire life, eating bland chicken every day and not knowing that, that is your experience, right? You just, you eat it and you’re like, okay, this is what life tastes like. Right? And you build ideas because everyone else is like.

Ooh, wow, this is so delicious. So in your head you are like, Ooh, this is so delicious. Right? Even though the ex emotional [00:52:00] experience isn’t there. And when you look at a lot of people that are on the spectrum they have this flat affect, right? They’re we speak in almost like a robotic way where there isn’t emotional context behind what we say.

You know, we say we love you and in our minds, we really do mean we love you. But that, that ping of. Joy and love that most normal people experience when they experience love, literally doesn’t fire in someone whose nervous system is inflamed. And with these AOLs, what’s really. Amazing is when it drops down the microglia, I think it’s the microglial tone and allows them to go back to that M two phase.

A lot of these pathways start working and I’ve seen it where children that were, you know, labeled as a SD are now the ones. Wanting to connect with other kids. They’re wanting to make friends, they’re wanting to go on play dates. They go to their mom and they give them a hug for the first time, and they [00:53:00] genuinely look and say, I love you.

And it’s just, I mean, I can’t tell you it’s the coolest thing you can possibly imagine to see happen when these children, you know, I think for me, it’s all of these kids have this ability, right? This is human innate. Capacity. It’s as I’m sure you know, with your background, our job is to take away the garbage that prevents that capacity from showing up.

Right? And the, these azos are one of the things that take away some of the barriers that allow these children to express or prevent these children from expressing their love in connection. And that innate gift, that innate ability starts shining through. And it’s the most beautiful thing ever.

Dr. Weitz: That’s great.  I see time is running out, so let’s bring this to the close despite the fact that I had about 20 more questions. So I want to thank you very much for joining us on the Rational Wellness [00:54:00] Podcast and bringing us your insights about how interconnected the gut, the immune. The mitochondria and the developing brain are how can listeners and viewers contact you and engage your services?  And then you have a book that’s gonna be coming out soon, right? 

Dr. Katiraei: I do, I do. I’m in the process of writing a book. It’s, I think it’s going to be called Autism Redefined. That’s the working title, and it’s literally around this very conversation with a lot of information that families can use with any provider that is open to working with them to.  Literally identify these exposures, control it and work through the healing process to get their kids into a healthy place. So that’s hopefully going to come out late next year. Where they can find me is my clinic website is wholistic kids with a w, so [00:55:00] W-H-O-L-I-S-T-I-C kids. If they type in my full name, my Substack is there and some of the protocols that I’ve published before or out there.  So families can start using those to start seeing what’s going on with their kids. And I’m also on Instagram with the holistic kids handle.

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

Dr. Katiraei: Oh, my pleasure. My pleasure. Thank you for having me. And thank you for hosting this conversation. And you know, I hope that the time we spent it will help inspire some families and individuals, you know, who have been struggling to save, my God, is this my kid?  Is this what’s happening to my child? Because that’s the best thing, right? If what we did through this conversation helped. Some families or individuals have a healthier and brighter life, then everything was worth it. That’s great.

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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 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 set you up for a consultation for functional medicine and I will talk to everybody next week.

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