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Ryan Smith of TruDiagnostic discusses the Tru-Age Test of Biological Aging with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.]

Podcast Highlights

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Ryan Smith is the CEO of TruDiagnostics, who offer the TruAge test, which is the best commercially available way to measure biological aging by measuring DNA methylation.  Their website is TruDiagnostic.com.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

 

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Podcast Transcript

Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates, and to learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.

Hello, Rational Wellness Podcasters! I’m very excited today to be discussing biological aging, which is one of the topics I’m very passionate about. We need to, it’s helpful to have ways to gauge our biological age as compared to our chronological age so we can find out how we’re doing in our longevity quest.  Are we on the right path? Are we aging slower? biologically than we are chronologically, which of course is the goal. And one probably the best way to do that is with methylation, biological aging tests, looking at DNA methylation, And the best commercially available way to do this is through True Diagnostics who offer the True Age Test.

And today we have Ryan Smith, the CEO of True Diagnostics to discuss biological aging and the newest variations of their tests that’s available that can help us not only to understand how good a job we’re doing with our biological aging, but perhaps with the newest version, giving us some way to figure out what sorts of diet, lifestyle, supplement, other recommendations we can make, particularly to help us improve that biological aging.  So [00:02:00] Ryan, thank you so much for joining us.

Ryan Smith:  Yeah, thanks so much for having me. I know it’s been a while since we talked about the topic and a lot’s happened.

Dr. Weitz:  Absolutely. So let’s start from the beginning. How did you start True Diagnostics and, how did you get involved in the field of DNA methylation, biological aging?

Ryan Smith: It’s a long and convoluted path. Biochemist as an undergrad, becoming a med school dropout, after finishing all the actual educational material, I got to the clinical portion of my third year and really hated it and decided to do something different.  Ended up creating a compounding pharmacy that was dealing in this sort of cash pay, preventative, integrative wellness space. And prior to that, I had no idea that this existed, but I loved that there was a community focusing on it. On preventative medicine in a true way.  It’s certainly something always easier to prevent than to treat.  And and so got really excited about that. Our pharmacy grew really rapidly. We were the fourth fastest growing company in healthcare. And then but we always knew that we wanted to to test a lot of our products to see how they were actually. Result of the digital translation of this [00:03:00] factory model is that CDN PCA is able to come up with cognitive creator days.  And that’s a way of kind of bringing together the different people that are working on specific huge tasks, So we actually developed this first device, which is a human to human live span, and we basically, from a software standpoint, we selected all of the people that we thought were going to be most effective at measuring age.  And that’s, when you think about it and in that time we built probably the largest DNA methylation database in the world and have created a lot of new algorithms to be able to read the information we find in your epigenetics. Right.

Dr. Weitz: Perhaps explain what is DNA methylation and why is it a better marker for biological aging compared to other biomarkers?  I guess some people use GRIP tests. We have VO2 max. In the past, it was a telomere length test, which I guess is still available.

Ryan Smith: Yeah, definitely. The so yeah, DNA methylation generally is what we call an epigenetic modification. So these are modifications above the genome which control your gene expression.  So how much is a gene turned on and turned off? And the reason that we need this is because obviously all of our cells in our body have the same DNA, right? Our heart or our skin, our brain, the same exact DNA sequence, but they behave very differently, right? You want your heart cells to behave like heart cells and your skin cells to behave like skin cells.  And to do that, they have to express different genes. So as your cells are going for. polypotent stem cells, which can do anything to the cell type that they’re meant to be, they’re doing it by turning on and turning off genes. And one of the mechanisms for that is DNA methylation. And DNA methylation really is the off switch that we sort of think about for some genes.

And so, DNA methylation in and of itself is not good or bad. Some, there are some genes we want turned off. There’s some genes we want turned on and different I would say abilities for each cell. And so that’s really what we’re measuring though, is from whole blood at True Diagnostic, what we’re looking at is all of those patterns of gene regulation, what’s turned on, what’s turned off, and we’re [00:05:00] interpreting that for an outcome.  And DNA methylation is probably the most frequently used biological aging tool mainly because it’s the most predictive. I think you mentioned some really great tools like VO2max and GripString. physiological standards that we know deteriorate with age. But generally, they’re not as predictive as some of these other clocks.  And that’s really how we judge if a clock is effective. Can it be very predictive of outcomes? So if we’re seeing, for instance, 10 year age accelerations, does that mean there were worse risks for everything in the future? Or if we’re seeing 10 years deceleration, are we seeing that risk decrease?  And that’s really what these clocks specialize in, is they’re incredibly predictive of outcomes. And so, and, they’re very precise now. So we can, measure the same sample and get the same result. And then now they also change with therapy and that’s really what we’re documenting as well.  So we can actually show that these are responding to the things we already know improve biological age. So for all those reasons, they’ve become I would say a leading method in biological age quantification, mainly because they’re highly predictive.

Dr. Weitz:  Can you explain the history of biological methylation clocks?  I understand we’ve had the first generation clocks like the Horvath and the Hannum clock and then the second generation clocks like Grimm age and Pheno age and now we’re into the third generation. So can you explain a little bit about what this evolution in Methylation Clocks is about?

Ryan Smith: Yeah, definitely. The at the end of the day, it comes back to one question, which is pretty hard to define, which is what is aging, right? There are a lot of definitions for it where other people say, is it a disease or is it not? In these biological age clocks, we first wanted to

Dr. Weitz: Officially right now, it’s not considered a disease.  Yeah. Yeah correct. So there are people pushing for that so that perhaps there’ll be insurance coverage or something for somebody diagnosed or wanting to utilize therapies to promote longevity.

Ryan Smith: Yeah, definitely. [00:07:00] And so we can have even drugs approved to treat aging as a primary cause. We can’t do it right now because it doesn’t exist in the regulatory framework.  And the World Health Organization does have an ICD 11 extension code for aging to say a disease is caused by aging, but we can’t actually say that. Aging itself is a disease. And so there’s a lot of of controversy in this definition because there’s so many things that happen as we age. There’s sort of, multiple hallmarks of aging that change across our body.  But also, the things that we would even just see while looking at a person, right? They’re, the wrinkles, the gray hair, all these different things. And so aging is sort of hard to define, but in order to create a surrogate or to measure or predict the process, we really have to start with some definition.  And those definitions started in 2013 with Dr. Steve Horvath at UCLA, where he was creating just predictors of chronological age. That’s what we call those first generation clocks. So can we, by taking the methylation patterns of a blood sample, predict how old your chronological age is? And at [00:08:00] first, that wasn’t used for health.

It was used for, forensics, to date how old someone was, if they left their DNA at a crime scene, or to date refugees, to see if they were adults or minors, and therefore eligible for asylum. But then they started to notice a really big pattern, which is that those people who, with this testing, were younger than their chronological age, were protected from health, negative health outcomes.

And vice versa, those people who were older with this testing were at more increased risk for negative health outcomes. And so even though it was meant to be a chronological age predictor, it was sort of measuring some biological function that was predictive of outcomes. And that’s why it was so exciting.

It’s for the first time, We might’ve been able to measure the aging process molecularly that could then, tell us about outcomes. And the reason that this is important is aging is the biggest risk factor for every chronic disease and death. If you can think of a disease, aging is the biggest risk and not by a small margin, we’re talking about 90 percent of the risk of Alzheimer’s is related to age.

Right. You can, and even things like, Smoking and obesity, which we know are bad for us are pale in comparison to the relative risk that [00:09:00] age is for most of these diseases. So age, we know this dysfunction, which happens with age, no matter how you define it is incredibly important to our health.

And so, whenever they started to see this molecular signature in 2013, it got people really excited. But ultimately it’s a little bit flawed, that definition, because we really don’t care about your chronological age, right? We know people in their. In their eighties, you’d look 50 and we know people in their fifties who look 80.

That’s sort of the process we want to measure, right? We want to be able to predict what negative outcomes are going to happen. So you can maintain the most optimal function. And so the second generation clocks, instead of being trained to predict the chronological age of an individual, we’re trained to predict biological features.  So things like blood based biomarkers or in the case of probably grim age, one of the most popular algorithms it was trained to predict time until death. And time until death is a good surrogate for longevity because it’s a clearly defined outcome and, but it doesn’t take into a lot of other things.

Dr. Weitz: By the way, just stop for one second. Explain [00:10:00] what you mean when it was trained to predict time to death. We’re talking about using artificial intelligence. Is that how we’re training it? What do we mean by training it?

Ryan Smith: Yeah. So all of these algorithms have to be trained. And so generally what we’re doing is we’re taking methylation data and we’re telling an artificial intelligence system to take in this information and create a tool that can predict X that could be chronological age.  It could be how much you’ve smoked across an entire lifetime. It could be, do you have COPD or not have COPD? It could be, a wide majority. of things, but we’re training using artificial intelligence to read these patterns to predict an output. And and so that, that output again, originally was chronological age, but the, in second generation clocks, it became biological function.

So whenever these things are trained to bring time until death, what they’re really doing is looking at a group of samples that have been taken over the last 40 years and where we know where that person has passed away and then seeing if it can [00:11:00] predict. how long until a sample passes away. And and even our newest clock, Omic age that we just developed with Harvard is about 92 percent accurate within a 10 year time period of predicting death.  So we can predict death within a 10 year time period with really good accuracy, even over 75 percent within a four year time period. And so, we can get quite accurate at predicting that as an outcome.  There’s been a lot of criticism of methylation clocks that they don’t really help us predict it very accurately.

Dr. Weitz: They don’t really add much to it. There’s been a number of articles criticizing it. And you hear some of the prominent people in the health world saying there’s really no benefit. But But I think as these clocks are developing, they’re overcoming, I think, a lot of these initial criticisms.

Ryan Smith: Oh, exactly.  And I think that we do not shy away from the criticisms. I think that they’re valid. And in fact, I think [00:12:00] that we like to point them out because some of the, knowledge that we’ve gained from those clocks are no longer relevant and we need to sort of advance. And so, there, there are quite a few issues that have happened with the clocks previously.  The most I would say the biggest issue has been precision of these clocks, as I think you mentioned. If you take the same sample and then retake that same sample and perform an analysis, how close are those results? And even with the Horvath clock originally, it had a mean absolute error of right around 3.

9 years which is. Not helpful a lot of times, right? Because if you’re doing within a period of four years are you sure that’s technical measurement change or just because of your biological change? And ultimately we, we don’t want something that changes with the wind. We want something that is really good at predicting outcomes based on your own independent biology.

And so, so that’s been one issue that’s certainly been fixed. One other big issue is. do they respond to interventions we already know are beneficial for aging? So for instance caloric restriction is probably the most well validated therapy across animals and humans [00:13:00] to improve health span and lifespan.

But whenever we do this analysis with the epigenetic clocks, we see those first generation clocks we talked about, trained at chronological age, actually go up, which doesn’t make a lot of sense, right? And so these newer generation clocks do respond to what we would expect, But some of that first generation clock, again, is giving us bad data.

And it’s not just caloric restriction. It’s also things like senolytics, like disatinib and quercetin go up with first generation, but go down with the newer clocks. And so, that’s also been an issue. And again, you don’t want to put a tool in someone’s hands that gives you the wrong data. Otherwise you’re acting against your own self interest.

So those should have certainly been there. And then probably the last of those big issues is this idea of what do you do about it? And that’s ultimately. Yeah, the important part, right? Yeah.

Yeah. I’ve run the test a few times in the past and that was one of the big questions is, okay, so I see this rate of aging, it’s either good or bad.  And then, there’s no in, from the initial part, it’s a version of the test is really, was no way to say, [00:14:00] okay, here are some of the things you need to focus on to improve that biological aging in this particular person.

Ryan Smith: Exactly. And, that the question is, if we’re going to recommend caloric restriction to everyone, regardless of how they score, do we even need to test in the first place?  Right. It might make people more motivated, right. If you have a bad score, they might say, Hey, I need to really do these, it’s a, to have a lot of effort into this, but ultimately that’s been a huge limitation in the past as well is, you and I might be aging much differently, right.  We might have someone who smokes who has, their lungs are aging, their cardiovascular system is at risk, whereas we have someone else who maybe is a little bit overweight, doesn’t exercise, they might have more musculoskeletal aging or metabolic aging, and so this is different in every single person, and being able to identify the why we might be accelerated in aging or decelerated in aging is important because then it helps us to Set A Proper Protocol To Improve Our Health.

And previous to really I would say September of last year we didn’t have any tools which could provide that resolution. Now [00:15:00] with some of the newer clocks particularly the Omic H clock I referenced earlier as that death predictor that we developed with Harvard and then now the Symfony AH clock that we developed with Yale, those are able to provide some actual individual resolution to then tell you maybe what would be the best recommendations for treatment time.

Dr. Weitz: You mentioned senolytics and that’s one of the 12 hallmarks of aging. How well does your test correlate with those 12 hallmarks of aging?

Ryan Smith: Some of those hallmarks are hard to define as well, right? We might, some of those, for instance, like nutrient dysregulation, sensing dysregulation, or proteomic dysregulation.  Those are hard to define. And and even to have that data in match cohorts can be difficult. If we look at some of the ones that are easier, like telomere attrition, for instance, or senescence burden it can be a little bit easier. And so for instance, we see that really, although telomere length is extensively validated it’s got, over 20,000 studies on being a feature of aging, it’s really not that predictive.

It, it really only explains in a study in [00:16:00] Generation Scholarland, 2. 8 percent of the variance in aging whereas those methylation clocks are now over 60%. So as we’re comparing them, there’s some biomarkers that we would prioritize to be more important, and that would be certainly the methylation clocks over things like telomeres.

In the case of senescence is a wormhole to go down into because we’re about to publish this article with Yale that, that actually shows that even Senolytics. don’t actually change the epigenetic methylation signature of cells after they’ve received similitics.  And we’ve tried to create some surrogate predictors of that process. 

Dr. Weitz: What is, what does that mean?

Ryan Smith:  Yeah, we don’t know. But but generally we don’t think we can act with DNA methylation alone adequately capture I would say senescence signature is very well, at least at the moment.  That doesn’t mean that senescence is not impacting the methylation clocks or correlated with those clocks. They certainly are. That’s why we saw this additive inquisitin improve the epigenetic clocks, but it’s probably through a different mechanism, such as reducing the inflammation that’s oftentimes associated with senescence.  So DNA methylation I think it’s still good at predicting [00:17:00] outcomes of aging, maybe not directly good at predicting those individual features like senescence, for instance.

Dr. Weitz: Or, maybe those hallmarks of aging aren’t maybe the exact right hallmarks of aging.

Ryan Smith: Yeah, that that’s one thing too, and and with all of these things, one of the big issues is we don’t know what’s causative or correlative, right?  So we can pick up these signals that are associated with aging, but we don’t know which of those signals are causing, dysregulation versus a result of it. And so that’s something else that will be elucidated in these further years to make these clocks even more accurate and more usable.

Dr. Weitz: So now tell us about the Omic age clock that you’re using now.

Ryan Smith: Yeah. So we really have, I would say three clocks in our testing that we think are the best clocks to use. That would be the Omic age clock. As I mentioned, that one is one we developed with Harvard. And we did this with the idea that the clocks get better when you feed them more biological data.  So we’ve started with, Morgan Levine’s, first second generation clock used nine blood [00:18:00] based biomarkers. And now as the clocks have started to improve the idea is that the more information you can feed this model, the more it can pick out what’s relevant. And whenever we first started, there were nine hallmarks of aging.  Now there’s probably 15 to 19, depending on who you ask. And so one of the things we wanted to do with this cohort was measure everything. So we did, we measured in about 5,000 patients. We measured full genome. We measured the epigenomics. We did some RNA and transcriptomics. We measured, over 25, 000 proteins.

We measured over 7, 000 metabolites. And then we had all of their clinical data as well. And we put all of this together in one big model to predict time until death. And so that’s what the Ohmic Age Clock is. It’s probably the clock that’s been trained on the most biological data. And and trained to predict death as an outcome.

And it’s quite good at that. It is up there with grim age as being the most predictive clocks of mortality. So if you’re really interested in mortality, specifically in living longer, this is a great clock for you. But we include some features in it, which are able even to predict your blood based biomarkers.  So we can tell you about your C reactive [00:19:00] protein or, your HbA1c or your fasting glucose, which can give us more of that resolution on what to do about it. 

Dr. Weitz: So we see that you’re talking about predicting the C reactive protein without directly measuring the C reactive protein.

Ryan Smith: Exactly. Yeah. We call those epigenetic biomarker proxies.  And in the case of C reactive protein, our predictor is actually even just a better biomarker than C reactive protein across the board. We have better hazard ratios to every disease and more significance which means

Dr. Weitz: Really? This is fascinating. So what are you seeing is you took patients, measured their C reactive protein, measured and looked at their and then found specific patterns of methylation that correlated with those biomarkers.  

Ryan Smith: Absolutely happens. Okay. Yeah, definitely. And and so this is sort of how I, for anyone who’s not watching and it is listening, you can refer to the YouTube for some of these images I’ll show really quickly, but yeah, we measured all of [00:20:00] these proteins metabolites and clinical values.

And we said, Hey, can we predict these with DNA methylation? And in the case of CRP, we certainly see this. This is data from a lithiathin birth cohort where we don’t see a trend of aging with regular CRP, but we do see a trend with aging with our DNA methylation predictor of CRP. In addition to that, we see that our predictor is more precise, meaning it’s more repeatable.

In measurements, we see associations with cognitive function we don’t see with regular CRP. We see here is brain MRIs, where we look at DNA methylation CRP versus regular CRP, and we see that our DNA methylation version is 6. 4 times more predictive of brain outcomes than regular CRP. And here you can see that sort of the effect size and significance is higher in all of these different outcomes of CRP, BMI, cardiovascular disease, diabetes, all better than even regular CRP.

So we see that and we can actually see what genes are affected in this process. So the high highest weighted gene in our algorithm comes from the SOC three gene, which is a suppressor of cytokine signaling which makes sense, right? A [00:21:00] as this gene is affected, our levels of cytokines and inflammation, it’s gonna be affected.

And so with DNA methylation, we can actually predict these other biomarkers, all with just a simple finger stick blood measurement. And we incorporate those into our models. They can tell us why we’re aging faster or why we’re aging shorter.

Dr. Weitz: Fascinating. So if I was working with a patient who has signs of cognitive dysfunction, how could I use your test and then make changes to that patient’s diet, lifestyle, et cetera, and then use that test again to see if we’re, Improving that brain function.

Ryan Smith: Yeah. I think that’s an important thing to mention is that if you have a patient who already has a disease, we know that aging is going to accelerate that disease process, but sometimes it’s not the most important thing, right? If we have someone who’s diagnosed with diabetes, we’re generally going to say, Hey, fix your HbA1c in your fasting glucose, don’t fix your aging.  Right. So a lot of times, once we [00:22:00] get to disease, this is a secondary consideration manage the disease, but for people who are looking to prevent. disease. So let’s just say someone has Alzheimer’s or a history of neurodegenerative disease in their family. We know that 90 percent of Alzheimer’s risk is age.  So this is absolutely something someone should focus on. 

Dr. Weitz: Yeah, let’s say they have one or two copies of the APOE4 gene.

Ryan Smith: Yeah, exactly. And so the idea would be that the lower that you can get your biological age, the lower your risk of developing early onset Alzheimer’s or any type of dementia. And we know that from multiple association studies.  These DNA methylation clocks, there’s now been over 2000 studies published on these DNA methylation clocks and outcomes. And generally you can find ’em connected to all outcomes. And so the idea would be that we’ll test, see where you’re at, and then make recommendations on how to improve that.

So for instance, let’s just say that you see someone come in, we give them a omic age, we tell ’em that their age is two years older than their chronological age. So they might be. 47 biologically while being 45 chronologically. They’re accelerated aging and we [00:23:00] would want to fix that. So we might recommend things to try and get that down.

Some of those things are pretty intuitive and the things that we know already work for optimal health, right? Exercise, proper diet, nutrition, reducing stress, getting the right amount of sleep, right? Those things are not. Terribly innovative, but they also work, right? And when they work, we see it reflected in reduced ages.

And then so we have that, but we can also make even, I would say, more exotic recommendations based on some of the studies we’re doing. Where hyperbaric oxygen will work, or young plasma would work, or senolytics would work, for instance and starting to make some of those recommendations as well.  So, first you get a baseline, then we will try and implement protocols to reverse that process. And then hopefully as we measure it, we see you continue to reduce that gap and become younger versus your chronological age.

Dr. Weitz: Now, what about personal, personalized recommendations? So with all these things we have some guidelines, but there’s a lot of controversy.  Which is the best diet for each person? Maybe one person’s going to optimize their [00:24:00] biological aging with a vegetarian diet, and the next person’s going to optimize it with any Mediterranean diet. And maybe, is there a way that we can use this testing to say, okay, for you, the vegetarian diet’s helping you to age better?

Ryan Smith:   So, yeah so absolutely. And that’s where these newer algorithms come in. Those epigenetic biomarker proxies from omic age, for instance. So for instance, we might see someone who has really low carotenoid levels, right? Beta carotene levels. We know that beta carotene is associated with better aging across the board.  All of these epigenetic clocks. And even just in regular meta analysis studies, we can say, Hey, someone has really low beta carotene. We need to encourage their consumption of beta carotene. Leafy green vegetables and carrots, right? To increase that metabolite, which we know is going to be, reducing their biological age, reducing inflammatory markers.

So we can absolutely make some specific recommendations like that. Some that are directly related to supplements, right? So, we have, even a metabolite called uridine, which can be supplemented and sold at places like Life [00:25:00] Extension to improve those markers. And so we can certainly make those individual recommendations based on Where you’re elevated and we know that elevation should be low, right?

So if we see your HgA1C is high, or your fasting glucose is high, we know that’s not good for aging. We want to get that lower. We’ll make specific recommendations for you. The other report that we just launched last week was Symphony Age. Symphony age is one we developed with Yale. And although we don’t report on individual biomarkers like hba one C or CRP, we report on aging of different organ systems.

And that’s so that we can actually, again, make more precise recommendations to say that your overall aging might look great, but. Your brain is aging really quickly. We want to try and improve that. So let’s pay attention to the tried and true methods we know to improve brain aging. And so one of the next publications we’ll come out with that same group from Yale, and because I keep mentioning them so much, I want to give them a direct shout out, which is Albert Higgins Chan and I would say his lab, which he took over from Morgan Levine.

Many people might know Morgan Levine. As a famous aging researcher, she’s amazing as well. They’ve created a great culture in that lab and are doing some amazing research. But one of the research [00:26:00] things I also wanted to give a shout out to a PhD student, Raghav Sehgal, as well. He is also doing some work here, but we’re about to publish a paper on 50 plus longitudinal interventional trials with all of the clocks analyzed.

And we’re really excited to do it because it’s a toolkit for both patients as well as physicians on how to best improve these clocks. And so we have some really exciting data coming out there. I’ll just give you a brief picture to show you some of this analysis. But here you can see some of the different analysis that we’re doing, everything from rapamycin to, vegan or healthy vegetarian guidelines.  And we can show what clocks respond and in what direction to give you a cheat sheet. But the one thing we find out is the three best clocks. 

Dr. Weitz: And of course, I see you, you got Ozembic in there. You got semiglutide….

Ryan Smith: Yeah, definitely. And some of these come with caveats. We’re about to publish a huge semiagglutide study as well.   But but yeah the idea being is that we’ll be able to, use the same measuring sticks across trials to then tell you what is the biggest [00:27:00] potential to change your biological age in a positive way versus a negative way. And we’re really excited about that. That’s very cool.

Dr. Weitz: So, the symphony age is now available as part of your program, right?

Ryan Smith: It is, and it is. And so you’ll get with our testing now, a big report. I can just even show you really quickly what that would look like as I sort of talk to you. I know, again, most people are going to be listening so we don’t have to spend a ton of time on it. But we can give you for instance, Your omic age, that’ll tell you your age versus the population.  We’ll track those changes over time. We can even then tell you how your aging is affecting your disease risk. So are accelerated aging leading to increased disease risk of each of these outcomes? We can then tell you what to do about it. So where are you out of range and what would we want to correct?

And then what are those things that most typically correct these different biomarkers? We also give that symphony age again with the age of each organ system and track that longitudinally as well. We give the rate of aging. This is the last of those aging algorithms that I mentioned. It’s the only third generation clock trained [00:28:00] longitudinally over time.

And it’s by far the most responsive to change. So in all of the, those 50 different interventional trials, it was the one that changed the most in measuring Effective change. So we’ll do that. We’ll do your immune cell subset percentages. We’ll do, your telomere length. We’ll tell you how much you’ve smoked and drank across lifetime as well as a few other different reports.  So you get quite a bit of information. Aging is certainly what most people are using this for now, but in the future we see this actually morphing to a diagnostic that can help with all areas of health. Interesting.

Dr. Weitz: What are, so from the interventions that have been done so far you mentioned caloric restriction.  What other things do we know that seem to impact biological aging?

Ryan Smith: Yeah, I would say again a lot of the data that’s out there tells us what we already know, which is not a bad thing. I think that people might say, hey, I see that, Mediterranean diets are super helpful for aging.  That doesn’t, that’s not a huge surprise to most people, right? But the fact that we’re seeing consistency with these measurements to what we already know is actually a [00:29:00] good thing because it shows that we’re on the right track. And so a lot of the things that we know are, Avoiding bad behaviors, right?  Off the bat. And most of you know what those bad behaviors are, right? They’re going to be the smoking and drinking, the processed foods, the lack of exercise, the lack of social connection and relationships, even workplace stress. Even people who work over 40 hours a week are on average 1.5 years older with some of these algorithms than those who are not. So service off stop bad behaviors. And then replace them obviously with good behaviors, getting the right amount of sleep, right? Making sure that. You’re not eating a lot of processed foods or fatty foods.

Making sure that you’re doing all the right things from a diet and nutrition perspective. When we get into the more exotic things, like the protocols, the procedures, the medications the supplements we start to see some different things that are a little bit more exciting. For instance, we’re seeing you know, good improvements with things like hyperbaric oxygen which again is probably not a surprise to a lot of people, but good to be replicated.

We’re seeing the satinib and quercetin again, similitics actually improve the biological aging over time. We’re seeing I, I would say [00:30:00] though, that the thing that jumps out to me time and time again is probably the most reliable therapy are things that inhibit mTOR. So things like caloric restriction, mTOR, this mammalian target of rapamycin is a sort of a master regulator of some of the processes in our cell.

And things that inhibit it generally have better outcomes. And so, Wrapamycin is another example of that. It specifically inhibits this enzyme and has been shown to increase lifespan in dogs by 33 percent in animal trials. recently in a rhesus monkey trial, 15%. And so I would say that, methionine restriction, caloric restriction, rapamycin derivatives, those are all play a big impact in, or one of, I think the most effective solutions we have now.

Dr. Weitz: Now you mentioned mTOR and mTOR has to do with growth and there’s kind of been two trends in longevity, Therapeutics. And one is an older trend and one is a newer trend. And the older trend was to focus on making sure that we [00:31:00] continue to regenerate our tissues. Because we know as we get older that things break down.  The cells break down, things don’t work as well, you lose muscle, you lose bone, we have sarcopenia, osteopenia etc. Brain doesn’t function as well. So We want to use things that stimulate growth and regeneration and we saw a lot of clinics using growth hormone and other hormones, testosterone other therapies that promote regeneration because as you get older, you fall you break a hip, etc.  And that’s a major cause of mortality. And in the last 10, 15 years. We’ve seen more of a trend of people talking about reducing mTOR. Let’s not have too much growth. Let’s make sure we in fact people have pointed to [00:32:00] there’s certain populations like the Laron dwarfs in Ecuador that don’t produce growth hormone.  So having less growth hormone is good. And so we have these two opposite trends, promote growth, regeneration, not lose our strength, not lose our bones, not lose our, or no, we have to reduce growth because growth is associated with cancer and we need to use things that suppress it.  And I’m sure at some point we’ll find out there’s a balance, what’s your sense of those two trends right now?

Ryan Smith: Yeah, I think there certainly is a balance, but I would say that time and time again, I think that we are more on the stop the proliferation than to encourage it. So more of the mTOR inhibition versus the growth pathways, IGF 1 and now in multiple studies, the higher the levels, generally the shorter the lifespan of the first ever animal veterinary pathway for drug approval for longevity is actually an IGF 1 blocker.  In canines. And so [00:33:00] I think that the more the data is coming I think that trying to limit proliferation or growth is generally where the data is pointing. Whereas and so things like rapamycin and mTOR inhibitors are a good way to do that. 

Dr. Weitz: On, on the other hand, the first study that showed reversal of biological aging, the Fahy trial used growth hormone and DHEA as two of its major interventions.

Ryan Smith: Yeah, but it was only in nine patients, all men and and, generally, one of the big problems with that is we know the growth hormone actually does have an effect at regenerating the thymus that immune organ that, that’s 

Dr. Weitz: Which that’s a major factor with aging.  That’s why so many older people die from severe infections is because they have Thymic involution, shrinking of the thymus gland, your immune system gets weaker.

Ryan Smith: Yeah, definitely. And, I think that metformin even if you looked at some of that interventional data, we were talking about in that trial with Yale it looks [00:34:00] good at reversing it.  So it’s hard to say which one is the main leader there, but with nine patients, it’s probably too small of a sample size to even to, to speculate. But with that being said, I think that yeah, I would go probably the mTOR inhibition over AMP kinase and some of those other activation pathways, but but I,

Dr. Weitz: it’s interesting, even some of the top researchers have said, well, yes, reduce IGF1 until you hit age 65, then it’s okay to promote more IGF1.  And this also relates to our recommendations for diet. So for example, Cool. Protein has been associated with promoting, potentially promoting, I don’t know if it’s necessarily as correlated as some people claim, but that it promotes IGF 1. And so therefore you want to have a lower protein intake, more of a vegetarian diet until you hit 65.  Then you want to have more protein because you don’t want the person to fall and break their hip and then they go [00:35:00] downhill from there.

Ryan Smith: Exactly. Frailty is one of the best surrogates we have from an FDA or governmental perspective for aging. And we know that is absolutely impacted by some things like IGF 1.

Dr. Weitz: And it’s also one of the reasons why weight training is so beneficial for aging. Because, that loss of muscle. There are people in nursing homes that can’t get out of bed simply because they’re too weak.

Ryan Smith: Exactly. Yeah. And so there are certainly, I think that’s why instead of looking for individual biomarkers, we really have to look at effective tools, right?  Tools that predict outcomes effectively. And that’s I think what we’re hoping to develop. Otherwise, you can get lost a little bit in every single biomarker that is associated with aging. That’s again, why these hallmarks of aging keep expanding. But we still are, I would say, still, So far away from having an FDA approved drug to treat that process.  And I, by the way, before we get away from this topic, the hyper function theory of aging by Mikkel Blagoslony is one that incorporates both models. I think. Oh, really? Tell me about that. Yeah, this idea that we’re optimized as evolutionarily [00:36:00] for reproduction.

But we never really turn off those developmental pathways. So we keep proliferating, we keep, sort of, growing, but the idea is that with mTOR inhibitors, you can stop or slow that process. And by slowing that process, we will lose function at a much later date. And that’s, so there’s a lot of good data to suggest this.

So for instance, rapamycin, Started earlier in life, generally has better effects than started late in life. So we’re preventing some of that degradation and signal loss versus I would say, trying to treat it once it’s already happened like we would lytics, for instance.

And so I’m a big fan of the hyper function theory of aging as well as this epigenetic information loss theory of aging. Where the instructions to ourselves on how to perform just get a little dysregulated over time whether a result or cause of disease. But yeah, I think that, those, how we manage it clinically is the end of the goal, right?

Are we using growth hormone? Are we doing nine months on mTOR inhibition and three months on, proliferative growth with, trying to improve, growth hormone levels or hormone levels or our NAD levels or whatever it might be. And so we’re trying to come to that, but through a [00:37:00] unified framework and that really means creating tools that we can use as surrogates to gauge this process.

Dr. Weitz: I suspect, even though the trend now is to reduce mTOR, that in the future we’re going to find out that this is a J shaped curve like we see with a lot of things, and having low levels of vitamin D is bad. Having, super high levels of vitamin D is probably not optimal either, and so there’s a J shaped curve where if your your promotion of growth and regeneration is too low, that’s going to be bad, and if it’s too high, that’s going to be bad too.

Ryan Smith: Yeah, definitely. And yeah, and I think we’re just now trying to answer those questions with again, something that’s reliable and reproducible. And I think that yeah we’ll get to some of that. I think in terms of where the best are, but I also want to bring up this idea of, in the future, I think probably the most exciting intervention of them all is this idea of cellular reprogramming.  It is incredibly exciting. And I think will really shift how we think about both disease as well as aging. [00:38:00] So what do we mean by cellular reprogramming? Yeah, so in, in 2012 a scientist named Yamanaka won the Nobel Prize. Oh yes. Yeah, and this is this idea that he was using proteins to take any cell and revert it back into a pluripotent stem cell.

So a cell that was a, for instance, a skin cell could go back and become anything now with that same genetic information. And in doing so, in further research, we’ve also seen that by expressing Yamanaka factors and giving them to cells, they actually epigenetically reset. So they go back to an age of a really young age for instance.

And so the idea would be, can we use those Yamanaka factors to restore function of different cells? And that’s certainly what’s happening now. They’re using Yamanaka factors to, restore vision in blind mice. They’re using Yamanaka factors to improve. Heart Failure in these animal models, it’s a way to go in and reset the instructions for a cell to its, it’s I would say like a hard restart of a computer, right?

Where you’re, going back to the factory [00:39:00] settings and starting from new where then your computer goes a little bit faster, it functions a little bit more like it should. And that’s what’s happening with those Yamanaka factors, is restoring them to the best version of themselves.

Dr. Weitz: Where, what’s the latest on the Yamanaka factors? Where are they starting to be used in humans?

Ryan Smith:  Yeah not in humans just yet. I would say the, I just got back from a trial conference in Barcelona where you’re only allowed to share unpublished data. And over the recent couple of weeks, there’ve been some major breakthroughs here.  Alatost Labs is probably the most notable company in this space. This is a company that got Steve Horvath from UCLA, got Morgan Levine from Yale. Got Yamanaka himself. So they’ve got the who’s who of scientific researchers. And they were funded by Jeff Milner with over 3 billion as a startup.  Oh, really? Yeah. That’s not the usual type of startup money going to some of these areas, but they just released some preliminary data that showed

Dr. Weitz: Horvath’s no longer at UCLA and Morgan Levine’s no longer at Yale.

Ryan Smith: Correct. They’re now with Altos, along with a host of other, Nobel prize [00:40:00] winners and other who’s who of scientists.  And so they’ve got the collection of an amazing team. And with that they just released their initial data and they showed that with a single injection, they’re improving lifespan in mice by 25 percent in over a thousand mice that have been studied. 

Dr. Weitz: A single injection of what?

Ryan Smith: Yeah. They won’t say, that’s what I’m doing, but it is based off of the Yamanaka factors. So based on some of that technology and, that’s an expensive technology, but people are now even finding small molecules that might do it, about Valproic acid is a good example of, a molecule which can cause some reprogramming and people are investigating.  What molecule? Valproic acid, which most people know, for seizure medications, right? Oh, okay. But but people are even using some of those molecules, and so there, there are ways that I think that it might become more accessible, but already it looks to be incredibly promising and the ability to regenerate, I think, as well as restore youthful information.  Fascinating. Yeah, very. It’ll be, I think, one of the biggest breakthroughs in medicine. I’ve always been [00:41:00] very skeptical of this living to 125, 150, but now with these Yamanaka factors, it looks like it’s in sight. Really? Wow. Very fascinating.

Dr. Weitz: And what do you think about the regenerative plasma therapy that’s available out there?

Ryan Smith: Yeah, I think that it’s certainly interesting. We’ve done a couple studies here. We’re about to release one with the Buck Institute and Dobry Kiprov, who’s the father of plasma apheresis. The, I think it all started with this idea that, if you take an old mouse and a young mouse and you hook their vascular systems together, so the heart of the young mouse is pumping blood to the old mouse and the heart of the old mouse is pumping blood to the young mouse.

They saw that the young mouse the older mouse regenerated, right? It got rid of gray hair and improved its muscle mass. It just looked physiologically younger, but on the other end, the younger mouse got older. It started to develop other phenotypic signatures of aging. And so it brought up this idea that maybe there’s something in our blood or plasma That is both causing age to get worse, but also maybe improving that process.

And I think the preliminary data [00:42:00] looks super exciting. There are a lot of different improvements. The problem is it’s really hard to get access to, it’s a little bit expensive. And we also don’t know how often you need to do it to have all the benefits. And so I’m very hopeful about it.  I think the preliminary data looks really good, but I also don’t know how sustainable it is. I also know the FDA doesn’t like plasma. Young plasma transfers as a strategy. So I’m not sure how widely robust it will be, but it certainly looks promising. Right.

Dr. Weitz: Essentially what you do is you go in and they take albumin from a younger person and re take, replace your albumin with that, right?

Ryan Smith: Yeah. So the whole plasma generally they also will supplement with new albumin and albumin is one of those biomarkers we know, again, declines with age and the higher it is generally the better we do. Binds the majority of proteins within your blood. It’s actually the number one factor, or should I say the secondary factor in our omic age algorithm.  It’s weighted that highly. So we know albumin is certainly important and this, it brings up this hallmark of [00:43:00] aging. Proteomic dysregulation that might end up happening as well. And some people estimate that’s why saunas help improve health is by activating heat shock proteins and getting rid of non functional proteins.

So you get, get to see a lot of these same narratives and across this, but yeah, I think it’s certainly an impressive strategy and certainly merits more research. There are a lot of companies now that are basically creating synthetic versions of young plasma that might be more likely to get FDA approved.

Really? Synthetic versions? That sounds a little scary. Yeah. Well, what they basically do is they compile hundreds of thousands of plasma patients and then start to filter segments. And those segments are generally what they’re they’ll give. Alkahest is the company there that’s been doing a lot of that research.  But but yeah, so definitely I think that there are probably ingredients in that plasma that can help improve aging. We’ve just got to find out what they are and then see how we can make it more accessible. And get rid of the parts of

Dr. Weitz: it that are making aging worse, which is the damage that occurs, the old proteins that are [00:44:00] incorporated, et cetera, et cetera.

Ryan Smith: Yeah, and that’s what a lot of people now are doing. Instead of just infusing young plasma, they’re just filtering their own to get rid of some of that stuff. Plasma,

Dr. Weitz: Phoresis, yeah.

Ryan Smith: Exactly. And so we’ll have trials published on both of them coming out relatively soon. That’s,

Dr. Weitz: that’s great. You’re right on the cutting edge of all this stuff and able to offer this test to clinicians and the public.  So how do Clinicians and people watching this find out about getting the is it still called the true age test?

Ryan Smith: Yeah, it is. Yeah. The true age test is something that continually changes for us. We add algorithms as we just did with Symphony Age. We add other insights but they can, the best way to do, it’s to go to our website at true diagnostic.com.

If anyone has any scientific questions about the test, they can always reach out to me personally or our support team atRyan@truediagnostic.com or support@truediagnostic.com. We also have, just a lot of educational [00:45:00] resources. If anyone wants to learn a little bit more to go to our research page, you’ll see some of the research that we’re doing with all of these universities as well, if they want to read a little bit more about it.

Dr. Weitz: And clinicians can sign up to become to offer the tests to their patients as well.

Ryan Smith: Yes, definitely. The we actually specialize with physicians because some of this information is a little hard to interpret and you really need a really big clinical picture. And so that’s why for our main market, and we do lots of education for physicians.  If you’re new to this topic, if you’re new to the idea of DNA methylation, I mentioned that, when I was in med school, And in undergrad I had probably less than a day of epigenetic education and that’s how new and innovative some of this is. And so we do a lot of education on this topic and love to I would say get clinicians up to speed and really try and implement these in clinical practice.

Dr. Weitz: And so when they order, when the test is ordered now, is the symphony age automatically included in that?

Ryan Smith: It is. It is. And generally you get all 11 reports that we do and those reports will continue to be expanded. The next areas that we’re really going to [00:46:00] go into is personalized nutrition. So we can actually tell you the levels of, things like alpha ketoglutarate or vitamin D or your omega threes with that same data set.  And then very soon we’ll also be doing methylation risk scores for disease. So how likely are you to develop these different disease outcomes?

Dr. Weitz: So you’re not going to be measuring the level of vitamin D, you’re measuring epigenetic marks that code for vitamin D levels, right? Is that what you’re doing?  Yeah, exactly. Okay.

Ryan Smith: Yeah, so we’re just using that DNA methylation data to predict surrogates and so we really do believe that in the future we’ll be able with one single fingerprick test, be able to read those DNA methylation patterns to do probably a large majority of the clinical testing that you currently do with a single diagnostic.  And that’s really what we’re excited about. Very exciting. Thank you so much,

Dr. Weitz: Ryan. Yeah, thanks so much. Appreciate it.

 

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Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast,  I would very much appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review.  As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health condition, and want to prevent chronic problems, and want to promote longevity, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office.  Call us at 310 395 3111 and we can set you up for a consultation for functional medicine. And I will talk to everybody next week.

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Lee Carroll discusses The Benefits of Medicinal Mushrooms with Dr. Ben Weitz.

In this episode of the Rational Wellness Podcast, Dr. Ben Weitz welcomes Lee Carroll, the Chief Medical Herbalist of Real Mushrooms, for an in-depth discussion on the health benefits of medicinal mushrooms. They delve into the properties of various mushrooms, including Reishi, Shiitake, Turkey Tail, Lion’s Mane, Cordyceps, and Chaga, and their roles in supporting immune health, fighting cancer, cardiovascular health, and cognitive function. Lee Carroll also explains the science behind the synergy of mushroom compounds, the importance of consuming mushrooms regularly, and the specifics of mushroom supplements. Don’t miss this informative conversation on the power of medicinal mushrooms and their potential impact on your health.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.]

 

Podcast Highlights

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Lee Carroll is the chief medical herbalist of Real Mushrooms.  The website is RealMushrooms.com.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

 

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Podcast Transcript

Dr. Weitz:  Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates. And to learn more, check out my website, drweitz.com.  Thanks for joining me and let’s jump into the podcast. Hello, Rational Wellness Podcasters.

Today, I’m excited to be having a discussion about medicinal mushrooms with Lee Carroll, the chief medical herbalist of Real Mushrooms. Medicinal mushrooms include mushrooms like Reishi, Shiitake, Turkey Tail, and Lion’s Mane.  These are mushrooms that have powerful health promoting properties, including strength in the immune system, and even the National Cancer [00:01:00] Institute has a whole detailed section on medicinal mushrooms for fighting cancer. Turkey tail. Reishi, Shiitake, and Maitake are four of the mushrooms most known for strengthening the immune system to fight cancer and infections.  Lion’s Mane is a popular mushroom used for cognitive health and you see it in a lot of brain formulas. Cordyceps is another medicinal mushroom that’s known to support the kidneys and the lungs. It’s often included in adrenal formulas and also has benefits for sports performance. Chaga helps with digestion and skin as well as with immune function.  So those are a few of the medicinal mushrooms that we’ll probably include in our discussion today. So Lee, thank you so much for joining us today.

Lee Carroll: My pleasure, Ben. It’s lovely to be here.

Dr. Weitz: So, how did you end up becoming the Chief Medical Herbalist for Real Mushrooms?

Lee Carroll: That’s a good place to start.

Dr. Weitz: How did you end up knee deep in fungus?

Lee Carroll: I have had a long career in herbal medicine. And when COVID happened in early 2020, I was working for a small company in Northern California, and I got the opportunity to develop a range of, of functional mushroom products using Namex extracts. And that was kind of like the segue I realized, you know, in 30 plus years, I hadn’t really focused on mushrooms much.  And then I fell in love with them and started developing educational materials for healthcare professionals around that. And I just haven’t stopped since. It’s just, there’s so much to learn. And, and, uh, there’s so much to discuss with mushrooms. They’re really underrated in the, in the modern clinic.

Dr. Weitz: Right. So let’s get into the science of medicinal mushrooms and how they can help us promote greater health. So why don’t we start with one of the properties that mushrooms are known for, which is immune health. Perhaps you can explain why mushrooms are beneficial for that.

Lee Carroll: Sure. So mushrooms as a group fall into a different kingdom of life to plants.  So when we’re thinking about the way that fungi interact with human biology, there’s a whole different set of chemistry that interacts with the human body. And if you go back a thousand million years, fungi and, and animals, humans have a common ancestor. So we split off from a common ancestor.  So we’ve got shared biological features. So [00:04:00] cholesterol in our cell walls is similar to ergosterol and fungal So there’s a lot of intracellular machinery. And then, as those two lineages interacted with each other originally, like in the primordial kind of ocean, fungi were needing to survive and eat food, so they would attack animals.  This is kind of like the highlight. So fungi and animals have been kind of going at it, you know, for millions and millions of years. And fungi have got these unique, signature molecules on their exterior cell wall, which are beta glucans to a lesser extent, alpha glucans, a few other unique molecules. So animal biology has evolved to recognize those patterns.

And when those patterns are recognized, it engages the immune system. So, if it’s a pathogenic fungus, it can cause disease. And humans are so resistant to fungal infections that it’s not a very common thing. So most of us are familiar with tinea and athlete’s foot, jock itch, dandruff, for example.  So when a human encounters a non pathogenic fungus as a mushroom, say shiitake or lion’s mane, those beta glucan signatures are still there.  They don’t represent any pathogenic threat because they don’t have that capacity, but they talk to the immune system in a very similar way to the pathogenic fungus.  And the message that the beta glucans send is to tell the immune system to be more vigilant, to be more accurate in your responses, to have populations of cell types that are more appropriate for the place where they hang out. So it might be, if it’s cordyceps, it might be the population of surface immune cells in the lungs, for example.

So this is driven by very highly specific receptors. that are, some of them are broadly tuned to receive all sorts of different messages from different sources, but some of them are very highly specific, and they’re tuned just to receive the messages from fungi, and mushrooms. So when we engage in the behavior of eating mushrooms, And we should dissect mushrooms out into their own kingdom of life.  And they should be a separate food group when we eat mushrooms on a regular basis, we’re educating our immune system to be healthier, to be calmer, to be more responsive, and to be more accurate at removing the neuro plastic cells that otherwise shouldn’t be there like neo plastic cells, for example.  It’s a bit more complicated than that. There’s a bit of fermentation that goes on in the gut. So short chain fatty acids play a bit of a role, but that kind of story is like the underpinning of the main reason why we should be eating mushrooms more frequently.

Dr. Weitz: You mentioned neoplastic, so that refers to cancer.  And which mushrooms are best for helping us fight cancer? I’ve heard a lot about turkey tail. I’ve talked to integrative cancer experts who recommend using various forms of mushrooms and mushroom extracts for fighting cancer.  Some have recommended Turkey Tail, some have recommended Reishi, a mixture, rotating them.  There’s extracts, like there’s one popular one known as AHCC, and I remember for a while there was one called Maitake D Fraction that was really big. What’s your take on which mushrooms are best for fighting cancer? Is it better to use or to rotate them or use a number of them?

Lee Carroll: It’s a tricky question that one.  Um, the first, the first thing I’d say is that if a person consumes mushrooms regularly as part of their diet or takes a supplement every day, a good quality supplement, you know, like a, like what Real Mushrooms offers, then the risk of developing cancer can be reduced. Uh, and there’s, there’s really good epidemiology data that backs that up.  Cancers of all types, uh, prostate cancer in men, breast cancer in women, colon cancer. So, um, in terms of our health, you know, modern humans aren’t that smart really because, you know, we don’t engage in the behaviors that are [00:09:00] preventative. So prevention is kind of optimal. So we’ve got to get more into having them as part of our regular diet.

If you have cancer and you’re looking to, you know, use natural supplements to kind of, you know, support the fight against that cancer. Mushrooms on their own don’t have great evidence to fight the cancer. What they do have is great evidence as part of conventional therapies. So when, when patients are undergoing treatments, mushrooms, across the board [mushrooms] make the patient more vital and they’re more able to cope with the rigor of the drug that they’re receiving because many of the drugs are really toxic. I’ve got a breast cancer patient at the moment. She’s taking a turkey tail extract and she was suffering badly as a result of the Taxol that she was having weekly.  And I just gave her turkey tail and a bioavailable curcumin. And over the course of four months, the oncologist said, well, I’ve never seen this drug work so well.  And her health improved significantly. She was, the complications and the side effects of that drug weren’t as great.  So it’s a little bit complicated and it’s beyond the time that we’ve got here, but when you have, when you have a particular cancer, you’ve got to go with the evidence.

Dr. Weitz: Oh, yeah. Look, I’m not suggesting that people should not get chemo or radiation or you know, targeted therapies.  I’m just suggesting from a integrative perspective, we want to help them support that person’s fight and help their immune system, which it needs to be a big participant. A lot of times these drugs, unfortunately, at the same time as they fight cancer, they end up suppressing the immune system.

Lee Carroll: Yeah, they do. So, and there’s, In China, many of the beta glucans have been purified and turned into drugs, and there’s about 30 of them. And they do, they’re ideally suited for all particular different types of cancers, so, broad brush, you can’t go wrong using Turkey Tail as an adjunct. You can’t go wrong using Reishi as an adjunct.  Uh, they’re very safe places to go. In terms of helping the patient and some of the drugs have their efficacy improved when they, when the treatment includes a mushroom. So the, some of the more specific drugs work a whole lot better under those conditions.

Dr. Weitz: Okay. Let’s talk about some of the other benefits of mushrooms.  I understand some mushrooms are beneficial for the cardiovascular system.

Lee Carroll: Yep. So Reishi probably gets the best, um, kind of track record there, although the evidence doesn’t really support it, but the, the tradition does. We just, the clinical trials that have been done with Reishi just haven’t been done very well, haven’t been done long enough, haven’t been done with quality materials. So, you know, if you’re an evident, if you’re on the evidence based end of the spectrum, it can be a bit challenging. But if we, but beta glucans play a role in cardiovascular health as well, but Reishi Hass got molecules called triterpenes that are very bitter.

And these triterpenes have got a structure that can interact with human physiology. The structure of those terpenes is similar to the triterpenes in a herb like Korean ginseng or bitter melon or astragalus for example. So those, those triterpenes, when you consume them, the first place they go is your vascular system.  And then they get, some of them get consumed by your liver, but then they end up in circulation. And the triterpenes get taken up by the endothelial cells in the vascular system. And much of the cardiovascular disease has its origins in dysfunctional, um, endothelial cell function. And the inner layers the intima, for example, they get stressed as well.  So in animal studies, the triterpenes can mitigate against the stress and the dysfunction in those cells and allow them to be more functional and healthy. So you get less cardiovascular disease. A curious thing that has not been studied is that those molecules are really very bitter and bitter receptors aren’t just in the mouth.  There’s bitter receptors expressed everywhere in the body and humans have 29 different bitter receptors and they perform very, very highly specific roles. And the heart and the vasculature express 21 of those 25 receptors and there isn’t one piece of research investigating how bitter molecules influence the functioning of the heart or the vascular system.  So it’s my theory that really good quality extracts that are very bitter are going to be more effective at supporting the cardiovascular system via the endothelial cells and the other, the original stuff that I mentioned, but also this unexplored area of bitterness and how it plays a role in cardiovascular health.

Dr. Weitz: Interesting. I was also reading an article about oyster mushrooms that have certain compounds that actually help to lower cholesterol.

Lee Carroll: Yeah. So that’s, that’s the other side of the equation and many mushrooms. Shiitake and oyster mushrooms kind of stand up as the dominant ones, they have minor influences over the levels of LDL, HDL, the amount of oxidized LDL.  And, cause that’s the real problem is how much oxidative stress there is in the bloodstream. So mushrooms help to mitigate against that as well.

Dr. Weitz: To get the most benefit out of eating mushrooms, is it better to cook them or eat them raw? 

Lee Carroll: It’s better to cook them. The button mushroom and crimini and portobello, they grow in cow manure, so it’s not a good idea to eat them raw because you might be getting a little bit of, you know, manure in your salad.  But mush, because mushrooms are 

Dr. Weitz: Oh, I thought they all grew on manure.

Lee Carroll: No, no, some, some will grow on wood. Okay. Some will grow on, you know, other types of substrates. Okay. But I think the real reason, the most important thing is that mushrooms have got a unique biology and if we want to extract the beta glucans and the other active constituents from the really robust cell walls that exist in these, in these organisms, then they need to be cooked, boiled is optimal.  So, you know, good quality extracts, processed using heat for a couple of hours and that gives the best extraction of all of the different phytochemistry and these things are very stable in heat. So, my rule at home is, and it’s a bit harder when you’re cooking because you’re on a time frame, you don’t want to spend all day in the kitchen.

Dr. Weitz: Yeah, who’s going to cook them for a couple of hours?

Lee Carroll: So, I tell people when you’re frying them or cooking them at home, 10 or 15 minutes at least to do some work at breaking them down. And the smaller the particle size, the more benefit you’re going to get. If you just, if you don’t chew your food well, and many people don’t, then if you’re swallowing large pieces of mushroom, they don’t get digested in the gut.  So they, they get a little bit of fermentation by bacteria, but we don’t have any enzymes or acid doesn’t break it down. So the smaller you chop them up the healthier it’s going to be, particularly for your large intestine.

Dr. Weitz: That’s, that’s what I do. I often have mushrooms with my eggs in the morning and I chop them up and  my favorites are shiitake and lion’s mane.

Lee Carroll: Yeah. Oh, that’s a beautiful breakfast. Yeah. I’d be all over that one as well.

Dr. Weitz: Um, [00:18:00] tell us about this compound ergothioneine. I’m sure I’m probably not pronouncing it correctly. That’s good. Yeah. And how it helps with, uh, cardiovascular health, with healthy aging, with brain health, with

Lee Carroll: Yeah, that’s, that’s a really fascinating topic that ergothioneine gets its name from the ergot fungus.  Uh, it was discovered back in 1909. So it was given the name ergothioneine because it’s a derivative of an amino acid.

Dr. Weitz: Is it now where like LSD came from?

Lee Carroll: And that’s where LSD came from. Yeah, and it’s also where ergotamine and other, other alkaloids came from that get used as vasoconstrictors and used in childbirth, et cetera.  The Chinese were using it for thousands of years. I think

Dr. Weitz: migraines.

Lee Carroll: Yeah, so ergothioneine is a derivative of an amino acid, and it’s technically a thiol, which makes it in the [00:19:00] same category as glutathione. So the role that it plays in the human body is the role of an intracellular, antioxidant. But it’s a very unique molecule and there isn’t any other metabolite in the body like it.  It’s totally unique. And just like vitamin C has got vitamin C transporters to bring vitamin C into the body. Vitamin C relies on glucose transporters to get into the cells. Uh, the kidney has got transporters to moderate the loss of vitamin C. So if you, if you’ve starved of it, then you’ll get better reabsorption.  So ergothienine has the same aspects to it. There’s, there’s very highly specific transporter proteins that bring that ergothienine from the diet into the bloodstream. And then many of the cells in the body have got transporters that are pretty much exclusive to [00:20:00] ergothioneine into the cells. And then the kidney doesn’t ever let any go.  It avidly retains any loss that might, you know, make it through to the kidney. So, um, that, that imparts upon it like a really high level of biological value, but Modern science has only worked out how important ergothioneine is just in the last 10 or 15 years since those transporters have been discovered.  One of the problems with managing human health is that the modern world creates It’s more oxidative stress than our kind of evolutionary capacity can handle where you’re exposed to all of the chemicals that are in our environment, you know, all of the psychosocial stress, heavy metals, all that sort of stuff.  So ergothioneine’s role really fits into supporting the modern person in a very highly specific way, because it sits at the boundary between intracellular oxidative stress and intracellular inflammation.

Dr. Weitz: So But yet, unlike glutathione, we don’t produce ergothioneine,

Lee Carroll: right? We have to get it from the diet.  Yeah. So it, it’s like a vitamin. It doesn’t quite meet the definition of a vitamin because a, a vitamin has, there has to be a deficiency disease associated with it. And in humans, it’s almost impossible to Um, create a deficiency because ergothioneine only comes from fungi and some soil bacteria and plants take it up from the, from the fungi and the soil bacteria.  So when you eat plants, you get 10 to 100 times less of the ergothioneine that you get if you consume a fungus. So, ergothioneines, this is Once you dive into the biology of it, um, it’s really quite fascinating. So when a, [00:22:00] when a cell experiences stress, so let’s just use the most simple example of someone exercising.

So the mitochondria are making more energy, there’s a bit of leakage from the, the, um, the, the electron chain of energy production. And so the, the amount of, of, um, free radicals increases in the cell, um, as a result of that. And the cell has got natural mechanisms to cope with that. So some of those, um, reactive oxygen species will interact with, um, NRF2, which is pretty, you know, popular and, and understood now.

And then that will engage, you know, more antioxidant defenses to cope with that stress. But you reach a point at which the glutathione in the cell, which is, you know, reacting with those. entities, it starts to get depleted and it takes a little bit of time to [00:23:00] regenerate glutathione. So when oxidative stress is ebbing and flowing in the cell, when glutathione is low, Um, ergothioneine steps in and plays a, plays the defensive backup role of being the antioxidant that allows the glutathione time to regenerate.

And then ergo has got this unique biology. So as the cell webbed, um, waxes and wanes in terms of its stress, the, the pH goes up and down. as a result of the, you know, the, the free radicals. When the free radicals are high, the, the, the cells are a bit more acidic. So ergothioneine, when the cell is acidic, it goes into its active form.

When the cell’s at its healthy normal pH, it’s in its inactive form. So as an antioxidant, um, it’s a very intelligent, adaptive mechanism that supports the cells. When things get tough, but it can’t auto [00:24:00] oxidize or cause mischief because when cells are healthy, it doesn’t, it doesn’t play a role. So it only engages in sites where there’s excessive stress.

And there are some places in the body that experience more stress and ergothioneine plays a more dominant role like in the eyes, for example, or in the liver, in the endothelial cells, ergothioneine plays a bit more of a dominant role, but it plays a role in all of the cells in the body and when we’re deficient in it, we get all sorts of age related diseases.

Dr. Weitz: And are mushrooms the only way to get ergothioneine?

Lee Carroll: They’re the only way to get, um, healthy levels of it. And humans need, uh, you know, three or four or five milligrams a day of this stuff. And the, the epidemiology that’s been done is, it’s not fully complete, but it suggests that the American diet, uh, on average [00:25:00] only has about one milligram a day.

Dr. Weitz: And I saw a paper where patients with Dementia or diminishing cognitive faculties seem to have lower ergothionine levels.

Lee Carroll: Yeah, and we don’t have a commercial test for it at the moment, so it’s still like a laboratory research tool, but I think we’re only a year or two away from having a diagnostic test that people can take that will say, if your ergothionine is below this level, and that number hasn’t been quite been set yet, um, you’re at a significantly increased risk of um, neurodegenerative disease, so mild cognitive impairment, Alzheimer’s, Parkinson’s, a bunch of other ones, um, and macular degeneration has got kind of like the highest association, but cardiovascular disease is in there.

Dr. Weitz: Macular degeneration, interesting, and that’s related to, [00:26:00] there’s some relationship between that and Alzheimer’s as well.

Lee Carroll: Yeah. And it’s, uh, there’s a vascular component to it and it’s, it’s to do with, you know, cells that can’t cope with the, with the stress that they’re under. So, you know, a neuron that has got too much inflammation, um, the, the, the enzymes that cleave the, the amyloid proteins go a little bit crazy.  And instead of making a healthy protein, they make an amyloid beta protein that can build up. So it’s all, it’s not a bad. Reducing, it’s not about targeting the, the, the amyloid protein in this case, it’s about reducing the inflammation to stop it being produced. You’ve got to go to the source, which is where all of our natural health, kind of philosophies take us.  And ergothioneine is the missing link in that bridge between how cells control their, their stress. and how they engage [00:27:00] their inflammatory responses. And Ergothenia has got this really interesting relationship with inflammation. So as, as the inflammatory environment increases, that engages Nucleofactor Kappa B, which, you know, many of us will be familiar with.

So as Nucleofactor Kappa B starts to get engaged, the ergotransporter proteins get increased in the cell to bring more ergothioneine in. And then as the inflammation starts to ebb, the ergothioneine transporters get removed. So ergothioneine sort of sits in the middle of, of managing stress and managing inflammation.  And then it’s, it’s uncontrolled inflammation that then leads to all of these downstream consequences, including cancer.

Dr. Weitz: And from what I read, the mushrooms that are highest in ergothioneine are Oyster, Porcini, and I think Shiitake.

Lee Carroll: Yeah. Yeah. You’ve done your homework well, Ben. You could put lion’s mane in there as well.  Okay. The yellow oyster represents the most easily accessible highest source.

Dr. Weitz: The yellow

Lee Carroll: oyster.

Dr. Weitz: Okay. Is it, does it have a yellow color? Is it easy to identify? Yeah. That’s,

Lee Carroll: that’s where it gets its name from. It’s this beautiful bright yellow color. Okay. Real Mushrooms has a, has a supplement called Ergo Plus, which is made using the yellow oyster.  So each capsule gives you a five milligram dose.

Dr. Weitz: Cool. Tell us about the stoned ape theory.

Lee Carroll: Well, that’s good timing with that question because it, I came up with that theory, um, as a result of my research into ergothionine. So Terence McKenna, who [00:29:00] was, you know, famous psychonaut and proponent of, you know, psychedelic, exploration and therapies, came up with this idea that,  it psilocybin mushrooms, um, by early humans that facilitated the rapid increase in the size of our brains a couple of hundred thousand years ago that psilocybin allowed for enhanced communication and the development of language and complex kind of problem solving skills. So when you look at the arc of ergothionine, it, it plays a role in neurogenesis and There’s many, many ape species, uh, you know, and, and primate species consume mushrooms as, as do many animals.

So, the essence of the, of the, the gourmet ape theory is that Um, there’s archaeological [00:30:00] evidence, the archaeologists scrape the teeth of archaeological specimens, and then they look at them under microscopes, and they, in some cases, they can get DNA out of them. So, 16, 000 years ago, The specimens from Spain were consuming vast quantities of boletes, so porcini, um, and vast quantities of agaricus mushroom.

For example, other species, other specimens have been, uh, looked at that are 48, 000 years old and they were consuming, um, Schizophyllum commune, which is a medicinal edible mushroom from China that’s still used today. Um, and Copranopsis, the Shaggy End Cap. So, there’s very scant evidence because mushrooms don’t survive.

Um, but the, the, the fact is that it’s very likely that modern, early humans Um, eight vast [00:31:00] quantities of mushrooms and the ergothionine content in the mushrooms will have played a role, um, throughout the evolutionary process and guided the way that, um, brains have developed. And when you look at Um, Ergotheanine’s role in cognitive function, that the TRACB receptor gets a lot of attention, and that’s a neurotrophin receptor that receives the BDNF signals.

It’s also a receptor that psilocybin binds into. Some of the molecules of lion’s mane might bind into that receptor as well. And when, when that receptor receives its signal, then the downstream intracellular messages, kind of housekeeping messages and house maintenance messages. So it might be Hey, you don’t have enough synapses, you’ve got to have more synapses, or your cytoskeletal arrangement internally is not quite optimal, or you’ve, you know, the [00:32:00] biological functioning of the cell might not be optional, optimal.  So ergothionine plays a role in making that, um, TRACB receptor, um, more able to deliver the messages via enhancing the intracellular domain of that receptor. So I think that, um, the human development, um, has in part been shaped by our consumption of mushrooms.

Dr. Weitz: It’s interesting. Other theories have explained that growth of the brain based on the fact that we started consuming meat and got concentrated  calories. Other people have talked about the consumption of fish and the omega 3 fats as being important for that, but 

Lee Carroll: And all of that is true but because ergothionine’s such a recent thing, um, it hasn’t been factored into [00:33:00] Those types of theories and mushrooms in general haven’t been factored into a, paleolithic diet.  So when, when researchers come up with what they think early humans ate, A, it’s very variable when you look at the data, depends on where you lived, where the fossils come from, but researchers look at collagen. And they look at the carbon and nitrogen isotopes, and that gives them an assessment of how much amino acid and therefore protein was consumed in those diets.  None of those researchers have ever considered that early humans ate mushrooms. And the little bit of work that’s been done shows that the, the isotope signatures, the carbon and nitrogen signatures that get reflected. in the collagen, um, can’t be distinguished between protein from animal sources or mushroom sources.

So the fact that we’ve got this archaeological evidence showing [00:34:00] that early humans ate vast quantities of mushrooms when they’re available probably, um, means that our Ideas around modern diets, um, haven’t included mushrooms because it hasn’t been factored in. And the more mushrooms we can include in our diet, the healthier we’ll be.

And there’s, there’s some really good evidence to show that if you can just swap two meat meals a week out of your diet and replace them with mushrooms. It has significant impact on your risk of diabetes and obesity and metabolic syndrome, for example. Interesting. So the gourmet ag theories are kind of broad Iraq.

And I think that, um, you know, the consumption of mushrooms going back, you know, probably millions of years, Um, not just the last couple of hundred thousand has really kind of shaped, um, you know, the way that, that human evolution, particularly from a nervous system point of view has transpired.

Dr. Weitz: Of course, some mushrooms [00:35:00] are poisonous and I wouldn’t want to be the guy in a primitive tribe who gets to test out the new mushroom.

Lee Carroll: Yeah, it’d be an awful, awful way to go.

Dr. Weitz: If I was considering taking, oh, let’s just follow up a little bit on the brain health, um, what is it about, um, what is it about, um, Lion’s Mane that makes it such a powerful factor for brain health?

Lee Carroll: Okay, that’s a great question. Can, can I start by saying that the consumption of all culinary mushrooms, when they’re done over the course of years, so, you know, two years, five years, 10 years, 20 years, um, the epidemiology of that tells us that just one serve of mushroom a week can improve cognitive function in healthy people as they age.  [00:36:00] And higher serving sizes, so when you get up to 7, 8, 9 serves of mushrooms a week. So a serve is about half an ounce of fresh mushroom. So not crazy amounts. Um, when you get up to those higher servings in a week, the risk of, um, developing neurocognitive challenges, you know, like Alzheimer’s and Parkinson’s, mild cognitive impairment, the risk decreases by about 75 to 80 percent.

So there’s something about mushrooms in general that is really quite significant, uh, in terms of how this plays out, but at the moment all of the attention is on lion’s mane and lion’s mane special for a couple of reasons. So, um, lion’s mane’s got beta glucans, they play a role, um, it’s got ergothionine, And at reasonably high levels, it’s kind of in the high category.

So that plays a role. And it’s got secondary [00:37:00] metabolites. And the metabolites are different between the fruiting body and the mycelium. And the fruiting body is where the tradition comes from. So the, the tradition around Lion’s Mane having these effects. was to do with people consuming the mushroom. So there’s the intersection of those three different aspects of the chemistry, which I believe have a synergistic effect, uh, which promote, um, you know, the optimization of how the brain works.

And in the modern world, It’s pretty hard to avoid people being reductionist. They want to hone in on just what is the one thing that’s the most important. You can’t do that in biology, and you definitely can’t do it when you’re talking about, you know, functional mushrooms and, and, um, natural medicines.

So Lion’s Mane, the beta glucans, um, get fermented in the gut [00:38:00] and beta glucans get converted into short chain fatty acids. And there’s really good evidence to show that. Um, any, any short chain fatty acids, uh, when they’re produced in the gut are going to have in, in, uh, improvements in brain health. So synaptogenesis improves BDNF as you know, is the driver of that, for example, certain areas of the brain can be increased in size.

Ergotheanine plays a role as I was just describing earlier. Um, it helps manage the oxidative stress in the brain and it allows the TRACB receptor, at least, but possibly many other receptors that we haven’t been explored yet to be more functional, to deliver better messages. And then you’ve got the secondary metabolites.

So in the fruiting body, the mushroom, um, it’s harrisonones, um, which, uh, interact with various receptors in the body to modulate the behavior of neuronal tissue and maybe increase nerve growth factor. What was

Dr. Weitz: that? What was [00:39:00] that term? Harrison mounds.

Lee Carroll: Hericinones. It’s a type of diterpene. So it’s a, it’s a class of molecule that’s quite unique to lion’s mane.  

Dr. Weitz: How do you spell that?

Lee Carroll: H E R I C E N O N E S, I think.

Dr. Weitz: Okay, cool.

Lee Carroll: So when you, when you get that cocktail of, uh, chemistry, um, at the right dose. And the clinical trials tell us that you need, um, three to five grams of the mushroom a day to move the dial on people that have got cognitive impairment. Okay. If you do it, if you do lion’s mane regularly, um, and you don’t have cognitive decline, one gram a day over the course of your life will, um, you know, prevent cognitive decline from happening and keep your cognition.

Dr. Weitz: Now, approximately how much [00:40:00] lion’s mane mushroom is in a gram? Like, like if you had a, um, a fist? Amount would, would that be a gram more? Yeah, if you’re eating fresh.

Lee Carroll: If you’re eating fresh lines mane. Right. Um, uh, it’s about 90% water. So if you had 10 ounces of lions mane, you’d have one ounce of dried mushroom.  Oh wow. You’d have 28 grams, so you’d have a whole month’s worth. So you could eat just a little bit every day. Okay. But the sort of capsules that, that people have access to, so the. The Real Mushroom Lion’s Mane Capsules, um, they’re 500 milligrams each, so two of them gives you a gram, that’s the equivalent of 10 grams.  I see. Fresh.

Dr. Weitz: So, but for, so, one gram would be, of a quality product would be sufficient for prevention. What was the amount for a patient who [00:41:00] already has, say, mild cognitive impairment? 

Lee Carroll: The research tells us about three grams.

Dr. Weitz: Three grams. Okay.

Lee Carroll: And clearly, you know, the, the more you throw at it, the better it will be.  There’s a long list of things that, you know, a patient will do well with.

Dr. Weitz: Now, you mentioned that a lot of these ingredients are in the flowering part of the mushroom rather than the mycelium. Can you explain what the mycelium is and the difference between, specifically as it relates to mushroom supplements, the importance of the flowering body versus the mycelium?

Lee Carroll: Sure. Yeah, that’s a, that’s a really vexing question at the moment. And in every industry disruptive ideas and practices get introduced, uh, which create a lot of confusion [00:42:00] and that’s happening at the moment and has been for the last 10 years in the mushroom industry. So, Let me see if I can kind of dissect it up to make it clear for people because there’s lots of opinions and a lot of emotion around this topic when you get into public debates.

So from a traditional point of view, uh, it was only ever the mushroom or the fruiting body, um, which was used as a medicine and These, these, uh, mushrooms were mostly boiled or decocted, uh, and taken as a, as a beverage, so as a tea or as a medicine. So if we want to, um, understand the traditional use and reflect that traditional use in a modern setting, then we need to kind of stick with the tradition.

So there’s a lot of, there’s a lot of value around the mushrooms. And then there’s a huge amount of modern research to back up the traditional use of it. And there’s a huge volume of research around beta glucans. [00:43:00] And then there’s a, there’s a developing body of research around all of the other constituents that support that.

So back in the sixties, scientists realized that mushrooms are quite special. And there was a lot of focus on cancer and mushrooms are hard to grow. So they thought let’s grow the mycelium in a tank of liquid, and then we might be able to extract the, the highly specific beta glucans from that mycelium, do it more cheaply and create like a drug out of it. So when we’re talking about mycelium, that’s the like, legitimate way to make a product from mycelium. So PSK and PSP from Turkey Tail, which are kind of famous names as, as very highly specific. beta glucans with, with proteins attached. Um, that’s, that’s a legitimate way to do it.

And there’s a large volume of science to back that up. So it’s a new discovery. Um, and for a new discovery to [00:44:00] have value in a modern setting, you’ve got to have the research to back it up. So the research has been done and it’s really overwhelming and conclusive. So if you want to embrace the use of mushrooms, They’re the two aspects of mushrooms you need to use.

Dr. Weitz: Now, by the way, if you look at a mushroom, you’ll see this, uh, let’s say you look at a traditional, um, you know, white mushroom, black mushroom, uh, you’ll see this bulbous thing and then you’ll see a little stem. Is that stem, is that the mycelium?

Lee Carroll: The mycelium is inside the the substrate that is being used as the food.  So it might be in the soil. It might be in the log.

Dr. Weitz: Okay. But, but it’s not in either the stem or the bulb.

Lee Carroll: Well, we’re getting into technical territory. So let me take that out for you. So the main organism of a fungus. Um, [00:45:00] is, is made up of mycelium and that mycelium inhabits the environment that, uh, that fungi is suited to.  So it might be a decomposing log. So the purpose of that mycelium, that’s kind of like the body of the fungus. So it’s rationale for life is to survive, to eat food, and then when conditions are right, reproduce. So when the conditions are right, that, that fungus produces the fruiting body or the mushroom, and then that’s the reproductive structure.  So you’ve, and then you’ve got spores, which are kind of like, in essence, the seeds. So you’ve got those three parts. as an analogy is much more complex. So the thing that’s really confusing the supplement industry at the moment is that people grow the mycelium on brown rice or sorghum or [00:46:00] oats, and then that gets that gets dried.

No fruiting bodies may be present or there may be primordial fruiting bodies or there may be a scant number of fruiting bodies. Um, those products get dried and they get sold as if they’re a mushroom and they’re not technically a mushroom. They’re a, they’re a digested or a technical, it’s not fermented really, but it’s a processed food and the science is not conclusive yet on any of the active constituents in those products and what they do.  There’s a small amount of science to suggest that they might have some immunological benefits, which puts it into the category of the shiitake that you mentioned earlier that’s grown on brown rice. So many people are being confused at the moment and they’re buying myceliated grains or mycelium on grain thinking that they’re getting a mushroom.

And you’ve got really slick [00:47:00] marketing campaigns that are behind these products. And if you want to be scientific about it, you know, there’s no consensus yet on what’s in those products that makes them work. They don’t contain beta glucans in any therapeutic level. Their ergotheanine is not detectable.

If you’re looking at Reishi, Reishi only produces its bitter molecules that I mentioned earlier, if it grows on wood. So if you grow it on brown rice, you don’t get any triterpene. So my myceliated Reishi, brown rice isn’t bitter. So you can’t get any of the, the pharmacological benefits of those bitter molecules.

So I do think that there will be some benefit to these products, but we can’t call them a mushroom and the benefits are likely to be very different and derived from a different set of chemistry to that from which, you know, the mycelium, the pure mycelium or the fruiting body is delivering. [00:48:00]

Dr. Weitz: So you’re saying to No, we’re going to get the benefits of mushroom supplements.  We’ve got to make sure that the product contains only from the fruiting body and not the mycelium.

Lee Carroll: No, the, it can be the fruiting body that can be the pure mycelium as a beta glucan. Oh, standardized extract. Or it’s the myceliated grain products, which are an outlier and they, they shouldn’t be considered a mushroom.  And the companies that promote those products, piggyback off all of the traditional claims. So let’s just use Reishi as the example. When you grow Reishi on brown rice, you get, you get very low levels of beta glucans and you get no triterpenes and none of the other molecules are there in any significant level.  So it’s unethical and fraudulent in a way to use the traditional claims that have been developed around the consumption of the mushroom or the fruiting body, which has got high levels of beta glucans, it’s got high levels of triterpenes. It’s not, it’s not. 

Dr. Weitz: So you’re saying there’s, there’s two problems.  The first problem is if the mushrooms used, in the supplement or even the mushrooms you buy at the store. If they’re not grown on the right medium, then you’re not going to get the right product. How do we know the mushrooms we even buy at the store are being grown the right way?

Lee Carroll: Well, the ones that you buy at the store you’re pretty safe.

Dr. Weitz: Oh, we know they’re going to be grown the right way, not on brown rice or

Lee Carroll: no, it’s the, it’s the supplements that, okay.

Dr. Weitz: Okay, so, so then when we’re talking about supplements, number one, [00:50:00] the mushroom in the, uh, supplement needs to be grown on the right medium to have the right raw ingredients, and then if the mycelium is grown on grains, how, how do we know if it says mycelium, that the mycelium is grown on grains, does it have to say that?

Lee Carroll: It has to say that on the label.

Dr. Weitz: Okay.

Lee Carroll: But the trickery is that the labels are replete with images of all of the mushrooms. So you get the consumer gets tricked into thinking, uh, and the average consumer doesn’t, you know, isn’t an avid reader of the labels. So it’s, it’s easy to be misled. So it’s incumbent upon the mycelium on grain manufacturers and producers and sellers to do the research to demonstrate that there is efficacy.  And there’s only a very small amount of that efficacy. [00:51:00] And the people that are prominent in that area create confusion by saying, you know, beta glucans, you know, aren’t all that everybody makes them out to be. There’s other things there.  

Dr. Weitz: So what should the label of a good quality mushroom supplement say in terms of where it’s from?

Lee Carroll: So it should say the, the exact, um, path that’s being used. So, um, the mushroom or the pure mycelium. So, you know, some products, as we talked about, you know, you, When you’ve got pure mycelium that’s grown in a submerged culture, you can get a pure beta glucan from that. And then there’s good evidence around, you know, how they work.

But for the most, they’re not as freely available. So the label should say that it’s, that it’s made from mushroom. It should have the levels of beta glucan. Um, in there for to, to ensure that [00:52:00] there’s, you know, going to be efficacy and where, where, uh, mushrooms have got easily measurable actives. Like Lion’s Mane, there aren’t standard tests yet, so you can’t put it on the label, um, if, if a label says it’s standardized for, for, um, the secondary metabolites, the haricinones that we talked about, that’s not possible because labs can’t do that test yet, so Reishi should have triterpenes on the label, and then a mushroom should be organic, Um, there’s, there’s good access to, you know, organic mushrooms these days and that guarantees, you know, an enhanced level of safety because mushrooms, um, you know, can fall foul of pesticides and chemicals just like plants can.  And China grows like 85, 90 percent of the mushrooms in the world. And they’re a very high quality source for mushrooms. So [00:53:00] the fact that China is the country of origin, um, you know, for many things, it might be a negative, but it’s not a negative for, for mushrooms.

Dr. Weitz: Yeah. As soon as I hear China, I’m like, ah,

Lee Carroll: Yeah, and rightly so. However mushrooms that the growers that, that Real Mushrooms and, and the parent company Namex work with are in the, in the woods of China. They’re being grown in, in pristine places in an organic way. Uh, and very often by people that are the embodiment of the tradition of those mushrooms.  So, there’s a huge amount of ancestral knowledge in China around the use of mushrooms. There’s, there’s numerous mushroom research institutes, you know, I think there’s only one in the US. Um, so. If you, if you’re growing mushrooms in the middle of Beijing, you know, [00:54:00] like, yeah, that might be a problem, but, you know, China is a massive country and there’s plenty of opportunities to, um, grow mushrooms where they’re, where they’re most ideally suited to grow.

Dr. Weitz:  So in terms of supplements, like the real mushroom supplements, is it, is it, better that the supplements are a capsule with powder, or that it’s in a liquid tincture, or some people make a coffee out of mushrooms, make a beverage out of it. Does that affect its efficacy?

Lee Carroll: It, unfortunately it does. Um, it is possible to make a good quality liquid mushroom extract, but I just don’t see any on the market. When you remove the moisture, you can get more concentration. So it’s much more cost effective to, and much more therapeutic in my opinion, to take a dried extract as a capsule compared to a liquid.  All of them. You can see behind me, I use a lot of liquids in my clinic. I see that. You got tinctures. Yeah. Even the, even the high quality professional lines that I use don’t do a good job of liquid mushroom extract. So it is possible. I just don’t see any. So. For the, for the consumer, I think it’s much safer to stick with a, with a dried extract.  There’s lots of reasons to back that up, but they get a bit kind of technical.

Dr. Weitz: So give us an idea of what, what sorts of supplements, let’s say somebody’s on a longevity program and they want to have maximal Brain Health, Neurological Health, Cardiovascular Health. What might be a regimen of, uh, mushroom supplements that they might want to include?

Lee Carroll: Good question.  I’ve been doing mushrooms every day [00:56:00] now since 2020 when I kind of discovered them. Um, so it takes time for the effects to build up. With me, one of the curious effects, there’s two curious effects. Been a herbalist 35 years and my frequency of of infections has been less in the last four years than it was in the previous 15.  So the only difference is mushrooms and my white hair is going black again. So there’s something about the Reishi that I take daily that’s rejuvenating the, the, the pigment cells in my hair. So to get the, to get the benefit out of mushrooms, it can’t be a fad. You have to buy into it. 

Dr. Weitz:  I’ll be totally honest with you, looking at your hair, I’m not sure I’m going to buy the idea that it makes your hair darker, but.

Lee Carroll: Oh, my hair was pure white. Oh, okay. And there’s about 15 percent black hairs there now. You can’t see it on the camera. Right, okay. So it’s just ever so slowly [00:57:00] going back to its original color. Okay. So for people to get the best out of mushrooms, you need to do a range of mushrooms. So, you know, a number of them over the course of years, you can’t just do it for a few months and say, Oh, I tried mushrooms and I didn’t get any benefit.

Dr. Weitz:  Right, I get that. It’s a long term deal.

Lee Carroll: So Real Mushrooms has got a product called 5 Defenders. So it’s got 5 mushrooms. Uh, there’s Lion’s Mane, sorry, there’s, there’s, um, Reishi, there’s, there’s Chaga, there’s Turkey Tail, there’s Maitake and Shitake. So that’s a fantastic blend if you’re, it’s available as a powder or a capsule.  So if you like it as a hot beverage or a cold beverage, it’s a very kind of strong, um, um, Robust, uh, coffee kind of like flavor. So, I would, that’s, I do, I do that daily. Um, so 

Dr. Weitz:  You have the powder or the capsules?

Lee Carroll: I like the powder. So, I do [00:58:00] a gram of that a day. 

Dr. Weitz: Could you add that to your, let’s say I, I made some coffee.  Could I pour that in there?

Lee Carroll: You could, yeah. I like mine neat, but a lot of people like it with the addition of a coffee flavor. So it’s entirely up to the individual how they want to, you know, kind of use that. So one or two grams of that a day, uh, long term is kind of like a, a, a basis for good health.  Um, and then if there’s concerns about cognitive function, I’d take lion, I’d take lion’s mane, you know, one, two, three grams a day. Um, if, if there’s lung and kidney issues, uh, in the patient, I’d recommend cordyceps. If there was, uh, an interest in improving athletic function, then, you know, cordyceps. And then to ensure that there’s enough Ergotheanine, because many of the benefits of mushrooms aren’t just, um, beta glucans, they’re ergotheanine.

I’d re I recommend, [00:59:00] um, taking an Ergo Plus capsule, which delivers a minimum of five milligrams of ergotheanine a day. So, um, you know, those, those three things, so the five defenders as a base, Pick a mushroom that suits, you know, your individual and specific needs, and then add a bit of ergothionine in.  And wherever I get the chance with a patient, that’s what I do.

Dr. Weitz: Right. Cool. So, I think, um, I’m ready to wrap. Um, final thoughts for listeners and viewers, and then, uh, tell us how we can get a hold of the real mushrooms. Are these just sold professionally through practitioners? Or are they sold direct to patients?

Lee Carroll: So it’s through both. So some practitioners have got, uh, accounts and it’s, direct to consumer, so you won’t find it in a shop per se. Okay? So if you go to real mushrooms.com, um, you’ll see all of the products [01:00:00] there. If you use my name, uh, just LEE, it’s very hard for me to say e with an American accent,  So you’ll get, you’ll get, uh, 20% off your order and, okay. My final comment, uh, I think in this whole topic is that mushrooms aren’t a fad. Uh, we need to accept that, um, you know, they’re a natural part of our human history and we need to start taking them as foods and as supplements and never stop. Um, you know, they need to become an integral part of our, of our daily lifestyle routine, just like exercise.  You can’t do. All of your exercise in one year of your life and have the rest of your life off. You know, you’ve got to do it regularly. 

Dr. Weitz: So the website is what? Realmushrooms.com?

Lee Carroll: Yeah, realmushrooms. com.

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

Lee Carroll: Lee. My pleasure, Ben. It’s been wonderful. I’ve enjoyed chatting with you.

 

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Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy Listening to the Rational Wellness Podcast, I would appreciate it if you could go to Apple Podcasts or Spotify and give us a 5 star ratings and review. If you would like to work with me personally to help you improve your health, I do accept a limited number of new patients per month for a functional medicine consultation.  Some of the areas I specialize in include helping patients with specific health issues, like gut problems. neurodegenerative conditions, autoimmune diseases, cardiometabolic conditions, or for an executive health screen and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way.  Please call my Santa Monica White Sports Chiropractic and Nutrition Office at [01:02:00] 310 395 3111. And we’ll set you up for a new consultation for functional medicine. And I look forward to speaking to everybody next week.

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Dr. Jill Crista discusses PANDAS and PANS with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.]

 

Podcast Highlights

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Dr. Jill Crista is a Naturopathic Doctor and the author of Break the Mold: 5 Tools to Conquer Mold and Take Back Your Health and now of this new book, A Light in the Dark for PANDAS and PANS. Dr. Crista offers several popular physician training programs on both Mold and also on PANDAS and PANS, as well as a course for patients on mold. Her website is DrCrista.com.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

 

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Podcast Transcript

Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates and to learn more, check out my website, drweitz.com. Thanks for joining me and let’s jump into the podcast. Hello, Rational Wellness Podcasters today.

We’ll be speaking about Neuropsychiatric illnesses in children, referred to as PANS and PANDAS, with Dr. Jill Crista, who has a new book on this topic called A Light in the Dark for PANDAS and PANS. PANDAS stands for Pediatric Acute Onset Neuropsychiatric Disorders Associated with Streptococcus.  And PANS stands for Pediatric Acute Onset Neuropsychiatric Syndrome. Dr. Jill Crista is a naturopathic doctor and the author of the best selling book, Break the Mold. She offers several popular physician training programs on both Mold and also on PANS and PANDAS, as well as a course for patients on mold. Dr. Crista is now focused on research, teaching and writing, specializing in mold sickness, brain injury, and PANS and PANDAS. Thank you so much for joining us, Dr. Crista.

Dr. Crista: Thank you for having me. It’s great to be back.

Dr. Weitz: Thanks. So how did you become interested in studying PANS and PANDAS?

Dr. Crista: I’m a mom of twins with PANS.

Dr. Weitz: Oh, okay.

Dr. Crista: Yeah. In the trenches, that was before it even had a diagnostic name. My kids are 24 now, so this is, 20 years ago. Oh goodness, what’s going on and how do I help them? So I’ve been in the trenches and then thankfully my kids seemed pretty normal, with all that they had going on.  They still went to school, played sports, all those things.  And and you get known as the person who helped them. Her own kids do that. Then it’s oh let’s have you, every special kid, then come see Dr. Jill. I got a chance to see a lot of kids with different neurological things going on and autoimmune diseases and things like that.  That’s how I got into it. And the tie between mold and PANDAS and PANS is that in many of the cases that I was seeing, mold was the trigger for the development of PANS.

Dr. Weitz: And it’s there’s certainly just seems to be a plethora of kids with psychiatric conditions these days. Anxiety seems to be everywhere.  ADHD, difficulty concentrating, learning, there’s so many kids with psychiatric conditions. And it’s fascinating to consider that these psychiatric conditions may actually be caused by physical things happening in their bodies, rather than just this being a mood or emotional disorder.

Dr. Crista: PANDAS and PANS have really, and COVID actually helped us with that as well, this paradigm change in mental health, that it’s not just wrong thinking, there’s actually something physically going on in the body affecting behavior.

Dr. Weitz: Some of the most common signs and symptoms of PANS and PANDAS are all these emotional things.  And how do we how do we wrap our heads around figuring out, how do we decide, how do we figure out what are some of the underlying causes? And I understand from your book that some of the underlying causes are mold, as you just mentioned, streptococcus, these other underlying infections, possibly toxins.  How do we go through trying to figure this out?

Dr. Crista: There’s the art of medicine, right?

Dr. Weitz: Exactly.

Dr. Crista: If you have a child who develops anxiety, separation anxiety, OCD, tics we often see urinary sensitivity. So urinary frequency, generalized abdominal pain. There’s a confluence of symptoms. There are different clinical criteria for each condition, but anxiety is the one that is in pretty much 100 percent of the kids.  There’s some level of anxiety. And what’s interesting is I see that with mold as well. Mold exposure there’s I don’t know that I’ve seen a mold sick patient that didn’t have some level of anxiousness that’s been ramped up. So if there’s that acute onset, and now acute could be a mild case coming on suddenly.  So it may not be picked up the first time at the onset, but then with recurrences and flares, you get this, exaggeration of the behaviors that were happening before with, not wanting to leave a parent, not wanting to leave their room. Maybe we see some aggression or irritability.  We might see some inability to write the way that they could. So they’ll start to drift across the page. So there’s all these little signs and symptoms. If we can catch the moment when it happened, and a lot of times that’s going back in time, family’s going back and saying, before it was really, really bad, it was bad, four months before that, remember when he couldn’t stop washing his hands all the time.

And we thought he was finally getting it and being clean. And instead that was actually the first onset. It was acute overnight, but it might’ve been mild. When we go back and we find, where was the time when the child’s behavior really changed? What was the fun? There was a fundamental difference or a behavior change, or maybe again, clinginess to one parent.  They didn’t want to leave the parent or they’d cry.  Or they might act out with anger ’cause they’re, that’s a real need for them. What was going on before that?  So in that three month period of time, before that happened, did you move to a new house?  Did they start at a new school?  Did they go to summer camp?  All those could be mold exposures. Did you get a new lawn ’cause you just moved into a new house or something like that and sprayed it with a bunch of chemicals?  And make sure it was, looking like carpet and not like regular lawns.  So the weed killers and the herbicides are the number one bad guy environmental toxin in these conditions.  And I can talk about why that is, but look back about three to four months before that moment. And that really tells us a lot about what was going on. And the people that are doing more functional medicine, like you and I that are treating these kids. We are expanding the triggers beyond just infection.

So if you look in kind of the, in the conventional model, the focus on what’s the bug? What’s the bug? What’s the bug? Let’s make sure we take care of the bug. And that’s important because if the child has environmental toxin exposure, that has wrecked their gut microbiome, which is where our immune system lives, Then, 70 percent of our immune system is from our gut health.[00:07:00]  If we are, they’ve just been chemicalized, talking chemicals or mold other things like EMS and mercury, if they’ve just had a dental appointment and they got a bunch of fillings or even one filling, if they’re a sensitive kid to mercury, that toxin exposure now has set the stage for the infection to just trip the last trigger.  So the infection is important to, manage it and keep the load down on the kid, but that’s not the whole story. The whole story is how did that kid get a regular old infection that other kids get and have an autoimmune disease start? So there’s the question. Yeah. So I think looking at time helps.

Dr. Weitz: Now, does it have to be acute onset? What’s the importance of acute onset?

Dr. Crista: Yeah. This is a debated subject. 

Dr. Weitz: I mean, cause we know most of these infections are low grade chronic things. And a lot of times we see even in mold, it seems to be a slow developing chronic thing.

Dr. Crista: [00:08:00] Yeah. So by the clinical criteria, yes, it needs to be acute. Where it gets a little wiggly is if it was acute and mild, then we can miss it. Usually, the classic story, the classic case is, the kid gets Strep, three weeks later, they change overnight, and they have tics, OCD, they can’t leave their parent, they have the anxiety, they have, all of a sudden this is a different kid.  And that can be anywhere from right after the infection, during the infection, usually not during because usually it’s like a secondary response, but it can be up to three to maybe even six months after that infection to fit the clinical criteria that you have a kid that just overnight changes, the parents will say, I feel like our kid was just like a body snatchers, they came and they took it and they put a monster inside of my kit instead.

And it’s very scary. And these kids can get extremely scary, sick, they can start to feel like maybe their parent [00:09:00] is an imposter. So they get afraid of their parent, one parent and clingy to the other, so there’s a lot of, the brain just doesn’t work right when it’s so that’s the classic picture.

However, and I talk about this in my book on the definition of PANS, the reason that we even created a second thing from PANDAS is they found out that, wow, not all of these cases that are classic had strep. Some of them got the flu. A lot of them. Flu is a big triggering infection for kids. Also Mycoplasma Pneumonia, Chlamydia Pneumonia.

Mycoplasma is a lot like strep that it can go, it can evade the immune system and can be persistent for a long time. So that’s a, that’s like a, and it loves the brain. So it’s a classic other bacteria that can happen. And then we can see things like so then they were like, okay not everybody has strep, so we’ll create this other condition called PANS.

So it still has the acute onset. It can be an older [00:10:00] kid. It doesn’t have this like tighter age requirement as long as it’s a pediatric, before they become an adult at 18. If it was onset during that, it might be onset in a teenager for mono. So they had to open it up and I’m hoping we’ll open it up one more time for the congenital infection because that’s where it gets a little squishy.

These are kids who never really developed a totally healthy immune system. And that’s where my kids fit. I gave, I gave ’em a great sense of humor, but I also gave them Lyme and Bartonella . So I had that low ly and didn’t know it. I was diagnosed with quote fibromyalgia. It was chronic Lyme disease, and I gave that to my kids, which reactivated when I was pregnant.

Dr. Weitz: Now, how can you give Lyme disease to your kids? Is it that the ticks actually spread or is that somehow their immune system changes?

Dr. Crista: Because I had it in my bloodstream when I was pregnant and it crosses the placenta.

Dr. Weitz: Okay. Okay. 

Dr. Crista: So they literally get Lyme disease. Okay. 

Dr. Weitz: And Babesia

Dr. Crista: and Bartonella do the same.  [00:11:00] So it’s a vertical transfer, it’s what we call it in medicine. But basically it’s like mom had it, it could cross placenta, it could infect baby. And we know this as, we know Lyme’s, some of the things that Lyme does is it reduces immunity, and it’s a neurotoxin, so it changes the neurology. So it’s a perfect setup for Pandas and Pans, which is an autoimmune disease attacking the nervous system.

Dr. Weitz: So those of us who like data, is there data to show that Lyme can be spread to children?

Dr. Crista: We have animal studies. We have a dog study that Dr. Charles Ray Jones, who I trained with in my Lyme training when we give a mom dog infected tick bite most, but not all the pups develop Lyme disease when they’re born or test positive for it when they’re born.  And the cord blood is also positive. So that’s a way that we, those of us that treat. People with Lyme who want to get pregnant, cause they’re, they had Lyme, they feel [00:12:00] healed, but pregnancy can be such a stress on the body that you can have a reactivation just like what I did. I had it under control, and then, a twin pregnancy was enough to stress it out.  So there is data in animals that show that there’s this vertical transfer is very possible and probable, we could say, because most not, but not all the pups got it.

Dr. Weitz: And then when it comes to infections, a lot of these, especially the viruses, tend to sit in your body and are already there, and then you get another infection that a lot of times will reactivate one of these latent infections.  Things like strep, a certain amount of strep is present in our system all the time, but then can be activated or grow to a point where it creates symptoms.

Dr. Crista: And that’s the mold connection. So mold mycotoxins deplete our immune system of all of our respiratory passages. So our sinuses, our lungs, our gut too.  But what can happen then [00:13:00] is we, if we don’t have enough immunity on those respiratory passages. The boss of the airways, which is strep, can then colonize, and that can become a fungal colonization if you’re exposed to mold spores in a moldy environment, and it can colonize with your own respiratory flora, so we get, basically, I think about our sinuses, our gut our mouth, everything has its own unique microbiome, and that is a healthy, sharing commensal community.

Everybody’s working together, working for the good of the whole kind of thing. But when you get exposed to mycotoxins, that starts to shift. So those commensal species, so all of these good flora that’s supposed to be there to protect us, which is primarily strep, by the way, they’re not all pathogenic types of strep.

Most of the strep in our respiratory passages are protecting us. But there are pathogenic strep that as you’re exposed to mycotoxins and you start to get that flora shift to having to act [00:14:00] defensively instead of communally and then over time that defensive activity is harming themselves and their neighbors and that allows more non commensal or what we’d say pathogenic species to be hosted in those passages.

And then you are dealing with antimicrobials, antibiotics, antifungals, to try to get that system back and, back in balance and have the commensal species take over again.

Dr. Weitz: Interesting. I want to go down a side rabbit hole just for a minute here and not get too off track. But How I’ve always tried to figure out, I don’t understand, but somehow I know they’re related.  They mold ends up increasing Candida. And I know that they’re both fungi, but mold is a different thing than Candida, but somehow you’re treating a patient with mold and they end up having this increased Candida that you have to deal with also.

Dr. Crista: a lot of times. So not [00:15:00] everyone with Candida has mold illness or mold exposure because you can get it from, a course of antibiotics or junky diet or those kinds of things.  But a lot of people with mold exposure have Candida overgrow. And so what the mycotoxins are, let’s talk about what they are. So when mold is in an environment, it’s making mycotoxins to compete for territory. And what mycotoxins are poisons that are meant to harm other living things. And they are meant to allow the mold to creep its territory.

So really the mycotoxin message is, I’m trying to move in, mold’s trying to move in. And so when we have mycotoxins in our gut lining, what mold’s moving in means is it is laying a red carpet for the fungal species to survive. And so it’s doing things like immune depletion, it’s reducing gut motility, it’s changing the kinds of nutrients that your microbiome [00:16:00] craves to become a carb craver versus a protein craver.

And so it’s just like laying the red carpet and saying, here we go. And then all the other fungi are like, yes, we’re going to take over this, and that’s how they, that’s how they work together. They compete, but they also work together in that way.

Dr. Weitz: Just for a second. I have to go down another slight rabbit hole.  I can’t help it, but what’s becoming really popular in, in the United States right now are medications to deal with obesity that work by slowing gut motility. And you were just talking about the problems with gut motility. And I treat a lot of patients with gut problems and motility is a huge problem.  And now millions of people, and this is even being recommended for kids, are taking these GLP 1 agonists. And I know some people have had wonderful benefits in weight loss, but it works by [00:17:00] slowing gut motility. And what plethora of problems are we asking for by doing this?

Dr. Crista: Probably in someone who is healthy, not much.  And I’m a huge fan of those for the right purposes used at a naturopathic dose. Not the big old doses that we would do for diabetes, but and actually my friend, Dr. Tina Moore, she’s taught me a ton about this and is a great resource for that. But in a normal person, that’s probably not doing much because it’s changing the motility globally.  So from the top down, so we’re not picking and choosing areas of motility changes like we see with certain kinds of neurotoxins like Lyme. like mold EMFs can change the calcium potential in a tissue and can change the motility. It can change neural function, all those kinds of things. 

Dr. Weitz: SIBO is often caused by motility problems.

Dr. Crista: Yep. SIBO is a motility disease, not an infection disease. If it’s motility first, infection [00:18:00] is the result.

Dr. Weitz: And that’s the first thing I think about when I think about patients who are, affecting their motility.

Dr. Crista: Yeah, I know I do wonder, I think slowing is different than reversing, SIBO, one of the main causes of that is someone having food poisoning and vomiting, so things, come up in a very violent way and then because we have the wrong species, the right species in the wrong place, That can affect the neurological system of that area.

And then you get focal or targeted neurological problems. And then in mold, in the cases of mold with mycotoxins. We can get these little focal areas as well, wherever there’s a concentrated lymphatic pack pocket. So you can get these kinds of spotty gastroparesis things that can have, or motility issues, gastro is technically stomach, but you can see these focal areas, of course, global, you can get top down.

But I think that, yeah, if you have had mold exposure, if you’re dealing with any kind of neurotoxin illness, if you have chronic constipation and you [00:19:00] can also have diarrhea, SIBOs, Diarrhea is the, reaction to that to try to clear them out. That’s a healthy reaction, but if it’s gone on long enough, then you get this like alternating constipation, diarrhea.  I, I think you’re being really wise to say, Hey, maybe this isn’t the right thing for you because we could be making the problem worse.

Dr. Weitz: So let’s go into testing for PANS and PANDAS.

Dr. Crista: First message is these are clinical diagnoses, which means they can be diagnosed and treated without having to have a positive lab test.  That’s a really important thing for parents to know and practitioners, because I will see practitioners be worried about using some of the medications we need to use. Some of these kids that get real sick, We need to put them on long term prophylactic antibiotics, because strep becomes their kryptonite, it’s just 

Dr. Weitz: And it can be hard to justify that without having data.

Dr. Crista: Without [00:20:00] having the data, I know, yeah. But right now, because it is such a new burgeoning condition, and newly recognized, it’s been around a while, but it’s newly recognized. And also on the rise, because we have things like covid, we have so much more environmental toxicity. So these are on the rise that when I first started and 20 years ago I think it was estimated that maybe one in 500 kids, one, one in 500 to a thousand, and now the estimate is anywhere up to one in 200 kids are gonna develop these conditions.  So that’s a ton of kids and that means it has been on the rise in a exponential way over the last 20 years. And now I completely lost your question.

Dr. Weitz: Oh, about testing. Oh, testing.

Dr. Crista: Okay. Thank you. So we don’t have the data yet to know exactly what’s the mechanism and is the mechanism different between the two conditions.  And like I was talking about with the congenital, we need a third category, so we have Pandas, [00:21:00] PANS, and we need plans, like pediatric long name associated, something like that. We need one, a third one. So we’re lumping these congenital ones into the PANS people so that we can administer treatment that’s effective for them.

But yeah it’s tricky because what tests do you do if we don’t know exactly what’s the target? So we know some targets. We know that the dopamine receptors in the brain, which is in the basal ganglia, get destroyed. We are assuming that’s an autoimmune. So the body attacking itself, that’s their, that’s why pediatric autoimmune neuropsych syndrome disorder associated with strep.

Dr. Weitz: Is there a way that clinicians can determine that?

Dr. Crista: By clinical symptoms. So yeah, once, that’s the thing is we’ve gone, we haven’t gotten from research to clinical completely. There is something called the Cunningham Panel that catches PANS pretty well. And that looks at some of those autoimmune targets against basal [00:22:00] ganglia and gangliosides and some of the things that are in the brain.

You

Dr. Weitz: can Which lab offers the Cunningham Panel?

Dr. Crista: That’s Molecular Labs.

Dr. Weitz: Okay.

Dr. Crista: Yeah, but just know that if you have a PANS or a uncategorized congenital, you may have a kind of normal looking Cunningham panel and they still have a condition.

Dr. Weitz: Okay.

Dr. Crista: That’s a nice test for when you have a PANDAS case where strep was the infection, then you have an acute overnight change in the kid.  I’m finding that the Cunningham panel is really nice for that. And it’s a nice piece of paper. It’s yes, there’s, this is an actual physical thing happening in your kid’s brain. It’s not just bad behavior. You’re not a bad parent, just Just, it’s okay, this is physical however, just know that can miss some of them, and so that’s the problem is that the newer research is showing that there’s also destruction of the cholinergic interneurons, meaning things that use acetylcholine, which is runs our autonomic nervous [00:23:00] system.  Those neurons, those inter neurons that are going to be telling one, one nerve to talk to the other using acetylcholine, those are having destruction as well. Yeah. And that’s why I like to use the herbs that I use because they address all of it.

Dr. Weitz: So what kinds of panels do you recommend for us to do, or should we just go right into treatment?

Dr. Crista: Again,

Dr. Weitz: the

Dr. Crista: clinical diagnosis is key. So you can feel like, okay, if there are, the child is meeting these major criteria there are certain criteria that need to be met. Some are major, some are minor, and then you can diagnose them and you can feel very comfortable treating them based on that.

That is that’s the standard of care is that we’re using clinical diagnoses. And those clinical criteria, just be really that, then you do need the acute part of it, the acute onset part of it. So yes, Cunningham panel can help to answer the question. Point more arrows. There’s also some of the things like Vibrant has a neural zoomer [00:24:00] that you can look to see, is there a blood brain barrier breakdown?

That gives me a little more hint that we’ve got to really focus on the gut, because if the gut’s leaky, the brain’s going to be leaky. And then Cyrex Labs has some really nice arrays. Their Array 7 is great Array 20, so we can look at some of the correlations of Again, blood brain barrier breakdown.

What are there any auto antibodies being made, meaning antibodies to the brain? So that can give you a picture if you are dealing with families that need paper proof, and that’s very helpful. And that’s only telling you like, yeah, this is probably pandas or pan, but it’s not telling you why did we get there?

And then if they’re a kid who needs psychotropic medication, I highly recommend. the gene site test where we pre test their genetics for processing those medications. Because most of these kids have blood brain barrier leakage and because psychotropic medications are designed with chemicals [00:25:00] to open up the brain so that you can get the medication up there.

So when you administer psychotropic medications, you’re causing blood brain barrier leakage on purpose. We know that’s what these drugs do. So if you have someone who already has an open brain and you’re giving them psychotropic medication that opens it farther, they’re going to be acutely sensitive to a regular dose.

So if they need psychotropic medication, what I will do to start is test their gene site to make sure they’re not a speedy or a slow metabolizer of that drug and know that I’m going to open up their brain like a sieve when I give these medication. So I started an eighth, sometimes even a 16th of the normal dose, and you’ll need compounding for that.

Dr. Weitz: Okay. So. Let’s what about if you’re suspecting Lyme? Do you do a Lyme panel?

Dr. Crista: That’s also a clinical diagnosis.

Dr. Weitz: Okay.

Dr. Crista: Yeah, and congenital Lyme won’t necessarily look the same as a classic Lyme. They’re not going to have, the blown up joints, but they have joints that are, that tend to injure very easily and they [00:26:00] take a long time to heal.

So a kid that’s just their ankle is out, now their knee is out, now their shoulder feels popping, those kinds of things. Like it, it doesn’t look like a classic Lyme case if it’s congenital. He found some core things in kids who were born with Lyme and had, had Lyme through congenital exposure.

And atonia was one of those. What does that mean? That means low or no autonomic tone. And these will be the kids that they’re the natural tone. If you’re out, if your autonomic system is toned, normally you will have your shoulders higher. Like I have You can probably even see them and people who are listening are like, what is she talking about?

Like my shoulders go down because I have dysautonomia. So if you have a normal autonomic system, you’re going to have a higher tone. You can hold your posture up better. So you’ll see that atonia, there’s just that little bit of drop in the shoulders. A lot of times you can look at like how far do their hands go down their [00:27:00] legs.

If it’s longer than, I think there’s measurements that we can do, but that’s because their body is not holding those shoulders up. And so the arms can drop down. So as a chiropractor, that’s an easy thing that you can test and see, okay, did they look like they have longer arms than they should?

That’s because they’re not holding the tone. They don’t hold chiropractic adjustments well. So these are kids that you adjust them and then the body doesn’t adjust to the adjustment, so to speak. There was one other thing. Oh, and then you can tell if they also have vagus nerve involvement, if you have them open their mouth, stick out their tongue and go ah, and try and go, Oh, like that a little higher, their uvula will go off to the side and that they have some vagal nerve.

So something’s going on in the autonomic system that we can take a look. If they have, those are little teeny, tiny signs. It’s this might’ve been a congenital. And then you look at mom, you check out her history, if there’s any, history of Lyme, history of fibromyalgia, those kinds of things, then we have a kid that may need to be treated for [00:28:00] Lyme.

Dr. Weitz: Okay, so let’s go into treatment.

Dr. Crista: Oh, I had one more thing.

Dr. Weitz: Oh, yeah.

Dr. Crista: If there’s Lyme Borrelia, which is the way that they move through the body, they corkscrew through tissues, and kids will have tics that have a twisty or corkscrew nature to them when they have that. When they have sinus colonization, they will have a lot of eye blinking as part of their tics because their body is, or they might even hum their tonsils have turned into just mush.  And they’re hosting a lot of things. They will have a hum because they’re trying to increase the nitric oxide on the surface and kill the bug. So by the, we can watch what the ticks are doing to tell us where the kid needs support.

Dr. Weitz: Do you swab the nose and test for strep?

Dr. Crista: Yeah, I test for everything.

Dr. Weitz: Okay. Most people don’t realize that the nasal cavity is this direct route into the brain.

Dr. Crista: Yes. I show, I [00:29:00] created a couple of images in my book for that very reason to show that strep throat also becomes strep nose. So what happens is when you get strep throat, the body will send messengers down to the lymph nodes in your neck, and then it’ll make antibodies.  And then those antibodies get sent to the throat, but also up to the nose. Cause the body’s duh, it’s our breathing zone. Of course our nose is going to have problems if the throat has problems, But when those antibodies get up there, we know from mouse studies, when they put strep on the nose of mice, those antibodies will migrate back to the basal ganglia, to the brainstem.  And that’s what’s running our whole background autonomic system. And then they see that they will start to make antibodies to that own tissue just by getting repeat exposure to their nose. The great study out of Columbia. Yeah.

Dr. Weitz: Oh, wow. Fascinating. It’s

Dr. Crista: not, it’s not the strep getting in the nose.

Dr. Weitz: It’s the

Dr. Crista: antibodies, which means every time you have strep throat, you could be getting destruction of the central part of the brain. [00:30:00]

Dr. Weitz: You wonder what role this can play in development of dementia when they get older? Because you were talking about deteriorating of handwriting, and that’s one of the characteristic things with patients with Alzheimer’s.

Dr. Crista: I think there’s a high correlate, high possibility of correlation with Parkinson’s. And Early Onset Panda’s Pans, because of the basal ganglia distraction. And then we

Dr. Weitz: also know about the research that’s been done about how amyloid plaque builds up to protect the brain from infection. So you’re getting these antibodies into the brain and then, it’s probably setting up an increased risk of this amyloid plaque building up to protect the brain.

Dr. Crista: And then, and yeah, I think Dr. Dale Bredesen was the first one that said, amyloid plaques are really good mycotoxin sponges.

Dr. Weitz: It’s interesting. There’s almost this symmetry between childhood and old age. And you start out in diapers and you end up in diapers. So [00:31:00] let’s go into treatment.  You have this really organized system of understanding how to set up a treatment protocol. It’s fairly complex, but it’s very well organized.

Dr. Crista: Thank you. Yeah. These are families in chaos. So I tried to be as. Organized as possible. So it’s there’s a step one, there’s a step two, here are the tools and here’s how you match it to the kid, yeah. So I came up with I put in the book core four, I wanted to put core 10, but I didn’t want to overwhelm anybody. So I made five, six, seven, eight, nine, 10 is all part three in the book of this is how you actually do recovery. And the core four is how you do rescue. So that’s the, let’s get out of crisis mode.

And then when you’re out of crisis mode, please go to part three. That’s how you get out of this finally, and keep your kid not so flareable. We see flares happen about every three months and that’s the tricky part with treatment is then. You start [00:32:00] administering treatment, the child might be really getting better with that and you can be high fiving yourself and it’s only because that was the course of the disease it was going to calm down anyway.

Y’all, you also might give some treatment and they flare a little bit and you think, did we do that? Did we push the body too hard? And it was just going to be that they were going to take a, you A turn, an increase in symptoms anyway, so you, this is a long game, I guess is what I’m trying to say.

Dr. Weitz: Patients and clinicians need to understand that this is going to be treated over a period of potentially years, right?

Dr. Crista: Years, usually yeah. Okay. And that’s how I wrote the book. I wanted parents to have tools in hand. And so they can be working with their practitioner and they know what to do in the, in between they know what to do between appointments and maybe even to, save appointments in general.

So I have the core for the first core is tame the flame. The second is beat the bugs. The third is regulate immunity. And the fourth is guard the gate. And that’s the rescue plan, so tame the flame has to do with all neuroinflammation. So neuroinflammation means inflammation in the nervous system.[00:33:00]

In these cases, primarily it’s in the central nervous system, like we were talking about deep in the brain. So we’re trying to take things that are going to calm down the neuroinflammation and paying attention to the trigger. So if we’re only focused on a bug, we might just deal with the inflammation you could handle with Advil.

But it isn’t only that inflammation, because they have environmental exposures that set the stage. So we know that there’s going to be mast cell involvement. We know there’s going to be specific types of inflammation we can adjust. And we know where it’s going to be. It’s going to be primarily in the central nervous system.

So that’s why I like to use things like Resolvins. These are the most anti inflammatory aspect of fish oil, so they’re extracted out from fish oil.

Dr. Weitz: Also known as like SPMs.

Dr. Crista: Yes, yeah, SPMs, Special Pro Resolving Mediators. They are, they can go into the brain tissue, and they can reduce inflammation. So they’re fat soluble, and that’s one of the reasons I put that as the first thing, because We know the type of [00:34:00] inflammation those are going to deal with.  We know if we extract that out of the fish oil, even people who have histamine responses to whole fish oil can tolerate the, these extracted aspects. They don’t get a histamine flush from them.

Dr. Weitz: What do you think about patients who have fish allergies?

Dr. Crista: Yeah, they can’t take it, unfortunately.

Dr. Weitz: Okay.

Dr. Crista: Yeah, I know. That’s the bummer. And that’s why I put other tools because it’s that’s not the only one, we can get at it a different way. Another nice fat soluble thing that tames the flame is PEA, which is not the food pee, but palmitoylethanolamide. And it’s basically this thing that we make in our brain naturally to reduce inflammation.

But if you have an attack on the brain. You will plow through that. So that’s a way to get that that nutrient, we could say anti inflammatory nutrient back in the brain where it belongs. And that’s another fat soluble one. So if I have somebody who’s fish allergic, then we’ll go heavy on the PEA [00:35:00] instead.

Dr. Weitz: Okay. And then fever few, which I usually think of something for headaches.

Dr. Crista: Yes. The parthenolides in fever few are amazing. They are hitting the type of inflammation that we get with these autoimmune attacks. And I cannot tell you, I have emails that I get that I’m just in tears reading that a family will say, our kid’s been sick for four years, won’t come out of the bedroom, has stopped reading, can’t go to school, obviously, this is a kid who’s losing their childhood.

They started the child on fever cue only. And then they like, they’re like, okay they didn’t react too bad. So we’ll add resolvents. So it was fever cue and resolvents. And the resolvence wasn’t even till the tail end. And in two weeks, the child was out of the room reading chapter books to the parents and it completely transformed the child.

So brains are inflamed and we have so many tools to help them with that.

Dr. Weitz: And then under flame the teams, you have these other categories. So you [00:36:00] have the

Dr. Crista: The mast cell managers, right? Yeah, because there’s different kinds of flame. So again, if it was just Advil, and sometimes kids are sick, we will go for the ibuprofen.

Absolutely. A two week trial of ibuprofen as a clinician. That is a wonderful test because if that changes the child’s behavior, you probably have a panda’s pants get on your hand. So just a two week trial of ibuprofen, a nice high dose like 10 mg per kg kind of thing. So it’s more of a pharmaceutical dose and you got to warn families, if you do that, there’s a risk of GI bleeds.

There’s a risk of bleeding in general, there’s Kidney things that can show for

Dr. Weitz: a hundred pound kid. You’re talking about 2000 milligrams is it

Dr. Crista: throughout the day?

Dr. Weitz: Yeah. Okay.

Dr. Crista: Yeah. And then I always do that with BPC one 57 so we can protect the gut lining. Okay. Tolerate it. You do it.

Functionally, right? It’s a very helpful drug. And there’s these other things that we want to make sure and [00:37:00] protect the tummy lining, but just to, you don’t do that forever, but that’s a wonderful drug trial to see if there’s a profound change. And you can see a kid who’s ticking, who can’t sleep.

Maybe they haven’t slept for two days. This, these are all the things that we can see from the autoimmune destruction of the basal ganglia. Why is that? That’s because. Those receptors receive dopamine and dopamine can transfer into glutamate really easily. And those are excitatory brain chemicals.

So is acetylcholine. So those cholinergic interneurons, when they get destroyed, acetylcholine doesn’t have anywhere to go. So the kids are, their brains are swimming, drowning in these excitatory brain chemicals. And that’s why the tics and that’s why the OCD, it’s like There’s all this energy with nowhere to go, and that’ll cause, in a lot of cases, it can cause insomnia, too.

Dr. Weitz: Okay. You have Perilla, which is an interesting one. We’ve used that [00:38:00] for allergies.

Dr. Crista: Yes. Yeah, and allergies are mass, so meaty,

Dr. Weitz: you

Dr. Crista: know?

Dr. Weitz: Have you tried that product with the quail eggs from Integrative?

Dr. Crista: Yeah, I haven’t seen huge differences. I know some people say it’s a game changer, but I think for my patient base, we’re also talking about dietary things typically.

Dr. Weitz: Okay.

Dr. Crista: However, with pandas and pans, one of the symptoms can be restricted eating. And so we want to be really careful not to add to that problem. My only. 100 percent like diet advice is organic and everything else is on the table, because if you have a kid who’s restricting food, we don’t need to take away anything.

Now, are there perfect things we could add? Yes, we could do a histamine free diet. A lot of kids with mold exposure have high oxalates. We can, reduce their oxalate load. But histamine is usually the one that does it. makes the big difference in the kid because of the mast cells going into the brain, [00:39:00] spill, spilling histamine.

A lot of times we can make a big dent there.

Dr. Weitz: That’s why I said a glyphosate. Do you take away gluten?

Dr. Crista: I don’t, because again, the restricted eating thing, just say, take the pressure off yourself. These are parents who, a kid isn’t sleeping for two days. Okay. They can’t, the parent can’t even take a shower without the kid.  Cause the kid has. Separation Anxiety they might be aggressive, so they have to protect the other people in the family, so things can get really off the rails.

Dr. Weitz: Okay. And,

Dr. Crista: With Glyphosate, and not just Glyphosate, but Atrazine causes a change in the dopamine receptors in the brain any kind of herbicides, pesticides.  If you’re doing organic, those are out and then you’ve reduced the, that exposure for the kid and we can try to recoup some of the gut microbiome so we can get their immunity back again.

Dr. Weitz: Okay. And then you have to beat the bugs.

Dr. Crista: Beat the bugs. So the bugs are a problem. What got the kid here, like I said, was this pre [00:40:00] state, this antecedent state that they had immune depletion.

That’s where the environmental toxins really come in, but then there’s a bug, so there is, there’s been a few cases where we, a kid had an acute glyphosate toxicity, like played on a soccer field. I have one case where played a soccer day, a whole tournament day, and they had just sprayed that morning and they didn’t tell anybody.

So they had just sprayed everything and the kid developed PANS. We couldn’t track any other infection. So in a few cases, it’s environmental only. But in the majority of cases, then there’s an infection that challenges the child’s immune system and the immune system just wasn’t up for it. So we do need to beat back those bugs and get things back in balance.

Dr. Weitz: And so the first category you have is these botanical avatars and you have Chinese skullcap as one of your favorites.

Dr. Crista: Yes. Botanical avatars, I name them that because an avatar means an ideal. And so when we look at all of the mechanisms that go into this condition, the immune [00:41:00] depleted state. The brain chemistry changes, what happens with the receptors themselves if they’re food restricting, low blood sugar, we’re looking at all of the things, gut microbiome, and when we look at the whole picture, these avatars in this section were perfectly made for these conditions.

You could use that one plant and that one plant only and make a big dent. So for me, once we get the kid out of flame, then the avatar becomes the foundation at the base of everything that we do. So an avatar stays with them their whole treatment period, and then we plunk the other things on top of that.

So Chinese skullcap is wonderful because it’s great for mycoplasma pneumonia, which is a really hard bug to get at. Also for strep and it has all the other things, the brain chemistry balancing, the gut microbiome. And we see that things like that, Oregon grape root, they have antibiotic activity, but people are like, okay, [00:42:00] so does that mean it’s going to wreck the gut?

It turns out that those two plants actually increase the butyrate, which is the favorite food of our commensal, of our favored microbiome in our gut. So the plants don’t act the same way. in their antimicrobial property as a drug does.

Dr. Weitz: Oregon grape is basically berberine. Is that the main ingredient?

Dr. Crista: Yeah. But the whole plant is what changed the butyrate, not just the berberine. The berberine.

Dr. Weitz: Interesting.

Dr. Crista: If you’re just going for the berberine, you’re going to miss the activity that we’re looking for pandas and Pam.

Dr. Weitz: You also have got a cola, which I always think of as a blood sugar thing.

Dr. Crista: Yeah interestingly enough, gotu kola, we can give this it crosses the blood brain barrier within 5 to 15 minutes of taking it.  And it’s a really nice tea. It doesn’t, it’s one of those things that kids will actually drink. You can add a little honey and you can get it down because it doesn’t taste like much. It just is like a musky green [00:43:00] flavor. But it crosses the blood brain barrier in 5 to 15 minutes and it will protect the microglia, which are the naughty little monkeys in the mind that do all this destruction.  It will calm them down so that when a child eats, if they get any increase in gut endotoxins. it won’t agitate the brain and induce attack. So part of the food restricting is that when kids eat, they will get this increase in endotoxin and it starts to increase the attack on their own tissue. So the body wisely says, stop eating.  We can’t do this. And, but unfortunately then kids can get very underweight. That go to Cola can be done ahead of time. You can give ahead of time before meals. And it’ll protect the microglia monkeys and keep them calm. Interesting. Yeah.

Dr. Weitz: Cool.

Dr. Crista: Amazing. Like we have so many tools. So cool.

Dr. Weitz: And then antimicrobials. So things like oregano, thyme. [00:44:00]

Dr. Crista: Just depends on what critter you’re trying to whack back. And that’s the clinical discernment. You as a doctor, are you dealing with a kid with Lyme? Probably need to get some cryptolepis and Japanese knotweed. You’re dealing with a kid with parasites.  These kids can get really wormy because they don’t have the gut immunity like most of us. There’s a lot of hypogammaglobulinemia in these kids. That was why they got Panda’s Pans. So they can tend to take on parasites. So I use a lot of black walnut with them and a lot, you just treat them like, treat them aggressively and they need the help,

Dr. Weitz: or

Dr. Crista: fungi, we need that omega 9 time.

Dr. Weitz: And you also talk about making a steam out of some of these herbs and getting it into the nose that way.

Dr. Crista: Yeah, that’s in the Guard the Gates because we do need to, their defenses are down. These are kids whose defenses are down. And just a simple steam inhalation can be both calming to the child and it’ll also, it calms them from a few things because those [00:45:00] volatile oils are also acting as an aromatherapy.  When we steam some of these plants that we know, we all know and love and we’re familiar with, like kitchen herbs. Sage in particular, and thyme, you can steam them. Those volatile oils have more antimicrobial property than eating the plant itself. So once we steam it, something magical happens.  and steam can reach every part of the sinus cavity. So a nose spray only goes so far, but a steam you can get everywhere and you can get into the lung tissue as well. There’s some research showing that a change in the lung microbiome can affect the brain as well. It’ll agitate the microglia monkeys in the brain.  So a steam is getting all of that taken care of. So we have the effect of the volatile oils on the bugs themselves. but also on the brain chemistry aromatherapy effect.

Dr. Weitz: And then we have to regulate immunity.

Dr. Crista: Regulating immunity is [00:46:00] primarily the gut. We are more microbe than man, as they say, so if we did a cell to cell count of your bacteria in your gut and your cells of your muscles, bones, all that thing, we’d have more cells in our gut that belong to the other guys than our own tissue.

And if you did a DNA count, it would be the same. So there’s more DNA that belongs to the critters in our gut than our own DNA tissue. So they determine a lot. And when autoimmune disease. It’s the body attacking itself. Why would it do that? Why it’s supposed to attack us

Dr. Weitz: reactivity, right?

Dr. Crista: Because it’s lost discernment of what is self. And so if our definition of self is basically our gut microbiota, because there’s more of them than there are of us and we have anything that is destroying our gut microbiota. Now the immune system is let’s see what’s self. What’s not self. It loses that discernment.

So when we regulate immunity, focusing on the [00:47:00] gut, what we’re trying to do is build back the microbes, not just the bugs themselves, but by giving them the food that they like, like butyrate. It’s wonderful. It’s known as a nootropic, which means it helps with the brain healing itself. It also helps with the panda’s pan’s brain as well by calming down the gut microbes and not having them feel so at risk.

Dr. Weitz: But you might also feed the bad bugs too, right? With butyrate?

Dr. Crista: Not as much as you would think. So that’s why we have beat the bugs first. So sometimes you can add, if gliotoxin is a mycotoxin that’s high in a kid because they have fungal burden veering toward fungal infection, they can have high gliotoxin and things with sulfur like butyrate can help the mold if you do too much, if you don’t have the Antistep on board first.

Dr. Weitz: So that’s

Dr. Crista: step two. And then we can add the butyrate kind of free form.

Dr. Weitz: And then [00:48:00] probiotics is part of the mix as well?

Dr. Crista: Yeah, probiotics, peptides. Yep. Those are all things. And then regulated immunity. We didn’t really talk about what drugs fit in each of those, but that’s where IVIG would come in because some kids do need that.

We give IVIG at a very high dose and I want to tell everybody, I have a typo in my book. It’s very important. It’s 1. 5 to 2 grams per kilogram of IVIG, which is a suppressive dose. So we flood the body with IVIG. with immunoglobulins and we do it over and over again because we want the bone marrow to take a vacation and forget that it was upset about, that it wanted to make antibodies to its own tissue.

If you do the supportive dose of immunoglobulins, which is below one, up to one milligram or grams. See, I did it again. gram per kilogram of body weight. You can actually make it worse because you can fuel the autoimmune attack.

Dr. Weitz: Interesting. So this is intravenous immunoglobulins. [00:49:00]

Dr. Crista: Yeah, and usually my, depending on the severity of the kid, we might do that every four weeks, every six weeks, every eight weeks.  The goal is to get them out of crisis, and then we stretch it out to see how long can we go before their immunoglobulins hit a trough again. We don’t want them to hit that trough because that, then can allow the autoimmune attack to happen.

Dr. Weitz: So that’s a strategy for acute flares.

Dr. Crista: To, for healing.

Dr. Weitz: Right.

Dr. Crista: For recovery.

Dr. Weitz: All right. And LDN, you use that as well sometimes?

Dr. Crista: Yep. I use it a lot.

Dr. Weitz: Oh, okay. Yeah. And you like certain peptides?

Dr. Crista: Yep. The BPC 157 the TB4 FRAG is, it’s basically thymicin. It’s from our thymus gland. And again, both of those go back to the pre immune depleted state situation.

So how do we get kids out of this? We nourish their immune system so that they can get [00:50:00] out of it.

Dr. Weitz: And both of these are oral peptides.

Dr. Crista: Yeah, they don’t have to be IV, peptides are very stable, so the capsules can be opened up, they go right through, they’re not broken down by the stomach acid, actually that’s, they’re the result of breaking down proteins in the stomach acid, so they’re like, yeah, they get the path.

Dr. Weitz: That’s cool.

Dr. Crista: Yeah.

Dr. Weitz: All right, good. Final thoughts about how to overcome pans and pandas?

Dr. Crista: Just know it’s the long game. And you’re not a bad parent. This is not behavior problems. This is a body problem. So if you’re not getting the support that you need with the doctor you’re working on, or if they’re not panned or pandas or pans literate, go find someone that is because you can do real damage.  The longer this brain attack can happen in your kid, the more damage that’s happening in their brain. So because it’s not immune, get to it.

Dr. Weitz: And how does somebody find a practitioner who’s skilled in pants and pandas?

Dr. Crista: Right [00:51:00] now in the footer of my website, I have Mold Literate, Lime Literate, and PandasPans, so you can go there and get links.

There are a couple of organizations. There’s the Pandas Network and then there’s the Neuroimmune Foundation. And those are some areas that you can go find. I do any continuing ed than any of those have given all through time. And there are tons of amazing doctors that also attend those that can help.

Dr. Weitz: Cool. And how can listeners get ahold of you and find out about your programs?

Dr. Crista: They can come to drcrista. com. That’s D R C R I S T A. com. And I’m also on Instagram and, Facebook and all those things. YouTube.

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

Dr. Crista: Thank you.

 

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Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast.  For those of you who enjoy listening to the Rational Wellness Podcast, I would appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings [00:52:00] and review. If you would like to work with me personally to help you improve your health, I do accept a limited number of new patients per month for a functional medicine consultation.  Some of the areas I specialize in include helping patients with specific health issues like gut problems. neurodegenerative conditions, autoimmune diseases, cardiometabolic conditions, or for an executive health screen and to help you promote longevity. and take a deeper dive into some of those factors that can lead to chronic diseases along the way.  Please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310 395 3111 and we’ll set you up for a new consultation for functional medicine. And I look forward to speaking to everybody next week.

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Dr. Kim Crawford discusses Inflammatory Bowel Disease with Dr. Ben Weitz.

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Podcast Highlights

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Dr. Kim Crawford is a nationally recognized, board certified Internal Medicine and anti-aging specialist who uses a Functional Medicine approach to help patients overcome various chronic disease, including Inflammatory Bowel Disease.  Dr. Crawford herself was exposed to high levels of environmental mycotoxins, which attacked her GI tract and this resulted in CIRS, leaky gut, and eventually Crohn’s disease, which for her was a totally life-altering autoimmune disease.  Her website is KimCrawfordMD.com.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

 

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Podcast Transcript

Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates. And to learn more, check out my website, drweitz.com. Thanks for joining me. and let’s jump into the podcast.

Hello, Rational Wellness Podcasters. Today, I’ll be speaking with Dr. Kim Crawford about inflammatory bowel disease from an integrative perspective. Inflammatory bowel disease, of which Crohn’s disease and ulcerative colitis are the most common conditions, is an autoimmune disease characterized by chronic inflammation of the gastrointestinal tract that leads to damage to the mucosal lining.  Crohn’s disease can affect any part of the GI tract, including the mouth, esophagus, stomach, and even the anus, and it most often affects the portion of the small intestine closest to the large intestine, and there tends to be patchy areas of damage, and the damage may reach through multiple layers of the intestinal wall.  Ulcerative colitis occurs usually only in the large intestine and the rectum. Damaged areas tend to be continuous and usually start in the rectum and spread into the colon and is usually only found in the innermost lining of the colon. Of course, Dr. Crawford, you can correct me if I’m misstating. 

Dr. Crawford: Good job, Dr. Ben.

Dr. Weitz: And then I wanted to read a couple of sentences from a blog post written by Dr. Crawford about the current allopathic conventional medical care [00:02:00] for inflammatory bowel disease. She writes in this blog post: “Crohn’s disease treatment starts off with brain and gut damaging corticosteroids.  Then we add in immunomodulators like Methotrexate and Mercaptopurine and eventually biological agents, which are TNF alpha inhibitors like Remicade and Humira and the story’s about the same for ulcerative colitis. All these drugs are super toxic, and none of them are curative, and their long term use not only causes severe side effects, but can lead to cancer.”  Dr. Kim Crawford is a nationally recognized board certified internal medicine and anti aging specialist who uses a functional medicine approach to help patients overcome various chronic diseases, including inflammatory bowel disease [00:03:00] like Crohn’s disease. Dr. Crawford herself was exposed to high levels of environmental mycotoxins from mold, which eventually attacked her GI tract and resulted in a chronic inflammatory condition, leaky gut, and eventually Crohn’s disease, which for her was a totally life altering autoimmune disease.  Dr. Crawford, thank you so much for joining us. Oh, I should say Dr. Kim.

Dr. Crawford: Okay. Thank you, Dr. Ben. And excuse me if you hear a dog barking in the background. I do collie rescue. I have four rescue collies here. Somebody might bark a little. It’s not a patient with a respiratory condition. I have four, four big collies here.  So anyway to your point about the treatment It’s not just, let’s say with ulcerative colitis and Crohn’s the allopathic medicine, the GI guys and girls start out with hydrocortisone, but [00:04:00] not bioidentical hydrocortisone, which is what I use. They start out with synthetics like prednisone or Medrol, and you’re not only just dealing with the synthetic hormone, you’re also dealing with capsules that may not be compliant with the dietary restrictions that I use for inflammatory bowel disease. And you’re dealing with fillers. These toxic capsules and fillers are in all pharmaceuticals. Some are actually not as bad as others. For instance, if you need a Tylenol, it’s better to take a Tylenol that is a name brand rather than a generic because it has safer for-your-gut fillers.  That’s just one little tidbit for your viewers there. But anyway, going back to how…

Dr. Weitz: So interesting. So you’ll use a bioidentical cortisol, cortisone, that’s different than Prednisone?  What’s the difference?

Dr. Crawford: Bioidentical hormones, okay? And I am board certified in functional medicine and one of the 12 modules is just hormones and it’s not, and if, I have a blog where I talk about all the hormones.  Everybody thinks about male hormones and female hormones, like testosterone, estrogen. Oh, and there’s other things, but we don’t know what they are. There’s about a hundred hormones we have to think about. One of them is our body, our adrenal glands make cortisol, or we can get bioidentical, meaning the body recognizes it as what you would be putting out, so the body doesn’t get upset.  We use bioidentical hydrocortisone in functional medicine. And when somebody flares they’re, I may use a little bit of bioidentical hydrocortisone. I may use methylene blue, which is an amazing anti-inflammatory, very powerful antioxidant product. Turns your pee blue, but that’s the only side effect.  And it’s also being studied, interestingly enough, for other conditions, neurodegenerative conditions. 

Dr. Weitz: So interesting, so you use methylene blue?

Dr. Crawford: Believe it or not, the dye, methylene blue.

Dr. Weitz: It’s been talked about on other functional medicine podcasts and I don’t know all that much about it.  What is the type of, is there a type of methylene blue or is there a way…is it a oral, is it an injectable? 

Dr. Crawford: The injectable is only necessary for people with a condition for which methylene blue was used decades ago. And so I use an oral form and I use a liposomal, so liposomal preparations get into the bloodstream faster.  Okay. So I’ll use, I use a liposomal preparation, but people who are there they go. Sorry. Thank you. People who are flaring really do respond to methylene blue and, it is over the counter, but I would just advise people not to, with inflammatory bowel disease, not to treat themselves.  But certainly if you want to, if you want to ask Chat GPT about methylene blue, Chat GPT, I’m sure will have a lot to say. Sorry.

Dr. Weitz: What’s the dosage of methylene blue that you typically use? 

Dr. Crawford: Anywhere between 25 and 50 milligrams twice daily when somebody’s flaring.  That’s the dose I’ll use. And again, I find that liposomal just tends to work better than regular.

Dr. Weitz: Is there a particular company that you like it from that makes a good product?

Dr. Crawford: I have a compounding pharmacy that I use, that compounds it for me.

Dr. Weitz: Oh, okay. Interesting. When you get a patient in your office, what’s the first thing that makes you suspect that they might, this might be somebody dealing with inflammatory bowel disease?

Dr. Crawford: Before I actually see somebody, I know what the diagnosis is [00:08:00] because my first visit with somebody is a very long visit. We go over many things, everything from exercise to sleep to stress habits. And what makes me suspect it quite frankly, most of the people that come to me have been treated by, allopathic doctors and are on a biologic and they have been switched, a biologic will tend to work for 18 to 24 months, then they’ll switch them to another, then they’ll switch them to another.  And they’ve been through this a few times and maybe they’ve had COVID one too many times and maybe they keep getting other infections.  They’re a bit immunosuppressed and they just, and they read that, gee, maybe I can get off of this stuff. And half the patients with IBD that come to me are already diagnosed.  And the other half I see a lot of patients with CIRS, Chronic Inflammatory Response Syndrome, or mold related illness what I had. And and when I had it, I was, nobody even knew what it was or knew how to treat it. So I had to figure [00:09:00] that out. I had to figure out when I developed Crohn’s, which I now could go back and block myself from getting, which is what I do if I see it brewing in a CIRS patient or a chronic Lyme patient.  I had to figure that all out too. So I really, a lot of times they’ll come to me and say, and they’re starting to get GI symptoms and I see that their CRP, Which is a lab that I’m, I know you’re familiar with, it’s a inflammatory marker and most people think it’s a coronary marker, but it’s really a better marker it’s the first thing you’ll see bump up in just about any autoimmune disease.

But somebody who’s trying, I say trying to develop, because it doesn’t just happen overnight, okay, trying to develop inflammatory bowel disease is going to have, maybe they’ll have a little belly pain, a little blood if it’s you see some diarrhea. It’s not, don’t get nervous. It’s not necessary IBD if you have diarrhea, people that are exposed to [00:10:00] mold or any other toxins by definition have leaky gut and you need to have leaky gut in order to develop inflammatory bowel disease.

So patients, you said, what makes me think they have it? They either come to me diagnosed or they come to me having had an exposure or something that people don’t realize. They come to me after a long period of stress, when they’re stressed, and their catecholamines are up, the neurotransmitters that make our heart go faster, the sympathetic side of our nervous system and their cortisol is up.  And cortisol actually, not only kills brain cells, it kills the lining of our gut. And so just a sustained high cortisol or a period, if somebody is going through a divorce or if somebody has a, loses a parent or any other, tragic thing that gets us all upset and stressed and raises our cortisol, makes us stressed, upsets our sleep.  That [00:11:00] is going to give somebody leaky gut.

Dr. Weitz: So as far as your workup for testing for a patient with inflammatory bowel disease, besides the CRP, I’m assuming you’re using like the high sensitivity CRP, what other labs do you run and do you recommend colonoscopy or other testing?

Dr. Crawford: I do complete labs on everybody, which everybody tells me is 20 tubes of blood.  Sorry, Barkadar. I hope you’re, I hope your viewers are dog lovers. I have two dogs myself, oh good job. Adopt, don’t shop. I check full labs because everybody with an inflammatory disorder, okay, is going to have other things that just the inflammation causes. For instance, if you’re inflamed, You’re going to be plaquing your arteries.  If [00:12:00] you’re inflamed, there’s going to be a diminution of output of the hormones that you need. If you’re inflamed, there’s going to be impaired enzymatic pathways. For instance, your SIRT1 pathway can be impaired, and that’s the pathway that controls glucose and cholesterol. I deal with the inflammation, just everybody gets a vagal nerve stimulation device because everybody’s in sympathetic, sympathetic side of the autonomic system is the, escape the wildebeest side.  And then the parasympathetic side is the rest and digest. And so I want people to get more into the parasympathetic side. Everybody comes to me, their cortisol’s are up, they’re in sympathetic overdrive. And that’s why one of the first things I do, I need to calm everything down I have them get a vagal nerve stimulation device.  I have them start managing their stress. Just about all of them are not [00:13:00] sleeping well.

Dr. Weitz: For listeners who don’t know what a vagal nerve stimulating device is. Can you explain that for a bit?

Dr. Crawford: I’m very, yeah, very sorry. I do have a blog on that. If people want to go to kimcrawfordmd. com, there’s a blog on that.  Basically it’s. A little handheld device and, oh, here’s an old one I have right here. And you just hold it against your neck, two minutes, twice a day. And it stimulates the vagus nerve, which is the longest nerve in the body. And it goes all through the nervous system. And if you’re feeling stressed and you put this little zapper on your neck, it will make it’ll increase your GABA, which is a neuro hormone that makes you feel calm. That’s the neuro hormone that goes up. If you take a Xanax or a Valium, which you shouldn’t take, you should use a vagal nerve stimulation device or use some liposomal GABA. Anyway, so that’s a vagal nerve stimulation device can help people fall asleep, can help [00:14:00] people get back to sleep and can reduce their stress levels.  And it’s been found in studies lately that people with inflammatory bowel disease tend to be higher stressed than the average bear. And and so everybody needs help with their stress and their sleep. Just losing one night of sleep will bump up everybody’s inflammatory markers.  Losing a week of sleep will make somebody, not a, not, a whole week of sleep, but let’s say somebody gets really bad sleep for a week for whatever reason. That’s enough to flare them. So it’s really important to manage stress, manage sleep. Everybody’s on the Uber rings, kick, it really is important.  Sleep is important. Stress management, diet. Exercise, all those basics have to be covered for everyone, but especially for the patient with inflammatory bowel. And let me go back to your last question about diagnoses. If someone is flaring, The traditional [00:15:00] literature, American Journal of Gastroenterology even, is saying don’t scope them.  Don’t get a colonoscopy if you’re flaring. And there is some GI docs that are still scoping people that are flaring, but you can actually perforate somebody who’s flaring. And it’s really, if you get a, what’s called a Fecal Calprotectin it’s a stool sample that’s very diagnostic. If somebody has an elevated CRP and sedimentation rate which are two inflammatory markers, and they have a high fecal calprotectin along with the symptoms of Crohn’s or UC, you can basically make the diagnosis without a colonoscopy.  You can also do. MRE imaging and imaging studies if you need to look at the small intestine, then you would need to do that with Crohn’s but just to make the diagnosis, just as I said before, you can make it without a colonoscopy with biopsies are needed for a definitive diagnosis [00:16:00] and to make sure you’re diagnosing Once in a while, you’ll get a crony that will bleed, and you need biopsies to make sure you’re diagnosing Crohn’s, not Ulcerative Colitis.  So that’s why you would need a colonoscopy with biopsies, it’s just for the definitive diagnosis. But for my purposes, if somebody’s really sick I don’t want to, obviously, first do no harm. I don’t want them to have anything done to them that’s going to make them worse, obviously. Yeah. ,

Dr. Weitz:  Have you used that Prometheus lab for inflammatory bowel disease?

Dr. Crawford: Prometheus Lab? I use LabCorp. They Okay. Thus far, LabCorp has given me what I need. Yeah.

Dr. Weitz: There’s some specialty lab thing for IBD.

Dr. Crawford: Yeah, there, you know what, there are so many companies that are opening up, they’re offering specialty labs or specialty, microbiome tests.  There’s one good one, and it’s the one I use. Which one do you like? It’s [00:17:00] actually, it’s, the company is, Enjoy, I N J O Y. And what’s cool about them is they give you a report that’s really actionable. Foods, probiotics, prebiotics, and they break down for you. What are the, what’s in your microbiome?  That’s bad for your inflammatory bowel disease. That’s bad for your metabolic state. They look at, how much you your microbiome produces three important free. Short chain fatty acids, say that three times. Short chain fatty acids. 

Dr. Weitz:  Butyrate, propionate, and acetate, right?

Dr. Crawford:  Good job.  Yeah. How many people know that? And it’s important to be producing enough of these things. And have enough good bacteria and not have bad bacteria. And, I, this company uses a, uses AI. It’s the only company I know of that does microbiome testing that’s using AI. And you get a subscription for, I think it’s 1.99 a month, and you can you put your symptoms [00:18:00] in and you get, and you can ask the chat bot questions. And there’s a little bathroom beacon. It’s quite interesting. And it’s a three sample test and it’s enjoy. You can find it in your app store and you can use my code DrKim10 and get it and get a 10 percent discount.

Dr. Weitz:  Interesting. Yeah. I’ve never used that.

Dr. Crawford:  Very important to get a good microbiome test. Yeah, even I, when this test finally got perfected and I did my test, even I found I had one, I had too much of a bacteria that was good to have if you had Crohn’s and the reason I had it was because I was eating, um, too much high fat dairy, which is not supposed to be AIP compliant, but as a re entry food, I was able to eat it, but anyway, I found only because of this [00:19:00] microbiome test, which is why I keep eating it. telling everyone, you really, you don’t know what’s in your gut unless it gets tested.  I tell everybody, you, you got to do at least one because if you’ve had any sort of disorder, what, whatsoever, it’s generally can be traced back to the microbiome and the data is evolving, but you’re reading studies, the same studies I’m seeing that, we’re, they’re linking it to obesity, metabolic health sorry, we have Arthur.

Dr. Weitz: It’s okay.

Dr. Crawford: Ob, sorry, obesity, me, meta metabolic issues. Inflammatory bowel. You know what let me ask my husband to let to Sadie quiet.

Dr. Weitz: Okay.

Dr. Crawford: You can, maybe you can cut that out.

Dr. Weitz: Yeah, I’ll cut that out.

Dr. Crawford: Sorry. I’m so sorry.

Dr. Weitz: What are the what are some of your favorite strategies for when you see a [00:20:00] patient and let’s say you see them and they’re having an acute flare?  What are some of the things that you like to use?

Dr. Crawford: In an acute flare, I, they go on a very strict AIP diet. Okay,

Dr. Weitz: what is AIP?

Dr. Crawford: Okay, Autoimmune Protocol, and people can find copies of that all over the internet.

Dr. Weitz: So this is an autoimmune paleo diet?

Dr. Crawford: It it is an autoimmune diet. It’s not a paleo diet because paleo diet.  But it’s similar and here’s why it’s similar. It’s similar because it’s no grains, no beans. The typical paleo, but paleo implies we want you to eat a lot of meat. And I don’t want anybody to eat quote a lot of meat. That’s just not good for you. But I would say to take out

Dr. Weitz: greens, beans, and then you also

Dr. Crawford: You take out initially you have to take out everything that’s paleo.  Okay, you look [00:21:00] at a paleo diet and in it’s alcohol, caffeine, and don’t hate me because I do allow you to re intro that back in. I am not coffee free anymore and I am not alcohol free anymore. So don’t worry, you won’t be either. But it’s paleo, which is No grains, no beans, no alcohol, no caffeine, no dairy.  And then also dairy and then no, no nightshade vegetables and nightshade spices and nightshades. You can Google what are nightshades, but it’s basically peppers and peppers, tomatoes, potatoes. Those are the big ones. And then you have to look at your spices. That was one of my problems is I like hot, spicy food.

And so my whole diet had to get much more bland than I wanted it to be. But I will say that we do what are called re intros when somebody says, Stable, and they’ve been in a nice remission, and one of the re intros is, this is going to [00:22:00] sound strange, but people can’t usually tolerate hot coffee, but they can tolerate iced coffee, and but and But some people can’t, and there were coffee alternatives, like there’s a company, Tachino, that makes coffee ish.

Dr. Weitz: Interesting,what’s the, why do you think that they can tolerate cold coffee versus hot coffee?

Dr. Crawford: That hasn’t been studied, and I just think, I just tried this on myself. And so it was an experiment because I just love coffee. I just love it. Okay. And I have some patients now sipping iced coffee.  And it hasn’t been studied. I don’t know, but. But, heat or hot food does cause peristalsis, whereas cold food causes less peristalsis, or, moving things along the segments in the small intestine and large intestine, so it might have something to do with the peristalsis.  I don’t really know. But but it’s not AIP compliant. So anyway, you asked about if somebody comes to me and they’re in a [00:23:00] flare, right? They’re immediate AIP. No, but even if people think they’re eating AIP, they’re usually not because for instance, Eggs are off it and they’re eating eggs, but you can have duck eggs and quail eggs on AIP.  So there’s that. Or they’re having some, they’re having some dairy and initially we have to cut out all dairy. 

Dr. Weitz: You take out nuts and seeds. Yeah,

Dr. Crawford: nuts and seeds, just like paleo. And those are a re intro that many people can re intro. So it’s not like you’re, you’re going to be without all these things forever, but just till you get out of your flare.  When somebody’s in a flare, they get the, all the peptides that I use, which are about five peptides. They get low dose naltrexone. They, now they get methylene blue. They get bio they probably get bioidentical hydrocortisone. And I also use if it just depends if I can’t get them out of the flare, which not good, hasn’t happened yet, but if I can’t get somebody out quickly after the [00:24:00] flare, I’ll have them come to the office and I’ll give them IV exosomes which are the little nanopods that they get out of the stem cells.  And then that will nuke the flare right there. Really? Interesting. Yeah.

Dr. Weitz: And It’s the first time I’ve heard using Exosomes for IBD.

Dr. Crawford: Oh yeah, it works wonders. Yeah. And it also and also if somebody wants to consolidate I use exosomes for many conditions, but for IBD and CIRS, they’re very useful.

Dr. Weitz: Interesting. Have you used ozone?

Dr. Crawford: Yes what people aren’t really fond of ozone even though it really, it does work. You have to have a sealed gut to be able to, to get Really the best effects. And so that means you already ha have to have had a couple of weeks of one of the peptides I use that seals the gut but oz ozone.  What people don’t [00:25:00] understand about ozone is you can go to the doctor’s office and get IV ozone for whatever that doctor charges. Per pop. Usually one 50 to two 50. Okay. Or you can use ho ozone and use intra rectal ozone, which actually works great when somebody is flaring.  You just have to use a real low dose. But int Rectal Ozone gives you 75% of the results that IV will, and it’s. for pennies on the dollar. And you can do it yourself. And so I personally have used intrarectal ozone. And I do have a few patients, but most patients are just ooeyed out at the whole prospect of sticking a tiny little catheter up their butt.  They just can’t take it. They can have diarrhea 25 times a night, but they won’t stick a little catheter up their butt. Go figure. But yeah ozone is helpful. And there are other modalities which are additive. There’s a lot of conversation about red light [00:26:00] therapy.  Red light therapy, if somebody’s flaring is helpful. And the easiest way to get red light therapy, easiest and quickest and cheapest, without having to go find a doctor, is join a Planet Fitness. Get a black card membership and that’s, I think it’s 25 bucks a month and that allows you to use their red light pod, which is a very good red light pod and you can go every day.  You could go twice a day. 

Dr. Weitz: And it’s just like a full body red light thing? 

Dr. Crawford: Yeah. Okay. And you just get in the pod and join a plan of fitness and use their red light pod. There you go.

Dr. Weitz: There you go.

Dr. Crawford: Yeah. And people ask about hyperbaric oxygen. That’s a little additive, but not a lot.  And people ask about cryotherapy. It’s a little additive, especially if there’s a lot of fatigue. That helps fatigue, not a lot. I, for fatigue, I’d rather just give them NAD trochees. NAD is the, there’s a lot of buzz about NAD and nicotinamide mononucleotide. And [00:27:00] that’s, Inflammatory bowel disease, just like all inflammatory diseases, is a mitochondria disease, a disease of the mitochondria, which are the cells of respiration. And there’s less ATP, adenine triphosphate production from your mitochondria. And so that’s why people with inflammatory disorders, including IBD, feel fatigued and you give them NAD and boom, that, that fixes the fatigue. So would you ever prescribe a biologic?  Oh, hell no. Are you kidding me? I write, I prescribe pharmaceuticals every once in a while if they’re needed. For instance, for hypertension, I use metformin for glucose control, not for anti aging because there’s really no subspecialty called anti aging and the data on continuous glucose monitoring and metformin use really isn’t there for age extension for life extension or [00:28:00] cellular life extension.  But I do use metformin if somebody’s blood sugar isn’t controllable with, for instance, berberine, etc. But would I, When I developed Crohn’s, I thought to myself, there is no way in the world I’m taking a biologic and and I thought I’m just gonna look around PubMed and try things and figure this out, which is what I did.

Dr. Weitz: Do you find that a percentage of your patients with IBD also have SIBO?

Dr. Crawford: You know what because they’re CIRS patients. Okay, just about everybody who’s living in a moldy house and the mold mycotoxin mix is always, it’s mold, mycotoxins, dust mites, actinomyces, the endotoxins, other bacteria, and they, a huge proportion of those patients get SIBO and SIFO.  Huge percentage. probably 80 percent. Of my just Crohn’s or just UC patients who are not [00:29:00] moldies I would say it’s less than 50 percent, but I do, I do check for that.

Dr. Weitz: Okay. So what do you do when they have mycotoxins, you test for mycotoxins and you put them on like a mycotoxin detox protocol?

Dr. Crawford: It’s a bit more complicated than that, but a lot of doctors test for mycotoxins in the pee and Which is silly, that’s not diagnostic. That tells us, that tells us you’re eating American food. American food is loaded with mycotoxins. From grains to beans to coffee to milk.  Mycotoxins are in every, are in everything. So if you’re peeing out mycotoxins, unless it’s a very unusual one, like for instance, gliotoxin, which is made by Stachybotrys, which is normally not found in the food supply. So if somebody’s got a lot of That one you can infer they’re getting it environmentally, but the way you test for Sears is you check the innate immune system.

You check [00:30:00] labs that conventional doctors don’t check, a TGF Beta 1, an MSH, an MMP9 things that other doctors probably haven’t even heard of. And then the first thing I do is, there’s two patients in mold. The house or, or the house in the house, who knows people have more than one house, they have a workplace.

So we’ve got those patients to deal with. And then we have the sick person who’s a patient, but you have to have all those environmental patients. clean enough to support the detoxing of the patient. And the first thing that has to happen that I see patients that come to me and other doctors haven’t fixed their guts, and if they’ve got a leaky gut, which by definition they have, they’re going to, and they’re given binders before they’re gut sealed.  then the binder binds in their GI tract and it goes right out the leaky gut, right into the bloodstream, and there’s leaky gut means you’ve got a leaky gut brain barrier, goes right into the brain, and so everybody who [00:31:00] comes to me who’s somebody’s put on, yes, who’s somebody’s put on detox agents, they’ll tell me, Oh, I 10 minutes after I take it, I feel terrible.  Yeah, because you’re binding the toxins, and then you’re releasing them into your bloodstream. That’s why you feel terrible. So anybody out there who’s taking binders, who hasn’t had their gut fixed, That’s why you feel lousy after you take the binders. So right. Yep.

Dr. Weitz: So you got to fix the gut first,

Dr. Crawford: fix the gut.  And then I do a lot of tissue repair with peptides and everybody’s hormones are messed up. Everybody’s inflamed. I do my thing for inflammation. Everybody’s having sleep issues because of a of a number of things that happen in Sears. Yeah. Gotta fix the sleep. As I mentioned before, lack of sleep is very inflammatory in and of itself.  But back to the topics you want to talk about, Ben.

Dr. Weitz: One of the things you mentioned on your website was that there are natural ways to inhibit TNF alpha besides taking [00:32:00] biologics. Maybe you can talk about some of the nutritional supplements that can be of some benefit here.

Dr. Crawford: These will tend to lower what I’m going to mention, but they don’t necessarily have a clinical impact.  So I would tell people, don’t think you can treat yourself with, quercetin and curcumin and resveratrol. Those are the big ones, the TNF modulators. Those are all very good supplements, but they’re not necessarily going to make a clinical difference. Okay. They might make a little, but curcumin, for instance, is not AIP compliant.  So when I have people that come to me taking a whole bunch of curcumin, a lot of times they’re just exacerbating their inflammatory bowel disease.

Dr. Weitz: Oh, interesting, huh?

Dr. Crawford: Yeah. Yeah.

Dr. Weitz: My experience has been the opposite on that one. I find curcumin very helpful for inflammation within the gut.

Dr. Crawford: Okay. Okay. [00:33:00] Inflammation in the gut is one thing, but if they have a diagnosis of inflammation related

Dr. Weitz: to an inflammatory bowel disease.  Yeah. Okay. Yeah. Okay.

Dr. Crawford: We’ve had you know what? So many of my patients have way more than just inflammatory bowel disease. And, have so many other things going on because they usually have chronic Lyme or Sears along with inflammatory bowel. And they, and sometimes, like half the time they’ll have, They’ll come to me with two or three autoimmune diseases.  There’s a lot more than just inflammatory bowel going on. Sure. 

Dr. Weitz: Patients who have one inflammatory bowel autoimmune disease are more prone to others.

Dr. Crawford: Absolutely. And once you get leaky gut, you are, you are genetically, there’s all, it’s who in your family had an autoimmune disease? If you get leaky gut.  You gotta be very careful.

Dr. Weitz: Does pretty much all your patients who come to see you for IBD end up on this [00:34:00] autoimmune diet? Or do you sometimes test for food sensitivities and and, customize it that way?

Dr. Crawford: You know what people with Sears develop food sensitivities and people with at a more rapid rate than people with just IBD, but people with IBD develop food sensitivities.  Now, there’s food sensitivities and food allergies. Sure. IgA mediated, IgG mediated, and IgE mediated. And the IgE mediated are like the peanut allergies. And that’s very rare. That’s, that’s a medical emergency. And so you’ve got to test if you believe there’s any IgE, throat closing, wheezing, hive, if there’s any of those reactions.

You check IgE levels to the foods you suspect and you get somebody an EpiPen, blah, blah, blah. If somebody just has food sensitivities, many times someone will come in to me with a [00:35:00] laundry list of food sensitivities. And rather than do, immunoglobulin testing to every single food, I give patients a choice, but they tend to know which foods are bothering them.

And the thing about food sensitivities in association with either Sears or Chronic Lyme or inflammatory bowel, etc, is they tend to reverse. And of course everybody needs to be on AIP. That’s like the The foundation of, that’s like step one of treating an autoimmune disease. And let me mention that there’s a Facebook group you can go on to, to find recipes, just look up autoimmune protocol.

It’s a really good Facebook group. I’m not trying to give Mark Zuckerberg more business here, but it’s a very good Facebook group and you can get recipes and Please cook something and send it to me. Cause I hate to cook. But anyway, yeah, I look at these recipes and I go, Oh, that looks great. Maybe I can find somebody to make that for me.

Dr. Weitz: I know. How [00:36:00] long do you keep your patients on the autoimmune diet or do they stay on nap for life?

Dr. Crawford: Until we can reset the genes with CRISPR. Autoimmune diseases go into remission, but you don’t cure them. What you can do with the exosomes, if somebody has got the finances and they want to do it, is you can calm it down because that, what’s in the exosomes mix that I get, and I, I can’t go into that because the FDA isn’t crazy about us using these things.  Isn’t great. The FDA just quite frankly, isn’t crazy about. functional doctors using things that are not pharmaceuticals. I’m just going to put that out there. I’m not a conspiracy theorist. I’m just saying pharmaceutical companies want you to buy pharmaceuticals. And there’s been a, like a, they’re going after certain things.  And now and now they’re looking at hemp products, which is where [00:37:00] we get CBD products, which are. which are also very useful for people with inflammatory bowel disease for pain, for sleep. There’s, really great sleep CBD products. They’re thinking

Dr. Weitz: about taking those off the market.

Dr. Crawford: They’re talking about that now, and they just took off some peptides. And they’re looking at exosomes. So I don’t like to really. Talk about it a lot, but I will say that that exosomes not only can get somebody out of a flare, but they can make them flare less.  Somebody with Crohn’s this hasn’t been studied. I’m just going to give you, I’m not big on doctors using anecdotal information, but I will tell you 15 years, which is how long I’ve been treating this I’ve just noticed that stress and lack of sleep is way, it flares my Crohn’s patients way quicker than it flares my UC patients.  It flares them too, so everybody, not to sound like a broken record, but everybody has got to do active stress management and [00:38:00] active sleep management. as well as dietary management and exercise management. I have one kid who’s a I’m just going to say that he’s a, he’s going to be a professional athlete.  And if he plays his sport too much, that can cause GI problems, because all the, The catecholamines, the, the adrenaline epinephrine that’s released when he is playing his sport. That, that’s hit in the gut. So everything really, about the lifestyle has to be managed.  And my favorite expression to use is don’t let this get your cortisol up. Whatever the news is, don’t let it get your cortisol up. ’cause that means you’re damaging your brain and you’re damaging your gut.

Dr. Weitz: Okay. Um, so let’s see what else you you talk about other things that can reduce TNF alpha and you mentioned ice baths, saunas, things like that.

Dr. Crawford: Yeah again, [00:39:00] not incredibly clinically relevant, ice baths and saunas are both a form of what we call hormesis, and we know that hormesis is really good For the human organism and hormesis is anything from timed eating to intermittent fasting to HIIT, high intestinal in high intensity interval training.  Sauna use ice plunges. All of that helps every inflammatory condition will raise your happy hormones, may extend cellular longevity, so all of those modalities are actually good to put in clinical practice for anybody. I would recommend it. say that, you don’t want to do all of them at once.  For instance cold plunges are quite good, but you don’t want to start doing HIIT, intermittent fasting, cold plunges saunas. You don’t want to start that all at once. If [00:40:00] you don’t know where to start, get a good functional doctor. And I think probably some coaches know how to talk you through these modalities too.

Dr. Weitz: You mentioned Methylene Blue. Can you explain what Methylene Blue is, and how that can be beneficial, and what dosages you use, etc.?

Dr. Crawford: Methylene Blue was discovered as a dye. And that sounds ooh, that’s disgusting. It was used

Dr. Weitz: to look at at Slides under a microscope, right?

Dr. Crawford: When I was in medical school we used to draw blood, put it under a microscope and, and look for certain bacteria with it.  So that was the use of the original use. It’s now been repurposed and it’s given as a medication. And functional doctors are using it for for different reasons. It’s being studied as a antibacterial and an anti malarial. There are definitely antiviral, antibacterial, antifungal properties to it.

It hasn’t been fully studied, [00:41:00] but but I will tell you on a personal level, I don’t take antibiotics. If I think that something is needed or I will take some Methylene Blue because antibiotics are really kind of death to the microbiome. If you need them, if it’s a life threatening thing, go ahead, but but if it’s not life threatening, don’t think that every time you get handed a prescription for antibiotics that you actually need it.  Really, think about it before you take antibiotics, proton pump inhibitors Motrin, Aleve any, all of that stuff is just really bad for your gut. 

Dr. Weitz: Methylene blue, is this, you use an oral formulation or an injectable and in what dosage and then how long a period of time do you use it for?  Is this something you do ongoing?

Dr. Crawford: If somebody’s flaring, this is one of my flare meds. Okay. If they also have a neurodegenerative condition as as is associated with Sears, which is what I see a lot of, I see a lot of people that have been diagnosed with [00:42:00] Parkinson’s and Alzheimer’s, but they really have severe.  Sears. And and this is being studied. Methylene blue is being studied for neurodegenerative conditions and I’m following that data. And sometimes even before data is published and finalized, I’ll use something if it really looks promising and it looks good. I’ll use it for flares. And as a nice side effect, it’s going to help clean up, clear up their noggin and I’ll use between 25 and 50 milligrams twice a day.  I use liposomal preparations work far better than just the over the counter powdered stuff you can get. And if you’re getting stuff over the counter, be very careful because what’s in the capsules and What’s the capsules are made out of, okay, may be toxic and the fillers that are being used may be toxic.  And that, that really is the case for the bulk of the pharmaceuticals out there. So when I get things compounded, I make sure I get a clear dye free veggie cap. And I make sure [00:43:00] that the fillers that are used, those are the inactive ingredients. If you’re looking at the label, And I’ll make sure that the fillers are non toxic.  For instance this isn’t going to sound toxic.

Dr. Weitz: Methylene, Methylene Blue is over the counter or it’s prescription?

Dr. Crawford: I get it. I use prescription Methylene Blue. Because I like Liposomal. I’m just saying people can find it. Okay. Over the counter. I wouldn’t recommend using it. But, people are going to use what they’re going to use.

Dr. Weitz: Okay. But it is available over the counter. Okay.

Dr. Crawford: I’m pretty sure it is. Yeah.

Dr. Weitz: Okay. And so methylene blue has an anti inflammatory effect. Is that its main benefit or what?

Dr. Crawford: It’s a potent antioxidant and it’s a potent anti inflammatory. Yeah, those are the two properties. And you asked about IV use.  IV isn’t necessary. IV is only needed in certain blood disgraces that have nothing to do with what we’re talking about, but [00:44:00] for our purposes, it’s oral. Yes.

Dr. Weitz: All right. And then talk about low dose naltrexone, LDN.

Dr. Crawford: Yeah, low dose naltrexone. People know naltrexone as an, as a, Probably they’ve heard of it or a related drug.  Narcan can, as something that reverses opioid ingestion, excess ingestions. But low dose naltrexone, not the 50 milligrams that’s used to reverse, reverse problems, but very low dose, meaning I start somebody at 0.5 milligrams. Okay. Work, work my way up. That, causes the pituitary to release growth factors and pain stopping factors and endorphins and enkephalins, which are like your natural pain relievers.  And those, Mod, help modulate the inflammatory response. So [00:45:00] LDN, and people can Google, or ask, don’t ask chat, GPT. I don’t know what chat, GPT is going to tell you. But there are websites on what does LDN work for? Are you a candidate for LDN? And LDN, just like everything else, can be used. prepared in a good way that’s not going to harm your gut or a bad way that’s going to harm your gut.

So when people tell me, Oh, I got, they come to me and they tell me, Oh, I got this cheap LDN and it didn’t seem to work. And then they show me what they got. They got something with a toxic filler. Sometimes I’ll see like filler is brown, dried brown rice, which doesn’t sound toxic. But if you’ve got, if you’ve got inflammatory bowel disease and you take a capsule of dried brown rice, It could flare you right there, just that one capsule.

So LDN has to be prepared correctly. It has to be made not from the crushed tablets because the [00:46:00] tablets have bad fillers in them. So you have to get LDN that’s made from powder and they put it with clean fillers in a clean capsule and then you go up very slowly or it can mess up your sleep.  That’s why I go up slowly on the dosing.

Dr. Weitz: All right, good.

Dr. Crawford: Okay, and so that is another component for most people of their therapy.

Dr. Weitz: It sounds like there’s a lot of things that can be used. And do you often use a lot of these all at one time or you pick and choose?

Dr. Crawford: It’s very dependent on the patient.  An ulcerative colitis patient is generally easier for me to get under control than a Crohn’s patient. So maybe they won’t need all five peptides, but the Crohn’s patients, they all need all five peptides and they all need to more carefully manage their stress. And they all need to do the vagal nerve stimulation more than the UC patients.  It’s, but it’s, I individualize. When you see, [00:47:00] when you see a patient, you individualize their therapy and I individualize the therapies that the patients I see as well.

Dr. Weitz: All right, great. So I, I think that’s the questions I had prepared. Anything else you want to tell us about?

Dr. Crawford: No, I just let me see. When we talked about, I don’t want people to get, diseases. Okay, so let’s talk about. So we don’t

Dr. Weitz: just cure them from their autoimmune disease, we want to make them healthier.

Dr. Crawford: You know what? I don’t want them to get an autoimmune disease because I can’t cure that right now.  I can. Quasi reset the epigenome with the exosomes. We can wait for CRISPR, but I don’t want to wait till people get these diseases. I want them not to get it. So how do you not get inflammatory bowel disease? What are the things that cause leaky gut? The main things. Okay. They’re eating ultra processed foods, the standard American [00:48:00] diet, so the first thing is you got to eat a healthy diet.  Second thing, we talked about how high cortisol can damage your gut line and give you leaky gut. You want to manage your stress. Number three, you want to avoid toxins. You want to make sure your house is not moldy. 50 percent of the houses in the U. S. are moldy. 25 percent of the people in the U. S. have the genetic makeup to develop Sears.

So you do the math, that’s millions of people walking around with other diagnoses and they’re just not getting the help they need and they’re not getting the mold cleared up in their house. And this goes to everything from mold to the bad types of seaweed that wash up to heavy metals, everybody should know by now not to eat tuna fish every day.

Like somebody running for president, I won’t mention names. Yeah. Thanks. Okay. But toxins, stress, lack of [00:49:00] sleep eating a bad diet. Those are really the main, those are the main reasons people get leaky gut. If you just take a look at your lifestyle, and if you need help, get a lifestyle coach.

Or, somebody who can help you with the big things. What should you eat? How should you exercise? How do you sleep better? How do you manage your stress better? Those are all the things that can keep you healthy. Manage your environment, get a nice air purifier, make sure you don’t have mold.

Mold sniffing dogs, by the way, I’m obviously a dog fan, but mold sniffing dogs, find mold 95 to 99 percent of the time and human inspectors find the mold about half the time. Oh, really? Really. I’ve had so many patients where they have a, the human inspector comes in and here’s the whole inspection report and here’s the samples and this is the mold it shows and then I put them on treatment and then, and then three months later.

I think [00:50:00] they’re doing well, and then all of a sudden they flare. And what’s the problem? Get a mold dog. The mold dog comes in and goes woof in the bathroom, and it’s behind the, and there’s more mold behind the tiles in the bathroom. I’m mentioning all of this just because it all ties back to inflammatory bowel, because a lot of people who develop mold illness will, if it runs in their family, will develop an autoimmune illness.

Dr. Weitz: We didn’t touch really on the on the microbiome. And I know you like to do a microbiome analysis, you mentioned, and then work on improving the health of the gut. So we didn’t talk about

Dr. Crawford: that. I don’t think we

Dr. Weitz: really did. Yeah. We just mentioned that you like to use a a certain microbiome analysis, but let’s talk about that.  And you get this microbiome analysis, this stool test,

Dr. Crawford: which

Dr. Weitz: is using old genome sequencing. Is that what it’s using?

Dr. Crawford: Yeah. Okay. And it’s basically sequencing your entire Microbiome. Okay. But it’s categorizing [00:51:00] it very nicely. And you can see if you do it, if you do it, you’ll get a report and everything is categorized for, not only just do you have a normal amount of firmicutes to bacteroidetes ratio.  The two main kingdom types of command, all specter kingdom. Yeah. Kingdom, Order, Class, Phylum, Genus, Species, but, the two kingdoms, do you, and then do you have enough diversity? And so you want a diverse microbiome. And then are you making the short chain fatty acids?  And then it goes through the sections. Here are the bacteria that you have or you don’t have associated with. inflammatory bowel disease. Oh, and here’s what you can do about it. And here’s the ones associated with metabolic disorders. And here’s what you can do about it. So the whole report basically has you altering your diet, maybe adding certain prebiotics.

For instance I will look at somebody’s report and I will look at the suggested foods and I’ll come up with okay, [00:52:00] once a week, I want you to make up your. Prebiotic Smoothie, and then here’s the probiotic I want you to take because this is what’s, and then here are the foods I don’t want you to eat because you got too much of this.  And for instance, a typical prebiotic smoothie recipe would be and I try to make it easy for everybody, is you grab a bag of frozen organic spinach, and you grab three apples and then you grab a can of unsweetened pineapple. That’s like your basic, nothing fancy here and you mix it all up.  It tastes just fine. You put it, you get little glass bottles, you freeze them, and every day you take one out for the next day. And you, if you take that with your probiotic, you’ve got a prebiotic and a probiotic, and your probiotic is going to take hold quicker. We know, for instance, Ackermansia is a probiotic that is essential for maintenance of the [00:53:00] gut lining.  And it’s amazing. Some people have none when you do their microbiome analysis. And so obviously those people, you give them that, but so it’ll take hold better. I have them drink whatever their prebiotic profile is in their report. I’ll have them do a smoothie that will, that will cover it.  And help their acromantia, if that’s the probiotic, take hold quicker.

Dr. Weitz: What about some of the prebiotic products on the market?

Dr. Crawford: There is nothing, I have tried them. There’s nothing that I find palatable out there.

Dr. Weitz: Okay.

Dr. Crawford: So I just have found nothing palatable. There are oligosaccharide, fructosaccharide mixes that are used for infants.  And that’s actually palatable. But it’s got too much, I call it goulash, when they put extra stuff that they don’t need to put that there’s too much goulash in the the commercially available. That’s why I have everybody just make their own. No [00:54:00] preservatives, no, no chemicals, no junk.

Dr. Weitz: And then how do you decide which probiotics to use?

Dr. Crawford: I will look at their profile, right? I will see As an example this one company I use, Enjoy, and my code is drkim10 for a discount. Okay. They will tell you you may have heard the term psychobiotics. And if you haven’t, it’s a term you’ll be hearing because we know that depression, anxiety manic depressive disorder, schizophrenia.  All sorts of things that we call psychological disorders are really neurological disorders and they’re, and they are primarily based in the gut. All things really do start from the gut. And so the psychobiotics are the things that will increase your good hormones and the things that you want. And one of the things I mentioned was GABA, Amino Butyric Acid, which is the thing that makes us [00:55:00] relax.

And this report measures your GABA. Now, we know in the literature that there are certain strains of bacteria that will produce GABA. And so I will pick a probiotic for a person who’s anxious and can’t fall asleep at night, that person needs more GABA. And I’ll give them a prebiotic drink with a probiotic with strains in it that are known to increase GABA.  That’s just a one of the four examples. But there’s a whole bunch of things that I take into consideration. And the data is evolving. Every week, even in the mainstream literature, I see probably 10 articles. In my functional literature, I see probably 30 articles talking about the relationship between the microbiome and other parameters of health.

Dr. Weitz: One of the tricky things though is, you can do one of these as stool analysis and see, say the patient is low on a, lactobacillus rhamnosus or [00:56:00] something. And then, but unfortunately, most of the data doesn’t show that if you take a probiotic with lactobacillus rhamnosus, that it becomes a permanent resident.

Dr. Crawford: That’s why you take it with a prebiotic drink. And just about everybody has enough of that, of lactobacillus remnosus. The plantarum is available, and that helps bloating. There are You know, Adalentis is available. That helps GABA. And again we’re really just at the beginning of the probiotic, prebiotic, and functional foods.  And this is going to be a thing. Functional foods. We’re just starting to explore those avenues. And AI is really helping this company. I think AI used correctly. And if we teach the chatterers, if we teach them what they need to know, which [00:57:00] is don’t come kill us, please.  But if we control AI, then it’s a useful tool for us. And so this company is using AI to go through tens of thousands of articles and be able to give recommendations like right on the app. And I will check it out just to, if I read something in the literature, I’ll check it out just to see did they tell the app that yet?  And usually they have, so it’s pretty cool. Okay, cool. We’re just starting. The reason that, that there’s there’s no real guidance about this is because we’re just at the cusp, what’s available for probiotics. It’s just, it’s 1 percent of what we’re going to have in another 10 years.

Dr. Weitz: So mention a couple of your favorite probiotics. Do you like the spore based probiotics? Do you use the Acromantia? What kind of products do you like?

Dr. Crawford: If somebody doesn’t have enough diversity which is, a lot of people, like I use, for instance, if I [00:58:00] can mention a company, I use Designs for Health.  And if somebody wants a discount. designs for health account, they can go to kimcarfordmd. com and go to the page where there’s products and If you use Designs for Health link under my product list, that gives you something like a 15 20 percent discount on everything. And for Designs for Health, I like their, they have a line called ProBiomed.  And those they have a sporulating probiotic called Probiospore. So for diversity, you want a sporulating. You want a lot of bacillus bacillus subtilis. You want bacillus coagulans. And there are, I think there are two other companies that have good sporulating probiotics. Rebel Health Tribe had one or has one and then there’s another company so 

Dr. Weitz: Microbiome Labs has the Megaspore.

Dr. Crawford: The Megaspore probiotic that’s a good product. [00:59:00] Exactly. And so for diversity you, you always want to sporulating. I always check like somebody can have too much acromantia. So I would say you know check your microbiome before, ideally before you start any probiotic.  So check and see, do you need acromantia? And if you’re deficient, I would recommend acromantia. And then the other, I’ll use ProBiomed that, the ProBiomed 50 or 100 because those there are lactobacillus strains and bifidobacterium strains that will help with the serotonin and GABA and that will help with metabolic stuff and that will increase your metabolism.  amount. If you have a really low level of Firmicutes I really want that level up. And this is a little controversial because high Firmicutes are found in obese patients or people well over their ideal body range. But on the other hand, if you [01:00:00] look in the blue zones and you look at those microbiomes, The Blue Zone people who all, there’s people with

Dr. Weitz: the longest Dan Buettner.

Dr. Crawford: They’ve all got high firmicutes. And they’re all thin, they’re thin, they eat they don’t eat a lot of meat. That’s why when we talked about paleo, that’s why I say I’m not a fan of a lot of eating a lot of meat for multiple reasons, for from a health standpoint it’s not a good idea to, from an inflammation just an inflammatory, and we’ll just leave it at that standpoint, it’s not a good idea.

And here’s the other thing about when you’re eating, when you’re eating animal products, whether it’s dairy or meat chicken, beef, whatever. or whatever it is you’re eating what those animals were fed. So if they were fed grains, those grains, are there, are the grains GMO grains? Were they sprayed with pesticides?   Were they sitting in silos covered with mycotoxins and the animals have ingested [01:01:00] mycotoxins? I figured out how to treat CIRS looking at the veterinary literature because they were treating animals who were getting Mold Toxin Related Illness, so everything that the animal eats, you eat, which is why I always say you must get grass fed everything, chickens, free range chickens that walk around and eat grass and lay eggs and Become your meal if you want it to become your meal and beef, beef if it’s fed grains, you’re eating the same grains the beef is, you’re, you’re, if they’re injected with hormones and antibiotics, you’re eating that too that’s why organic, it is more expensive, but if you’re trying to be a healthy person and not develop inflammatory bowel disease, You’ll eat organic, and you’ll eat organic with not only your meat, but with your grains, with your fruits, with your vegetables and an easy rule of thumb about what to get organic is if you can peel it and eat the inside, [01:02:00] then it doesn’t have to be organic, but if you can’t peel it, like you’re eating an apple or you’re eating a strawberry, those have to be organic.  If you get a sweet potato and you take off the skin, that doesn’t have to be organic. That’s the rule.

Dr. Weitz: Sure, or you can go to I’m drawing a blank on the clean ten or the Yeah, the dirty dozen. Dirty dozen, yeah.

Dr. Crawford: I’m just saying if people don’t have access to that list and they’re at the grocery store and they’re looking, that’s a way to think about it.  Sure, absolutely.

Dr. Weitz: If you’re not going to eat the outside of it and it’s covered in a shell, you’re going to get less of the pesticides inside.

Dr. Crawford: like an avocado.

Dr. Weitz: Yeah, absolutely. Okay, great. A lot of great information. Thank you so much for sharing with us, Dr. Crawford. And how can viewers and listeners get in touch with you?  What’s your website, etc.?

Dr. Crawford: It’s Kim Crawford, like the wine 

Dr. Weitz:  Is your wine called Kim Crawford?

Dr. Crawford: There’s a guy in New Zealand that owns a vineyard, okay? And he makes a good Sauvignon Blanc. Oh, okay. And I get three, three texts a week with people sending me Kim Crawford wine and asking and saying, Is this yours?  I wish. So they can go to kimcrawfordmd. com. And I do one off consults. If you just want to want a 45 minute to 75 minute consult, I do those. And then I’m still, I do get a lot of applications on a daily basis, but I do. So I don’t take every new applicant as a new patient, but I do get you situated and I help you and I do answer every single person that, that gets in touch with me.

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

Dr. Crawford: Thank you, Dr. Ben. Lovely being with you.

Dr. Weitz: The same.

Dr. Crawford: Bye.

 

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Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who [01:04:00] enjoy. Listening to the Rational Wellness Podcast. I would appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review.  If you would like to work with me personally to help you improve your health, I do accept a limited number of new patients per month for a functional medicine consultation. Some of the areas I specialize in include helping patients with specific health issues like gut problems. Neurodegenerative conditions, autoimmune diseases, cardiometabolic conditions, or for an executive health screen and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way.  Please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310 395 3111. And we’ll set you up for a new consultation for functional medicine. And I look forward to speaking to everybody next week.