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Improving your posture is an anti-aging strategy with Dr. Steven Weiniger, who is interviewed by Dr. Ben Weitz. 

[If you enjoy this podcast, please give us a rating and review on Itunes, so more people will find The Rational Wellness Podcast] 

 

Podcast Highlights

3:49  Dr. Weiniger talks about some of the negative consequences of poor or weak posture, including neck and back pain.

8:32  The key to posture is taking a picture of yourself and drawing lines and measuring how you stack up. Then make some changes and next year take another picture and see if you have changed. 

9:22  The invention of the smart phone on top of the computer now has led to about 90% of people in the US having weak, folded posture being bent over with rounded shoulders and forwards head.  This is an epidemic in our society that is getting worse. 

10:22  I pointed out that the more time people spend on social media, the more lonely they get, which increases their risk of chronic diseases and early death. 

13:00  We talked about Dr. Weiniger’s PostureZone app that allows you to take a picture and measure where their head, torso and pelvis is in space over where they are standing. Those are the four posture zones and the Posturezone app lets you measure the degrees of deviation from vertical of the poor posture zone.  This app both lets people become aware of their posture and allows professionals to measure posture and generate reports showing changes over time before and after treatment. 

23:20 Dr. Weiniger explained how we go about constructing an exercise program to improve posture with his strong posture protocols. He also mentioned that chiropractic manipulation is very important in helping to improve posture, as is proper nutrition.

 

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Dr. Steven Weiniger is a Doctor of Chiropractic with a specialty in posture analysis and correction. Dr. Weiniger is an author, speaker, and internationally recognized posture expert  https://www.bodyzone.com/posture-expert/  Dr. Weiniger has written Stand Taller Live Longer: An Anti-Aging Strategy available through Barnes and Noble  https://www.barnesandnoble.com/w/stand-taller-live-longer-steven-weiniger/1009154991?ean=9780979713606  and Posture Principles-–5 Principles of Posture. 

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

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Podcast Transcripts

Dr. Weitz:            This is Dr. Ben Weitz, with the Rational Wellness Podcast, bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to Rational Wellness podcast on iTunes and YouTube, and sign up for my free ebook on my website by going to drweitz.com. Let’s get started on your road to better health.

                           Hey Rational Wellness podcasters, thank you so much for joining me again today. We’re going to talk about posture again and it’s such an important topic because it affects so many factors in our overall health. And as a chiropractor, I constantly see patients every day who come into the office and they say, “Doc, why does my back hurt? Why does my neck hurt? I didn’t lift anything, I didn’t do anything.” And so, in so many of these cases, posture is the unthought of, underlying cause and as somebody who’s into functional medicine, I always believe in trying to get to the root cause of problems. And the same thing for chiropractic, we can’t just correct your neck and back pain with a drug that’s gonna relieve the pain, we’ve gotta try to get to the underlying cause. And I personally have found that poor, bad, inefficient posture is a major factor, in not only the cause of their pain but also in your inability to heal properly from the pain. And the fact that, the pain is likely to come back.

                            By the way, all of you who enjoy the Rational Wellness podcast, please go to iTunes, or wherever you get your podcast and leave us a rating and a review. That will allow more people to find the Rational Wellness podcast. And so, our special guest for today is Dr. Steven Weiniger. Steve is a posture expert, he’s the author of Stand Taller, Live Longer, a tremendous book, the creator of the CPEP training program for professionals, helping people check their own posture with his PostureZone app that you can get on your phone, and he’s the chief posture evangelist of May. And May is posture month, and he’s the head of the posture month organization. Anyways, Steve, thanks so much for joining me today.

Dr. Weiniger:      Ben, thanks. Thanks for having me, I appreciate it. And the chief posture evangelist label came when we decided to do a public health initiative for a CPEP, Certified Posture Expert Professionals, and the label …

Dr. Weitz:           Hallelujah!

Dr. Weiniger:      Because basically, I’m going around and I’m talking to media. It was just a really cool thing that came out on CBS yesterday. We’ve been with them talking about posturing. I feel like I’m evangelizing. I’m cured. I’ve not been doing evangelical work, but it’s true because people … It’s something everyone knows about, but people don’t stop and really look at. And my job becomes making people talk about it and that’s why we’ve expanded posture month to not just CPEPS, but to anyone that’s worked with posture to be able to take a picture or to offer the public a picture of their posture to create awareness of what their posture looks like, because it affects your health in a tremendous way.

Dr. Weitz:           Cool. Can you tell us, what are some of the negative consequences of somebody having poor posture or inefficient posture?

Dr. Weiniger:     Well, there’s two sides to it. One is the health consequences and the other is the personal consequences. Beginning with the health that is one that’s most important even though it may not be the one that’s the most emphasized. It effects back pain and neck pain tremendously. A recent study found that 89 percent of primary care physicians, considered posture to be one of the primary causes of back and neck pain, which is not surprising because your body is not aligned, it puts more mechanical stress on your joints. Especially if you’re living on that all the time. But there’s other issues as well, because when your body is folded, it can affect how well you can breathe. It affects how different organs’ work and things like this don’t occur quickly, but especially if you want to get to the root core of the problems, if someone’s living with their body folded and they can’t take a deep breath … There’s been a lot of research that shows that breathing is really important for your health. If you don’t breathe, bad things happen.

Dr. Weitz:          And it’s important to breathe that way as I’ve learned, because I was always a mouth breather and recently, in the last six months, learned how to breathe through my nose with a help of a breathing professional. It makes a huge difference.

Dr. Weiniger:    And there are breathing professionals that work with posture as well, because it’s not just a reflex thing, when your head goes forward of your torso, it changes the muscle relationship in the front of your neck going to the mandible, the jaw bone. That effects the opening for the air coming down into the lungs. It’s easier to breathe with the chest than it is to breathe with the abdomen or the diaphragm. And once you’ve developed that habit, it becomes like any habit. It’s easier to move that way. Try this. Press your fingers like this. Look at which fingers are on top, the left one or the right one?

Dr. Weitz:         Which one’s on top?

Dr. Weiniger:    Yeah, when you’re looking at your thumb, which thumb is on top?

Dr. Weitz:         Oh, the right one.

Dr. Weiniger:    Okay, cross it the other way. Put the left one on top. If I asked you to cross your hands, things like this, a thousand times, how often would you do it this way?                                               Most people … If you worked with it your good. Most people I would do this, would find that …

Dr. Weitz:         Well, you see I play golf. So, actually this is my normal golf grip.

Dr. Weiniger:    In that case you’re not using it. But most people that do that, find that …

Dr. Weitz:         My wife is always reminding me that I’m not normal.

Dr. Weiniger:    No, you’re better than normal. You pay attention to your body. That’s the point. Once your body learns to move in a pattern, you keep on moving that way without thinking about it. And that stresses some muscles, stresses other ligaments and your body literally folds into that pattern. You think your moving one way, but a camera proves that you’re not moving that way and that’s why taking a picture so that you can see how you’re standing when you think you’re standing tall is one of the first ques to building posture awareness.

Dr. Weitz:         So, since you brought that up, how do people become aware that they have bad posture. Is it simply because they have neck pain and they go to a chiropractor and that chiropractor tells them they have bad posture?

Dr. Weiniger:    I really don’t like the phrase bad posture. Because no one’s posture … Unless someone’s body is perfect, their posture is not gonna be perfect. Your posture is bad if you’re having some symptoms from it and that’s for certain. But even if you might have symptoms …

Dr. Weitz:         How about if we call it inefficient posture? ‘Cause isn’t the key to posture, resisting gravity, and we can’t resist efficiently if we have a certain posture?

Dr. Weiniger:    Inefficient is a good way to look at it, especially from a sports point of view. The way that we talk about it would be what is weak posture. Because if your posture is inefficient your body is gonna be weak and it’s not about as being as strong as the strongest person in the world, or as tall as the tallest person in the world because that’s probably not most of our genetics. It’s about being as tall as your body should be, as strong as your body should be for what you’re doing. If you’re working your body inefficiently, your body is gonna get better movement inefficiently and that makes problems. So, the key to posture is just taking a picture of yourself and measuring. Not making a pathology of it, not making it bad, not making it a problem, but it make it just, when I’m trying to stand tall, this is what I look like. And looking at it, and then coming back next year and comparing it again and measuring your body as something your aware of. If you see your body folding from your one to two to three, if you look more and more like an old person, you’re gonna start feeling like an old person and having pains like an old person before you should be.

Dr. Weitz:         So Let’s say we call good posture optimal posture. Right?

Dr. Weiniger:    How about strong posture?

Dr. Weitz:         Okay, so, let’s say we call it strong posture. Can you say approximately what percentage of the population has weak posture?

Dr. Weiniger:    In our world …

Dr. Weitz:         Yes.

Dr. Weiniger:    There’s been this great invention that I don’t know that it was made by chiropractors, but if you wanted to invent something to have a device that you could put in front of people and then have them spend half their day hunched over with this over rounded forward typing on something, you’d have a hard time advising that business model, but it’s been great for chiropractors because we end up seeing and helping so many people walking around in pain. In our society, I’d say 90 percent are walking around with posture problems. One thing that I’ve noticed is when I travel, I’ll see families with kids, and sometimes the little girl looks like mom and the boy looks like dad, and usually when I used to see people like this, the kids had good upright erect posture and the parents were a bit more slumped forward in general. Now, the kids look worse than the parents. This is an epidemic going on in our society, and it’s getting worse.

Dr. Weitz:         So, this is negative health consequence of cellphones, on top of so many other health consequences. I was just listening to another podcast on my way in here and they were talking about how loneliness is a parameter that increases your risk of early death and chronic diseases.  The more people spend on social media, the more lonely they get. So you spend all this time interacting with other people, but not in a real way so, you end up decreasing your health as a result of that.

Dr. Weiniger:    And that’s a … I completely agree with that perspective. One of the things of that is, people spend a lot of time trying to curate the perfect image on social media so that they look really good. And when they then compare themselves to other people that look better, it becomes a competition of how well can I artificially make myself look good and if they compare themselves to other people. And it’s like a world full of barbies of people shaped in ways that no human being is shaped. Whereas if you and I are sitting together and we’re being comfortable and we’re opening up to each other, that’s a different kind of friendship than occurs online.

Dr. Weitz:        Yeah. That creates this unrealistic body image that people have when they see these people on Instagram and Facebook and Twitter and stuff, having these ridiculous looking bodies and they feel all worse about their own because they know nobody can look like that and those are not real images, unfortunately.

Dr. Weiniger:   And one thing that I’ve become more aware of personally is the old custom of breaking bread with people, we don’t talk about that, but when you sit down and you eat with somebody, it’s a more intimate thing where … People don’t show videos of themselves eating, they show videos of the meal because I can curate it, I can make it look right. I can put the glass to the left of it. I can arrange the silverware so it looks like the food they get are perfection. Whereas a video of somebody chomping away at something, that doesn’t look so good because that’s a more openness of how people truly are. And when you sit down and have a meal with someone, if you like them, that’s when you come away and you say, “We can have breakfast together. We can have dinner together.” The saying a long time ago was people breaking bread.

Dr. Weitz:        Yeah, interesting. So, how’s … Tell me about your app that lets people be able to take a picture and get a better since of how good or how strong or weak their posture is.

Dr. Weiniger:   Posturezone app is a free app that’s on iPhone, iPad, and Android. And it’s a way for everybody to take a picture of themselves and measure where their head, where their torso, and where their pelvis is in space over where they’re standing. Those are the four posture zones. And it’s not about trying to pathologies something with this is normal and this is not normal. I mean, if somebody is five foot five for male, and the normal population is 5’7 to six feet, does that mean that person that is 5 foot five is abnormal? Of course not. It means that’s the way that person is and there’s a population demographic. Normal means different things. You don’t want to confuse a normal population demographic with normal for that individual.

If someone’s 5’5, if they’re standing tall, they can have strong posture. If someone’s six feet and they’re slumped over down to five foot ten, they’ve got horrible posture. So it’s not about being tall, it’s about standing taller. So that’s the direction of that is aligning your head over your torso, over your pelvis, over where you’re standing. The more those four posture zones are vertically aligned, in a line, the taller the whole system is. The taller the person is. The more the person is flexing forward, the shorter they are, and what the Posturezone app does lets you measure the degrees of deviation from vertical of the poor posture zone.

Dr. Weitz:         Do you have it on your phone right now? Can you show us real quick how that works?

Dr. Weiniger:    Sure. I can show you on my phone. If this …

Dr. Weitz:         So this is an app. It starts out as a free app and then there’s advanced features that you can purchase on … You can put it on your phone, your iPad.

Dr. Weiniger:    You can put it on your phone, iPad. It’s 29 dollars for the pro version, which is for professionals. If you’re a professional watching this, you want the pro version ’cause it will let you take a comparison picture of somebody and compare it in a report over time. If you’re a regular user, the app will let you take pictures over time and compare them. You can just flip back and forth and look at your pictures and you can see the number, but you can’t create a report and you can’t keep things in tables to work with people. [inaudible 00:15:52] designed to give the consumer or the health enthusiast the ability to check their own posture and posture of friends, but if you’re doing it professionally, it cost 29 bucks, but it’s a one time thing. It’s not an all the time thing. The reporting is again, of the angles of deviation. It’s not saying this is normal, this is not normal. That’s like a fear based marketing thing that I don’t care for.

Dr. Weitz:         Hey … You ever done a study to validate this? Maybe with patients after whiplash?

Dr. Weiniger:    Working on it.

Dr. Weitz:         Okay.

Dr. Weiniger:    There’s a couple that are working on things that are working on exactly and there’s been other studies that have been done that point to the lack of validation of some other things that a lot of people talk about and that the most promising way of recepting posture is the head, torso, and pelvis over the gravity line, which is exactly what we do. Dolphins did a really nice study of that and that was the only thing that correlated with back pain. There are things like high shoulder or a high hip, really didn’t correlate though, it’s just … Over mechanical, as you put inefficiently, the more everything expands out, the more efficient mechanical advantage there’s gonna be but less energy is spilling, the less strain there is on muscles and joints.

Dr. Weitz:         Okay. Go ahead.

Dr. Weiniger:    So if you wanted to take a look at it, this is … My office is a mess, but if you … Don’t look at …

Dr. Weitz:         You gotta hold it … Right there, good. Okay.

Dr. Weiniger:    So basically … Oh, I’ve got a great idea. Don’t go away.

Dr. Weitz:         Okay, you gonna bring somebody in to help demonstrate it?

Dr. Weiniger:    I’m gonna bring Harry in.

Dr. Weitz:         Okay. Hi Harry.

Dr. Weiniger:    Harry is my posture [inaudible 00:17:38]. Okay we’re gonna see if we can do this. So basically, you want to take a picture and notice when I rotate this back and forth, the line turns green.

Dr. Weitz:         Okay.

Dr. Weiniger:    In the middle. When the lines green, it’s level. Since my screen is not level, this is gonna be a weird picture, but if I put Harry between those two lines, I can bracket him between those two lines and I’ve got a grid in the background that if I were smart, I’d have it setup where I could show you that grid, but that’s not today. That’s not gonna happen today.

Dr. Weitz:         That’s okay.

Dr. Weiniger:    Professionals will need the grid and if I took a picture of Harry, and this is not gonna be nearly level ’cause I’m not that coordinated, but if I can take a picture of Harry. Did we get it? I got it. Good, this is far from perfect, but I can then take … You don’t need to see this, but I need to set it up for side view or front view, I can take a side view. I can then move the brackets to bracket the head over the torso over the pelvis over where the feet are standing. And this is not well placed cause I can’t do this sideways very well, but I can then check that and it will measure the degrees of deviation the head over the feet, the torso over the feet, and the pelvis over the feet.

So just measuring how the body is balancing and what the body is going to be vertical. And this is what the free version does. If I wanted to add other lines, and let’s say that I’m a pitcher or a golfer, you can add another line. I can call that a golf line. And then I’d be able to make a line between my shoulder and my front foot for example if I wanted to add that measurement to see how my body aligns. When I think my shoulder’s right over my foot, if it’s really two degrees off, and I start working on it and then it’s one degree off, it’s going in that direction. It’s a way of bench marking the accuracy of your perception and of the way your body is to the truth of where your body is.

Dr. Weitz:                            Cool.

Dr. Weiniger:                     And you can then if you want to save it and I’ll just put it into a case, and hopefully this is nobody that I don’t want to show you.  Within that case, I can look at an image and compare Harry today to Harry yesterday. Or in the pro version, I can generate a report to compare that to prior images. No. Sorry, I can add that to prior images and move backwards. There we go. Where I can do a checkoff. You can see that and get a report and then I can generate that report … And the report disappeared. I can’t do this backwards very well. There it is. I can generate that report and that report that has those images as well as the deviations of where the body is in space. And the cool part for consumers, if you’re looking for a professional near you, on the bottom there’s a locator for CPEP so they can find somebody that’s in their area and now you know where I live, but where there’s a CPEP near them. And that is someone that if they want to work with a posture professional that can take a picture of their posture and help them to do exercises to strengthen their posture.

                    And that’s the idea behind posture month. People have to become aware of their posture ACE, A is awareness. Next part is C, control. Do exercise to strengthen your posture and professionals work with people from a clinical point of view, especially, really strong posture exercises to strengthen how people move. Other things like yoga, Pilates, are also what I call controlled motion exercises and they can help posture, but the external posture exercise have the advantage of being able to be very, very targeted to help someone’s weaknesses and strengthen their weaknesses especially when there’s been a problem that needs any kind of rehab.

Dr. Weitz:                            You know, another thought about using this and I just started to incorporate this app, is insurers, third party payers, want to see objective measurements of the improvement that we achieve with our treatments and we know our patients feel better, but simply having a patient who says, “I’m in pain.” And then saying, “Now I feel better.” That’s not very objective, of course, we use these zero to ten pain scales that the patients fill out and that’s a little bit of objectivity, but it’d be nice to have something like this that we can include in a report to either an insurer or on a personal injury case to show some objective improvement. So, I think this is pretty cool for that idea.

Dr. Weiniger:                     I’ve personally had adjusters that we’ve worked with and they said, “You know what, when you showed me the picture of what the person looked like the first time they came in and what they looked like a few weeks later after that, it makes it very real. People unlike online texts, that’s not real. A picture of you in eye when you see somebody talking that’s much more real.

Dr. Weitz:                          Yeah.

Dr. Weiniger:                     And then you have someone standing against an objective, that’s more real.

Dr. Weitz:                          Okay, so once somebody identifies that they have poor posture or once a practitioner whose maybe has gone through your program identifies somebody with postural issues, how do you go about correcting those?

Dr. Weiniger:                     The first thing you do is you take a picture so you benchmark where you’re starting from because it’s not necessarily correcting, it’s strengthening. My best review of this is almost certainly gonna be different because we have different genetics and we treat our bodies differently along the way. And your body is not gonna be balancing the exact same as somebody else’s, but having an awareness of how you’re balancing at the beginning. To strengthen balance you want to strengthen each of what are called the three elements of balance. How your body is aligning, how your body is balancing, and how your body is moving. And basically those words balance, alignment, motion or BAM, are what we talk about in my book Stand Tall and Live Longer and the posture exercises are what CPEPs and other professionals teach their patients and teach people and it’s often trainers and massage therapists that teach people how to do postural exercises.

For posture month, there’s a number of balance exercises we’re putting out every day and for each week, we’re going to be focusing people on one exercise. So week one, we’re focusing people on an alignment exercise, it’s really easy. Go to the wall, walk til your back’s against the wall. Remember when you were in school they told you that you should be able to line up your shoulders, your feet with shoulders, your feet, your butt, your shoulders and your head against the wall and be straight. Did they have that when you were in school?

Dr. Weitz:                         Well I remember doing that after the air raid drills.

Dr. Weiniger:                   Okay, same thing.

Dr. Weitz:                         Like that will really protect you if a nuclear bomb strikes near your school.

Dr. Weiniger:                   In my school, they had us hiding under the desk.

Dr. Weitz:                        Oh, okay. Like that’s gonna help you.

Dr. Weiniger:                   What does help you is connecting your perception of your body with how it really is. Going to the wall, stepping one foot away from the wall with your feet parallel, leaning your butt against the wall and your shoulders against the wall, and then really lock in. Look straight ahead. Keep your head level. And try to keep your head level, that’s the must. And move it back towards the wall. If your head can’t touch the wall, and keep it level then that’s saying that you’ve got some distortion where your head, torso, and pelvis aren’t lining up ’cause if you take your feet away, you should be able to align head, torso and pelvis unless there’s something holding something forward. The strong posture exercise all use what’s called the must versus try killing. The must in this exercise, keep your head level. If someone says, “Yeah, I can touch the wall.” But the head’s not level, they’re not doing the must. And if you can’t touch the wall, the exercise is quite simple, go as far back as you can, but keep it level. Keep your head level as you pull it back.

It’s similar to the turtleneck that some people teach from an exercise point of view, but it’s more effective because if you take your feet away from the wall, you’re reducing some of the impact of the solace on the upper lumbar and lower thoracic spine and it makes easier to isolate the real cause for that particular posture distortion.  And so practicing keeping your head level, pushing it back and doing that with your breaths. So, doing it for what we call five slow breaths. Breathing in, letting your head come forward, breathing out, pushing it back to the wall. And you’ll notice by the third or fourth, you can get a little bit more play if you’re doing it right when you’re stretching the tight link of the chain. Doing that twice a day for a couple of days, you may find that you start to find it easier to keep your head level, which is what we’re trying to do, to open the body up, which opens up the second week of posture month, which is the first balance exercise.

And the first balance exercise is holding your best strong posture and balancing by lifting one leg up so your thigh’s parallel to the ground and holding it for five slow breaths, and then repeating it on the other side. And doing that just three times a day, just dialing in to standing tall and you can’t see me now, but I’m lifting leg up because if I lift my leg up, and my body is going like this and I’m twisting, I’m not strengthening the muscles of my posture. You want to first do alignment so you have an awareness of what standing tall feels like and then hold that feeling, lock that awareness in, and then challenge it by lifting one leg up. And as you know from a rehab exercise point of view, the way you strengthen something is by challenging it. That’s the second week. Do that a couple times a day, second week.

The third week of posture month, we’re coming out with the first motion exercise, sitting on a ball and just like you would sit at work, sitting really tall and trying to only move your pelvis. So instead having to focus the head, torso posture zone, we’re moving the focus back to the torso, pelvis posture zone. The key is moving the ball making three circles to the right, three circles to the left, but there’s two musts here. One must is don’t move your knees. The second must is don’t move your torso. So you’re sitting tall, you’re not moving your knees or torso, the only thing left to move is your pelvis. It sounds really easy, but it’s way harder than it looks, especially when you try to make a circle to the right, many people that have any kind of an issue will quickly notice that their circle isn’t round, but there’s a lack spot in their motion where they’re not able to control something actively in that arc. And what they’ll also find that if they make three circles to the right and three circles to the left, the inaccuracies of motion, the kinks, the things that are locked, that they didn’t know that were not moving, are not the same on both sides.  And it’s been not able to be recruited and used when you’re really focusing on it when you’re not focusing on it, when you’re doing a bunch of other things at the same time, you’re not gonna be using it and that’s why there’s this prior protocols that become so powerful that isolate and strengthen the weak link in each individual’s movement connect chain.

Dr. Weitz:                          What do you say to patients who say, “You know, why do I need to do these dorky exercises? I’m already going to the gym and I’m doing squats and deadlifts. I’m doing one of these other exercise programs where I’m lifting all these free weights. Why do I need to sit on a ball?”

Dr. Weiniger:                     Because exercise is good, but exercising effectively is far more important. If someone … I remember going to the gym and seeing guys that were bench pressing 250 pounds and they were doing it by lifting their head up, rolling their shoulders in, and bouncing it off their chest. And just saying, “I’m benching 250.” And especially, those guys, if you try to go over to them and say, “Try doing this with tight form.” Their response is, “I can’t lift as much, and the only thing that’s important is how much I can lift.”

Dr. Weitz:                          Of course.

Dr. Weiniger:                     And that’s not good. If actually, you’re a chiropractor and you want to take care of patients, it’s great for business, but it’s lousy for people’s bodies. All motion begins with your posture. All motion ends with your posture, and that’s why the awareness part becomes so important. If in your awareness, you think standing tall is standing like this, when you exercise all of your exercises is gonna be like that. If you’re a golfer, if you golf, golf begins with the address position where you’re getting set up, standing tall and then you’re … That’s what every pro that I’ve ever spoken to tells you to do. It’s when you think you’re standing tall in an address position, you really adapted in some subtle way like those silly ball things that we just talked about that you said, then you’re going to be taking those in asymmetries into whatever that larger motion is.  The only way you can strengthen the subtltees is to focus on only them. When you’re doing big macro motions, you can’t be aware of the small subtltees. Your body thinks in whole motions, not individual muscles. Start focusing on the subtltees and such incredible power, both from a pain point of view as well as from a performance point of view, as well as how other people see it.  Because the other part we need to talk about is when your training well, people look at you better.

Dr. Weitz:                         Are people actually making themselves worse by exercising in poor posture, and reinforcing that posture?

Dr. Weiniger:                    I’ll go back to what you said at the beginning. When a patient comes into you and they say, “Doc, why am I hurting? I’ve been going to the gym, I’m doing all this stuff, but this happened. What happened?” Because what you think you’re doing may not be what you’re really doing and everything that you do always begins with the posture. That’s why if you want to exercise effectively, you want to begin with effective posture.  And there’s been number of studies that have demonstrated that training bodies to move towards greater symmetry with greater accuracy makes a big difference in back pain. In fact, if you recall, last years guidelines both care of both acute and chronic lower back pain from the American College of Physicians said that surgery a lot of times is not good, opioids, not good, and they said things like Advil are not as highly recommended as they used to be and there should be alternatives like spinal manipulation, which chiropractors have been saying thank you very much, but also motor control exercises. That’s exercise really looking at the starting piece of motion. That’s precisely what the strength type exercise I designed to do.

Dr. Weitz:                          Okay, so do you tell somebody … Let’s say somebody comes in, and their posture is pretty bad. Do you tell them to stop all their other exercise until they can correct their posture or do you tell them maybe while they do their exercises, try as much as you can to get into a better posture?

Dr. Weiniger:                     And the better posture is what they’re learning to feel when they’re doing the strength posture exercises. Especially, if they’re working with a CPEP. But because if they’re coming in clinically, you want to be not creating more pain, not creating more tissue damage. So, you may possibly pull back from some of the exercise, and you may increase other exercises depending upon the person’s clinical story, the person’s exercise and their functional ability. That’s why we have the must versus try protocol becomes so powerful because we let you tailor it to their functional ability. The exercise is a test of what they can do functionally, which is then teaching them how to do in a way to strengthen the weak in their mechanic chain. So, in general, if you’re exercising, you want to work out quickly how to get the most benefit out of your exercising. That’s what a professional can help you do.

Dr. Weitz:                          Now, you talk about strengthening and balance, but what about stretching? So Let’s say you have this sort of rounded shoulder, forward head posture that you see in a lot of people and certainly strengthening the romboids and the middle and lower trapezius and some of the intrinsic neck muscles are important, but don’t you need to stretch out some of these shortened muscles in the front as well?

Dr. Weiniger:                     Absolutely, and that comes back to the point at the beginning. It’s not one thing, it’s everything. It’s like which tire on the car is most important? The left front, or the back rear? You’re going 60 miles an hour on the highway, you don’t want any of them to blow out. And if one blows out, the whole system doesn’t work the way its supposed to. In terms of correction, very very commonly someone’s gonna have a short pectoralis, more likely a short pectoralis minor, coracobrachialis, which the muscle underneath that is another really, really common shortness that’s missed because if you think about it, if there’re different layers of muscles, which there are, if the superficial muscles are tight, then other parts are gonna move differently. If the short muscles are tight, the muscles closer to the center of action of rotation of each joint, then nothing around that is gonna be able to move and you can stretch the superficial mussels out all day long, but you’ve gotta also get the deep ones. That’s why the pattern can be really different for different people.

And it’s what you just did, it’s not just open up what’s on front, it’s simultaneously strengthening what’s in back, but it’s not just the front and the back because when we did this, we also unfold the torso pelvis a little bit. We lean towards the back. So, if there’s an imbalance between torso and pelvis, that’s gonna keep on pushing it forward and you can try to open this up, but you’re gonna have to do something else to compensate. Posture is a whole body phenomenon. It’s not just your head, it’s not just your back, it’s literally how you balance your body. And that’s why the balance exercises are so key to strengthening posture.

Dr. Weitz:                            And what’s the role of chiropractic in this?

Dr. Weiniger:                     Tremendous. Chiropractic’s main goal of focus began with spinal manipulation, which is working on the segments of the spine, the vertebrae of the spine to restore motion and to allow more normal neurologic function because the spine houses the spinal column and that connects the brain to the muscles and then the nerves. And if those are not moving well, if there’s not accurate information coming to the brain, it means the way that you think you’re moving is even less likely how you’re moving. From a biomechanics perspective, if there’s a locked link in the chain, so my hands should be moving like this, and my fingers are not moving, it’s gonna move like that. That’s gonna put more stress on one joint, more exercise on one joint, and less on others. The same thing happens in the spine where one spinal segment is working more, breaking down more, getting more exercise at one level, and less at others and that imbalance then drives how everything else is moved. So the combination of chiropractic spinal manipulation with strong posture exercise is like this.

Dr. Weitz:                            Right. For those in the audience who aren’t really familiar with what chiropractic does is, one of the core factors treatments of chiropractic that really no other professional really does effectively is the manipulation or adjustment and it sounds like your understanding is similar to mine, is we’re trying to find those particular joints in the body, whether they be spinal, or extra spinal, in the shoulders or elbows or knees or wherever, and making sure all those joints are moving freely in all those different directions that they’re supposed to move in. For example, your spinal joints are supposed to bend forwards and backwards and side to side and rotate and we’ve gotta make sure they’re doing all those motions so that you actually can attain the type of posture and maintain that type of posture.

Dr. Weiniger:                     Exactly, and I talked about the spine, because you said where chiropractic began, but from a perspective of postural rehab perspective, we also want to be … A good chiropractor to me addresses all of the links in the kinetic chain because if you’ve got a problem with your big toe. I drop a cinder block on your big toe, your posture when you walk is gonna go to heck ’cause it’s gonna hurt and you’re gonna adapt to it. So a good chiropractor should be able to address all the links in what we call the kinetic chain. It’s the body how to move symmetry, how to move with greater symmetry. In other words, a chiropractor unlocks motion, stimulates neurology to function more accurately, but if you don’t retrain the body to move more accurately, it’s gonna keep ongoing back to the old patterns. The chiropractor unlocks and restores motion, strong posture exerciser retrains that motion. They both fit together.

Dr. Weitz:                          One more question. Is there a role for nutrition in promoting posture?

Dr. Weiniger:                     Oh, absolutely. If your body doesn’t have the materials that you need from a biochemical basis to function, it’s gonna function adaptively. Everything from enough water, which is something that is one of the underrated issues with a lot of people with lower back pain, to enough calcium, to other things like functional medicine that you can use to stimulate or to decrease how different things are functioning to address it. Our bodies are not just biomechanical, it’s not just nutritional, it’s both working together.  As well as, biopsychosocial or attitudinal or mind or emotional, however you want to phrase it. Your head space, your attitude, will affect your posture and effect your health, and effect your biochemistry. They’re all together as mind, body, and spirit, which is kind of how chiropractic began once upon a time and it’s cool seeing more things go in that direction now.

Dr. Weitz:                          There you go. That’s kind of a evangelical saying from the posture evangelist. With a prayer here.

Dr. Weiniger:                     It’s funny because as you’ve noticed, I’ve got … I wear a number of different hats, and I’ve been at different boards and I didn’t want it to sound stuffy. I wanted to make it more of a fun thing to engage people and that was literally put out there as a kidding around and some people started banting it around and it became kind of what it is, but it’s true. Posture can make a big difference in your life. The posture month. Be aware of your posture, take control, engineer for a strong posture environment and next year recheck and see how you’re doing. And all the time, do basic posture exercises. You have a problem, see someone that can help. And the Posturezone app lets you check it and will help you find somebody.

Dr. Weitz:                          Cool. And so for listeners who want to get a hold of you, what’s the best way for them to contact you or get ahold of your book and learn about your programs?

Dr. Weiniger:                     From a public point of view, Stand Taller Live Longer, is the website for the book because that’s the name of the book. From the public point of view, Bodyzone.com, is where public information is. In the professional point of view, Posture Practice is where we teach people how to be CPEPs to strengthen people’s posture and from everyone’s point of view, download the Posturezone app. And all of those sites have ways to contact us that they can get a hold of me.

Dr. Weitz:                          Sounds great. Thanks, Steve. Keep spreading the word.

Dr. Weiniger:                     I appreciate it. I very much enjoyed it. Thank you.

Dr. Weitz:                          Okay, I did too. Talk to you soon.

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Dr. Karima Hirani speaks about Low Dose Immunotherapy and Low Dose Allergy therapy with Dr. Ben Weitz .

[If you enjoy this podcast, please give us a positive review on Apple Podcasts, so more people will find The Rational Wellness Podcast] 

 

Podcast Highlights

3:33 We discussed Low Dose Allergy therapy (LDA), Low Dose Immunotherapy (LDI) and the differences between them. Low Dose Allergy therapy has been around for 50 years, having been called Enzyme Potentiated Desensitization in England. This was eventually brought to the US by Dr. William Shrader, who is one of the head people at the American Academy of Environmental Medicine. LDA is a form of Low Dose Immunotherapy using a proprietary formula of a broad-based mixtures of allergens (antigens) made immunologically active by the enzyme glucuronidase. It is used for allergies, but allergies can present as autism and using LDA you can see improvements in speech and language.

6:00  Besides LDA, her other top LDIs are yeast, Lyme, and strep for PANDAs.  Rather than the traditional method of subcutaneous injections of the FDA, they are using it as sublingual drops, thanks to Dr. Ty Vincent.  And they are using further serial dilutions of the FDA tincture that comes from the compounding pharmacy that makes it, since it is too potent. It ends up being diluted a quadrillion times, so it is really a homeopathic formula.  The same T regulatory cells that are found under the skin are also present under the tongue.  This is a way to train the immune system to build tolerance.

10:08  Dr. Hirani often finds Lyme Disease in her patients with autism and Lyme Disease is really a condition of immune dysfunction. The Lyme LDI seems to turn off the autoimmune component of the chronic Lyme disease.

12:15  Dr. Hirani explains that PANDAS found in kids is the pediatric autoimmune neuropsychiatric diseases after strep infection.  She gets amazing results with LDI to create immune tolerance and this alleviates many of the symptoms. This also turns off such infections that create chronic illness. She will also often give such patients high dose vitamin D to help the immune system. 

15:25  Dr. Hirani noted that if she gives a dose that is too strong and it can trigger a herx reaction. If she has an autistic kid and she gives too strong a dosage of strep LDI, it can trigger a strep infection and these kids will have strong reactions, so she may prescribe an antibiotic and she will use a rescue formula of supplements.

20:04  Dr. Hirani explains that in the last few years many more patients are testing positive for Lyme infections with the Western Blot and they will also often have a low CD 57, which is a marker of immune dysfunction.  She will also often test her patients for Lyme, Epstein-Barr, cytomegalovirus, Human Herpes virus 6, herpes 1 and 2, mycoplasma, measles, mumps, strep, and varicella IgM titers. The measles, mumps, and varicella titers can result from the vaccines and these things can trigger an autoimmune disease in these kids, as these infections turn off and on.  

 

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Dr. Karima Hirani is available to see new patients by calling her office in Culver City at (310) 559-6634. You can get additional information about Dr. Hirani by going to her website http://www.drhirani.com/

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure as well as chiropractic work by calling the office 310-395-3111.

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Podcast Transcripts

Dr. Weitz:           This is Dr. Ben Weitz with the Rational Wellness Podcast, bringing you the cutting-edge information on health and nutrition from the latest scientific research and Bible interviewing top experts in the field. Please subscribe to the Rational Wellness Podcast on iTunes and YouTube, and sign up for my free e-book on my website by going to drweitz.com. Let’s get started on your road to better health.  Hey, Rational Wellness podcasters. Thank you for joining me again today. We have a very exciting show. We’re going to be interviewing one of my friends for a long time Dr. Karima Hirani. She has a thriving practice in Culver City. She is a medical doctor who specializes in functional and integrative care. Doctor, let me give you a little bit of introduction into her background and then we’re going to highlight a couple of therapies that she’s using in her practice, which are low dose allergy and low dose immunotherapy. We’ll also going to try to cover neurotherapy if we have enough time.

                                So Dr. Karima Hirani is board certified in family medicine, as well as in integrative and holistic medicine, as well as in clinical homeopathy. She holds a Master’s Degree in Nutrition from UCLA.  She specializes in autism, ADD, and PANDAS in children. She also treat adults with chronic illness.  She is an expert in specific types of treatment that she uses for her chronic patients, including low dose allergy therapy, low dose immunotherapy, and neurotherapy.  Low dose allergy therapy and low dose immunotherapy are essentially ways to help individuals overcome allergies and food sensitivities to foods, chemicals, molds, toxins. This therapy can be used for whole range of chronic illnesses, including autoimmune diseases and chronic fatigue and Lyme disease, et cetera. So this is a type of therapy that helps to balance the immune system when the body is not able to tolerate certain bacteria, fungi, viruses that live within us that others can tolerate or maybe that your own body could have tolerated at a different point in time. This is certainly the case with Lyme disease and many other chronic diseases that many of us in the functional medicine world find coming into our offices very frequently.

                                Dr. Hirani, thank you for joining me today.

Dr. Hirani:           Thank you for having me. It’s a pleasure.

Dr. Weitz:           Boy, we’ve known each other for a long time. How many years have we known each other?

Dr. Hirani:           A long time, maybe 15, 20 years.

Dr. Weitz:           Yes, yes. I remember going to all those Dr. Bland seminars and I would always get to talk to Dr. Hirani.

Dr. Hirani:           Yes.

Dr. Weitz:           So can you explain a little bit about the differences–What is low dose allergy therapy? What is low dose immunotherapy? What are the differences between those?

Dr. Hirani:           So low dose allergy therapy has been around essentially for about 50 years now. It was first discovered in England. It was called Enzyme Potentiated Desensitization. It was brought to United States several decades ago by Dr. William Shrader. He is one of the head people at the American Academy of Environmental Medicine. He and many other doctors have been using low dose allergy therapy for several decades. What they’re using it for is to treat allergies. As you know as a functional medicine doctor, one of the most important things that we look at is allergies in our patients. Sometimes allergies don’t present as the classical symptoms, where you have the runny nose, itchy eyes, teary eyes, et cetera, sneezing.  Allergies can present as chronic fatigue.  Allergies can present as autism. When we treat with LDA, we see amazing things happen, anything from improvement in speech and language.  To my adults patients, they are not tired as much anymore.  Their brain fog is better.  They lose weight, because when you have allergies or you have a chronic infection, it can cause inflammation and then it can lead to weight gain.  So we see a whole spectrum of improvement by just giving the patient the LDA.  Again, I have to really stress the fact that it’s not the typical allergy symptoms that you should be looking at. You should really be thinking of everyone as having potentially allergies and then to just give them a trial dose of the LDA. That’s usually one of the first treatments that I offer without even doing any functional medicine testing on my patient. I just give them the LDA dose and then we see what happens.

Dr. Weitz:           What percentage of patients do you see some sort of positive response?

Dr. Hirani:           I haven’t really like scientifically quantified it, but if I could just generalize, my top three most beneficial LDA-LDIs is LDA is one of them and then I have my other LDIs, which are really effective in my patients are yeast and Lyme and then Strep for PANDAS. These four seemed to be my most effective treatments.

Dr. Weitz:           Interesting. So my understanding of LDA is that this could best be described as a form of low dose immunotherapy and is a proprietary mixture of foods and other things that could create allergic reaction.  Is that sort of the way to understand it?

Dr. Hirani:           Absolutely, absolutely. Ty Vincent, thanks to Ty Vincent.  We’ve taken it one step further and that traditionally, most doctors were just injecting in the skin. They were just using the original dose that you get from the compounding pharmacy because this proprietary mixture comes from one compounding pharmacy in the United States. What Ty Vincent has been doing and he’s taught doctors like myself to do is to make further serial dilutions of the actual LDA because many, many patients are extremely sensitive. The original tincture that comes from the compounding pharmacy is too potent.  So that’s something that we’ve done.  We’ve been able to help even more patients than we could by LDA by making the serial dilutions.

Dr. Weitz:           Now it’s interesting because this is something that’s alluded billions even trillions of times, right?

Dr. Hirani:           Correct, yes, like quadrillion, quadrillion times.

Dr. Weitz:           Essentially, we’re talking about a homeopathic formulation. There’s really no real amount of the original compound sort of just the energy of it essentially, right?

Dr. Hirani:           It’s the energetic imprint that’s been left in the mixture and that’s what we’re giving the patients, and I do it and I think Ty Vincent does it also. We do it sublingually. We’ve moved away from the subcutaneous injection because it’s very painful.  It leaves behind big red bump and itchiness and swelling.  Patients don’t care for that.  So when we do it sublingually, we have the same T regulator cells that are subcutaneous that are under the skin.  There are also under the tongue.  So we’re basically training the immune system to build tolerance.  That’s what we’re doing.

Dr. Weitz:           In contrast with homeopathic medications, if a homeopath wants to give you a more potent formulation, he makes it more dilute. But with the low dose immunotherapy when you make it more dilute, it’s less potent, right?

Dr. Hirani:           Correct, yes.

Dr. Weitz:           I mean that makes rational sense to me. One of the problems I always had with homeopathy is to tell me you’re going to dilute it, another hundred thousand, million times and it gets more potent. It just totally is very difficult for my rational, scientific mind to wrap around.

Dr. Hirani:           The way that traditional homeopaths look at it is when you further dilute it, it’s working at a deeper level. To me it makes sense because when we have to further dilute these potions and we give them to patients who can tolerate them, these are patients that are probably really affected at a deeper level than somebody who can just handle the original mother tincture.  So to me, I see a correlation.

Dr. Weitz:           So when you’re treating a chronic condition like … I read some of your blog posts and watched your video that you did at the Autism conference. So you often find Lyme disease as an infection that affects patients with autism, right?

Dr. Hirani:           Yes, and my adult patients as well with chronic illness.

Dr. Weitz:           So essentially, when you look at Lyme disease, you’re not really looking at it as a disease that is like a typical acute infection. This is something that’s really creating a problem because it’s created, the body is reacting, the immune system is overreacting to it. It’s not that the bacteria is actually eating away your tissues or things like that, right?

Dr. Hirani:           Exactly. I think that there’s two processes going on. One is there is this infection that seems to turn on and off. When it’s off, the immune system thinks the infection is still there, so it’s mounting an attack against the patient. It’s this autoimmune phenomenon that is really making the patient really ill, so that the LDI, the line of the I that we give to the patient seems to turn off the autoimmune aspect of the illness.  Does it ever get rid of the illness?  We’re not quite certain, but we certainly seem to have amazing results just in curing all of these symptoms and getting rid of all of these symptoms from the fatigue to the joint pains to the brain fog.  I mean, you name it, we’ve seen improvements.  So the autoimmune concept, the reason why it makes a lot of sense to me and it may not make a lot of sense to a lot of doctors if they’re not treating PANDAS. Are you familiar with PANDAS?

Dr. Weitz:           Somewhat.

Dr. Hirani:           So if you understand PANDAS, for your audience, PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Strep.  So this is an autoimmune phenomenon that has occurred after a Strep infection.  These kids can have OCD. They can have ticks.  They can have aggression, ADHD, anxiety, bedwetting, whole host of symptoms that they can have.  So this is an autoimmune response to this infection.  When I first heard Dr. Ty Vincent speak and he was talking about the autoimmune concept of infection of these infections like Lyme and yeast and Epstein-Barr, it just like it rang bells in my head and it just made sense.  I just dived into it and I’ve had amazing results in my chronically ill patients.

Dr. Weitz:           Now this is a different way of thinking about infections and say the average person who thinks about a flesh-eating Staph bacteria, you have this bacteria, it’s eating away at you. Unless you get rid of it, you’re going to end up suffering dire consequences. In this sense, you’re thinking of an infection as the problem is not really the bacteria per se that’s damaging your tissues. It’s that your immune system is not tolerating it, right?

Dr. Hirani:           Exactly. It’s the autoimmune aspect of it. For example, I’ve had patients who come in with oral herpes or with genital herpes. We’ll give them their herpes LDI and we will turn off the infection. So we can literally turn off active infections by giving the LDI to them. So what does that tell you? It tells me that there’s a huge autoimmune component to these infections and that a lot of these infections are probably they’ve been living with us for eons.  Probably not causing us a lot of harm but for some reason in the last several decades, these infections are being threatened and so they’re coming alive. They’re creating all of this autoimmune havoc in the body and then creating all this chronic illness.

Dr. Weitz:           So do you ever use killing strategies at the same time? Do you ever prescribe antimicrobial herbs, so that you can knock down the bacteria at the same time that you’re getting your body to be more tolerant of it?

Dr. Hirani:           No, I don’t need to.

Dr. Weitz:           You don’t need to.

Dr. Hirani:           I don’t need to. It’s wonderful.  Patients come to me from other doctors with this laundry list of supplements and herbs that they’ve been on.  I don’t need to give them anything other than just high dose vitamin D, because the vitamin D seems to just really help the immune system and help the LDIs and the LDA work better. That’s really all I need. Now if I give a dose that’s too strong, say let me use PANDAS again, so I gave a Strep dose to a child and it was too strong for the child, it can trigger a Strep infection. In autistic kids, they can go bonkers. So in that case, I do sometimes need to prescribe the antibiotics and some rescue treatments to turn off the, we call it the herx reaction. So sometimes I do need to prescribe antibiotics, but it’s very rare or we have the parasite LDI. The parasite LDI is just a boon for my children, because they have classical symptoms of parasites from teeth grinding to foul-smelling gas to hair pulling, licking, chewing, mouthing.  So when I give them the parasite LDI, if it works, it’s miraculous. It turns all of the symptoms off and the parents are thrilled. When it’s too strong, it can actually worsen all of those behaviors, so in which case sometimes I have to prescribe a parasite medication for them and a bunch of oral supplemental rescue treatments for them.

Dr. Weitz:           So it’s interesting you bring up parasites. We know that there are some parasites where protozoans or even some worms that coexist in humans and actually maybe beneficial for us and there are others that can kill us. So how do you resolve knowing when you want to be tolerant, the difference between I want to be tolerant of something my wife does that’s really annoying to me as opposed to I don’t really want to just be tolerant of Charles Manson living in my house because it’s probably not going to be good to just be tolerant of it?

Dr. Hirani:           Well, basically if you’re walking into my office and you have symptoms, you’re not tolerant of these organisms that are living in you. Then if you got classical symptoms, in adults it tends to be just a foul-smelling gas.  I had one young woman.  She is still a patient of mine. She had this habit of picking at her skin.  She was picking away at her skin and she had all of this scarring and acne.  I treated her with the parasite LDI and all of that picking went away.  So if the patient presents to me with classical symptoms of parasites, you have to know what those symptoms are.  If you give them the LDI, you’re going to turn it off and you’re going to be so grateful.  The foul-smelling gas, I mean, how many patients have you seen that have problems with flatulence and foul-smelling?  You give them the right dose of the LDI and you just turn it off, I mean it’s miraculous, so.

Dr. Weitz:           I just read about some airplane. that had to have an emergency landing because some guy wouldn’t stop passing gas.

Dr. Hirani:           He needs the parasite LDI.

Dr. Weitz:           Once again, I just want to come back to the same thing. How do you know that it’s not a parasite that’s going to eat its way through your intestine and eat away at your liver and your brain? There are some parasites that are deadly and you don’t just want to be tolerant of them.

Dr. Hirani:           I get what you’re saying. What you need to understand is that LDI isn’t going to kill these infections. LDI is just helping your body become tolerant to them. If you already have a tolerance, then that LDI is not going to do anything. It’s not going to make it worst. For example, like Ty Vincent says, he doesn’t really have any symptoms of Lyme but he tried one of the Lyme LDIs and he noticed that his plantar fasciitis went away. So he obviously had a symptom that he didn’t associate with Lyme. Again, if you don’t have any symptoms and I give you the LDI and you don’t have a problem, it’s not going to make anything worse. It’s not going to turn off the parasites. Does that make sense to you?

Dr. Weitz:           Yes, it definitely makes sense. Treating somebody’s chronic conditions are so difficult.  So when you get a patient with autism, how do you know where to start? I know that you said you find Lyme. Do you test for Lyme? Do you just try a Lyme protocol or?

Dr. Hirani:           I’ve been doing this for a long time now so I can have it down to science. So I do do a whole battery of testing on these patients. Before I even get the results back, they all go home with the LDA, because like I said the LDA is one of my most effective treatments. When they come back for follow-up to do lab work review, I am now testing for Lyme through Medical Diagnostics Laboratories. A ton of these kids are coming up positive with the Western Blot whereas way back like maybe 10 years ago, nobody was turning up positive. All of a sudden, so many patients are turning up positive with Lyme. So this is very helpful to convince my parents. Before I was even doing the western blot or the MBL labs, I would just use the CD57 as a biomarker and everybody has a low CD57.

Dr. Weitz:           What is the CD57?

Dr. Hirani:           The CD57 is a white blood cell that gets rid of infection and also cancer cells. So in everyone that walks in my door, adult or child, the majority of the time I would say about 90% of the time, this biomarker is abnormal. It’s low and that’s a marker of immune dysfunction. Lyme disease, Epstein-Barr, CMV, even heavy metals have been shown to lower the CD57. So when I do this lab test and I show it to the parents or my adult patient, I tell them that, “Look, this could be a marker for Lyme and let me treat you with the Lyme LDI.” I do so and then lo and behold they’re better.   

Dr. Weitz:           So what percentage of the improvement do you see in kids with autism using your protocol with the Lyme LDI? Do you do other things or is that a protocol in of itself?

Dr. Hirani:           So almost every kid gets the Lyme LDI.  It may not be the second or the third, because sometimes they have active measles or mumps in their blood.  So I check for IgM titers in kids that have been vaccinated. So if they come and they have anything that’s IgM positive, like either the measles or the mumps, now nobody is testing for this. I’m probably one of few physicians that’s doing this testing.  I’m encouraging other doctors to measure this but if they’re not, shame on them.

Dr. Weitz:           Well, so is that a test offered by conventional labs? Where do you got to tested it?

Dr. Hirani:           Quest, LabCorp, they all do that. The LA County Department of Health doesn’t like that I’m measuring the IgM, because IgM means active infection. So they have to go through the process of calling me and finding out if this patient has active mumps or active measles. Usually, the child does not have any evidence of an active infection, but I know that it’s affecting their brain because these infections can cause an encephalitis. So when I see these IgM positive infections, sometimes even the varicella because these two vaccines, the MMR and the varicella were live viral vaccines. So sometimes these vaccines can trigger an autoimmune response and then the infection is turning on and off. So if I see these active infections and the titers are really high in the blood, I might first want to treat these infections. Or if the Strep titers are really high indicating PANDAS, I might want to treat with that first. So it really depends on what lab results show and then I go by all of that. So I usually go after, of course, the active infections first.

Dr. Weitz:           So what’s your complete panel? Which different things are you testing for when you get a typical kid with autism say?

Dr. Hirani:           So I test for Lyme. I test for Epstein-Barr. I test for cytomegalovirus. I test for Human Herpes virus 6. I test for herpes one and two. I test for mycoplasma and then I test for varicella. I think that’s about it and I check the IgG and the IgM titers, so.

Dr. Weitz:           IgG and IgM titers for which particular vaccines or organisms?

Dr. Hirani:           All of those that I just mentioned.

Dr. Weitz:           Oh okay.

Dr. Hirani:           IgG and IgM for all of those that I mentioned.

Dr. Weitz:           I mean, you also do the measles-mumps-rubella.

Dr. Hirani:           Exactly. The MMR, IgG, IgM exactly yes.

Dr. Weitz:           Okay, and the varicella, right?

Dr. Hirani:           The varicella, correct.

Dr. Weitz:           What about other vaccines like influenza?

Dr. Hirani:           So I don’t necessarily test titers for those if the parents tell me that my kid got the DTaP and then we lost him. We have the DTaP LDI. We have the hepatitis B LDI. I don’t use those quite as often as I use the MMR and the varicella. Now I do need to tell you that I don’t just treat the IgM. If the IgG, which indicates past infection and these IgG antibodies are super high in the blood, I will also treat those with LDI. I mean, we’ve seen just amazing things happen like I had two-year-old kid with active Epstein-Barr virus. We gave him the EBV LDI. Luckily, it was the right dose and he is talking now. So, I mean, when you treat these infections especially these active infections, it’s a big deal. Of course, infection is not the only thing we treat. We treat heavy metals, because these kids are loaded with heavy metals. So aluminum is huge in these kids.

                As being a proud … I don’t now if you came across a recent study that was published just at the end of last year. It came out of England where they autopsied the brains of I think 10 autistic kids who had died for unfortunate reasons. They found shockingly high amount of aluminum in their brain. So we know that these heavy metals are also playing a role in these kids.

Dr. Weitz:           Where are they getting these levels of aluminum?

Dr. Hirani:           That’s the big controversy. You may have heard of the chemtrails. Have you heard about the chemtrails?

Dr. Weitz:           No.

Dr. Hirani:           So I think that’s something you need to really look into, because you see those planes flying above when it’s a clear sky? You see those planes?

Dr. Weitz:           Okay, yes.

Dr. Hirani:           They’re spraying aluminum on us.

Dr. Weitz:           Really?

Dr. Hirani:           It’s been purported that it’s for climate control. However, a lot of people question the truth to that because-

Dr. Weitz:           How does it affect climate control?

Dr. Hirani:           Yes, exactly, I don’t know. Why are we trying to control the climate, I don’t know. Basically, every single country in the world has chemtrails. These are chemtrails you can see in every country in the world yet nobody seems to question it. Nobody seems to care about it. Nobody is talking about it. [inaudible 00:28:01] from Malibu collect her rainwater two days in a row. She sent it to a lab that tests for heavy metals. The rainwater had 50 times the acceptable amount of aluminum in-

Dr. Weitz:           Wow.

Dr. Hirani:           So, yes, it’s coming down on us. The aluminum is coming down. Obvious sources of aluminum are also aluminum foil, non-stick cookware. All of these things are sources of aluminum.

Dr. Weitz:           What about the aluminum that’s often found in vaccines?

Dr. Hirani:           They’re definitely an issue as well, absolutely yes. We have to consider that as a concern for these kids.

Dr. Weitz:           In fact, my understanding is the aluminum is often added to the vaccines as an adjuvant, meaning it’s something to actually create immune system reaction, because-

Dr. Hirani:           You know what? The aluminum hasn’t been found to be a great adjuvant. It’s not a great adjuvant-

Dr. Weitz:           Oh, really.

Dr. Hirani:           … but yet they use it. There’s a really great book that you might want to read. It’s by Mayer Eisenstein. He’s an MD, PhD. He’s a pediatrician, sorry, he’s an MD, JD; I apologize. He’s an attorney. He had to go back to law school to protect himself because he’s not anti-vaccine, but he’s very pro educating his parents about what’s in the vaccines. He’s published a book showing you the effectiveness of these adjuvants and aluminum is really not a very effective adjuvant.

Dr. Weitz:           Interesting. So then you will administer a low dose immunotherapy of aluminum to help these kids?

Dr. Hirani:           Yes. Again, we see amazing results. Even my Alzheimer’s patients, their cognition gets better, their thought processes in another language. The autistic kids their speech becomes amazing what we see with the aluminum.

Dr. Weitz:           Once again, one thing I’m having trouble wrap my head around is you’re now creating a tolerance to the aluminum. Don’t you want to remove the aluminum?

Dr. Hirani:           That’s something we don’t know for sure because we haven’t studied it. I personally think that by giving the aluminum LDI to the patient we’re actually helping the immune system remove these metals from the body, because these metals–it’s very hard to eliminate them especially if you have poor detoxification. I think that these LDIs are helping the body excrete them. I haven’t really done like a comparison study, some case studies on my patients to show like a before and after urinary porphyrins perhaps because that’s a lab test that we can use to determine if they have heavy metals. That’s something I definitely need to do and then I can really definitively say we did this LDIs and now the porphyrin levels have lowered so obviously it’s helping excrete these metals. So I personally think it’s doing that.

Dr. Weitz:           Do you ever combine it with a heavy metal detox protocol of some kind whether that be glutathione or NAC or chelators or something along those lines?

Dr. Hirani:           I combine it a lot. So I’m actually known as the chelating doctor. So I have a lot of experience chelating these kids from doing the transdermal, so topical to suppository to IV chelation, so I combine those a lot. Then I also have patients who don’t want to, parents who don’t want to do any kind of traditional chelation then we will just do the LDIs, and I have them on detox supplements as well, like glutathione, etc.

Dr. Weitz:           Interesting. Of those various forms of chelation, which one do you find to be the most effective?

Dr. Hirani:           As far as the traditional?

Dr. Weitz:           Yes, yes, but just stepping away from the LDI just for a second, even though I know that’s our main topic. We were talking about chelation. You mentioned suppositories and oral chelation, etc. Which do you find to be the most effective?

Dr. Hirani:           So the IV chelation is the most effective. The number two most effective is the suppositories. The number three most effective is the transdermal. I like to start with the transdermal actually on the younger kids because it’s so non-invasive. It’s just a cream that parents can apply at home. I send them home with the mineral supplement. I tell them that it’s going to pull out the good stuff as well, so you need to replenish with the mineral supplement. Then you need to look at for yeasty and parasite behaviors, because remember that parasites and yeasts, they actually hold on to your metals for you. So when you’re chelating, you’re also removing the metals from the yeast and you’re removing the metals from the parasites. So these bugs are going to get activated and these kids will present with symptoms of yeast and parasites, so we have to treat with either LDI and/or prescription medications like for yeast or for parasites.

Dr. Weitz:           Interesting. So one of the real benefits of using this low dose immunotherapy is not only is it especially effective, especially in the case of a skilled practitioner like yourself, but it has very low side effects. Isn’t that right?

Dr. Hirani:           Exactly, exactly. So with the LDI, parents are usually very eager to jump on it and I’m happy to prescribe it because it’s very safe. There’s always the risk of having a dose that’s too strong and I warn the parents about that. I tell them that “Look, if that happens, you just have to email me and I will send a protocol to do that’s a rescue treatment protocol with high-dose glutathione, high-dose CoQ10, high-dose vitamin D. If those three supplements are not working, then I’ll bring them into my office and we do rectal ozone and we do an auto-urine injection and we do a foot bath. I find that the ionic foot bath is very, very complimentary to detox and to treating especially herx reactions in patients. So I have a whole host of rescue treatments that I offer in the office for patients to do at home should the dose be too strong. I haven’t had too many problems with children herxing from the heavy metal LDIs, as I have with, I’ve had more herx reactions from the infection LDIs than I’ve had from the heavy metal LDIs.

Dr. Weitz:           For people watching this podcast who aren’t familiar with the herx reaction, can you explain what that is?

Dr. Hirani:           A herx reaction is a reaction that you get after you’ve taken a particular treatment. So for example, even Lyme patients who were doing antibiotics can have a herx reaction. So when we give an LDI dose that was too strong, the patient can have a herx reaction. The herx reaction is basically a worsening of your current symptoms or an emergence of new symptoms that you never had before, or a re-emergence of symptoms that you had before but they’ve come back again and now you’re really ill from these reactions, the symptoms that you had in the past but now they’ve come back again, or you never had them and now you have them. Or you have symptoms already and now the herx reaction is making your symptoms just worse than what they were before you took the LDI. So that is the risk that we are taking. We’ve tried to come up with methods to lower the risk especially with the muscle testing.

                I’ve identified 18 red flag symptoms that if the patients have any one of these 18 red flags, we automatically go 10C weaker on the dose that we find through the autonomic response testing to further minimize the risk of having a negative reaction. So it’s very important to have that discussion with parents because it is going to happen at some point with some particular LDI. We just have to reassure them that majority of the time, probably about 95 to 98% of the time, we’re able to reverse it.

Dr. Weitz:           When the patient does have adverse reaction to this low dose immunotherapy, you have to wait a certain period of time and then give them a lower dosage or less concentrated dosage.

Dr. Hirani:           Exactly. We tell the parents or we tell the patient that we need to wait now two months before we can retry this same LDI again, but we’re going to go 10C weaker or 20C weaker in terms of the dosing to really, because what I explain to them is if you herx from this reaction, that means you have a serious major issue with this particular bug or with this particular heavy metal and that we need to treat that again.

Dr. Weitz:           With respect to kids with autism, I’m sure it’s best if you can get to these kids early. What about the parent who has a kid who’s seven years old, 10 years old, 16 years old and none of the treatments have really been effective. Is this something that at that point can still be beneficial?

Dr. Hirani:           Oh, yes. Older kids, I have a 20-year-old kid and a 22-year-old kid that are just doing amazing. In fact, their dad is supposed to send me a video testimonial so I can post it on my YouTube channel, https://www.youtube.com/user/HiraniWellness. This kid, for example, his dad has left no stone unturned. His dad has tried everything out there for his kid. He has done chelation. He has done everything. He will tell you that nothing has helped his kid as much as the LDIs have helped his son. They can have a normal life now.

Dr. Weitz:           He just started this recently, right?

Dr. Hirani:           Two years ago, because I’ve been doing it. I just started it in 2015, so it will be three years now.

Dr. Weitz:           Wow, that’s great. That’s awesome, Dr. Hirani. What is your YouTube channel?

Dr. Hirani:           It’s just Dr. Hirani.

Dr. Weitz:           Okay good.

Dr. Hirani:           Dr. Karima Hirani.

Dr. Weitz:           Okay great. So I think that was a great amount information for our listeners to absorb and very, very helpful. Is there any final thoughts you would like to provide us?

Dr. Hirani:           Well, if your patients are out there struggling especially the adult patients with any kind of chronic illness, whether it’s IBS or chronic pain or brain fog, do give LDI and LDA a chance because it could be really life changing.

Dr. Weitz:           For practitioners who are listening to this who’d like to investigate LDA and LDI, where should they go to learn more information or attain some of these products?

Dr. Hirani:           They should contact the American Academy of Environmental Medicine. They should buy the LDA manual and they should attend one of the LDA courses at AAEM. Then they should also contact Ty Vincent and then buy his manual for LDI. When you buy his manual, he will also send you all of the LDIs and then in his annual he tells you how to make the further dilutions and how to use LDI. Nobody talks about the muscle testing. So if you’re new to muscle testing, I recommend you maybe check out Dr. Dietrich Klinghardt and take one of his courses on autonomic response testing. I’ve only taken level one. I don’t need to do all of the other levels because I don’t need to. The level one was good enough. So do think about using some sort of muscle testing to find the right dose. If you don’t and you’re just guessing like Ty Vincent and other doctors are, then you’re going to herx more patients than you want. So that’s my advice.

Dr. Weitz:           It’s my understanding that these are over the counteri and can be recommended by chiropractors and non-MDs as well. Isn’t that correct?

Dr. Hirani:           I’m really not sure about that because you have to check with Ty Vincent about that. With the LDA, I know you have to be an MD because you have to-

Dr. Weitz:           The LDA.

Dr. Hirani:           … order that from a compounding pharmacy. With the LDIs, it’s possible that you can get it from Ty Vincent. I don’t know if he is requiring you to be an MD. I don’t know because he never asked me for my medical license, so it’s possible.

Dr. Weitz:           Okay, excellent. So for viewers, listeners, and practitioners who would like to get a hold of you, what’s the best way for them to contact you?

Dr. Hirani:           Drhirani.com is my website. There’s a Ask Dr. Hirani a Question, so they can contact me there. So it’s D-R, Hirani, H-I-R-A-N-I dot com.

Dr. Weitz:           Great. Thank you so much, Dr. Hirani. I’d love to have you back at some point and talk about neurotherapy.

Dr. Hirani:           I would love to, I can’t wait, because these are two of my most amazing treatments on mother practice.

Dr. Weitz:           Awesome. Thank you and so nice to touch base with you again.

Dr. Hirani:           So much, Ben. It was a pleasure. Bye.

Dr. Weitz:           Bye.

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Dr. Philip Goglia speaks about how to help his clients lose weight with Dr. Ben Weitz. 

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Podcast Highlights

1:48  Dr. Goglia explains how he increases compliance among his clients by asking clients who don’t follow their food program to “walk the pig.” He actually has a large plastic pig with wheels and a leash around it that he asks clients to bring home if they have not been following their meal plan. This increases his clients’ compliance with their weight loss program. 

3:56  Philip briefly explained his metabolic typing concept that allows him to determine the best nutrition program for each person.  Philip explained that this program is both proven by science and tested in practice by him and others since the 1980s. He says that when he was studying nutrition at Duke University they discovered three metabolic structures: clients who are efficient at digesting fats and proteins, clients who are efficient at eating carbohydrates, and duel metabolizers. This will also be indicated by their lipid profile that he tests in office. Once you are eating an appropriate macronutrient pattern for how your body works, you’ll find that you have more energy, you’ll lose weight, and you’ll be healthier.  And this food program will be sustainable over time. If not, you’re on the grapefruit and milk diet and you might lose 10 lbs but you’ll just gain it back later. Also, don’t be fooled by weight loss. If you start almost any new food program, because your calories were mismatched and all over the place and because your caloric heat patterns are stabilized, you’ll lose 10 lbs.  But does this program suit your chemical structure–that is the big question?  According to Dr. Goglia, if you are on the wrong food program for your metabolic type, your weight loss will stop. At this point, clients are inclined to think that they need to exercise more and eat less. But calories are a measure of heat energy and your metabolism is a measure of that heat. If you don’t create enough heat, you can’t burn fat. If you exercise more, you break down muscle tissue. If you exercise more, you need to eat more to support new muscular density. The more you eat, the more heat you generate and more bodyfat you lose. Think about taking up less space in the room. Weigh as much as you can, taking up less room in the room. Muscle is heavy and dense.

11:20  Dr. Goglia explained that you need to keep in mind that working out, going to the gym is not building you up. It breaks you down. It is when you rest and sleep and when you eat protein that you use to build muscle.

12:44  Philip discusses the proper diet and explains that 70% of the population is fat and protein efficient and have insulin resistance and will do better on a high protein, high fat, managed carbohydrate program. We have all these low carb programs today like Paleo, South Beach, Bullet Proof, and Ketogenic, but Dr. Atkins was very successful years ago with a low carb program and his program is really being rebranded without giving him credit. Dr. Atkins was the one who said you are not going to run a marathon at night and you don’t need a bunch of carbs with dinner. These carbs will just prevent your body from going into deep REM sleep, so you’ll wake up tired and craving carbs again. Your dinner should be your biggest protein meal to rebuild the muscle you have broken down.

15:16 I asked Dr. Goglia what his recommendations are for types of exercise for weight loss?  Philip explained that he will often recommend that they start by focusing on changing their diet and just continue with their current exercise regimen. Once they are eating properly, then we can strategically modify their exercise to help them accomplish their goals. 

 

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Dr. Philip Goglia is available to see clients by contacting his office at 310.392.4080 or through his website http://www.pfcnutrition.com/

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure, as well as chiropractic work, by calling the office 310-395-3111.

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Dr. David Brady discusses the microbiota, autoimmune diseases, and stool analysis with Dr. Ben Weitz.

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Podcast Highlights

4:53  I mentioned that I had just reread Dr. Brady’s 2013 excellent and important paper clearly laying out some of the connections between the microbiota and autoimmune diseases, Molecular Mimicry, the Hygiene Hypothesis, Stealth Infections and Other Examples of Disconnect between Medical Research and the Practice of Clinical Medicine in Autoimmune Disease.  https://scirp.org/journal/PaperInformation.aspx?PaperID=27948  I consider this mandatory reading for anyone in Functional Medicine. 

7:10  Functional Medicine doctors might look to the gut and order stool testing for patients with autoimmune disease but this makes no sense to conventional medicine. But Dr. Brady pointed out that medical research is in line with the Functional Medicine approach, as there are many studies linking gut dysbiosis and specific gut pathogens with specific autoimmune diseases. Here is a slide that Dr. Brady provided me on this: 

10:10  The Importance of the Microbiota and the Microbiome.  Dr. Brady discusses the need to look at ourselves and our state of health in what is called the super organismal context, meaning it’s not just us and our cells, and our biochemistry, and our physiology. It’s also all of those other organisms that share our experience. The organisms that live on us, in us, through the gastrointestinal track. Research is really supporting the importance of the microbiota and the links with chronic diseases, like autoimmune conditions.

13:02  Discussion of Dysbiosis.  Dr. Brady explained that dysbiosis is a term that came from EE Metchnikoff and it refers to an imbalance of the bacteria in the gut. You don’t necessarily have a parasite or pathogen. You get an overgrowth of opportunistic organisms, which when overgrown become problematic, referred to as potentially pathogens. It’s aligned more with a state of illness or lack of optimal wellness of the host.

15:58  I asked why we might have a pathogenic bacteria that comes in through our gut and it becomes a permanent resident that we have trouble erradicating, but when we consume healthy probiotics they are only temporary residents?  Dr. Brady explained that this is not necessarily the case. Most pathogens fortunately pass through and don’t actually take up residence in our gut. And when you look at beneficial probiotics, like lactobacillus, bifidobacteria, they make up a small minority of the GI microbiota in its totality, which is mainly made up of anaerobic bacteria, not aerobic or facultative organisms. These beneficial organisms have an incredibly beneficial effect even though you are not really reseeding the gut, which a lot of practitioners make the mistake of thinking that they can if they just take enough billions of probiotics. They are more like pixie dust. They change cytokine expression. They are more like messengers than foot soldiers.

20:27  We discussed the link between digestive health and autoimmune diseases, including the hygiene hypothesis.  Dr. Brady pointed out that he laid out some of these arguments in his paper in the Open Journal of Rheumatology and Autoimmune Disorders noted above and also in a similar paper that he wrote in the Townsend Letter   http://www.townsendletter.com/June2012/autoimmune0612.html   Our modern methods of sanitation and hygiene have reduced our exposure to infectious diseases in order to reduce cholera, typhoid, dysentery and and similar serious infections that result from drinking contaminated water. But we have taken it too far by the overuse of antibiotic soaps and wipes and the frequent use of antibiotics and not letting your infants play in the dirt and put things in their mouths. This reduces our exposure to microbes in our environment and prevents us from developing the tolerance that we should have and our immune system may overreact to organisms that are not much of a threat. We’re left instead with an immune system that’s stuck in an overaggressive stance, and more likely to crossover with subtle differences between what it’s trying to actually attack, which would be a microbe, and a host tissue, like a joint, or like a thyroid gland.

23:30  Dr. Brady discussed how helminth therapy (worms) can help with immune system regulation.  

28:29  We discussed the best way to test the microbiota with proper stool testing, including using the GI Map test through Diagnostic Solutions that Dr. Brady is has helped to develop. Dr. Brady explained that GI Map uses a more sophisticated quantitative PCR, polymerase chain reaction, method of detecting both pathogenic and also opportunistic microbes that may have overgrown. Dr. Brady explained that this is a clinical test that can enable you to determine if a microbe that is found is clinically relevant and needs to be treated, including if it may result in autoimmune diseases. This should be distinguished from testing that uses next-gen sequencing like a uBiome test, which was not meant for making clinical decisions on patients at the point of clinical care.  

 

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Dr. David Brady can be contacted at his website https://drdavidbrady.com/ You can check out the site for The Fibrofix book that he wrote at https://www.fibrofix.com/ You can get information on the GI Map stool test from Diagnostic Solutions at https://www.diagnosticsolutionslab.com/

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure as well as chiropractic work by calling the office 310-395-3111.

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Podcast Transcripts

Dr. Weitz:            This is Dr. Ben Weitz, with the Rational Wellness Podcast. Bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to the Rational Wellness Podcast at iTunes and YouTube and sign up for my free ebook on my website, by going to drweitz.com. Let’s get started on your road to better health.  Hey, Rational Wellness podcasters, thank you so much for joining me again today, and we’ve got a very interesting topic.

We are going to talk about the microbiota, autoimmune diseases and stool testing, with a very special guest, Dr. David Brady. The microbiota is a community of commensal or good bacteria, symbiotic, neutral and pathogenic bad bacteria. This microbiome has been found in every multi-cellular organism from plants to animals that has ever been studied. The microbiota includes, bacteria, archaea, protozoans, fungi and viruses. The microbiota is crucial for the health of the host, esp. for the immune system, hormone production, metabolism and a host of other important health processes.  The term, the microbiome is often used interchangeably with microbiota, even though technically microbiome refers to the genetic makeup of these microorganisms. The main place that the microbiota exists in humans is along the digestive tract. But these microorganisms also live in the vagina, along the urinary tract, the lungs, the mouth, the eye, on the skin, lining virtually every mucous membrane in the body. In fact, almost everywhere. Some would also argue that worms that have lived in the bodies of humans for thousands of years, are also important organisms that contribute to this community of microorganisms, and are important for the health of the host. Listen to episode 38 of this Rational Wellness Podcast where I interviewed Dr. William Parker about worm therapy.

                                Now, when it comes to autoimmune disease we’ve been seeing a huge increase in the rate of autoimmune diseases, especially in the US and other developed countries in the last 10 to 20 years. Now, autoimmune diseases are diseases in which our immune system, which is designed to kill outside pathogens starts focusing its attention inwards, and starts attacking our own tissues. This is believed to be partially related to the decline of bacterial diversity in the microbiota in the gut, and the breakdown of the gut lining, often referred to as leaky gut. There are now over 80 recognized autoimmune diseases including Hashimoto’s hypothyroidism, celiac disease, type I diabetes, inflammatory bowel disease, MS, psoriasis, lupus, rheumatoid arthritis. Properly analyzing our microbiota with accurate stool testing can potentially enable us to determine whether we have a healthy microbiota. It may enable us to intervene and potentially prevent or reverse autoimmune diseases through changes in diet, lifestyle and nutritional supplementation.

                                In order to help sort this out, I’m thrilled that we’re being joined today by Dr. David Brady, an internationally known speaker, Doctor of Chiropractic, Naturopathic physician. He’s also a Professor at the University of Bridgeport. He’s the Chief Medical Officer for both Designs for Health, and Diagnostic Solution Labs. Dr. Brady is a prolific writer, having published a number of scientific papers, contributed chapters to various text books, and he’s also written several books, including his latest, The Fibro Fix, published in 2016. Dr. Brady, thank you for joining me today.

Dr. Brady:            Hey, thank you for having me. It’s a pleasure to be on your podcast.

Dr. Weitz:            Excellent. So, before we get started with the questions, I just wanted to say, this morning while I was eating breakfast, I just reread your 2013 article from the Open Journal of Rheumatology and Autoimmune Diseases on “Molecular Mimicry, the Hygiene Hypothesis, Stealth Infections and Other Examples of Disconnect between Medical Research and the Practice of Clinical Medicine in Autoimmune Disease”. I feel like this is such an important paper. It so clearly lays out the link between the microbiota and autoimmune diseases. For me, this is one of those seminal papers in Functional Medicine, along with Dr. Fasano’s Scientific American paper on leaky gut, and some of Dr. Vojdani’s papers, that I strongly encourage every Functional Medicine practitioner and even laypersons interested in a functional approach to autoimmune diseases, to read this paper. And so, on behalf of the Functional Medicine community, Dr. Brady, I thank you for your contributions to our profession.

Dr. Brady:            Well, thanks for those nice comments. I’m sorry to ruin your breakfast, but I’m very happy to be included in that prestigious list of colleagues that you threw me into. I’m not sure I deserve that, but thank you anyway. It was just me trying to get some of these concepts out there into the conventional medical literature, which we’ve always held true for my whole career in Functional Medicine, which is over 25 years. These concepts are nothing new to us in Functional Medicine, that the ecology of the gut is of prime importance to the over health of the organism. That it’s really the place where the meter, the setpoint, the balance of the immune system in general starts, is with mucosal immunity in that really quite complex and potentially full of toxins and antigenic material in the GI lumen. It was really getting some of those overarching concepts out to colleagues that may not be familiar with the way we deal with autoimmunity and we deal with chronic disease even.

Dr. Weitz:            Yeah. I imagine that a lot of the conventional medical doctors, if somebody went to a Functional Medical practitioner and was concerned about autoimmune disease and ordered a stool test, they’d say, what are you doing? Are you out of your mind? What does that have to do with anything.

Dr. Brady:            Yeah. It’s amazing. Medical research is right in line with Functional Medicine. What they’re looking at right now in the fields of immunology, in the fields of autoimmune disease and rheumatology, and gastroenterology, and right on down the line is really in harmony with what we’ve understood in Functional Medicine for a longtime. They’re pushing the boundaries of the granularity at which we understand it and how all the dominoes fall and how all the underlining mechanisms, and making new associations between aberrant patterns, let’s say, in the GI health area or the microbiota, and specific chronic disease including autoimmune diseases, but really we’re kind of talking the same … We’re singing the same tune, but that’s not the case when you cross over into clinical medicine.

                As you said, if someone with an autoimmune disease goes to a rheumatologist, let’s say a classic rheumatology managed disorder like rheumatoid arthritis, they’re highly unlikely to have any attention paid to their GI microbiota, or their gastrointestinal environment, or the health of their GI mucosa. Getting a stool analysis, they don’t do that. That’s what the gastroenterologist does. The problem is, the gastroenterologist doesn’t do a stool analysis for those things. They don’t do any work-up in autoimmune disease. When they do, do a stool analysis, it’s a very limited stool analysis that’s really meant to look for pathogenic disorders that cause diarrhea or maybe fueling an inflammatory bowel disease in some cases. Even that is generally not done.

                                There’s really a disconnect right now between conventional medical research in the conventional Western paradigm, and the practice of medicine. They really don’t connect very well. I really do think that the current research and the threads of it and where it’s going really harmonizes more with the Functional Medicine approach than it does with the conventional medical approach.

Dr. Weitz:            Can you explain the important of the microbiota and why it plays an important role in our overall health, as well as with the link with autoimmune diseases?

Dr. Brady:            Yeah. From a 30,000 foot sort of overarching kind of concept, I will try to do that. For most of Western Medicine’s history, we’ve looked at the human condition from the standpoint of our own physiology, our own biochemistry, our own metabolites, and things like that. But, we really have just now begun to break out of that very reductionist, myopic way of looking at ourselves. We need to look at ourselves and our state of health in what is called the super organismal context, meaning it’s not just us and our cells, and our biochemistry, and our physiology. It’s also all of those other organisms that share our experience. The organisms that live on us, in us, through the gastrointestinal track. We know that they are roughly equivalent to us as far as number of organisms to number of cells in our body. We know that they house many more genes than we do, probably 100 times or more, more genetic material than we do. They genes talk to our genes. We have to deal with and process and react to their metabolites, the things that they express on their surface. It’s really a community. We think that we carry around these bugs, and maybe they’re carrying around us when you look at the numbers. When we look at our overall state of health or dis health, or illness we have to factor in all of those components, not just ourselves.

                                Finally, that’s beginning to happen. It’s with the microbiome project and the study of the microbiota in general. As you correctly pointed out and most practitioners don’t understand the nuance there. The microbiota are the actual organisms, their phylum, their genus, their species, that are on us, in us, around us. Where the microbiome is all of the genetic material of those organisms plus all of the metabolites that they’re producing. It’s really more, when we look at the microbiome, we’re looking at not what bugs are present, but what is their overall impact on our condition. They are slightly different, but usually they’re used interchangeably. It is true that we have a tremendous amount of organisms living on our skin, living in our lungs, any mucous membrane, but the most complex environment is the microbiota, the portion of the microbiota that has been most firmly linked to not only the association, but now the genesis of specific chronic diseases, and nothing more closely connected or the dots most conveniently connected than in autoimmune disease than the GI microbiota.  All those bugs that live in the gut are of prime importance and it’s probably along with specific immune modulating antibody drugs if you will, in onco therapy, that and the microbiota and the microbiome are the hottest areas of research in the Western Medical paradigm, by far.

Dr. Weitz:            You use the term dysbiosis is some of your writings. Can you explain what that means and what it’s importance is?

Dr. Brady:            Yeah. It’s actually quite an old term that has had a reemergence with this sort of burgeoning microbiota research and understanding of why these bugs are so important in the gut. But, it was originally termed I believe, by E. E. Metchnikoff, who is a Russian zoologist and physiologist who is known to have coined the term, orthobiosis and dysbiosis. Orthobiosis, ortho meaning normal, biosis the microbes that live in the gut. So, orthobiosis is a healthy beneficial balance of microbes in the gut, that would be aligned with a healthy state of the organism. Where dysbiosis is where there is some sort of aberrant pattern. Things are not quite in the right balance. It’s not necessarily a state where there’s pathogenic infection that would cause acute fulminating diarrhea or some specific acute disease state, but dysbiosis is when things are just not right. There’s overgrowth of opportunistic organisms of various classes. It’s aligned more with a state of illness or lack of optimal wellness of the host.

                                Of course Metchnikoff is the father of probiotic therapy in the modern western paradigm, after he observed mainly populations, which we would now call a blue zone, in Bulgaria who were living high up in the mountains. They were living to very advanced ages for the time, and they were living very healthfully into those advanced ages. He wanted to know what was different about them. They lived in a very nice environment up in the mountains. They never retired. They kept working. They were very active. They had a good social network. All the things that we understand now about the blue zones. But what he really found striking is that they tended to use the milk, or the dairy from cows that were free-range feeding on the local vegetation in the mountains. They were culturing it and making what we would now call like a yogurt or a cultured dairy product from it, a kiefer, a yogurt, cheeses, things like that. They were getting a high intake of these organisms that were used to ferment the dairy. Now we know that strain is lactobacillus bulgaricus. Right? Because of Bulgaria, from that community. So he was really the father of probiotic therapy and obviously a real hero of Functional Medicine.

Dr. Weitz:            Isn’t it interesting how when we consume bacteria from yogurt, or if we get some pathogenic bacteria that enters our GI tract, it ends up populating our microbiome, or microbiotic? But, when we take probiotic supplements, apparently they’re only temporary residents there. Do we know why that is? Why is it that if a bacteria, especially a pathogenic bacteria comes into our system through our gut, all of a sudden becomes a permanent resident, whereas we take these healthy probiotics and they only become temporary visitors.

Dr. Brady:            Well, I’m not sure that’s always accurate.

Dr. Weitz:            Oh, okay.

Dr. Brady:            I think it depends on the state of the GI environment in that host. Certainly we’re exposed to pathogens transiting our GI tract all the time in food mass and things like that. They probably don’t setup more than they do. It depends on the virulence of the specific pathogen. Some of the are really nasty critters and if we get almost any exposure to them, even a robust host would be very likely to fall ill. But, we’re getting exposure to lots of organisms that we would not want to set up and colonize our GI environment all the time, and they don’t.

                                Conversely, the beneficial organisms, some of them colonize, some of them don’t. They can colonize from a good quality probiotics, or cultured or fermentable foods, or not. I think in both cases, I think it’s really host-dependent than it even is what the actual source of the environmental seeding of the gut is. But, you mentioned the pathogens might be more likely to take hold than a beneficial organism. Why might that be the case? Well, pathogens are pathogens for a reason. They’re very virulent. They’re aggressive. They’re very robust, so they can cause significant disease, where things that we would consider commensal or beneficial organisms don’t have that dramatic effect on us. Quite frankly, they’re extremely outnumbered.

                                When you look at things like beneficial probiotics, like lactobacillus, bifidobacteria, they make up a small minority of the GI microbiota in its totality, which is mainly made up of anaerobic bacteria, not aerobic or facultative organisms. But, it’s interesting, those beneficial or commensal organisms, they are very powerful. They have tremendous clinical effects as we know from the research studies, and as we know from clinically utilizing them even though they don’t represent much of the population in the gut. They have effects that are far more powerful and reaching than their numbers suggest. That is sort of a pet peeve of mine. I think even in functional medicine, in nutritional medicine, and integrative medicine, I think practitioners still make the mistake of thinking of probiotics and probiotic therapy as a numbers game. That you’re going to fundamentally reseed the gut and change the numerical arrangement of the person’s gut, and we know that that doesn’t occur, from serial assessments with molecular stool analysis.

                                You can change it temporarily but you don’t change it long term, numerically. But that doesn’t mean that you don’t have profound clinical effects, because Stig Bengmark, one of the world’s experts in probiotics for instance, talks about probiotics as pixie dust. Right? It’s not a matter of how much. It’s a matter that you actually introduced the organism and the peptides associated with it, and the metabolites associated with it. It’s actually talking to the GI or what we would call the enteric nervous system, but also the enteric immune system. That it’s actually changing cytokine expression. It’s changing mucosal immunology by virtue as being a messenger more than a foot soldier, if that makes sense.

Dr. Weitz:            Sure. It’s about communication.

Dr. Brady:            Yeah, exactly.

Dr. Weitz:            You often speak about the links between digestive, or gastrointestinal health and autoimmune diseases, including what is known as the hygiene hypothesis. Dr. Parker, who I interviewed a few weeks ago, he uses an analogy of leaving your teenager home alone with nothing to do. He or she will often get into trouble. Can you explain what the hygiene hypothesis is and how this contributes to autoimmune diseases?

Dr. Brady:            Yeah. There’s a couple of major thematic things that you need to understand in the modern autoimmune epidemic. I do try to go through them one at a time in that paper that you mentioned in the open, Journal of Rheumatology and Autoimmune Disorders, and also in a similar paper that I had in the Townsend Letter. The hygiene hypothesis is pretty simple. It just basically says that, in the western industrialized countries, we’ve cleaned our environment up so much, and some would argue with that because they think, what about all the toxins. We’re talking more from an exposure to microbe standpoint. The way we’ve cleaned it up is basically with modern hygienic water treatment, water supplies to large populations. We’re no longer in a village taking water out of a stream, that another village a couple miles up was going to the bathroom in.

                                It’s not that kind of environment anymore. We don’t live in caves. We don’t live on dirt floors. We live in houses. We use antibiotics. These days, a lot of mothers unfortunately are scrubbing their young children with antibiotic triclosan laden soap every ten minutes because they’re germaphobic. They won’t let them crawl on the ground. They won’t let them put something in their mouth that was on the ground. Really that’s part of … Infants have that oral phase where they’re putting things in their mouth all the time, purposely to get exposure to their environment, to learn to have some level of tolerance to the microbes we share our planet with and learn how to react appropriately. To have the right setpoint of surveillance, where if we’re exposed to something that could really do us harm, like a pathogen that we would mount a robust reaction, appropriately. But that if it is other organisms that really aren’t that much of a threat, that we don’t freakout and overreact to them.

                                Part of that learning process, when the immune system is young and learning to size up their environment, is to have exposure to a larger diversity of different types of organisms. We’ve taken away that exposure to a large degree, and we’re left instead with an immune system that’s stuck in an overaggressive stance, and more likely to crossover with subtle differences between what it’s trying to actually attack, which would be a microbe, and a host tissue, like a joint, or like a thyroid gland.

                                It’s interesting you brought up helminth through worm therapy. One of the things we’ve eliminated most dramatically compared to our ancestors even 100 years or more ago, is helminths, or worms. Worms have been in our intestines for the whole time we’ve been on the planet essentially. We’ve radically changed the landscape when it comes to helminths in the last 100 years, certainly in the last 50 years, in particular in the western industrialized countries, where we really don’t have nearly as many worms or helminths in, let’s say, young childrens’ intestinal tracks. Those helminths, it’s very interesting. In order to survive and be symbiotic with us, they put out different chemical messengers that actually down-regulate our immune response. The body’s response to that is to up-regulate. It’s reaction to try to kind of find this homeostatic balance. We kind of meet in the middle, if you will.

                                But if you very suddenly in an evolutionary context take away the helminths that are suppressing the immune system, the body’s set point then is left to hobbit in too aggressive of a stance. With that theory there were certain researchers that talked about using maybe helminths as therapy. Of course, they observed populations in what we would consider underdeveloped countries where these helminth infections, round worms and things like that, are extremely common. It was probably most observed in Laos, in Vietnam, and stuff like that, and westerners were in there in different interventions as we know. They did observe that the children there had no allergies, no atopy, they didn’t have hay fever. They didn’t have dermatitis. They had none of that kind of stuff until they started treating them for the worms. When they started giving them anti-helminthic, antiparasitic medication, all of sudden those pediatric populations started developing those disorders like we see in western children. That provided further connect the dots kind of information.

                                Joel Weinstock, who is a famous medical physician and researcher, did most of this work seminally at the University of Iowa, but now I believe he’s at Tuft’s in Massachusetts for quite a longtime. He did work with trichuris, or pig whipworm, in treating inflammatory bowel disease, like ulcerative colitis and Crohn’s disease, to significant success in that there’s actually helminth-based drug therapy for inflammatory bowel disease in Europe. The drug is call OvaMed, there. It’s in, I think, phase three trials here in the US, but not approved to date.

Dr. Weitz:            Interesting. So, they’re actually using helminths? Is that what it is?

Dr. Brady:            Yes. A lot of integrative or functional medicine practitioners use helminth therapy sort of in an off label way. They’re not a drug, per se, but it’s called h.diminuta, which some people call it, rat tapeworm. It’s not a tapeworm. It’s a helminth, or roundworm, actually. It’s really a beetle derived, or an insect derived helminth that is then consumed by rodents when they eat the insects, and then it can inhabit their GI microbiota. But, it’s a benign helminth that if you give it to the human host, it will setup there. It will exert the beneficial immune modulatory effects of a helminth, but that if you stop giving it over a time, it goes away. It will not sustain over long periods of time in the human host unless you keep reseeding it.

                                That’s one of the reasons why Weinstock used trichomatous, because for the same reason that roundworm can affect positive changes associated with helminths, but you have to give it continuously. So, if you do give it as therapy, you don’t then have to go eradicate it with another therapeutic agent should you want to get rid of it in that subject.

Dr. Weitz:            Now, it’s my understanding that at the present time, helminths are not approved by the FDA, so how would one of your patients get a helminth?

Dr. Brady:            Well, there are some practitioners who use them.

Dr. Weitz:            Can they be legally administered?

Dr. Brady:            I don’t know, technically. It’s not approved as a drug. They’re not being used as a drug, per se, for specific disease process, but they can be accessed, I believe online. I have patients coming in that are using them, and they are getting them, but they’re not technically approved in the US, no.

Dr. Weitz:            Right. Okay. Interesting. I think the human hookworm is another one that’s being used for certain therapies. So, let’s see. What are some of the best ways to analyze the gastrointestinal system? I understand you’re involved with Diagnostics Solutions, GI-Maps is your stool test. So, a lot of us Functional Medicine practitioners have been using stool testing to try and analyze microbiota. My limited understanding of stool testing is, a number of years ago we started using the GI Effects stool test, which was a genetic based test. Genova bought it, and then at some point, I remember going to a seminar that was put on by Doctors Data, and some paper came out criticizing genetic-based stool testing, and saying that there were problems with it. As I understood it, one of the issues with it is if you’re detecting the genetic basis, of let’s say, a parasite, it could be a parasite that’s not really there. So, they were touting their culture-based stool testing.

                                Genova then seemed to have modified the GI Effects and started using culture again, for parasites instead of pcr genetic testing. A number of the practitioners that I know in the Functional Medicine community were not happy with that test anymore. They felt like it wasn’t picking up things that like, parasites and other pathogens that they had seen on the GI Effects and they were able to eradicate and help their patients. Now they felt like this test wasn’t finding some of those. It’s my impression that your GI-Maps test is stepping in to help out using a more sophisticated type of genetic testing to help us find what’s going on in the gut. Is that right?

Dr. Brady:            Yeah. Well, that’s a long story and I’m going to probably differ from getting involved in the internal squabbles and politics between the various commercial interests in companies, but I can say that I’ve been doing stool analysis in my clinical management of patients and research for 25 years plus. Once upon a time, the only thing we had was culture-based old school microbiology-based testing, because that’s all we had. It was really before PCR was readily accessible, certainly by clinicians.

Dr. Weitz:            And by the way, PCR is what?

Dr. Brady:          Polymerase chain reaction. It’s what’s used to amplify DNA to be able to do a lot of the molecular or DNA-based technologies that we see today that have transitioned from research to actually clinical tests. But basically, here’s the reality. Molecular is where it’s at. A lab that does a microbial or culture-based technology claiming that molecular is not the way to go and we should do culture-based methodology, is like someone driving by on Main Street in a modern US city, in a horse and buggy, yelling that we should not use cars. This is a better mode of transportation. That’s how absurd it is.  This is based on one study, with about 30 samples, funded by that lab and it was directly comparing to another lab who is a competitor of theirs who was using a test that was developed in-house with a quasi-molecular methodology, which was not a developed methodology by a major bioscience company, and had a valid third party validated. In many cases these platforms are FDA cleared for various uses. That’s not what this was. This was the first attempt in the Functional Medicine space, many years ago at a molecular stool technology, and the first attempt was at Metametrix Clinical Laboratories. They did it for all the right reasons. I applaud them for the first attempt. For whatever reasons they decided not to use one of the already developed and vetted out by very large bio companies technology, they decided to develop their own methodology, in-house. I don’t know what their exact reasons for that was. Sometimes that’s done for reasons of developing protected intellectual property rights and things like that.

                                We know when that test first came out, it was a big step forward. But it did suffer from some problems. One there were  longer than expected turnaround times, because the methodology was a little bit long and unwieldy. It wasn’t fully molecular either. Elements of it were molecular. Elements were not. And, it actually did not suffer from not finding things. It suffered if anything from oversensitivity. And what practitioners may remember is getting a lot of what’s called, basically that the organism type was detected, but taxonomy unavailable. A lot of that was theorized to be what we call, scattered DNA. A little bit of DNA of different kind of organisms that can be located in the food mass.  That doesn’t implicate all molecular technologies as suffering from those same problems. If you go to any major hospital pathology lab, at an academic medical center in the western world right now, they are running their samples using DNA molecular technology. When someone has a systemic infection, if they nick a bowel, and they have sepsis or something, and they’re coming in with some really weird infection, and they’re going into organ failure, and they need to know what it is, they need to know now and they need to know what’s going to kill it, what antibiotics will be effective, which antibiotics will it be resistant to, they do not do culture technology. They do molecular technology. That’s just how it works. You just need to apply it to stool testing in the proper way.

                                That’s what we set about doing with GI-Map. We developed this in the incubator at the molecular biology center at Georgia Tech University, which is the number one molecular biology center in the world.  Along with one other center in Massachusets who were the first to map the human genome.  Very advanced technology and talents. Basically, when we developed the GI-Map, we took a very different route. Many of us were actually involved in that first generation testing. We were sort of the ones who didn’t win out in the argument of look, we need to use a bulletproof technology that’s already been totally vetted, tested out, and in many cases cleared by FDA for certain applications. That’s what we did, but we applied it across a wide spectrum of clinically relevant organisms in a manner that a Functional Medical doctor would want to see.

                                In conventional Gastroenterology, when they do stool testing, even if they’re using molecular, they’re generally looking for a very short list of pathogens that may be causing diarrhea in a patient. The Functional Medicine doctor needs a much wider lens. We want to look not only across pathogens, and not only five or six pathogens, but a long list of pathogens in classes including bacterial, fungal, protozoal, helminth, viral. Right? The viral realm, but then we want to look at commensals. We want to look at beneficial organisms, and a whole range of those. We also want to look at opportunistic organisms. That’s really where the gold is, the opportunistic organisms that have the potential to overgrow if the environment is right, if the host is susceptible to it.

                                A lot of these opportunistic organisms when they overgrow to a certain level, can then create problems, and they are associated with the genesis … First of all they were just associated with different disorders, like various autoimmune diseases, but now we actually have the emergence of causal data and mechanisms by which we know how the higher presence of a certain bacterium, let’s say, in the gut, can actually ultimately translate to an immune attack against your joints, or against your thyroid, or against your nervous system. In the GI-Map, we’re using what’s call quantitative PCR. PCR, polymerase chain reaction, right? It’s a molecular technology. We’re hunting the DNA of these bugs, but we’re doing it with a quantitative platform. What that means is we get the actual numbers of the organisms, versus other molecular technologies, which are also good, but they’re not meant for the same application, which is caused next-gen sequencing, which many people may know of.

                                Examples of the two. Next-gen sequencing is a test like a uBiome test, where a lot of people get that done. It’s not a test that was ever meant for, nor was it developed for making clinical decisions on patients at the point of clinical care. It’s a research test meant for metadata collection and analysis to quantify signatures, not qualify, I should say, signatures of the microbiota. Meaning, what is a normal GI microbiota looks like on the West coast of the United States, or in Eastern Europe, or in Asia? Because it’s not going to be the same. It won’t be the same in people following different types of diet schemes. What those kind of tests do with next-gen sequencing is they look at a long, long list of organisms in the gut, many of which have no clinical significance that we’re aware of. They’re reporting them as a percentage of the total organisms. They’re never saying how many are there. They’re just saying what percentage of the total organisms does this genus of organism makeup, or they can look at it from the phylum level. They’re only looking at one little portion of the DNA.

It restricts them from getting down to the species level, and they certainly cannot get to the level of looking at the characteristics of the organism, like virulence factors for instance, which answers the question, is this form of lets say, H-pylori a problematic form, or a benign form? Because it was never meant to do that. They don’t look at pathogens. They don’t quantify anything. It’s a very valuable test for research. The reason uBiome, and companies like that are doing that test is to try to answer these questions, and find these major associations between overgrowth in one way, and a certain autoimmune disease, and what they were really doing is collecting massive amounts of data to then monetize it by selling it to pharma as a metadata set to develop drugs and things like that. That’s why you can do the test at such a small amount and actually you’re paying less than it probably costs them to run the test. Same with 23andMe. They made all their money by selling all their metadata to pharma. So, if you’re okay giving your data over, and your genetic information for that purpose, that’s fine.

                                The GI-Map though, uses quantitative PCR, because it’s a clinical test. We’re looking at a range of organisms in the classes of pathogens, commensals and opportunists that we know have clinical significance. If they overgrow they’re going to cause diarrhea, or they’re going to cause gastric upset, or they’re going cause disease, or they’re associated with autoimmunity. We carve out different sections for autoimmune triggers that we know have this organism has a certain expressed, let’s say peptide on its surface, which looks a lot like a host protein. Organisms like klebsiella, citrobacter, or proteus, prevotella, overgrowing in the gut beyond a certain point, puts the person at risk if they’re genetically susceptible to things like rheumatoid arthritis ankylosis spondylitis, or Yersinia overgrowth and Hashimoto’s or Grave’s disease. I can go on down the line with a whole bunch of other ones, but the test is quantifying using molecular technology across that broad range of organisms that have clinical significance so you can decide for instance, if a pathogen is coming back elevated, it’s beyond a certain cut point, which we know is clinically significant, it means you need to treat that.

                                You’re not going to get that from a uBiome.  It’s just not intended to do that.  And then parallel to that, we’re running all of the modern stool chemistry.  We’re calculating for inflammation, and even bowel cancer risk.  Zonulin for intestinal permeability or leaky gut. Things like elastase-1 for pancreatic excretin output. Steatitic for amount of fat in the stool. Beta glucuronidase for risk for estrogen dominance in females based on the function of their microbiota.  Things like total secretory IgA and antigliadin secretory IgA, are you reacting to gluten and gliadin containing grains at the level of the gut lining, that’s mucosal immunology. It’s not a test for Celiac disease per se, but it let’s someone know, hey, maybe my immune response is not super compatible with these field grass greens.

Dr. Weitz:            Let’s say you find a pathogen like Yersinia, which you’ve written about how that’s connected with autoimmune thyroid disease. Can you explain how the appearance of a pathogen in your gut can lead to an autoimmune disease that affects your thyroid?

Dr. Brady:            Yeah. There’s a couple of possible mechanisms, but probably the most direct line or understood one is a process called molecular mimicry. Let’s take Yersinia as an example since you brought it up. Yersinia on its surface has some proteins or peptides that … All microbes have surface characteristics, structurally. These help communicate with other like organisms. It helps them form a locus of infection, or a colony, and provides communication and other types of things. That is where the immune system learns that organism. So, a naive T-cell let’s say, will be educated to react to that peptide on the Yersinia because other parts of the immune system have looked at it and said, this isn’t me. I don’t know this structure, therefore it must be something foreign. It’s a potential threat. It’s an antigen. Let’s develop antibodies to bind to that antigen to cover all those surface peptides so it can’t communicate and bind and form a locus of infection. But, it’s also being tagged for other cellar elements of your immune response, to take it out basically, whether its phagocytosis of other types of processes. Basically it’s using the structure of that protein or peptide on that surface of that organism.

   Now, the reason why we can have an association between not just one microbe, but a long list of microbes and a certain autoimmune disease is because many of these surface proteins or peptides are conserved across various families of organisms. In rheumatoid arthritis, we have klebsiella, citrobacter, prevotella, we have proteus, we have a lot of different organisms, which we have a similar response to. It’s not a one organism, one disease type of scenario. That’s what freaks conventional medicine out, because it rocks the one cause, one disease paradigm. You have to think a little bit more complicated. But, those surface proteins on Yersinia, coming back to the question, have a structural similarity to TSH receptors on the thyroid. They’re not exactly the same, but they’re enough the same that if you also harbor a genetic propensity or an HLA pattern to overreact to that environmental antigen, that you will kind of freakout when you see that reaction. You’re going to then be susceptible to reacting to something else that looks a lot like it.

                                It’s a mistake in identity. It’s like the TSH receptor is a doppelganger to the protein on the Yersinia, and when you develop these antibodies to bind to that antigen to get to the gut to fight the infection, they see the TSH receptor on the thyroid and they go, close enough, and they lock into your thyroid and they tag your thyroid for destruction by the rest of your immune system and you get an erosive inflammatory response against the gland, which in the early stages creates an over secretion of the gland. So, inflamed glands generally over secrete their hormone. So with Hashimoto’s you get a hyperthyroid state, but when enough of the thyroid is destroyed and you don’t make enough thyroid hormone, you end up in the hypothyroid sort of bimodal presentation of Hashimoto’s. Most people don’t even get diagnosed until it’s in the hypo stage, where they have high antibodies, low hormones.

                                So, that’s an example of molecular mimicry, but there are other examples that we know, such as if you have bad oral hygiene and you have overgrowth of P. gingivalis, which is the most common organism that causes gum disease or periodontal disease. We know that that organism produces an enzyme, which actually will citrullinate host peptides, so it modifies arginine on host proteins and citrullinates them and makes them a hapten. They’re no longer your own structure. They look foreign to the immune system. The proteins that they citrullinate are things like collagen, vimentin, fibrinogen, all of the things that make up the schematics structures of joints and things like that. You’re really susceptible to develop autoimmune arthritides, basically like rheumatoid arthritis. That’s why in diagnostics when we do a rheumatoid panel, yeah, they do rheumatoid factor, but what’s the other test they do? Anti-cyclic citrullinated peptide.

                                What’s creating the citrullination of those peptides that has been understood for a while, we’re not finding out is the organism overgrowing in the mouth creating the enzyme, which is facilitating that protein modification. We’re going to learn a lot more about these type of phenomenon in the next 10 or 20 years, I’m sure. We’re probably just scratching the surface.

Dr. Weitz:            I just want to point out that one of the really exciting things is, you can have a patient who doesn’t have hypothyroidism, doesn’t yet have an autoimmune disease, and you can find some of these pathogens like Yersinia and some of these other pathogens in the gut, and or you could do auto antibody testing.

Dr. Brady:            Usually you do them in combination if you have a strong family history, you’re suspicious for some reason. If you come back with thyroid predictive auto antibodies in a serological test, then we look into the GI microbiota for sure, to find out if there is Yersinia, or is there other changes in the ecology that we need to address by either eradicating the bug that we know is associated and trying to change the landscape to the level of our ability to do so. But, also addressing things like hyperpermeability or leaky gut. We’ll have our eye on the zonulin and the calprotectin marker. We’ll look at anti-gliadin secretory IgA in the case of autoimmune thyroiditis, because we know agglutinate and antibody complexes have an affinity for the thyroid. That’s why people with let’s say, frank’s Celiac disease, where they have significant reaction to gluten and gliadin, they have about 20 times the rate of autoimmune thyroid conditions as non-Celiac’s.

Dr. Weitz:            Through this analysis and through a Functional Medicine approach you can truly prevent some of these autoimmune diseases before they’ve even developed. I just think that, that’s so amazing.

Dr. Brady:            Hypothetically, we don’t have the long term, longitudinal studies to prove that, but certainly there’s no harm in doing so, and there’s potential big upside. I can tell you that clinically we have seen patients who we did all of these things, taking what we call the straws off the camel’s back. We can’t change their genetic propensity for a certain autoimmune disease. We can’t change our HLA patterns and things like that. Right? At least now. At least yet, but what we can do is change their exposures within our ability to do so, within the ones that we understand. Right? Which is if I have someone that’s coming back with HLA B27, and they’ve got a family history of rheumatic arthritides and things like that, well, I’m for sure going to be doing a stool analysis on them looking for klebsiella, citrobacter, patellare, all of those.

                                If I find those things, I’m using things to eradicate that to the best of my ability and I’m usually using standardized botanicals, volatile oils, things that have a little bit more of a functional nudging affect and are going to take down those opportunists without bombing everything out. Without getting rid of all the normal organisms, I’m going to backfill with probiotics and the right pre-biotics. I’m going to use the right kind of blocking agents to block antigen antibody interaction and immune proliferation. Things like N-acetylglucosamine. Things like mycologist botanicals. We use these in gut therapy all the time, whether its okra, cat’s claw, aloe, there’s slippery elm.  There’s all these kind of botanicals that have historical use in gut function that we used to think just coated the gut and allowed it to heal. Actually they work in a much more complex fashion with glycobiology on blocking immune proliferation and docking of the antigen or the antigen with the antigen presenting cell to the T-cell. And we’re going to be doing things like glutamine, and other things to help the gut lining. Making sure the vitamin D levels are good, because that affects junction expression proteins that can treat leaky gut. We’re going to get them on a good whole fresh food diet. We’re going to get them off of dietary antigens.

                                Sometimes we’ll run a cellular response test looking for up regulation of innate immunity or inflammation due to certain foods, like an ALCAT test or something like that which is not a food allergy test. It’s innate immune response to food test. We’ll utilize those types of strategies and basically bring everything we can to the fort to change their lifestyle, change the landscape to where … Fasano talks about the triative autoimmune disease. Genetic susceptibility, an environmental antigen and leaky gut. We can’t change the genetic susceptibility, but we can change the exposure in many cases. We can certainly change the leaky gut. That’s where we go after, on those two legs of the stool, if you will.

Dr. Weitz:            So, leaky gut or hyperpermeability, you’ve mentioned that several times. That is where the mucosal membrane of the gut breaks down, creating spaces where toxins say, given off by bacteria like endotoxins and other toxins can enter our system and create problems.

Dr. Brady:            Right. Correct. Not only LPS, and things from the microbiota, but actual toxins themselves in the food mass, and toxins that are metabolites of the microbiota, but also foods themselves. If we’re allowing translation of complex peptides that are not broken down enough in the digestive process, of food that maybe perfectly benign if you had an intact gastrointestinal lining and adequate stomach acid and digestive enzymes, becomes antigenic and fuels the fire of the immune system if you’re not producing enough hydrochloric acid, or you’re taking a PPI, or histamine receptor, antacid type of medication, and or you’re not putting out enough digestive enzymes, and you have leaky gut. Sometimes it takes a bunch of things to gang up on you, but these things are not all that uncommon.

                                What the GI-Map tries to help the clinician do is answer a lot of those questions. Are there pathogens there? Are there overgrowth of opportunistic organisms? Are there not enough commensal organisms? But also, is the pancreas putting out enough enzymes? Do you have enough secretory IgA to have proper immune surveillance along the GI mucosa? Are you reacting to gliadin in a way that would be more excessive than what would be considered normal? Is there signs of inflammation, which causes damage to the GI mucosa like calprotectin being elevated? And, are you producing the glycoprotein that can actually directly cause leaky gut, which is zonulin? Trying to put all of those things together, all the clinically relevant markers that make sense for the clinician to need to know.

Dr. Weitz:            Do we know how accurate the zonulin measured in the stool is compared to serum zonulin versus zonulin antibodies?

Dr. Brady:            I don’t have a nearly as much familiarity with serum zonulin and zonulin antibodies. I know some laboratories do that. I know that there’s been some controversy over serum zonulin as a valid marker of intestinal permeability. But the best data and information out there is on fecal zonulin because that is where the rubber meets the road. It’s the enterocytes producing the zonulin, which is creating the hyperpermeability. I don’t think serum is the logical place to look for zonulin. I think the stool is the logical place to look for it.

Dr. Weitz:            Great. This has been an amazing podcast, Dr. Brady. Thank you so much for bringing our listeners some really interesting and clinically useful information.

Dr. Brady:            Sure.

Dr. Weitz:            Where can listers learn more about you, and your GI-Map testing?

Dr. Brady:            Sure. Well, if they just want to access some information about me and a lot of my articles, including the autoimmune articles we talked about and so forth, they can just hit my website at, drdavidbrady.com. Just D-R davidbrady.com. There’s a media tab with articles and things like that. A lot of full text stuff you can pull down. There’s a lot of interviews on different topics, in the media tab as well.  If they want more information on global pain and fatigue syndromes like fibromyalgia in my new book, The Fibro Fix, they can just go to fibrofix.com. F-I-B-R-O-F-I-X.com. And then finally, if they want information on the GI-Map test, from Diagnostic Solutions Labs, just go to diagnosticsolutionslab, so diagnosticsolutionslab.com. There’s a whole whitepaper, all supportive literature, lots of webinars, tutorials on interpreting the test, and there’s full clinical support when you order your first couple of tests and you need some assistance with that, as well. There’s instructions there on how to get test kits and so forth.

Dr. Weitz:            That’s basically for practitioners. For laypersons who’d like to get your stool tested see a functional medicine practitioner, like yourself Dr. Brady, like myself, Dr Weitz. If you want a listing for a functional medicine practitioners, you can go to the Institute of Functional Medicine website, and they have a listing of functional medicine practitioners. I think a good idea to see somebody like that who can really go through and interpret the data and help you to set up a program to improve your overall health.

Dr. Brady:            If there are practitioners out there who are not ordering clinicians with diagnostic ordering privileges, the GI-Map is also available for those practitioners through Evexia Diagnostics. So, E-V-E-X-I-A Diagnostics.com, formerly known as Doctor’s Choice. They have you work with physicians to get the test ordered.

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

Dr. Brady:            You’re welcome. Thank you.