Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Toxic Mold with Dr. Jessica Tran: Rational Wellness Podcast 79
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Dr. Jessica Tran discusses how to avoid and correct Mold Toxicity with Dr. Ben Weitz.

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Podcast Highlights

6:05  The diagnosis of mold toxicity is difficulty to make, since the symptoms like fatigue, joint pain, skin rashes, respiratory problems, cognitive and neurological issues, fatigue, and headaches could be indicative of many other conditions.  Mold may be a diagnosis of exclusion, after other causes have been ruled out.  Patients with dementia or Alzheimer’s may have mold toxicity as a trigger.  In fact, Dr. Tran said that she has seen a handful of patients with triple negative breast cancer who have all had tremendous mold exposure.  Patients who have multiple chronic illnesses, say somebody who has hypothyroidism, Lyme infection, allergies, etc. will often have a mold allergy or mold sensitivity or a mycotoxin issue.  We can get mycotoxins from our food, which most people will eliminate on their own.  But these patients may have a compromised ability to eliminate mycotoxins.  The key is to take a good, detailed history.

14:12  Dr. Tran likes to screen patients who she suspects of having mold toxicity with a urine test through either RealTime Labs or Great Plains but she likes to have them take either liposomal oral glutathione 500 mg three times per day the day before or an IV Glutathione drip or push the day before collecting the urine.  This will increase mold excretion.  Without doing the glutathione challenge, you can have someone who has been exposed to mold and is reacting to it, but they may be a poor excreter.  It may be stored or stuck in their body and not coming out.  It’s the same concept when you test for heavy metals and do an oral chelator challenge and then test the urine. Dr. Tran talked about the Autism study when they looked at the baby’s first haircuts looking for mercury to see if mercury was related to autism. But they found the opposite–those with autism had lower levels of mercury. But what this study really showed was that the autistic kids were poor mercury excreters.

20:25  The best ways to test your home for mold is to contact a mold expert to come and impect your home or office.  If you want to test it yourself, the ERMI kit is better than the HERTSMI, since the ERMI looks at more forms of mold and is more extensive than the HERTSMI.  If your budget is very limited, you can get a petri dish from Home Depot or Amazon and just leave it in your home for a couple of days and then mail it in and they send you a report.

21:57  A Functional Medicine approach to treating mold problems should include looking at the whole person and also look at food allergies and other environmental allergies. For the mold component, treatment should start with glutathione, either liposomal or intravenous. You should also add phosphatidylcholine, which helps improve the lipid membrane. Dr. Tran says she may also use binders like psyllium, bentonite clay, and/or activated charcoal.  She finds that cholestyramine is fairly harsh, so she does not use it.  Dr. Tran will also look at the gut, esp. since mold has a relationship with candida overgrowth. 

 



Dr. Jessica Tran is a board-certified Naturopathic Doctor who is practicing Functional Medicine at the Wellness Integrative Naturopathic Center in Irvine, California, where she practices with Dr. Darin Ingels. The website is WellnessIntegrative.com and she can also be found at DrJessicaTran.com   Dr. Tran’s office phone is 949-551-8751 where she sees patients in office or remotely. 

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



 

Podcast Transcripts

Dr. Weitz:            This is Dr. Ben Weitz with the Rational Wellness Podcast, bringing you the cutting-edge information on health and nutrition from the latest, scientific research and by interviewing the top experts in the field. Please subscribe to the Rational Wellness Podcast on iTunes and YouTube, and sign up for my free ebook on my website by going to drweitz.com. Let’s get started on your road to better health. Hello Rational Wellness Podcasters. Dr. Ben Weitz here. Thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness Podcast, please go to iTunes and leave us a ratings and review. That way, more people can find out about the Rational Wellness Podcast.

Our topic for today is toxic mold, its effect on our bodies, and how to get rid of it, with Dr. Jessica Tran. Exposure to mold and mold toxins, known as mycotoxins, affects many people and often is an undiagnosed underlying trigger for many other symptoms and conditions.  Many people are unwittingly living or working in water-damaged buildings, and this exposure may be causing many negative effects on their health including skin rashes, respiratory problems, cognitive, neurological issues, fatigue, headaches, joint pain, even increased urinary frequency, and a list of other symptoms. When looking at a patient from a functional medicine perspective, we usually focus on likely underlying triggers and root causes of their health condition, and mold may be one that is sometimes overlooked.  Research indicates that mycotoxins can bind to DNA and RNA and cause damage, alter protein synthesis, increase oxidative stress, deplete antioxidants, alter cell membrane function, act as potent mitochondrial toxins, and alter apoptosis, which is important for killing off cancer and other cells that we don’t want in the body. Molds and mycotoxins can negatively affect our hormones including our sex hormones, thyroid, and adrenal function. In some cases, POTS, postural orthostatic tachycardia syndrome, fibromyalgia, chronic fatigue, and a bunch of other conditions can be caused by mold exposure.  Other conditions that may have a mycotoxin component include various cancers, diabetes, atherosclerosis, heart disease, hypertension, autism, rheumatoid arthritis, lipid problems, Crohn’s disease, Sjögren’s syndrome, MS, Alzheimer’s disease, et cetera. 

This is why we’ve asked Dr. Jessica Tran to join us today. Dr. Tran is a board-certified naturopathic doctor having completed her naturopathic degree from Bastyr University. She also completed a three-year specialty environmental medicine fellowship, and she also recently completed an MBA in health care from UC Irvine.  Dr. Tran is extremely knowledgeable about mold and mycotoxins and environmental conditions, and this is why we’ve asked her to join us to share some pearls of wisdom with us today. Dr. Tran, thank you so much for joining us.

Dr. Tran:              Thank you so much for having me. I’m excited to be here.

Dr. Weitz:            Excellent. How did you become interested in environmental medicine and studying mold and patients suffering with mold toxicity?

Dr. Tran:              It was through my fellowship program at Southwest that I became more familiar with mold. It was never on my radar. It wasn’t anything I ever learned in undergrad or even living in Seattle where it’s very moldy and damp. I rarely had encountered anyone or any patients that came in for us with symptoms that remotely resembles mold, toxicity or mold allergy. I was probably seeing them, but it wasn’t anything that was exposed to me at that time.

Dr. Tran:              In my fellowship program, because I was at the Center of Environmental Excellence there, we saw patients from around the globe, and it was there that I had patients come in, and it was through my mentor and faculty director who through our history uncovered that patients who were living in water-damaged homes or had exposure to mold had chronic illnesses that after seeing 40 or many, many different doctors, their symptoms and condition wasn’t resolved.

One of the things that really fascinated me was that you can have mold exposure and not even see it in your home because it could be behind the drywall of the home, and patients would usually have a history of, “Yeah, we had water damage. We cleaned it up,” or, “The toilet overflowed,” but we then … Part of the fellowship program, you learn about building practices and how to ask certain questions. We have our patients or a home inspector go in, take a look, and lo and behold, sometimes people would have black mold behind their shower wall or in their bathroom or even in their home or kitchen sink, roof leak, and that was really where I learned a ton about patients who were exposed to mold and having mycotoxin issues.

Dr. Weitz:            Cool. So, what would make you suspect that a patient that you’re dealing with may have an underlying mold problem that’s part of their health struggles, especially when symptoms of mold toxicity could also be caused by a number of other things?

Dr. Tran:              That’s the hardest aspect. It’s usually for most … As a general practitioner, it’s really hard to know because patients are coming with fatigue, joint pain, and all these other things that are so many different things that you can have value … they have … For me, sometimes, I’m one of the last people that patients see, and it’s a diagnosis of exclusion. If it’s something that a doctor hasn’t looked at, it’s something that I usually ask. One of the things that are strange, rare, peculiar, or that patients will come and being overlooked is patients with dementia or Alzheimer’s.  To this date, I’ve had a handful of patients who have triple negative breast cancer, and hands down, every single person has had a tremendous mold exposure. So there’s certain cancers that I believe-

Dr. Weitz:            Wow.

Dr. Tran:              Wait. We don’t know if it’s the culprit, but it’s definitely an association that we see. It’s definitely something that’s, for me, just my bias is strongly correlated that I see in my practice. We take an environmental perspective, environmental history, and part of the history, somebody who has many chronic illnesses, I would say three or four conditions, like hypothyroidism, Lyme infection or other allergies. Most of them will struggle with a mold intolerance, and that could be mold allergy or a mycotoxin issue.  The mycotoxin issue, we get mycotoxins from our food, right? So we’re all exposed to mycotoxins to some degree. Our body naturally will eliminate mycotoxins on its own. But as you know, people who struggle with metal issues, their ability to eliminate may be slowed based on their genetics. So they may have a compromised ability to eliminate. Even though, naturally, we all have the ability to eliminate it, some people eliminate slower than others, and because it’s slower there’s a buildup that occurs, and we develop this toxic burden, and it’s not just with mold, it’s with other things like metals in the environment, glyphosate, like different herbicides. You know, pesticides we’re exposed to also.  So it’s the totality of everything that we have to look at. But definitely, the mold mycotoxin issue is huge, and it’s hard to really know if it’s how big a factor it is.  I’m always asking a patient about whether they have water damage in their home, and most patients who are mold-sensitive will know because through their history, with their itchy eyes, runny nose. When they walk into a damp room, they’ll know. Others may not. So it’s a good history, is what I’d say.

Dr. Weitz:            So what percentage of patients that have symptoms of mold toxicity or that do have mold toxicity know that their home or office has mold that they’re getting exposed to?

Dr. Tran:              Surprisingly, I believe, and maybe my patients are more educated. They will say to me, “I think my home … ” Maybe I’m mold-sensitive because I’ve read about it online. But for most patients, I don’t think … They don’t suspect because it’s never anything that they’re clued into.

Dr. Weitz:            Right.

Dr. Tran:              So I actually believe it may be more diagnosed than we ever realized it to be because it’s something, but it’s not really talked about or taught in conventional medicine. Most conventional practitioners will send a patient to an allergist. The allergist will do a skin scratch test. It may not even show up because the mold, allergy is not IgE-mediated–it may be a delayed response. So we may-

Dr. Weitz:            An IgE or IgM reaction.

Dr. Tran:              Yeah, so there are patients who are immune-compromised that are more susceptible to getting certain mold infections, especially in their lungs. When patients are immune compromised, that’s recognizing how much medicine. But for people who have a low-level toxin exposure with mold accumulation, it may be overlooked.

Dr. Weitz:            You mentioned triple negative breast cancer, and we’ve had a few patients with that over the years, and that’s really a grim prognosis, very hard cancer to treat. Do you find that treating the mold increases their prognosis?

Dr. Tran:               It’s hard to say. But in my experience caring for these patients, with triple negative, their prognosis is better, and I think it’s because we’re doing everything else, right? We’re changing their diet. We’re helping them change … decrease stress. I think it’s everything together. But I say that with the triple negative breast cancer because there isn’t anything … The prognosis is terrible. Some patients go around different chemotherapy agents, which usually have no evidence, which blows my mind because it’s supposed to be a research … science-based.

Dr. Tran:               But I know they’re doing their best. They’re trying to find the best regiment for patients.  I find a lot of my patients with the triple negative breast cancer and comparing to people who decide to go conventional versus integrating Functional Medicine, alternative medicine aspect, they do better because of everything they’re doing, the diet, lifestyle, supplements and hormonal balance. Even though estrogen/progesterone isn’t playing a role, there’s cortisol, the adrenal glands, right? So that plays a role too. We have to address that.

Dr. Weitz:            Yeah, and I’m not convinced. Even though they’re estrogen-receptor negative that estrogen metabolism still isn’t important in these women.

Dr. Tran:              Oh, and it’s gut, right? Gut function?

Dr. Weitz:            Right, yep.

Dr. Tran:              Gut function’s essential, right?

Dr. Weitz:            Right.

Dr. Tran:             Our microbiome is very important. How our gut … You know, B vitamins are important. If the patient has dysbiosis, they’re most likely to have an altered level of beads. I mean, we know that there’s so many different co-factors in our body that we need for metabolism, essential detoxification. I really believe for triple negative and certain types of cancer, it’s the depletion of essential nutrients that leads to altered or uncontrolled growth of cells, right?  So that’s why when we see patients with certain cancers, we’re always looking at nutrient levels. How can we support them from that?  And food is medicine.  We start there first and look at how will they absorb.  We can see that we go through higher levels of intervention.  We may need like IV nutrient therapy.

Dr. Weitz:             Right. Do you find any tests useful for screening patients for mold toxicity? Such as, say, some of the urine tests?

Dr. Tran:              They can be useful, yes. So the caveat for that is that when you do these urine tests, it doesn’t tell you what your burden is. It tells you your level of exposure, and it tells you you’re able to excrete. Similar to toxic metals, so we … There are some people who are non-excreters. They don’t excrete well. What I do find in the patients who are poor excreters, they’re not going to have a high level of mycotoxins in their urine. It’s going to actually show a low level. It’s counterintuitive, but then what I learned, and I learned this through Dr. Tim Guilford that glutathione binds to mycotoxins.

So what I’ve done in patients where I know they’re living in a water-damaged home. I know they’re … They have every classic symptom that the urine test shows that it’s negative. I do a glutathione challenge. So the day before, I will either dose with liposomal glutathione throughout the day, with 500 milligrams three times a day. Or I’ll do an IV bolus of glutathione drip or push and then collect the next morning first urine void. Then you’ll see it.

Dr. Weitz:             Cool.

Dr. Tran:              I do have a case. I can show you with the lab results at the presentation. So whole family has exposure living in the moldy home, and there’s one … The mom has very high levels of leukotoxin, and of fragilis in the home, from air samples in the home. Her urine test shows that she’s exposed. Her friend who has developmental delays and issues, his levels showed very little, like nothing. Nothing excreted out. The interesting thing is that the son saw my colleague in the office, Dr. Ingle. I recommended the tests. He saw the results. He’s like, “Oh, okay. No exposure.”

Dr. Tran:              But when you look at … because they’re exposed. The kid has to have some excretion.  But what it tells me is that this kid is a poor excreter.  He’s probably very, very burdened but he’s not excreting well.

Dr. Weitz:            Did you do the glutathione and retest with him?

Dr. Tran:              Yeah, and so you will see when you do the glutathione and then you retest. You see a greater level of excretion, maybe not a ton. I have a handful of cases where that’s the case, where toxic mold exposure. Their practitioners will do … I see them. They will see other practitioners around town. They have a test. It’s negative, and I’m like, “Let’s try this. Let’s try a glutathione challenge test,” and then lo and behold you see a greater expression of mycotoxins, and I believe it’s because it’s stuck, stored or what not in the body, and not excreted well. We see that with metals. So it’s my experience in metal toxicology with the chelaters. I drew from that to apply in this situation.

Dr. Weitz:            Meaning when somebody comes in, you suspect might have heavy metal toxicity. Instead of just measuring their urine, you give them a oral chelater, and then you measure their urine the next day with the idea that the chelater is pulling the metals out that then will get excreted?

Dr. Tran:               Exactly. That’s the exact concept because we don’t really … When we’re doing a first morning urine challenge test either for mold or heavy metals, just first … No chelater. First morning void just shows us what the patient is exposed to and how well they’re able to eliminate. It doesn’t tell us what’s bound … For metals, we know this from metals really well, is that certain metals will bind very strong to proteins and make certain enzymes non-functional. It’s the affinity of these metals that bind it so strongly when you have a chelating agent on board, it pulls it off and then freeze it up, and then you excrete it out through the urine.

Dr. Tran:               So, same concept. I don’t know if you’re … Are you familiar with the autism study When they looked at the baby’s first haircuts and looking at mercury?

Dr. Weitz:            No.

Dr. Tran:               There’s a study looking … because we had believed that mercury was implicated in developing autism. So there’s a study that looked at babies’ first haircuts, and we expected to see a higher level of mercury excretion in kids on the spectrum. But the opposite was what the studies showed. It was in fact the neurotypical kids. The control’s had high levels of mercury versus the autistic kids, and that study demonstrates and illustrates the fact that the autistic kids are poor excreters since their genetics doesn’t allow them to excrete. That’s the takeaway from that study.

Dr. Weitz:            I see.

Dr. Tran:               We have a study similar, which I’ll talk about. Same thing with children on the spectrum do not excrete ochratoxin very well either. So you’ll see the control group will excrete really well, but the children on the autistic spectrum will not excrete ochratoxin very well. The study doesn’t take the leap to do a glutathione challenge test or anything. They hopefully one day will get there. But the research does show that there are people who just do not excrete very well.

Dr. Weitz:            Cool. So what’s the best way to test your home for a mold or mycotoxins?

Dr. Tran:               There’s different ways to test. So you can do a spore trap analysis. You have somebody come to the home, measure the spores in the home. You could do … The inexpensive way to do it is … I tell some of my patients. You can get a petri dish. You go to Home Depot or buy on Amazon online a petri dish mold, you know, test. Just put it in the home, and if you just leave it in there, in the home for a couple days, then you send it back and you get a report. It’s not very expensive.

Dr. Tran:               I usually recommend patients to get it evaluated by a mold expert or somebody who comes in the home. They can do the moisture test testing, looking at indoor mold samples and outdoor mold quality. There’s some people who will talk about the ERMI and the HERTSMI. So we’ll go over that at the presentation, the pros and cons. But in a nutshell, the ERMI is a more extensive evaluation. The HERTSMI is looking at the five molds, mycotoxins, like producing molds that Shoemaker believes are most … has the most adverse effects on our health. So those are the differences in a nutshell.

Dr. Weitz:            Okay, so let’s get into treating. So how do you treat a patient that we believe strongly or is confirmed from testing are sick from mold or mycotoxin exposure?

Dr. Tran:               For treating a patient, you also have to not only look at the molds. You look at the whole entire person. You have to look at the food allergies and there are other environmental allergies to get the best resolution. There’s some people who will just treat in isolation, like feel like we will do a disservice if you just do that. But there’s some people who just want just the mold component. If you look at just the mold component, what the evidence shows is that liposomal glutathione, IV glutathione does bind into the mycotoxins.  If we’re talking about mycotoxins alone, you know, glutathione, in conjunction with phosphatidylcholine, because it helps improve the lipid membrane, is essential because we know it impairs cellular … a lipid bilayer. So phosphatidylcholine is another oral or IV. It’s something that can be used. Looking at the gut microbiome is really important.

Dr. Weitz:            So it’s interesting. You talk about liposomal glutathione is something that binds to the mold. I’ve been hear people talking about liposomal glutathione or the forms of glutathione as a way to push the mold out and then using clay and charcoal and pectins and things like that to bind it.

Dr. Tran:              Yes.

Dr. Weitz:            One of the experts calls it the push-catch strategy.

Dr. Tran:              In my experience, if we had to pick one, glutathione’s my favorite.

Dr. Weitz:            Okay.

Dr. Tran:              The binders, yes. Some people like to use cholestyramine. I find that it’s really harsh. So there are other binders that are good like psyllium, bentonite clay, that’s good. It’s hard to find a good source of it too. It’s fairly inexpensive. Some people will take activated charcoal at nights.

Dr. Weitz:            Right.

Dr. Tran:              I think it’s essential for us to know how to schedule it so patients don’t deplete their nutrients more than they are depleting their nutrients.

Dr. Weitz:            Right, because those binders if they’re consumed at the same time with foods that have a lot of nutrients or nutritional supplements, they’ll bind with those two and take them out.

Dr. Tran:              Yes, yeah, absolutely. We’ll do a lot of gut work too when patients are exposed to mold. Some patients are like, “Why do I have to look … Why are you making me do a stool test?” I’m like, “It’s part of the evaluation,” because it’s not just … because mold has a relationship with patients with candida too.  Some people who have an overgrowth of candida will just experience symptoms of mold, allergy, and toxicity to a greater degree.  So we want to make sure we evaluate it, and we treat it appropriately.  That’s why I like the sensitivity testing, our functional comprehensive stool analysis, because we can actually treat with the correct nutraceutical.

Dr. Weitz:            Cool. Of all those binders, I’ve seen clay, charcoal, cholestyramine, chlorella, zeolite, modified citrus pectin, beta-sitosterol, glucomannan, diatomaceous earth. Can you sort those out? Or what are your two favorites? Or do you like to use some in certain cases?

Dr. Tran:              I would say my favorite would probably be the bentonite clay and activated charcoal.

Dr. Weitz:            Okay.

Dr. Tran:              And there are super soluble fiber products that I like to use too. I think fiber’s important because it also helps, and it really depends on the patient’s budget too. So, activated charcoal is relatively really expensive, and it is something that’s put on board for just to help. If they can do with different fibers, and we rotate the fibers, that’s something that I like. Some people can’t tolerate one fiber over the others. That’s why you have to understand what theIr intolerances are too.

Dr. Weitz:            Okay, interesting. Hey, have you noticed that we seem to be in this charcoal phase of consumer products? I mean, in fact, in my household, my wife had brought home a toothpaste with charcoal, a facial mask with charcoal. Occasionally, we have a treat of ice cream made from coconut, and they have a flavor that is charcoal ice cream.

Dr. Tran:             I think that’s a new trend and fad.

Dr. Weitz:           I mean, it’s … Everywhere is charcoal.

Dr. Tran:             I was with a friend this weekend, and I ordered a lemonade charcoal, and she was like, “What is this?” I’m like, “It’s lemonade charcoal. It’s a trendsetter.” We went and had an amazing bowl in Los Angeles, and it had charcoal, and she was like, “I can’t … Why is there charcoal in everything?” I’m like, “Just wait. In a couple of months, six months from now, it’s going to … support everyone there. But it’s trending here in LA. Yeah, it’s every … lemonade, yeah.

Dr. Weitz:           Yeah, I guess we haven’t had a new fruit that only grows in the Amazon that’s the new super antioxidants. So we got charcoal now.

Dr. Tran:             I could tell you about other exotic fruits that hasn’t been well talked about.

Dr. Weitz:           Oh okay. Maybe we could start a trend right here on the Rational Wellness Podcast.

Dr. Tran:             I’ll bring that to you next time, other botanicals and nutrients that aren’t trending yet that that we can tell about, yeah.

Dr. Weitz:           Okay. We’ll be the trendsetters. So when you’re treating a patient for mold or mycotoxin toxicity, do you have them avoid foods that may contain mold or … And do you have them avoid eating mushrooms, by the way, which is another trend is foods that have dried mushrooms in them, like reishi and chaga and whatever the latest trendy medicinal mushroom is-

Dr. Tran:             Cordycep.

Dr. Weitz:           … that’s put in coffee and tea and everything else?

Dr. Tran:             Yeah, so, it really depends on the patient’s tolerance, and that’s of the other thing is making sure we understand the patient’s food intolerances. In general, most providers who are treating patients with molds, they avoid all of it. Even avoid the mushrooms. Avoid cheese, everything. I find that some patients will be able to tolerate taking cordyceps or reishi for adrenal support when they’re mold sensitive, but there are other patients who cannot tolerate it. So it’s patient specific. You really have to identify their needs, yeah.

So as a blanket statement, I think, in general, sure, you can avoid. But I think mushrooms have such beneficial uses, and I also there are good uses of mold. Not all molds are bad.

Dr. Weitz:           But we could very easily say since these are common foods that have mushrooms, and they’re also very common allergen, say, avoid wheat, corn, cheese. There’s a few other common foods that also are probably irritating to the gut. You could easily take those out as part of your program and improve their overall health. Take out alcoholic beverages.

Dr. Tran:             Yes, yeah, you can.

Dr. Weitz:           Should we be using an air filter?

Dr. Tran:             Well, in Orange County, LA area, I think we should … air filter.

Dr. Weitz:           What’s the best kind of air filter to get?

Dr. Tran:             It depends on what you’re trying to eliminate. So what I tell patients-

Dr. Weitz:           Mycotoxins.

Dr. Tran:             So if you’re looking to get rid of mycotoxins and mold spores, you want to look for an air filter that has a MERV 8 rating at least. Each filter will have a different rating. I’ll show that to you in the presentation. There’s different types of air filters and qualities, and the issues of the air filter is … You can have charcoal, carbon filter, air filter, or you can have one with ozone. Then people will say that certain air filters will emit too much EMF. So you have to look at the EMF excretion. You know, the emission of EMF.

Dr. Weitz:           Yeah, I just did a podcast with Oram Miller, and he’s the EMF guy. He spoke in our last Functional Medicine meeting as well.

Dr. Tran:             One of my favorites air filter, which is the IQAir Air … You know, he and other people will say, “It emits too much EMF for certain patients.” So I like the IQAir, Blueair or the Austin Air are the three top air filters that … It was just passed down from me … I’m just regurgitating that information … and in our industry is what we recommend to patients. There are other ones like-

Dr. Weitz:           So what are those three again real quick?

Dr. Tran:             The IQAir.

Dr. Weitz:           IQAir.

Dr. Tran:            IQAir is big and bulky, but it’s beautiful. It’s quite expensive. The Blueair is nice and sleek.

Dr. Weitz:          So we can turn our home into a blue zone with the Blueair filter.

Dr. Tran:            Yeah. The Molekule, which is newer. I have one in my office. It’s-

Dr. Weitz:          Could you repeat that last one because you broke up a little bit.

Dr. Tran:            Oh, I apologize. My internet. I am hardwired, though. Is the Molekule. The Molekule is the last one that a lot of you were … or a lot of people have been talking about. I actually have three in my office. I love it.

Dr. Weitz:            Oh, wow.

Dr. Tran:               I have every single one in my office. I have the Blueair, Austin Air, just so that I can show patients the different types of air filters they can pick for their home. I think honestly, like anything at Costco is good too. If they want to go Target, most products at Target are sufficient too.

Dr. Weitz:             Yeah, but don’t buy your fish oil at Costco.

Dr. Tran:               I know. I don’t get that. But yeah, it’s interesting. But yeah, but quality of Costco fish oil is just …

Dr. Weitz:             Oh my God.

Dr. Tran:               We’ll talk about … I don’t know. Do you talk about that on your podcast because I don’t think the consumer, the public knows about the quality of their own fish oils.

Dr. Weitz:             I haven’t done a podcast just on that, but it’s definitely something I’m passionate about, but I definitely should.

Dr. Tran:               I have lab results for patients who take my supplement, and then they want to go to Costco to get it for less expensive, and their numbers change, and I’m like, “Well … ” I just don’t pay attention because my staff deals with the dispensary side. I mean, dispensing supplements, and I’m like, “Well, what supplement are you taking?” They show me this Costco bottle. I’m like I cringe.

Dr. Weitz:             Oh, I know, and it’s the size of a garbage can, and it costs $20, and you go, “What do you think?” You think you’re going to get caught?

Dr. Tran:              They’re like titanium dioxide. I mean, which is more than a lot of supplements and more patients can be safe. But there’s a lot of coloring and fillers, and I haven’t even … Yeah, you read the label, and you’re like, “Wow.”

Dr. Weitz:            I know.

Dr. Tran:              But it is something, and if it’s what they can afford, something is better than … But I don’t know. It depends on the situation.

Dr. Weitz:            Okay, Jessica. So thank you for providing us with some very interesting, useful information about mold. How can listeners and viewers get ahold of you? How can they contact you?

Dr. Tran:              At my office or through Gmail?

Dr. Weitz:            Yeah, yeah. Well, I mean, what’s your website? And you can give out your office phone number, and you do consultations in person, and do you also do them remotely?

Dr. Tran:              I do for certain situations, yes. So my website is wellnessintegrative.com. My office number is 949-551-8751, and I’m on drjessicatran.com. Instagram is Dr. Jessica Tran. I also have a Facebook page, I guess. People message me through that, my Facebook.

Dr. Weitz:            Okay, good.

Dr. Tran:              That’s Dr. Jessica Tran-Naturopathic Doctor.

 

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Reversing Diabetes with Dr. Mona Morstein: Rational Wellness Podcast 78
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Dr. Mona Morstein discusses how to overcome Diabetes 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]

 

Podcast Highlights

2:57  There are four or five main types of Diabetes:

  1. Type I is an autoimmune disease where a person’s own immune system attacks their pancreatic beta cells, and destroys it enough so that they cannot produce the insulin that the person needs to live. 
  2. Type II is the most common type and it is due to insulin resistance.
  3. Type 1.5 is Latent Autoimmune Diabetes of the Adult (LADA), which is type I that happens in people over 35, say generally 35 to 60 is where we see people getting a less intense type of type I, but can lead to the need for insulin.
  4. Gestational Diabetes, which is when a nondiabetic woman enters pregnancy, and then becomes a type II diabetic, generally due to gaining too much weight during the pregnancy
  5. MODY, mature onset diabetes of youth, which is diabetes because of gene defects, like when the beta cell produces insulin, but lacks a good gene to secrete it, or a cell doesn’t genetically have a good receptor.

5:34  Type II diabetics if poorly controlled or poorly managed, the high blood sugars cause oxidative damage that can destroy their pancreatic beta cells and these patients end up needing insulin, like type I diabetics.  And most diabetics are not properly controlled. 75% of type II diabetics do not get their HgA1c below 7 as recommended by the American Diabetic Association. And type I diabetics, if they end up injecting too much insulin in order to try to control their blood sugar–say 100 to 200 units a day–can develop insulin resistance like type II diabetics. Normally our bodies secrete between 30 and 40 units of insulin per day, so 100 units is a lot. The reason so many diabetics are poorly controlled is that we are only using a big pharma approach based around medications.  We need to use diet, exercise and lifestyle approaches to control blood sugar.  And most of the drugs do not directly affect insulin resistance, except for Metformin, which deals a little with insulin resistance. But Metformin’s main job is to decrease the liver’s production of glucose. The TZDs like Actos and Avandia were directly affecting insulin resistance, but they are not in broad usage because of all their side effects. The 2nd most common category of drugs for diabetes are the sulfonylureas, like Glyburide and Glipizide, which can cause weight gain, hypoglycemia, and they can aggravate insulin resistance. They also don’t significantly reduce the HgA1c. The DPP4s like Januvia lower the HgA1c at the highest dose say 0.5%, but a low carb diet can take someone who’s at 10 and lower them down to 6 in 3 months. There is no drug that can do what diet, exercise and lifestyle changes can do, what a Functional Medicine approach can do.

13:30  With type I Diabetes you have a gene that can turn on and give you type I Diabetes and then we have to look at what factors might turn this gene on.  These could include gluten, dairy, vaccine, environmental toxins, family stress and nutrient deficiencies.  Finland has the highest rate of type I Diabetes and they have done studies showing that giving newborns vitamin D and fish oils reduces the onset of type I.  Celiac disease can lead to type I diabetes.  Leaky gut seems to precede type I diabetes in many kids, so the gut is an important factor. 

26:16  When it comes to type II Diabetes, eating refined sugar, refined grains, junk food, and fast food and lack of exercise are important causative factors.  But Dr. Morstein also believes that saturated fat intake can play a role in worsening insulin resistance. If you are getting too much saturated fat without omega 3 fats to offset it, this will make diabetes worse. Here is a reference: Dietary fat, insulin sensitivity and the metabolic syndrome.

30:06  The lab testing that Dr. Morstein recommends for patients with diabetes include the following:  

  1. CBC
  2. Chem screen (liver, kidneys, etc.)
  3. Ferritin, which is the best early sign of fatty liver.
  4. Fasting glucose, HgA1c C-Peptide, which tells us how much insulin your pancreas can secrete, insulin (as long as they haven’t injected insulin)
  5. GlycoMark is a test that gives you a better idea of blood sugar control than HgA1c because it picks up blood glucose excursions better.
  6. HsCRP for inflammation
  7. Testosterone in guys.
  8. Red Blood Cell magnesium and zinc.
  9. Fibrinogen to see how clotty they are.
  10. Random Microalbuminurea through urine to pick up early, early liver damage

 

35:05  The best diet for Diabetes is the low carb diet and two of the most well known advocates for this are Dr. Richard Bernstein and Dr. Richard Feinman and here is a paper that they were among the authors of: Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base.   There is another approach that has evidence to show that it is also effective for diabetes, the Macrobiotic diet, which was demonstrated in the Ma-Pi2 study: The Macrobiotic Diet for Diabetes. Dr. Mornstein feels that for most patients, the low carb program will work better. She does think the low carb diet can include nuts and 30-40 grams per day of carbs, but no grains or legumes. She does not think you have to do keto, which is very, very low carb and harder to follow. Dr. Morstein thinks you can include some muffins or bread or pancakes made from almond flour. and she advocates including at least 5-10 grams of fiber powder to make up for the lack of fiber in a low carb diet.

40:34  Dr. Mornstein recommends not snacking between meals in contrast to some nutrition programs that advocate having a small meal or snack every 3 hours to maintain a stable blood sugar. The human organism easily has the capacity to not eat for 5 hours and that way you let your body rest from having to process foods. And this lets the liver and the digestive system rest.

46:00  Dr. Morstein recommends certain supplements for patients with diabetes, including a good multivitamin and mineral, like one that might require taking 6 capsules per day.  Taking a one a day multi may be a waste if the nutrients are not found in therapeutic dosages.  Dr. Morstein mentioned that she is big fan of fish oil and she is not a big fan of krill oil because each capsule contains fairly small levels of EPA and DHA, the active ingredients, such as a total of only 50 mg of EPA and DHA combined in a capsule. To get a therapeutic dosage of say 2000 mg of EPA and DHA would require taking 40 capsules per day. It’s a joke!  Dr. Morstein designed a proprietary formula made by Priority One called Diamend that includes therapeutic levels of nutrients that can benefit diabetics, including Zinc, Chromium, Berberine, R-Apha Lipoic Acid, Gymnema extract, Benfotiamine, Bilberry, NAC, Green Tea Extract, Turmeric, and Vanadium (4 capsules taken after breakfast and 3 capsules taken after dinner). With respect to Lipoic acid, if you take R Lipoic acid you get twice the amount of the active ingredient than if you take just Lipoic acid, which is a combination of the R and the S isomers, but the S form is not active in the body. An elevated HgA1c is causing oxidative damage to the body, so taking the proper anti-oxidants can prevent some of this damage, such as R Lipoic acid and NAC that can provide antioxidant protection, reduce insulin resistance, and also support the liver.  Berberine is a great herb that is comparable to Metformin and also supports the liver. Benfotiamine is the fat soluble form of thiamine (B1) which can prevent damage to the nerves, the kidneys, and the eyes, at a dosage of 450 mg per day. The Burmannii or Indonesian type of cinnamon is a helpful supplement that if taken in capsules at bedtime can help to lower their morning glucose at a dosage of 1000 mg per day. Fat cells in the stomach region can make tumor necrosis factor alpha that causes insulin resistance and curcumin can help to decrease the inflammation and help with insulin resistance. Curcumin can also help rpotect the brain and reduce the risk of developing Alzheimer’s.  Gymnema sylvestre is Dr. Morstein’s favorite botanical and it has been shown to help the pancreas produce insulin again, and it also reduces cravings for sugar. If you are going to a holiday party, bring some gymnema sylvestre and swish some around in your mouth and it will reduce your craving for sweets.

 

 



Dr. Mona Morstein is a board-certified Naturopathic Doctor who is practicing Functional Medicine at the Arizona Integrative Medical Solutions with a focus on treating patients with obesity, diabetes, thyroid, hormonal imbalances, and gastrointestinal disorders like SIBO and IBS. She is the author of the best-selling book, Master Your Diabetes: A Comprehensive, Integrative Approach for Both Type I and Type II Diabetes. She is the founder and executive director of the Low Carb Diabetes Association. Her website is Arizona Integrative Medical Solutions and Dr. Morstein is available for telemedicine.

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



 

Podcast Transcripts

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

Hello Rational Wellness podcasters thank you so much for joining me again today, Doctor Ben Weitz, here, and for those of you who enjoy listening to the Rational Wellness Podcast, please go to iTunes and give us a ratings and review, so more people can find our Rational Wellness Podcast. Our topic for today is diabetes and prediabetes, which are epidemic and increasing in the United States and around the world. 9.4% of adults in the US are diabetic, and in some states as many as 15%. This equates to about 30 million Americans with diabetes, and somewhere around 90 million with prediabetes, and these rates are climbing among children and teens.

One out of three Americans have diabetes or prediabetes, and 90% to 95% of these are type two diabetes, which are caused by diet and lifestyle. Rates are even higher among certain populations among American Indians, blacks, Hispanics, and Asians, and among whites. This paralleled by an increasing shocking rates of obesity and being overweight with about 70% of the US population being overweight or obese. Of course, these numbers are pretty much paralleled by the rest of the world especially as we spread our American lifestyle around the globe.

I’m happy to have Dr. Mona Morstein to join us today to give us some information. She’s a naturopathic doctor from Tempe, Arizona, who’s practicing functional medicine at Arizona Integrated Medical Solutions with a focus on treating patients with obesity, diabetes, hormonal imbalances, and gastrointestinal disorders like SIBO and IBS. She’s the author of the bestselling book, Master Your Diabetes: A Comprehensive Integrative Approach for Both Type I and Type II Diabetes. She’s also the founder and executive director of the Low Carb Diabetes Association. Mona, thank you so much for joining us today.

Dr. Morstein:                    Thanks very much. Ben, I really appreciate it.

Dr. Weitz:                         I’d like to begin the discussion by talking about the different types of diabetes, and the distinctions between these.

Dr. Morstein:                    Yeah. There’s kind of four or five main types, there is type II diabetes, which is the most common type is due to insulin resistance where usually early on at least for sure people can make insulin but their cells are no longer responding to the signals to take glucose in, and like you said there are a number of reasons the cells don’t respond. Obesity being one of them, but there are other factors involved, as well. Type I diabetes is an autoimmune disease where a person’s own immune system attacks their pancreatic beta cells, and destroys it enough so that they cannot produce the insulin that the person needs to live.  There’s gestational diabetes, which a nondiabetic woman enters pregnancy, and then becomes a type II diabetic, generally due to gaining too much weight during the pregnancy. There’s MODY, a mature onset diabetes of youth, which is diabetes because of gene defects, like the beta cell produces insulin, but lacks a good gene to secrete it, or a cell doesn’t genetically have a good receptor. Then the last is type 1.5, Latent Autoimmune Diabetes of the Adult (LADA), which is type I that happens in people over 35, say generally 35 to 60 is where we see people getting a less intense type of type one, but they can still for sure lead to full need of insulin.

Dr. Weitz:                         Yeah. Type 1.5, right? I never heard of that, before.

Dr. Morstein:                    Yeah. Type 1.5. Yeah.

Dr. Weitz:                         Interesting. I think there’s some confusion among the general public, I’ve heard people discuss diabetes and say that type twos become type one-

Dr. Morstein:                    Yeah. Right. Yeah. We have a couple things. One, we have a lot of patients who are adults getting type two, very commonly misdiagnosed as type two, and there’s a very simple blood test that can be done. We do have some lean type two patients. You will see lean, so we have to make sure is it really type two, or do they have LADA. Now, the type two becoming type one, so if you are under poor care and/or are not making changes you need to reverse your type II, if you have bad control of your type II, the damage that these high blood sugars can cause over the years can affect the pancreas as well as eyes, kidneys, nerves, and heart, you know the blood vessels, and so people can kind of destroy their pancreatic beta cells and this oxidative damage from poorly controlled diabetes, and then as a type II need to be on insulin, like a type I.

Dr. Weitz:                         Right. Then type Is can also have concurrent type II, if they’re poorly controlled?

Dr. Morstein:                    Yes. I’ve seen type I’s coming into my office that are injecting a 100 or 200 units a day, so for a nondiabetic, say for not a lean, but a normal weight nondiabetic, so we make maybe around 30 to 40 units of insulin a day, for whatever we eat, or drink, or whatever. If you have someone walking in the door, and they’re injecting a 100 units a day to control their blood sugar, that’s going to cause insulin resistance.  That’s way above the physiological norm of what the body is designed to have in it all the time, so you can get type Is that have insulin resistance. Now, a type I is going to develop insulin resistance when their blood sugars go over about 170 anyway, just high blood sugar can make them insulin resistant, so that is a part of it, but it’s not the core nature of their condition, which is the autoimmunity.

Dr. Weitz:                         Right. It’s amazing, though, the patients that I’ve seen how many are poorly controlled, the kids they really don’t want to prick their finger, they don’t want to test their blood sugar, it’s a pain, and the type II a lot of them are in denial, or just think everything’s okay, and they don’t want to test regularly, so I don’t know what the percentages are, but it seems like a lot are uncontrolled, or poorly controlled.

Dr. Morstein:                    I know the last statistics we really have in that regard, you know, from 2002 to 2006 where almost 75% or so of people couldn’t get below seven-

Dr. Weitz:                         Wow.

Dr. Morstein:                    Which is the ADA guide. 

Dr. Weitz:                         On the hemoglobin A1C. Yeah.

Dr. Morstein:                    There’s a significant generally 50 to 60, to sometimes 70 depending upon the study do not obtain at least what they consider the three ADA goals, which is an A1C less than seven. LDL’s less than a 100, and blood pressure less than 130 over 70, so we have very bad goal reaching in our country, and a lot of it is of course due to the obvious, that it’s a big pharma based treatment, that it’s drugs, and those with type II there’s only one drug really that was designed to deal with insulin resistance, and that was the TZD’s, which because of a lot of problems with them have essentially gone off the market. I mean, you can use them, but-

Dr. Weitz:                         What drugs would those?

Dr. Morstein:                    Those were the Actos and Avandia type drugs.

Dr. Weitz:                         Okay.

Dr. Morstein:                    Right? Now, Metformin deals a little bit with insulin resistance, but it’s not it’s main job, which is to decrease livers production of glucose, so you have a disease of insulin resistance, and essentially no medications out of the huge list of medications that they give patients that actually deals with insulin resistance, they’re all just about clear the glucose out of the bloodstream, and the way they do that can actually cause quite a number of problems in patients.

Dr. Weitz:                         Why is that? I guess they’ve just been unable to develop a drug that controls insulin resistance.

Dr. Morstein:                    Yes, or that controls insulin resistance, but again you’ve got it also might cause this or that damage. Right?

Dr. Weitz:                         Right.

Dr. Morstein:                    Drugs have side effects, many of them, we’re lucky with Metformin that it’s just some gastrointestinal distress, and doesn’t really cause anything else.  But some of these other drugs, the second most common one, the sulfonylurea’s, they cause weight gain, they can aggravate insulin resistance. They can cause hypoglycemia, significantly. They’re all just designed to clear the glucose-

Dr. Weitz:                         By the way, what drugs are included in the sulfonylurea?

Dr. Morstein:                    Sulfonyurea’s are like glyburide, which is the worst for causing hypoglycemia. Glyburide, Glipizide, so those kind of drugs, but they’re cheap. They’re going to be by conventional care, another drug to use, but they have problems. Right? Also, many of them don’t really significantly reduce the A1C’s very much, like the drugs like Januvia, the DPP fours, they may lower the blood, the A1C in three months at the highest dose of maybe 0.5% where a low carb diet could take someone who’s at 10 and lower them down to six in three months. The diet, and the lifestyle there’s no drug that equals the amount of improvement that just what we’re trying to do on this naturopathic, or functional level can do. Right?

Dr. Weitz:                         Right. But that word doesn’t seem to have gotten out.

Dr. Morstein:                    Yeah. Well, you know the ADA acknowledges there is a low carb diet, it’s not like they’re saying, everybody should be on it, and then now they’re approving bariatric surgery for people who can’t get their A1C’s under control, but they can’t just come out and say, hey, everybody, you guys, everybody, really just do the low carb diet.

Dr. Weitz:                         Right. Yeah. They’re still recommending whole grains, and a low fat diet.

Dr. Morstein:                    Well, you know, I went to the ADA site, and you know I will say there’s a lot of good things about the American Diabetes Association.  For one thing, they devote a lot of money to research, and they have also, if you’re a fireman, and you’re a diabetic, or you’re in school, and you’re a diabetic patient they’ve paved the way for the rights, the civil rights, and the working rights that people with diabetes in our country.  However, to become a sponsor in the ADA you have to drop at least a $100,000.00, that’s the lowest level.

Dr. Weitz:                         Wow.

Dr. Morstein:                    You know, who aside from drug companies can be supportive of the ADA?  That’s their funding.

Dr. Weitz:                         Yeah. Let’s talk a little bit about type I diabetes.

Dr. Morstein:                    Yeah.

Dr. Weitz:                         What are some of the most common triggers?  A lot of people have talked about milk products–dairy sensitivity–as being one of the triggers. Can you talk about that?

Dr. Morstein:                    Well, here’s the deal, obviously the number one cause of type I diabetes is you have a gene that can turn on and give you type I diabetes.

Dr. Weitz:                         Right.

Dr. Morstein:                    It starts from you just randomly got this gene. Then what might be factors turning on the gene?  Well, you know I go through things with every patient, and there’re questions on vaccinations on gluten, on dairy, on environmental chemicals, on stress in the families, on nutrient deficiencies. The Fins, Finland, had the highest per capita onset of type I diabetes, and they’ve done studies where giving new born vitamin D and fish oils reduced the onset of type I in those populations compared to the kids that didn’t get those supplements.  What is it individually that affects each child, who knows? We have a lot of kids drinking milk, and they’re not getting type I, so we can’t say, oh, my goodness. I will say this, I read a good article, a study saying that with, you know, for me, as I note in my book, if we could identify kids with celiac disease early on, right away, and we got them off of gluten their risk of developing type I would go down about to zero.

Dr. Weitz:                         Wow.

Dr. Morstein:                    We’ve got all these pediatricians giving them antibiotics of their ears, or vaccinations whatever, but we need to get them to screen every child who’s now eating gluten, because you have to be eating gluten, so toddlers, a two year old, right, test them for celiac disease before potentially it’s unknown and then we get kids developing type I diabetes since those two are so connected, but-

Dr. Weitz:                         By the way, what’s the proper test for celiac?

Dr. Morstein:                    The proper test with celiac in a child is you can do a stool sample for toddlers. Right? There’s also a blood test, a pediatric blood test, but people, you know, you have to be eating gluten every day, like equivalent of about a piece of bread for at least three to four weeks before the test, otherwise we can’t see if there’s celiac disease. 

Dr. Weitz:                         Unless you do an intestinal biopsy.

Dr. Morstein:                    Well, they’re going to do that after the blood work.

Dr. Weitz:                         Right.

Dr. Morstein:                    Yeah. We’ve got a lot of kids, I see kids, they never had a vaccine, parents, they’re a very loving family, there was no stress, like a pet dying, or grandma, God forbid, they don’t spray environmental, they don’t have an exterminator come into their house, or outside, and you’re just like, why did this happen? We just don’t know. We can’t identify it on each individual.

Dr. Weitz:                         Right. I notice in your book you mention the A1 milk being more problematic than A2 milk?

Dr. Morstein:                    Yeah. I think most people understand, or not most people, but milk in America, that A1 milk is from cows that have a different amino acid basis to the protein molecule of milk, and that is more allergic in humans versus many other countries in the world use cows that make what’s called the A2 milk that has a different amino acid, it’s very less reactive. Our milk is why we certainly see many people have at least a cows milk sensitivity, which can be a lot of mucus, and sinus, and asthma, or it’s the number one food that causes GERD, reflux, even without mucus, it just goes right to the stomach. Those are from the allergy to the milk protein.

Lactose intolerance, you just can’t you just can’t digest the lactose, that would be A1 or A2, but in terms of allergic to milk, and there are some connections if you have that allergic to milk, there are some similar proteins on the pancreatic cells, so if the immune system is kind of attacking the milk, and it could get confused and maybe attack the similar proteins on the pancreas.

I do want to mention one thing, though, when we talk about food sensitivities, or just in general we’re talking about often times leaky gut, and what’s interesting with leaky gut is that when kids have diabetic antibodies, but are not yet showing the disease they pick up an upregulated Zonulin, they show leaky gut in these kids. Another reason people might get type I is a virus getting through the gut wall, and then attacking the pancreatic beta cells, and causing damage to them, so we look at the gut quite a lot, and if you’re getting into food sensitivities, we’re going to think your gut is unhealthy, as well, since it all comes from the gut, but leaky gut seems to precede type I diabetes in many kids.

Dr. Weitz:                         That’s interesting, because we heard about the research from Alessio Fasano, who talks about this triad of autoimmune disease where you have a leaky gut, and then you have gluten, and then you create this upregulated immune system and that sets up the potential for autoimmune disease.

Dr. Morstein:                    Yeah. Although, I will differ in one regard, I know there’s a very big anti-gluten, anti-dairy, but for those of us like myself who does a lot of food sensitivity testing, you know some people are sensitive to corn, and some to soy, and some to eggs, and some to almonds, and I think before we just pull everybody, and not everybody actually reacts to gluten. I really think that we should always strive to do very individual care with the food sensitivities and really see what does this patient, what does their body reacting to?

Dr. Weitz:                         One of the problems is these food sensitivity testing is so problematic.  Sometimes you do a test, you seem to get reasonable results, and then you do a test and nothing comes up except clams, and some other bizarre food, which they’ve never eaten, and now you spent all this money for this test, and nothing comes up, or-

Dr. Morstein:                    I would say there are-

Dr. Weitz:                         Or you do a test and everything comes up.

Dr. Morstein:                    Everything coming up, obviously, is a-

Dr. Weitz:                         Leaky gut.

Dr. Morstein:                    Sign of leaky gut, but I think there’s a lot of labs doing food sensitivity, but I know the lab I use, I’ve flown out there, I visited their lab. I can verify the one I use for the last 16 years, which is Alletess Labs at foodallergy.com, they must have got that right at the beginning. I mean, I can verify their consistency with truly finding what people seem to be reactive to, and if people have a lot of foods, you know, the idea with food sensitivities you take them all out the first month, start healing their gut with the supplements, and then they come back in a month, then they should be significantly better, and then you can start adding the foods back in. Nobody has to be off all of these foods for a year, or two, or whatever. It’s an indication of something needs to be healed, but guts heal from leaky gut enormously quickly when the irritant is removed, because they’re so vascularized.

Dr. Weitz:                          Yeah.

Dr. Morstein:                     Yeah.

Dr. Weitz:                          I just want to point out, I just had a discussion with Cyrex where I had one of these tests come back where there was nothing tested, and they said, from now on we can include a total IGG with the test at no additional cost, and that way you can tell if the person’s immune system just isn’t working well, and they’re total IGG is suppressed then they can factor that in, and recalculate the results, and-

Dr. Morstein:                     I guess there’s also cheaper tests than Cyrex.

Dr. Weitz:                          You mentioned vaccines as triggers.

Dr. Morstein:                     Yeah.

Dr. Weitz:                          As possible triggers for type I diabetes

Dr. Morstein:                     Possible.

Dr. Weitz:                          And I noticed in your book you mentioned giving the kids some supplements to help with their immune system like you mentioned vitamin D, and echinacea, and milk thistle.

Dr. Morstein:                     Yeah. When I was in medical school we had a pediatrician come in and say, “Hey, when I have to give vaccinations I’m boosting their immune system a couple days before, during, a couple days after.” Then obviously it made great sense to us, because we don’t usually get exposed to viruses by injection, we breathe them in, and then it takes days for the process to happen, so it’s a little bit of a shock to the immune system. I think giving NAC, you know, there are kids that maybe can’t make glutathione, that might get, as well, they might get some nerve damage.

I do a product called Immugen from a company called Progena, because it’s glycerine, kids love it, it’s a great immune system booster, and D, and maybe some Liposomal, now, I give glutathione, because kids can’t really take, obviously, an NAC capsule, and it’s nasty flavor wise, so by giving some ways to support antioxidant status, immune status, it can really, I hope, seem to boost things in the kids, so they don’t have a really serious reaction against not only just against the vaccination, but the liver as just part of the excipients, but I have a good website where the CDC lists all the excipients in all of the vaccinations, and so-

Dr. Weitz:                          Yeah.

Dr. Morstein:                     That’s what we’re trying to have the liver clear better-

Dr. Weitz:                          Right.

Dr. Morstein:                     It’s that junk that it comes with, you know the virus that they’re injecting.

Dr. Weitz:                          Yeah. The World Health Organization actually recommends giving 200,000 IU’s of vitamin A prior to the MMR vaccine.

Dr. Morstein:                     Yeah. They came out 25 years ago saying they’re very much into 2,000 units of vitamin A, also for treatments, if someone has measles they said, “Hey, give them a 100,000 vitamin A,” as this huge immune booster. I’ve used that in many conditions in toddlers that were pretty sick. Of course, I do it maybe for three days, or four days, but vitamin A is cheap and the World Health Organization can use it in rural villages, it’s easy. It’s a huge immune booster. I would just give a clinical pearl, don’t give it all at one time, if it overwhelms the kid, they can have a really nasty headache, so you want to break it up into several doses throughout the day, and that should stave off the headache that can last for a few hours with acute elevated vitamin A.

Dr. Weitz:                          Yeah. I never liked the idea of giving one huge bolus, the same thing with the 20,000, or 50,000 injectable vitamin D, it seems to make so much more sense to give 5,000 or 10,000 a day over the course of a week than give them a 50,000 unit shot.

Dr. Morstein:                     Yeah. Shots are a little rough, anyway.

Dr. Weitz:                          Yeah.

Dr. Morstein:                     With vitamin D, it’s oily. 

Dr. Weitz:                          Moving on to type II diabetes, and-

Dr. Morstein:                     Yeah.

Dr. Weitz:                          Mechanism for type two. Most of us are aware of the fact that eating sugar, and lack of exercise are some of the main factors, because we got this rising blood sugar, and insulin resistance, but I read in your book that you also said that increased saturated fat intake can play a role.

Dr. Morstein:                     Yeah. I mean, I know there’s a lot of ketogenic, and et cetera, Paleo people out there, but the science is pretty clear that if you are getting too many saturated fats and I believe it’s too many saturated fats unopposed by a good amount of omega three fats, so omega three fats lower insulin resistance. Saturated fat, if you’re getting too many they can absolutely worsen insulin resistance.  The idea is not that you can’t eat saturated fats, but that we have got to make sure people are getting into their diet a balance of omega three oils, for sure. If you get even with meat, if you get grass fed, grass finished organic meat, half of that is essential fatty acids, but if you’re getting it, you know, you’re just lazy, or you’re going out to eat a lot, that’s feed rot meat, that has no omega threes, after 90 days of being fed grains, that meat has no omega threes left in it, so this can be throwing people off with their oil balance.

Dr. Weitz:                            Interesting. Yeah. It’s true with the Paleo movement, and the ketogenic movement there’s a big push for saying that saturated fat is perfectly fine, and a lot of people are sort of like, can it really be fine? Should we really have as much butter as you can consume? Then of course, there’s the fat with sugar problem. You know? That I think Mark Hyman calls sweet fat, which is that’s really a bad combination is when they’re eating junk food, and they’re getting the saturated fat with the high glycemic carb, sugar combination.

Dr. Morstein:                     Yeah. I mean, it’s certainly refined sugar, refined grains, junk food, fast food, but if you just want to overeat anything, gluttony, unfortunately is whatever you’re overeating to gain that abdominal fat is going to be a problem, and of course the problem with insulin resistance is once it sets in insulin is one of the hormones that tells your brain I’m full, I’m done, that’s enough, you know, that’s it, I don’t need to eat more, and you can get that insulin resistance in the brain can tell people I’m still hungry, I still want food.

It’s not lack of willpower, it’s literally our appetite is driven by chemicals and hormones, and when they’re thrown off we’re just not going to get signals that I’m done, that’s enough, walk away from the table. Once people get on a low carb diet in a week, they’re like, “Oh, my God, it’s easy. I can just eat a piece of fish, and this, I’m full,” because that can settle down in their brains very quickly through food when we get that under control. Whatever you’re overeating to become overweight, or drinking, of course, soda pop, you know, energy drinks, these sugary, sugary things they’re just really some of the worst. Right?

Dr. Weitz:                          Yeah. Even Gatorade-

Dr. Morstein:                     Yeah.

Dr. Weitz:                          And some of the things people think are healthy. When it comes to lab testing, what labs do you like to run for patients with either prediabetes, or diabetes?

Dr. Morstein:                     Obviously, people need to have their yearly with the liver, and kidney, and glucose, and the lipids, and their CBC. I always include ferritin, which is not standard on labs, not just ferritin, has three different roles in the body. One is storage of iron. Two, we store it when there’s a bacterial infection, a serious bacterial infection, and three is acute phase inflammatory marker, and if we have a type two who’s got elevated ferritin while you do maybe have to rule out a condition called, hemochromatosis, which is a genetic hyper absorption of iron from your food, mostly these people have fatty liver, and so we need to do an ultrasound of their liver, and we can pick up fatty liver. That really drives insulin resistance, and fatty liver is the number one chronic disease of the liver in our country, today, and can cause the same kind of fibrosis and cirrhosis that alcoholism does.

Dr. Weitz:                          And truly caused by sugar and high glycemic carb intake. Right?

Dr. Morstein:                     It’s just caused by too much fat, really, whatever caused the fat. It’s the abdominal fat will then go and get to the liver, and cause the liver to have now too much fat in its cells. Of course, an A1C, a C-peptide, so you can draw insulin to see how much insulin they make as long as they’ve never injected insulin. As soon as someone’s injected insulin, that you can’t measure it anymore, it’s an inaccurate reading, because as soon as you inject insulin you’ll make insulin antibodies, so C-peptide is the part of the insulin molecule that breaks away from it for it to actually form insulin, so they’re equal.  There’s one C-peptide for one insulin, but we never make antibodies to C-peptide.  That tells us what is your pancreas able to produce in terms of insulin.  There’s another test called GlycoMark, which is a 1,5-AG substance that helps us look at excursions, and sometimes interpret the A1C better, because you can have an A1C at six, because you’re having lows all the time-

Dr. Weitz:                          By the way for those who don’t hemoglobin A1C is believed to be a three month indicator of blood glucose levels.

Dr. Morstein:                     Yes.

Dr. Weitz:                            Right?

Dr. Morstein:                     A1C is our monitor, how you’re doing longterm. It could the same number of A1C can be there if you’re under good control, or if you’re just going up and down all the time, so the GlycoMark can help us interpret that. I do vitamin D, we might need to check thyroid, we might need for guys, we might want to check their testosterone levels, there’s just maybe some red blood cell magnesium, red blood cell zinc, these can be low in people with diabetes. I would want to do an HsCRP, which is a monitor of inflammation that’s related to cardiac disease, and a fibrinogen to see how clotty they are, just because people with diabetes type II, well, if it’s not well controlled have a very high increased risk of dying of cardiovascular disease, which is basically what they usually die from. These are broad base labs that we’ll want to do.

Dr. Weitz:                          Cool. Do you include adiponectin and leptin in your labs?

Dr. Morstein:                     I don’t. I don’t do either of those.

Dr. Weitz:                          Okay.

Dr. Morstein:                     For one thing, leptin, you know there is a leptin resistance, or adiponectin, those are going to be fixed when fix their weight, so to measure them we don’t really have any specific ways, I feel, that’s really effective in that, and those will readjust once the insulin resistance is settled down.

Dr. Weitz:                          Cool.

Dr. Morstein:                     One other lab, the Random Microalbuminurea that’s a good urine test to pick up early, early liver damage, before it shows up in the lab work. No, I don’t measure those hormones.

Dr. Weitz:                          Okay. Cool. Let’s talk about treatment.

Dr. Morstein:                     Yeah.

Dr. Weitz:                          What type of diet is best for diabetics, and prediabetes?

Dr. Morstein:                     Doctor Richard Feynman and Doctor Bernstein, Richard Bernstein and 25 other physicians, or researchers came out with an article that was printed in Elsevier Journal on that a low carb diet is the premiere treatment for people with type two diabetes.  https://www.sciencedirect.com/science/article/pii/S0899900714003323 Actually, other researchers just came out showing that type one diabetes pediatric patients were improved on a low carb diet, plus a thousand other studies. Now, you’ve got two, you do have the MaPi2 study, which show that people on a macrobiotic diet, that was higher carbs, but no animal fat at all, no real oils at all, actually was very significant in uncontrolled type two diabetic men at really reducing everything we wanted to have reduced. The Macrobiotic Diet for diabetes study. You get some people that are saying, you know, a plant based diet, higher carb, but for most people it’s got to be low carb.

In our society, honestly, people are going to thrive much better in our society, and be able to socialize and eat out, and on a low carb diet then they will on some macrobiotic diet. Now, the low carb can be what I call the omnivore low carb, where you eat some meat, and fish, and some organic soy, and you make things out of nut flours, and coconut, and eggs, just all around variety, you eat nuts, or there’s the keto aspect, which is very, very low carb, or there’s actually a vegan type of low carb, and then there’s an ovo-lacto vegetarian type of low carb.

Dr. Morstein:                     For my patients, in reality, most of them don’t want to do keto, and I don’t make them, and I don’t think you need to, but they do that 30 to 40 grams a day of carbs, which will work very well for almost everybody, but it gives them a little more food to eat, you know, almond muffins, or pancakes, and things that make life more enjoyable for most people eating low carb.

Dr. Weitz:                          Do you let them include any whole grains, or legumes?

Dr. Morstein:                     No. I don’t. No, the grains, you can’t, no, you can’t do any grains.

Dr. Weitz:                          What about legumes?

Dr. Morstein:                     Yeah. Legumes, no, you can’t, now, every now, and then I have a couple patients who are in really great control, and if they have a couple tablespoons of hummus, because there’s got oil in it, and it’s got the garlic in it, they say that a little hummus doesn’t bother them. Okay. No, beans and grains, and potatoes, and sweet [crosstalk 00:38:29]-

Dr. Weitz:                          Beans are so high in fiber. Right?

Dr. Morstein:                     Yeah.

Dr. Weitz:                          And their glycemic index is in the 20s.

Dr. Morstein:                     You would think with the beans it would work, but for my patients eating beans, you know, they’re going to go up now, they might come down just after an hour or two, say, but it’s tough. The beans are incredibly high in fiber, in fact that’s for a nondiabetic patient, I’m not an advocate of keto, or Paleo at all, and there are studies where these changes in the microbiome by not eating grains, or not eating beans in nondiabetic patients just as a general diet are devastating to the microbiome, because the microbiome, the beneficial bacteria eats fiber.  When we take out these great sources of fiber, we change the bacteria, we start making less short chained fatty acids, and that’s not a good thing for colon cells, or even systemically. On a low carb diet I’m very adamant that my patients have to add fiber powder back in. If you’re on low carb, you’ve got to be getting at least five to 10 grams of fiber powder in a day to make up what we’re taking out, because vegetables just really won’t do it enough.

Dr. Weitz:                          Yeah. Of course, whole grains are also high in fiber, too, which that makes it harder to get the fiber.

Dr. Morstein:                     Yeah. I mean, for people that are nondiabetic to eat whole grains, and to eat beans I am an advocate of that, as well, for sure, but once you become a patient with diabetes they just can’t do it anymore, so at least with supplements we’ve got to replace both water soluble, and water insoluble that balance of fiber at least into the diet while having to eat healthy diet, or otherwise.

Dr. Weitz:                          I notice you recommend no snacking, and for years we’ve always recommended snacking, you don’t want to go to long, or your blood sugar will dip, so every two to three hours you have to have some food in your system to keep an even blood sugar, and that theory seems to be gone.

Dr. Morstein:                     I have from day one in medicine, which is about 30 years ago, I’ve always been an anti grazer, even for hypoglycemia you have to eat many meals throughout the day, that’s called enabling the condition-

Dr. Weitz:                          Yeah, but grazing is different than snacking, like say, here I’m going to have 12 almonds as a snack, or something at 3:00.

Dr. Morstein:                     I mean, if you just want a snack, but the question is that the human organism easily has the capacity to not eat for five hours. I eat a breakfast, and I go hike 10 miles without eating, that’s what the human organism can do. Right? This idea we cannot go from breakfast to lunch, and lunch to supper, and then from supper to breakfast, we can’t do that physiologically, this as just wrong, and so we want to at least in terms of intermittent fasting, at least from dinner to breakfast, at least 12 hours. Right?

Now, you want to go 16, whatever, there’re other ways to do intermittent fasting, but we have got to teach people that have trust in your body, eat a decent meal, and then don’t eat for five or six hours, and you’re going to be fine, and not only that, now you don’t have to think about eating, and now your adrenals aren’t stressed, and your liver isn’t stressed. You know what, I tell patients, when we’re measuring your heart rate, or excuse me when we’re measuring your blood pressure, the first number is when it’s feeding and the second number is when it’s at rest, and the second number is really the number we are really interested in. Right? Because that heart needs to rest, and you know what, your gut needs to rest, as well, it does not want to be digesting food all the time.  You don’t want to be active all the time, you need your sleep, you need to rest. Think of your gut as any other part of your system that needs rest. Right?  That means it doesn’t have to digest all the time. In fact, fasting is the healthiest a human can do to get over an illness, a chronic illness, that’s not eating at all, is putting your gut totally at rest. We just have to retrain people, and especially people who are injecting insulin, snacking, well, how are you going to, that’s going to screw up your insulin totally, so yeah, I’m a very big anti grazer, for everybody.

Dr. Weitz:                            You know, when it comes to intermittent fasting I just think it’s so ironic, because I’ve been involved with healthcare, and nutrition for 30 years, and I know when we got started the biggest thing was you have to eat breakfast, you have to eat within a certain period of time, everybody skipping breakfast, and they’re running out of the house, and that’s why they’re fat, because they eat too much at dinner, because they didn’t eat breakfast, and you have to eat breakfast, because that gets your metabolism going, so that was so important, and now the big trend is if you want to be healthy you got to skip breakfast.

Dr. Morstein:                     Well, not me-

Dr. Weitz:                          Okay.

Dr. Morstein:                     But that is for some. I eat breakfast. I’m breakfast, lunch, and supper. We have to learn, everybody

Dr. Weitz:                          A lot of people do the intermittent fasting

Dr. Morstein:                     Yeah, they do. I do fast from supper to breakfast, but I like breakfast.

Dr. Weitz:                          I’m with you on that. I prefer to skip dinner if I’m going to skip a meal. Right?

Dr. Morstein:                     I know. Here’s the deal, we have unfortunately, right now on planet earth we extremism all over the place with politics, and whatever, this, and that, and it’s certainly

Dr. Weitz:                          Planet Trump, now.

Dr. Morstein:                     Yeah. You know, it certainly entered into nutrition, too, and I think what we have to realize is that there isn’t one way that everybody is going to thrive eating, and so our jobs with Functional, Naturopathic medicine is what does this person need for their health? Me, I like breakfast, and I work better with it, but other people, especially if you have weight to lose, and so forth, doing a longer fast is great, and working out, where you don’t have food in you can burn more fat.  If it works for them, and they can do it, I mean, these are good ways to consider, but we just have to not make rules that everybody has to eat this way, and unfortunately we get too many docs that say, “I eat this way, so now everybody has to eat this way,” and that’s the exact opposite of the beauty of say Functional Medicine where we’re supposed to be looking at each individual.

Dr. Weitz:                       Right. And individualizing the program 

Dr. Morstein:                  Right.

Dr. Weitz:                       To their specific physiology, and their needs, and the way their body works.

Dr. Morstein:                  Exactly.

Dr. Weitz:                       For the final section, here, I’d like to talk about supplements that can be a benefit for patients with diabetes, or prediabetes.

Dr. Morstein:                  Yeah. Now, just to get out of the way, I have a proprietary formula called Diamend

Dr. Weitz:                       Yeah.

Dr. Morstein:                  From Priority One, which I think is a really good product. It’s in one bottle, you get everything you need at therapeutic doses, but when we’re taking supplements, yeah, I mean, people with diabetes say everybody needs to me on a good multiple vitamin, and a good one, like maybe you’re taking six a day that gets in all of the basic nutrients, so we know that you’re getting in everything you need to have your body work well, and antioxidants, and nutrients that help your organs, your liver, your adrenals work better, and help you become less insulin resistant, which is zinc, and chromium, and vanadium, and so forth, and it’s just easy to get them in one good package. 

Dr. Weitz:                       I know you mentioned therapeutic levels, and-

Dr. Morstein:                  Yeah.

Dr. Weitz:                       You talked in your book about how you can take some multi one a day vitamin-

Dr. Morstein:                  Oh, yeah.

Dr. Weitz:                       It has these ingredients that people are reading about in the latest news story, but they’re in trace levels that are going to be insignificant if you’re going to take a specific nutrient like chromium, or like cholic acid, or some of these others, it’s got to be a therapeutic level, or you’re kidding yourself.

Dr. Morstein:                  That’s an excellent point, and that’s why I think docs like us, because we can have patients bring their supplements in, we know how to read the label, see if it is a valid supplement, a good dose for what they need, or not, and like with fish oil, I’m not an advocate of krill oil. Right? Because when you see the amount of EPA and DHA 

Dr. Weitz:                       Oh, it’s a joke.

Dr. Morstein:                  It’s a joke.

Dr. Weitz:                       I know.

Dr. Morstein:                  It’s a total joke. 

Dr. Weitz:                       24 milligrams of EPA, and 30 of DHA-

Dr. Morstein:                  Exactly. People have heard that it’s krill oil, so you’re paying twice as much for a useless therapeutic EPA/DHA product, so 

Dr. Weitz:                       I know you’d have to take 20 of those capsules to get-

Dr. Morstein:                  Right.

Dr. Weitz:                       Two grams of EPA and DHA.

Dr. Morstein:                  Exactly. Thank you. Yeah. I am a big advocate of quality fish oils just like you said, and then there are supplements, you know diabetes damages oxidative damage. There’s several different pathways that happens through, but it’s oxidative damage, so we need supplements that help reduce insulin resistance, and that help protect the body, so that even if their A1C isn’t at 5.1, because an A1C over 5.5, and certainly over 6.0 is indicating by science it’s causing damage to the human body. That damage is oxidative. You’ve got some supplements like alpha lipoic acid, or NAC. they’re not just antioxidants, but they reduce insulin resistance. Right? They both help the liver, and most patients who are type two diabetic, and overweight have fatty liver. You can get some nutrients that really have a really big crossover benefit in several ways to the body. Right?

Dr. Weitz:                       By the way, in your book when you talked about lipoic acid, you mentioned something that I think most people are not aware of, which is that there’s a difference between lipoic acid, which is commonly seen on the market, and R-Alpha Lipoic acid. Can you talk about what the R four means and the difference?

Dr. Morstein:                  Right. There’s two different isomers, or chemical ways it presents Alpha Lipoic acid.

Dr. Weitz:                       We usually think of D and L forms, but-

Dr. Morstein:                  That’s with vitamin E-

Dr. Weitz:                       Oh, okay.

Dr. Morstein:                  Of course, certainly-

Dr. Weitz:                       Right.

Dr. Morstein:                  Yes, exactly D and L, and that’s with phenylalanine as well as a DL-

Dr. Weitz:                       Right.

Dr. Morstein:                  But in alpha lipoic acid there’s the R and the S isomer.  The S isomer is not active in the body.  In fact they say it may interfere a little bit with the R. Only the R isomer is active in the body, and if your bottle just says alpha lipoic acid, half of it is R, and half of it is S. About 20 years ago, companies figured out a way to make just R, and have it be stable, and so if you’ve got alpha lipoic acid, 600, only 300 of it is the R, if it says R alpha lipoic acid 600, you know, you’ve got a double effect, so we prefer just the R’s when we’re working with our patients.  Of course, Berberine, right when 

Dr. Weitz:                        By the way, what’s a therapeutic dosage for R, lipoic acid?

Dr. Morstein:                   I would say orally if you’re getting around 600 milligrams a day, there’s a very, very rare side effect I’ve only seen in two patients in 30 years, which is it can burn the stomach, but I mean for literally the hundreds, and hundreds of thousands of people that I’ve put on Alpha Lipoic acid it’s very rare. But you certainly can’t open the molecule and drink it down, it’s an acid, so it does have to be swallowed in a capsule. Little kids can’t take it until they can swallow a capsule.

Dr. Weitz:                        Okay. I’m sorry, keep going.

Dr. Morstein:                   No, I’m just saying we mentioned Berberine-

Dr. Weitz:                        Yeah.

Dr. Morstein:                   Had that great study comparing it to Metformin.

Dr. Weitz:                        Right.

Dr. Morstein:                   We like Berberine, it can upset some stomachs, but if you give a 1,000 or 1500 most people can handle that. Also, a very good liver herb as well. That’s another good product to consider.

Dr. Weitz:                         Okay.

Dr. Morstein:                    We’ve got the blueberry, bilberries for the eyes. Green tea extract was shown to help the pancreas. There’s little 

Dr. Weitz:                         You got benfotiamine which is the fat soluble form of B1

Dr. Morstein:                    Yes. Benfotiamine, very excellent, shown in studies for nerve damage, kidney damage, eye damage, and of course that, and the endothelial lining are the four areas where diabetes has its most effects, because those cells cannot prevent glucose from entering them. Insulin resistance does not affect those cells, so if your blood sugar is 300 your eyeballs are 300, and your kidney is 300, and your nerves are 300, and your endothelial lining, your blood vessels, so this is why those degenerate so commonly in people with diabetes, but benfotiamine around the max doses around 450 milligrams a day, very good safe, safe product. Ironically, we usually think fat solubles are harder to absorb than water solubles, but with benfotiamine it’s actually better absorbed than water soluble thiamine.

Dr. Weitz:                         Cool. In your book, you also talk about L-carnosine.

Dr. Morstein:                    Yeah.

Dr. Weitz:                         Which can reduce glycosylation.

Dr. Morstein:                    Yeah, I actually don’t use it too much.

Dr. Weitz:                         Okay.

Dr. Morstein:                    Yes. I learned about that from another physician years ago, and there are some studies supporting that, but to me also vitamin E might be able to do that, I just think if we’re getting the person under better control then that should lower, and it does, the glycosylation throughout their body. We think of it as the A1C, but it can also, fat and protein, it’s a fat and protein reaction, the maillard reaction, and that can happen in joints, and tendons, people with diabetes can get more into injuries of frozen shoulders when their blood sugars and A1C’s are higher, because that’s happening throughout their body, not just on their red blood cells where we can measure the A1C.

Dr. Weitz:                         How about cinnamon?

Dr. Morstein:                    Yes. Cinnamon. There’s a type of cinnamon that was shown in studies to help lower blood sugars. Some people 

Dr. Weitz:                         Which type of cinnamon is that?

Dr. Morstein:                    The Burmannii type of cinnamon. It tastes good, and it’s good in the fall when it’s getting cold. Cinnamon is another. Some patients take cinnamon, like some capsules at bedtime, and they say it can help lower their morning glucose, so it’s a pretty benign substance, it’s a 1,000 milligrams, they did studies on a 1,000, 3,000, 6,000, but even the 1,000 might be beneficial, or just using it as a spice on your food. Curcumin of course, as an anti-inflammatory, we do know that the tummy fat makes tumor necrosis factor alpha, it makes Interleukins, these can go to cells that cause insulin resistance, and so decreasing inflammation via fish oils, and curcumin can all be helpful to patients. Also, we do know the association with Alzheimer’s in people who have had poorly controlled diabetes, and curcumin has been shown to help reduce the risk of Alzheimer’s, so there was a good study in India that people eating more curcumin have less risk of developing Alzheimer’s, so again, and it’s also a good herb for the liver, so these things, again, have really good crossover for our patients.

Dr. Weitz:                            You talk about fiber and the need for fiber. What do you think about some of the resistant starch supplements on the market, and they have medical foods with resistant starches?

Dr. Morstein:                     Yeah. I mean, you know I’ve tried those and never really saw they did too much, and historically there were bars that were given to kids at night time to prevent them from having lows during the night, but kids on insulin don’t have to have lows during the night if they’re on a low carb diet. I mean it’s not like, I mean in conventional care eating whatever you want and covering it with insulin is the axium of treatment, and that’s going to cause all kind of highs and lows, but in terms of did I see real clinical benefits to resistant starch, I honestly didn’t, and if people are just eating correctly, that’s going to work for so many people. I mention it in the book as people think about it, I haven’t seen it clinically that helpful addition.

Dr. Weitz:                          You also mentioned the herb gymnema sylvestre.

Dr. Morstein:                     Yeah. I should have mentioned that earlier.

Dr. Weitz:                          Yeah.

Dr. Morstein:                     Gymnema sylvestre is my favorite botanical. There’s that and bitter melon as kind of two, but I love gymnema sylvestre, the studies have used 400 milligrams, but with some patients I’ve gone up to 2,000 or 2400. Gymnema sylvestre has been shown to help the pancreas produce insulin again, and it also reduces cravings for sugar. In a tincture form, it’s pretty amazing, that if you put a tincture of gymnema sylvestre in your mouth, and swish it around for a minute and then swallow it you can’t taste anything sweet, it’s disgusting. You can’t eat it. For some patients that are still working, you know, the holiday times, and going to parties I’ll give them a little one ounce bottle and say, “Just take this before you go to the party, then try to eat that cookie,” you’re not going to spit it out, because-

Dr. Weitz:                          Wow.

Dr. Morstein:                     It’s just going to be nothing in your mouth, and it’s really an amazing way to go, it just numbs the sweet taste for about an hour, or hour and a half.

Dr. Weitz:                            That’s great.

Dr. Morstein:                     Yeah.

Dr. Weitz:                          That’s a great hint. I know we both have patients, and we got to go, so let’s make this a wrap here. For listeners who want to get a hold of you, what’s the best way for them to contact you, and to get a hold of your book?

Dr. Morstein:                     Yeah. My book, the short name is Master Your Diabetes, it’s up on Amazon, Doctor Morstein, M-O-R-S-T-E-I-N, Master Your Diabetes, and my website is drmonamorstein, M-O-R-S-T-E-I-N, and from there I’m in Tempe, Arizona. I do telemedicine, as well. Check out my website, and give a call if you are interested.

Dr. Weitz:                          That’s great. Doctor Morstein, thank you so much for this interview.

Dr. Morstein:                     Thank you very much, Doctor Weitz …

 

 

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Detoxification with Dr. Bryan Walsh: Rational Wellness Podcast 77
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Dr. Bryan Walsh discusses proper detoxification with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Itunes, so more people will find The Rational Wellness Podcast. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]

 

Podcast Highlights

3:04  Dr. Walsh had the typical health care provider’s view that we are all toxic and we should detoxify when we can. But then he heard a detox guru talking about phase three detoxification and it didn’t accord with his understanding of it.  Secondly, he learned that there was a phase zero detoxification. Thirdly, he had read that there was a biphasic response to toxins in that certain nutrients at a low dosage increased detoxification enzyme activity, while at a higher dosage it inhibited the same enzyme for detoxification.  This meant that the amount of some of these nutrients found in food would stimulate detoxification, while the concentrated, isolated forms and the amounts found in supplements such as in detox formulas and powders might actually be inhibiting detoxification.  This led Dr. Walsh into doing a deep dive into the scientific literature and to formulate a detox program that does not include a lot of supplements.

8:24  Which toxins each person gets exposed to has to do with your socioeconomic status, your occupation, where you live, your lifestyle, what kind of cosmetics and cleaning products you use, your water, and your air.  When you look at the data from National Health and Nutrition Examination Survey data from the CDC, we’re excreting all kinds of toxins, including heavy metals like mercury and arsenic, organophosphates, organochlorines, and aflatoxins from mold.  Some toxins exert oxidative stress and others are endocrine disruptors and may disrupt the thyroid, sex hormones or adrenal function.  Toxins may also have a direct cytotoxic effect on our cells.  Some toxins affect the endocrine system, while some have more of an effect on the neurological system and the brain.

13:52  Dr. Walsh doesn’t like most of the serum or urine tests for toxins and prefers using questionaires.  Here are two of the questionaires that he finds helpful to screen for toxic exposure:  http://www.eha-ab.ca/acfp/docs/taking-an-exposure-history.pdf  and  Qeesi.org

19:22  To properly detox you have to do three things: 1. Mobilize, 2. Optimize the detoxification pathways, and 3. Promote excretion. To mobilize, you want to go on a hypocaloric diet so that you start breaking down fat stores, which will mobilize toxins stored there. You should also use a 6-8 hour time restricted eating period, which means that you should have your two or three meals within an eight hour period of time and have no food the rest of the time. To optimize the detox pathways, this is heavily nutrient dependent, requiring certain vitamins, minerals, amino acids, and other nutrients.  You need methyl groups, you need sulfur groups, you need glutathione, you need certain amino acids, like glycine. To promote excretion, you have to sweat, so Dr. Walsh recommends using a sauna.  You want to drink a lot of water, so that you urinate.  You want to consume enough fiber so that you poop and include some binding agents to insure that the toxins leave the body.

28:18  Detoxification does occur in the liver, but also in the kidneys, the enterocytes, and even in the testes.  The four phases of detoxification include phase zero, which is the entry of these environmental pollutants into the cells. Phase one makes the fat soluble compound water soluble by adding a hydroxyl group. But it also produces a toxic intermediate, so it is important that phase two be sufficiently upregulated so that these toxic intermediates go through conjugation or sulfation or methylation or glucuronidation or glutathione or acetylation.  Then phase three takes that water soluble detox product out of the cell to be excreted through stool, urine or sweat.  You need to be careful to avoid nutritional supplements like curcumin, piperine, and milk thistle, which inhibit phase three of detoxification. For excretion, it is important to include fiber and binding agents, like bentonite clay, charcoal, and chitosan.  And it’s also crucial to sweat, such as by using a sauna, though Dr. Walsh does not like steam rooms, unless you are using purified water.  But overall, Dr. Walsh is not a believer in taking a bunch of nutritional supplements for conducting a detoxification program.  For example, when you take curcumin via food, it enhances phase III detoxification, while curcumin as supplement decreases it: https://www.ncbi.nlm.nih.gov/pubmed/18439772

43:17  Dr. Walsh also recommends as part of his 10 day detox program, 4 days of a modified Fasting Mimicking diet.  He cites the work of Dr. Valter Longo from USC who has published research on the anti-aging benefits of it, though he is not worried about the issue of a low calorie diet mobilizing toxins, which Dr. Walsh is concerned with.  So Dr. Walsh uses the same macronutrient ratio recommended by Dr. Longo, which is basically a low protein, ketogenic program, though Dr. Walsh recommends including foods that facilitate detox.  While Dr. Longo recommends the same amount of low calories to everyone, Dr. Walsh recommends low calories, but with the exact amount of calories based on your weight.

 

 



Dr. Bryan Walsh is a board-certified Naturopathic Doctor who sees patients and teaches at the University of the Western States and is an expert at detoxification. Dr. Walsch’s web site is drwalsh.com and he offers a course on detox for patients https://www.metabolicfitnesspro.com/walshdetox/  and also a course on detox for other doctors and practitioners: https://www.metabolicfitnesspro.com/everything-you-wanted-to-know-about-detoxification-2/

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



 

Podcast Transcripts

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

Hello, Rational Wellness podcasters. Thank you so much for joining me, again, today, Dr. Ben Weitz here. For those of you who enjoy the Rational Wellness Podcast, please go to iTunes and leave us a ratings and review. That way, more people can find out about the Rational Wellness Podcast. Today we’re here. We’re going to speak about detoxification, getting rid of toxins from our bodies. We all are probably aware of the fact that we live in an environment in which there are toxins in the air, in the food, pesticides, chemicals in products that we put on our skin, use in our house. We have tons of information that we been exposed to about all these different toxic substances that get into our bodies and, potentially, have negative health affects.

Today we have Dr. Bryan Walsh, who’s a board certified naturopathic doctor, who sees patients, teaches courses in biochemistry and physiology at the University of Western States. He’s also scientific advisor at Lifetime Fitness. He’s devoted a considerable amount of time researching and writing about the concept of detoxification to help us to get rid of some of these toxins. That’s what we’ll be discussing today, his particular approach to detox. Dr. Walsh, thank you for joining me today.

Dr. Walsh:           Thanks for having me. It’s a pleasure to be here.

Dr. Weitz:            How did you get interested in detox as a particular topic?

Dr. Walsh:           Well, that’s a great question. I’ve been steeped in the health world for a long time, well before I became a naturopathic physician. I started out as a fitness professional a long time ago, read up on nutrition as much as I could. I was a massage therapist. I was really into that world and it doesn’t take long being in that world to come across this concept that we’re all toxic and we’re going to die if we don’t detoxify. You’re introduced to all these different ways of supposedly detoxifying your body from foot baths, to colonics, to you can see people online saying, “Drink a little bit of lemon juice in the water. It’s a great way to detoxify the body,” and all these different claims.

My initial, I guess, exposure to this whole concept was that of what everybody else’s is. We’re super toxic. It’s killing us slowly and if we care about out health, we should probably detoxify. And that was it for a really long time. Then, I forget the specific time, but there was a time, recently, I’d say maybe this year or last year. I heard a particular detox guru talking about phase three detoxification. Which most people in this industry have heard of, it’s been around for a little while. I think phase three might have been discovered in the early ’90s. The way that he was describing phase three didn’t entirely jive with what my understanding was. This guy is a guru, I’m not. At least, I don’t consider myself to be. I thought, “That doesn’t really … that’s not right. I don’t think.”

I decided to go into the scientific literature and say, “What is phase three really?” I’ve heard a lot of people say a lot of things about phase three. What it is, what it’s not. I decided, I was like, “I’m not going to listen to anybody else, I’m going to do this myself.” You know how PubMed works. Where you go in and you read a paper. Then it’s cited in other papers and then you go down, the next thing you know, you have 50 tabs open in Firefox or Chrome and you’re reading all these papers. This little mini dive to just trying to figure out what phase three was three things happened.

One was I realized that this guru, who’s teaching people about phase three to sell his supplements, wasn’t entirely accurate. I have a problem with that, as we were just talking about that prior to this interview. In this space, whatever you want to call it, Functional Medicine, nutritional medicine, alternative complimentary medicine. We need to be 100% accurate with what we’re talking about, because we’re so intensely scrutinized by conventional medicine. First of all, the way he was describing phase three to practitioners wasn’t entirely correct.

The second thing that I saw was that there’s a phase zero detoxification. Which, I’ve been in this business for a long time, and I have never heard anybody ever, at any time, utter phase zero. I thought, “Wait a minute, what is this phase zero, that I’ve never heard about?” If we’re talking about detoxifying people, it should be a part of this conversation that we’re having. So, that blew my mind.

Then the third thing, and this may have been one of the things that really sealed the deal for me, was I started reading about what’s called a biphasic response when it comes to certain compounds, or nutrients, or herbs, or minerals, whatever. This biphasic response, specifically in these papers, was talking about how, at a low dose, increases certain detoxification enzyme activity, but, at a high dose, inhibits the very same enzyme for detoxification.  I thought, “Well, wait a minute.”  A low dose would be the kind that you find in food.  So if you were to eat the herb, itself, or to take turmeric, for example, for its curcumin content that, that might stimulate detoxification.  But these papers didn’t explicitly say this, but in a high dose, which I read as, isolated, concentrated, supplement form.  Trying to get as much of the herb, or nutrient, or compound in your body, as possible, might inhibit detoxification.

When those three things happened … All it was, was this guy was talking about phase three. I thought it was wrong. I decided to look it up myself. A, he was a little bit wrong about phase three. B, there was a phase zero that I never heard about. And, C, I really wondered if what we’re doing, as an industry, if we were actually detoxifying people, or not, by giving people these powders, and potions, and supplements in concentrated, isolated forms when the studies were pretty clear that many of the things that we’re using in detoxification formulas might actually be inhibiting detoxification. Then I though, “Oh my gosh, I need to completely get any bias out of my head. Everything that I though I knew about detoxification.” Wiped my brain clean. Wiped my desk clean. And I started from the very top. I said, “All right, what have I heard? That we’re toxic. All right. What does the literature really say? Are we, in fact, toxic or not?”  Two was, are these things stored inside of us? We hear that they are. Is there a synergistic effect of multiple low-dose toxin exposure all at the same time? We hear that, but what does the scientific literature say? Does the dose matter? We hear that the dose makes the poison. And, at the doses that we’re probably exposed to, that it’s not going to cause a problem, so I wanted to look into that.

 Then after answering all these, I guess, basic questions that you and I have heard about for a really long time in this industry. If those are true, if we do have exposure, if it does get stored, if it is causing damage, if there is a synergistic effect, if the dose doesn’t matter, and if a low dose can cause just as much damage as a high dose, what can we do about it? What does the scientific literature say or suggest is the most efficient and safe, I will add, safe, efficient, effective ways of actually detoxifying the body, and assessment. That was a big … How do we test this? You know the labs. There’s labs out there that are supposedly these toxin panels and will … What does the literature suggest about those, as well?  That was the dive. I ended up reading over 300 papers on this topic over the course of months.  That’s my story with this.  So I have come up, now, for air again with a brand new view of what detoxification is.  With really solid answers to those questions that I feel very confident talking about, in fact.

Dr. Weitz:            Okay, maybe we could start by just talking about what are some of the most common toxins that we get exposed to in our environment, and get stored in our bodies. What are some of the health consequences of some of these?

Dr. Walsh:           That’s actually … That’s interesting. That’s a difficult question to answer, because … Well, I just give you an example. There was one specific paper that I found that said that based on one’s socioeconomic status, we are exposed to different toxins.  For example, somebody might have a garden in their backyard, and they’re, therefore, spraying pesticides.  But somebody with a lower socioeconomic status might eat more fast food and, therefore, are more exposed to certain other toxins.  A certain class might use more, what’s it called, sunscreen on themselves, or their kids, or certain cosmetics.  They’re all common.  When you look at the NHANES data, in terms of what people are excreting. We’re excreting everything. We’re excreting everything from elements, so things like arsenic, and the heavy metals, mercury, aluminum. We are exposed to a lot of organo-phosphates and organo-chlorines that persist of organic pollutants. We’re exposed to … Some people might be exposed more to aflatoxins, because they have mold exposure, which other people don’t.

I actually think that’s a really difficult question to answer, because it depends on, well, according to studies, your socioeconomic status, the job that you have, where you live. We’re out in well-water country. I can tell you that we don’t use any pesticides in our yard garden, but I drive down the road, and these farmers around us are spraying who knows what. That’s absolutely getting into our water.

Dr. Weitz:            Absolutely.

Dr. Walsh:           But, on the other hand, and somebody that lives in an urban society and is drinking city water. They’re going to have different exposures. So it depends on your lifestyle. What kind of cosmetics and cleaning products do you use? What kind of food you eat? The water, the air, all these things. I think it’s difficult to say what are the most common ones, because that really will be specific to one’s diet, lifestyle, job, where they live, for example.

The second part of your question is the damage. That was another question I had. We hear these things are so bad. Well, why? Why do they cause problems? And it turns out that depending on the specific, I’ll call it a toxin, they’re really xenobiotics or environmental pollutants. Or the class that they’re in, they really do exert different effects. One of the most common ones, though, that across the board is oxidative stress, surprisingly. I didn’t know that, that was going to be the case, but in many individuals that have multiple chemical sensitivity, they exhibit a tremendous amount of oxidative stress. Other ones, you hear them as endocrine disruptors, but what does that really mean?

It turns out the stuff is so compelling, though, when you look at it. Depending on the environmental pollutant, let’s just talk about thyroid. Just about every single aspect of thyroid hormone physiology can be negatively impacted by an environmental pollutant. So, starting up at the top, the hypothalamus, the pituitary, TCH, thyroid’s ability to bind onto … thyroid binding globulin on the receptor, itself, and conversion on the thyroid’s production of this, every single step. We often think of the sex hormone, that these are all estrogenic. That’s not entirely true. There are some that have been shown to suppress adrenal function, and suppress cortisol, for example.

Then there’s other ones that have direct, what I call cytotoxic effects, on a cell. For example, certain ones might mess up the membrane of the mitochondria. Other ones might negatively impact some of the enzymes involved in the citric acid cycle, or the electron transport chain. Other ones have more indirect effects, like with the immune system, and then that will have system-wide effects. It’s really … There’s so many of these things out there. There’s so many classes of these and they all exert different effects. That it’s hard to say. Some of them exert more neurological symptoms, whereas other ones might impact the endocrine system more. It really depends on the environmental pollutant and what specific effects it causes. But …

Well, here’s another quick one. In the scientific literature, so many chronic conditions have been linked back to xenobiotic or environmental pollutant. Things that you don’t … I mean, of course, the neuro developmental things, like ADD, ADHD, and autism, as well as, things like Alzheimer’s and Parkinson’s. But then there’s things, like obesity, things we never think of, but the studies are really clear, cardiovascular disease, atherosclerosis, hypertension, and even diabetes. Some of these papers say the correlation is so strong that, perhaps, xenobiotic exposure is, not only associated with diabetes, but maybe a significant contributor.  Anyhow, that just speaks to the fact that it depends on what it is, but it can impact virtually any part of a cell, the mitochondria, the pliable membrane, the endoplasmic reticulum, enzymes, transporters, hormones, neurons. You name it, they can cause damage in some way.

Dr. Weitz:            What’s the best way to screen to see what kinds of toxins that we have in our body?

Dr. Walsh:           That was disappointing to me. When I looked into the literature to see what really was the … That’s the big question, of course, because … So, right now, what have we talked about?  Yes, we’re exposed. There’s absolute proof that they’re stored. They do cause damage. Then the next rational question is, all right, well, how toxic am I? When people are talking about how toxic they are, what they’re actually asking is, what’s my total toxic load or total body burden? Which is really to say, “How much do I have stored in my body?” That’s really the question. And the problem is, there’s no way to assess that. There’s no way to evaluate that. I know that people, “Well, what about the hair tissue mineral analysis test?” No. What about the urinary test to show excretion? No. I can go into some of the reasons why too.

One of the gold standards in toxicology, when evaluating this, is a fat biopsy. That’s really what we’re looking at … How much is stored in fat? Well, it turns out that for a variety of reasons, and there’s papers on this too, that suggest that you have different amounts of stored xenobiotics in subcutaneous fat, than you do visceral fat, than you do in different fat depots in different areas of the body. And these papers say that, that doesn’t correlate to serum levels, so you can’t do a blood test and say that, that reflects you and what your storage is, because it may differ.  Then there was one, and this is a rodent study, so you have to take that into consideration. Well, here’s a good example. Let’s say you and I, right now, let’s say we practice in the same area. We live the exact same lifestyle, exact same exposure. You’re following a hypocaloric diet, right now. Intermittent fasting, time restricted feeding, hypocaloric diet. I’m stuffing my face, standard American diet. I’m eating more than my basal metabolic rate. We both go to do a test. Now, because you’re in a hypocaloric state, you’re probably mobilizing more of your stored xenobiotics, and every mammal study says that. That when there’s a hypocaloric, or fasted, state, serum levels of xenobiotics go up every single time, every single mammal, including humans.

Now, I’m in an anabolic state. I’m storing things. When we go to do this toxic panel, you come out sky-high in all these toxins. And you see your practitioner and they’re like, “Oh my gosh, you are so toxic. You must do a detoxification program.” Then, me, because I’m in an anabolic stuffed fed, overfed state. That mine are probably stored. And my levels, on my test, might come back as normal or low. And the practitioner says, “Wow, you’re not toxic, at all.” When, in fact, I might be far more toxic, in terms of my storage, than you are, but you’re in a hypocaloric state. Right there, that totally negates … It’s a severe confounding variable when considering assessments.

Then the last one, that rodent study I was going to say, they showed that when these … They put these rats on a yo-yo diet, poor rats. They would go hypocaloric and their xenobiotic levels would go up in their blood. Then they’d make these rats hypercaloric and guess what happened? These xenobiotics went into different tissues. You might have a certain amount in a certain fat depot in your body that does get mobilized, but then it’s going to go somewhere else depending on your caloric state. In terms of screening, all of this is my opinion. It’s based on the scientific literature, but people can use it how they want. Is there is some pretty good questionnaires that are out there, that are in the … They’re validated questionnaires in the scientific literature that, I personally, think are amongst the best ways of screening if we have toxic exposure or not.

Dr. Weitz:            Can you mention which ones those are?

Dr. Walsh:           There’s a whole bunch of them. One of them is abbreviated and I forget the actual … It’s the Qeesi questionaire. If you do links to this in your show notes, we can-

Dr. Weitz:            Yeah, I will. Yeah, maybe you can email me.

Dr. Walsh:           That one’s the most elegant. It’s fairly long. I’ll give you a couple of them that I like for two reasons. One is this one is very comprehensive. It’s not quick, 10 questions, are you toxic or not. It looks at a variety of things from your actual physical exposures and your lifestyle, as well as symptoms across a variety of systems in the body. And I think is really very comprehensive. The benefit of some of these, though, is it forces you, when you ask these, or answer, these questions to jog your memory to see what your exposures might be that you are totally unaware of. Right now, you can say, “What are my exposures? I drink reverse osmosis filter water. I eat organic food. I use coconut oil for my lotion. Apple cider vinegar for my deodorant. I don’t have any exposures.”  But when you go through some of these questionnaires that have these questions, you say, “Oh my gosh, I work in a building that whatever.” They’re really good at helping, not only see if you might have a certain amount of toxicity, if you will, but also what the sources might be.

Dr. Weitz:            Okay. In your concept of detoxification … Actually, you were talking about the phases of detoxification. I’m not sure everybody even knows what phase one and phase two are, and you were talking about phase zero and phase three. Well, actually, your concept of detoxification, you have three basic principles, and then you list the phases in a second one. Maybe we could go through your three main important principles of detoxification that you outline in your program.

Dr. Walsh:           Yeah. And, again, I humbly will say that I think my … I’m a teacher, not by choice, I think I was born into it. When I look past throughout my entire life, everything has been teaching. I say that because when I go through what these three principles are, there’s a feeling you know that being empowered just feels amazing. That you feel like that you know enough information that nobody can pull the wool over your eyes. That you’re an informed individual. So by teaching these three things, these are just … These are principles that must be in place for anything to call itself a detoxification program. I say this so that when people are evaluating, “Well, what about this detoxification?” They can run it past this list of three things.  The first thing that for something to call itself a detoxification, that it absolutely must include is mobilization. You have to get these things out of storage.

Dr. Weitz:            I thought you were going to say it has to come in a box, just kidding.

Dr. Walsh:           No. It can, if it’s a well developed one, it absolutely can, UPS, no.

Dr. Weitz:            Okay.

Dr. Walsh:           You have to mobilize in the first place. The best ways to mobilize, that I’ve seen, and also makes physiological sense, is to go on a hypocaloric diet. Now, i think a calorie restricted diet, I also believe a time-restricted feeding in a window of about six to eight hours, is probably the best. And all that calorie restriction means is less than, essentially, your basal metabolic rate. Exercise. So the technical word is, lipolysis, which is the breakdown of the lipids, or fat cells, but that’s where the majority of these things are stored. When you are in a state, a catabolic state of lipolysis, you do get mobilization of toxics, period. This is not conjecture.

Dr. Weitz:            Right.

Dr. Walsh:           Every mammal study that I’ve looked at, including humans, when people, or mice, or monkeys go hypocaloric, their levels in the blood go up every single time.

Dr. Weitz:            You’ll have to admit that virtually every detox program out there involves some sort of modified fast or fast. They pretty much all involve eating less foods.

Dr. Walsh:           Right.

Dr. Weitz:            So this concept, I think, is incorporated in most of the commercial detoxification-

Dr. Walsh:           Whether they knew it, or not, right. It absolutely involves that.

Dr. Weitz:            Right.

Dr. Walsh:           The second thing, then is, and this speaks to those phases of detoxification. You have to optimize detoxification. Step one is to get them out swimming in your body. All these things, now, are mobilized. They’re going through your blood. You are not going to get rid of them. These are the fat soluble ones that you do not, you cannot … The normal routes of excretion are any water forms of excretion. You can sweat it out. You can urinate it out. There’s a little bit of water in stool, so you can poop it out. You can, technically, salivate it out, or if you cry a lot, you watch a lot of This is Us reruns, then you can cry it out, technically, through tears.

Those are all … I mean, in theory, you could measure any one of those as a form of toxin … Those are all measurable things. We have to take these things that are fat, they like fat, and turn them into things that like water, so we can get rid of them. Those are those four phases of detoxification; phase zero, phase one, phase two, phase three. You have to optimize those. If you’re not, then these things just go in the body and you can’t excrete them, because they’re still fat soluble. Then the third, and last one is, you have to focus on excretion. I’ll just take a step back and say, “Let’s talk about different detox programs to see if they fit those things.”

Mobilization, improved detoxification pathways, and then to really, really facilitate excretion in some ways. Let’s say that somebody were to do a juice fast, some popular juice fast where the juice comes in a box, or maybe they’re just juicing things on their own. Are they in a hypocaloric state? Probably, if all they’re doing is just drinking juices, they’re probably in a hypocaloric state. So they’re probably mobilizing, and that’s fine. Step two is, are they improving detoxification pathways? Now, it depends on what they’re consuming. There are studies that suggest that things commonly juiced, things like carrots and celery-

Dr. Weitz:            We’ve had a technical difficulty, so we’re going to continue this podcast. We’re not exactly sure where we left off, but hopefully we won’t have any lost train of thought. So, go ahead Dr. Walsh tell us more about detox.

Dr. Walsh:           Yeah, no problem. You can tell me if I’m going too far backwards. I was saying the three things that are required in order for somebody to do a detoxification program; mobilization, optimizing detoxification, and then optimizing excretion. Those three things are critical. Then what I said was if you go back, and you start evaluating things that are supposed to be detoxification programs, where they detoxify the body, they have to have those three things. So, just a juice fast, is really common. You mentioned that most juice fasts are hypocaloric, so they probably are increasing mobilization. But then, I think this is the part that we got a little bit glitchy, is depending on what somebody’s consuming, you may, or may not, be either stimulating or inhibiting detoxification pathways. The things that have been shown in the literature to stimulate detoxification pathways, people typically aren’t juicing things like, broccoli, for example, or cabbage, or possibly things like mung beans, which aren’t really juiceable.

Dr. Weitz:            But it is the case that detox is a nutrient dependent process, right?

Dr. Walsh:           Absolutely. Well, yes. I mean, if you want to really get into the biochemistry of it, there are a number of different micro-nutrients, vitamins, and minerals that are even required for these pathways to be taken place in the first place.

Dr. Weitz:            Right.

Dr. Walsh:           In phase two, which I’ll get to, but just really quickly. You need methyl groups, you need sulfur groups, you need glutathione, for example, you need certain amino acids, like glycine. It’s heavily nutrient dependent.

Dr. Weitz:            Hence, the concept of trying to put together a program that has concentrations of these nutrients has some basis in the science, right?

Dr. Walsh:           Totally. Here’s the point. Is a juice fast a detoxification program? From the mobilization standpoint, yes, it probably is. You will be mobilizing. But from optimizing detoxification, I think that, that’s highly skeptical. And it depends on what somebody’s juicing. There’s some evidence in the literature that things that people usually juice, like apples, carrots, and celery may actually inhibit certain detoxification pathways, so then, that’s questionable. Then for excretion, if somebody is just doing a juice fast, they are not doing anything to enhance excretion. In fact, if they’re only consuming juice and, therefore, not fiber, and we can go into great detail on this, or not, but they’re probably urinating, and that’s fine. If they’re not sweating, that’s a huge problem. It’s a huge problem when it comes to detoxification.  Certain things are preferentially excreted via sweat, other ones are preferentially excreted via biliary, in the bile and the gastrointestinal tract. If you’re not sweating, or your not binding things up severely in your gastrointestinal tract, and in the juice fast, you’re not, then you’re not excreting. I, myself, would say that a juice fast is not a detoxification program. Yes, it mobilizes whether, or not, it increases detoxification pathways depends on what you’re consuming. Then the third one, excretion, I’d say a big, no, to that.

Does a colonic, is that a detoxification? Well, if you’re not mobilizing, then, no, all you’re doing is your moving things through your bowels faster. Which is great, that’s excretion, that does nothing for the second step detoxification of the first step, mobilization. That’s what I really want people to do is to be able to look at a detox … something that is allegedly a detoxification program, and say, “Does this increase mobilization?” Check, yes. “Does this increase detoxification pathways?” That’s a big one. That’s questionable with a lot these nutrients that people are using in powders, and supplements, and capsules. And excretion, is just saunaing detoxification? You maybe excreting things that you had swimming around in your interstitial fluid, technically, but not out of your cells, because you might not be in that mobilized state.

Dr. Walsh:           So those three things are critical for something to be called, to truly, truly be called a detoxification.

Dr. Weitz:            Can we go through those detox pathways? People typically talk about phase one and phase two of detoxification. It’s phase zero and phase three that are the newer ones. Typically, people talk about phase one and phase two as related to the liver, correct?

Dr. Walsh:           Yeah, well, and that’s not true, at all. When people talk about these … I’ll tell you what the phases are, then we’ll talk about why it’s not just a liver. The liver happens to be a huge organ and, yes, it does this, but the kidneys do this very well. The enterocytes of the intestines do this very well. In men, it turns out the testes, actually, do this very well also. Which isn’t surprising, given the role of the testes in terms of, essentially, passing along somebody’s DNA in that xenobiotics. If one couldn’t detoxify well down there, then that could really disrupt somebody’s …

Very simply, if you’re to picture, like a box. I’m trying to look for a prop real quick, but I don’t have one. If a box is a cell or, you’re in a room there. I would say, if somebody’s in a room it’s pretty easy to picture. If this room has two separate doors, this is as simple as it is. Phase zero is quite simply the entry door into your room, which is the cell. Your cell has a nucleus and mitochondria. It has a computer. It has lights and electricity and ATP. That first door is phase zero. That’s the entry of one of these environmental pollutants inside of a cell. You can say a liver cell, but it’s not the only organ that does this. It comes in, now, it’s inside the liver cell. We’ll say it’s a person came through that door.

Then phase one is biochemically not too challenging, but I’ll say what it does biochemically and then I’ll change it back to this metaphor or analogy. Phase one makes that fat soluble compound, first of all, makes it water soluble. It does so, not exclusively, but either by adding what’s called a hydroxyl group or exposing one that was already there. Now, this has this hydroxyl group on it. It’s water soluble. The way that I use this as an analogy. If somebody walked through the door, phase zero. They’re now inside the cell and you, put a sticky note on their forehead, just right on their forehead, or you start berating them, “You suck as a human being. You’re a horrible, miserable, ugly, smelly human being.”

Now, and that’s phase one. Now, this person is really angry. Who wouldn’t be if you start to berate … and they have a sticky note?  So they start trashing your room. They throw your computer across the desk. They start knocking lights over. They start doing all these things.

Dr. Weitz:            Fake news.

Dr. Walsh:           But in a cell, after phase one, and this isn’t across the board, all the time, but it’s actually considered to be more damaging to the body than, in some cases, the original environmental pollutant was, after phase one. You just berated this person, “You’re fat, ugly and your breath stinks.” Now, they’re really, really mad, but that’s phase one. But phase two is collectively called conjugation, and conjugation means, to add something.  Now, in phase two, you’re like, “I’m so sorry. Here’s $100 bill.” Well, the person may have had hurt feelings about what you said, but now you gave them $100 and they’re not angry anymore. After phase two, it’s still water soluble, but it just got $100 bill. It’s not going to damage anything inside of your cell anymore. It’s not going to damage your room. Now it’s a happy person. You made fun of it, it was angry, it started messing things up after phase one. Phase two, you handed it something, now, he’s happy.

Dr. Walsh:           Now-

Dr. Weitz:            Now, let me just stop you for one second. So the story that’s often told about detox, especially from some of the companies that provide these detox programs is, phase one produces a toxic intermediate that’s why if you just do a juice fast you get all these toxic reactions, and headaches, and all these negative things. You have to have the right nutrients that help support phase two, so you take that toxic intermediate, put it into a water soluble form so it can get excreted. Therefore, you support phase one and phase two, and that’s the end of the story.

Dr. Walsh:           Yeah. That’s a good story, but if the intermediate metabolite, after phase one. With that hydroxyl group, it’s technically a free radical. Now, I haven’t seen too many people that get sick from free radicals, if that makes sense?

Dr. Weitz:            But doesn’t that explain when somebody does a juice fast and they have toxic reactions-

Dr. Walsh:           I think that part of it-

Dr. Weitz:            – and the amino acids and the other nutrients for phase two.

Dr. Walsh:           I don’t know. I’m not convinced that, that … It might be because of mobilization, and they’re not excreting things. I don’t know if it’s only because it goes through phase one. Technically, I mean, they’re water soluble, but technically it’s still inside the cell. It hasn’t gone out of the cell yet, so that’s a good story, and it might be true, but I don’t think there’s any proof as to that’s what’s causing this.

Phase two is the conjugation. You hand them $100 bill, or in the case of actual biochemical pathways, sulfation hands to the sulfur group, methylation hands to the methyl group, glucuronidation hands to the glucuronic acid, glutathione gets glutathione glycine, acetylation gets in the acetyl group. That’s the $100 bill. Now, it’s water soluble and happy. Now, it has to get out of the cell to go back into the interstitial fluid, which is water, to be excreted. That’s the other door and that’s phase three. Now, here’s the problem. There’s certain things that can block phase zero, like diesel exhaust has been shown to block food. It’s fairly new. It’s only been discovered in the early 2000s. But phase three, curcumin blocks phase three, piperine from black pepper, which is usually used with curcumin to make it more available, blocks phase three. Milk thistle, honestly, is a mild phase three inhibitor, as well.

And here’s the thing, so now you have this happy person that could leave that third door. Then you’re done with them. You’ll never see them again, because they get excreted. But here’s the problem, you know, beta glucuronidase, which undoes glucuronidation. There are other enzymes that can undo conjugation, which to put it back into the metaphor is, there are things that can take that $100 bill away from that person, whether it was sulfation or methylation. Can take that $100 bill and, now, they’re the intermediate metabolite again. If you block phase three, and that person, metabolite, after phase two stick around inside that cell, now, the conjugation reaction can be undone. Now, it’s back in the intermediate metabolite. That’s why making sure that … This becomes my opinion, at some point here, but I don’t know that we should be taking a lot of supplements when it comes to a detoxification program. Because the reality is, and I can go head-to-head with a lot of people on some of these things, it’s really hard to say whether something actually improves detoxification or not.

Not from enzyme activity, or MRNA expression, for these proteins. There are all these things, but if it actually … What I’ve looked at, which is biphasic response, is that food, and the doses that are found in food, will generally stimulate detox … There was one great paper, by the way, that looked at food-based curcumin and isolated curcumin. Food based stimulated detoxification pathways and isolated absolutely inhibited. In fact, conventional medicine … Think about cancer, think about chemotherapy. What they really want is to keep that chemotherapeutic agent inside of the cell, so that it can fight cancer, correct?

Based on what we’re saying is that best way to do that is to block phase three. If you close that second door, you keep inside that cell whatever is inside that cell. If it’s a chemotherapeutic agent, that’s what you want to be able to exert more of an effect on cancer. What is conventional medicine using as a potential phase three inhibitor to help augment, or improve, chemotherapy? Is curcumin, so should curcumin be in a detoxification program? If it’s truly detox, you want to open up phase zero, have phase one and phase two working very well, and keep that second set of doors wide open, phase three, so that stuff can actually get out. Then, for the third part of the detox, is to be excreted via sweat, via bile and poop, via urine, or, like I said, technically, salivate, saliva, or tears.  I don’t know if that answers the question. But that’s phase zero. Phase zero is entry into the cell. Phase one redox, oxidation, the hydroxyl group is added or exposed, intermediate metabolites, sometimes more toxic, not always. Phase two conjugation gets handed something. Phase three exits the cell and then is excreted, as long as the body is excreting.

Dr. Weitz:            Interesting.  In order to promote excretion, you talk about using particular fibers and binding agents to help get rid of some of these toxins?

Dr. Walsh:           Yeah. What I did, again … Bentonite clay, I’ve been familiar with bentonite clay, as a fitness professional, and different types of fibers, and all these things. But what I wanted to do was look to the literature and say, “Well, what actually shows an improvement in the excretion and, not necessarily, of xenobiotics, but of bile.” So like a bio-acid sequester, like cholestryramine, the old cholesterol lowering drug, bound up bile to excrete it. If we can bind up bile, because so many xenobiotics are found in bile, and is their primary form of excretion, we need to bind up bile. We need to bind up all the stuff in the gastrointestinal tract for a variety of reasons, but I tried to find things that had some scientific basis behind it, so things like charcoal, for example, fiber, soluble, insoluble fiber.  An interesting one is chitosan or ketosan, which is typically used for fat loss, not very well. But there is papers showing that it is, actually, effective at increasing xenobiotic excretion via bowel habits. The other big one is sweat. You have to sweat. In fact, I recently came across a paper that, the short version was and, again, if I come back in a future life as a lab rat doesn’t sound very good. They had two groups of mice or rats and they gave one group a pretty significant burn on their skin, which is unfortunate. They injected both sets of mice with a certain xenobiotic and, not surprisingly, the ones that had a burn had higher levels of this environmental pollutant, because skin is such a major route of excretion. And, in fact, is the preferred route of excretion of some xenobiotics, not all, but some.

So if somebody is not actively sweating, during this hypocaloric phase, then I don’t think we’re getting rid of as much as we need to. To the point then, this is a bold statement. But I have some more papers that I’ll be adding as some bonus content coming down the pike. This stuff just blows your mind, blows your mind. I would not, myself, my family, or any patients, or clients put them on a fat loss program without supporting detoxification pathways, period. If they couldn’t sweat, I would say, “You probably don’t want to do a detoxification program.” If it’s really … I’ll just give you a tip on some of these things. There’s evidence that weight loss actually increases one’s risk for dementia, cardiovascular disease, diabetes and cancer, very strong, and the author cite this as a reason. Weight loss induces mobilization of xenobiotics. They go up and if you’re not getting rid of them, cause damage to cells way down the level.

Now, you look good in sexy jeans, or skinny jeans, but in 20 years might have cancer, or dementia, because of the weight loss. And, in fact, a steady increasing BMI, as one ages, seems to be protective over some of these thing, which is counter to what we want to look like, ourselves, but it’s very compelling stuff. Yeah, this is real, man. I would not do a fat loss program without making sure I was sweating and excreting and supporting detox. I would not. I would not put a patient on one, because I think that the detriments are too strong.

Dr. Weitz:            Sounds good. I know you’re a fan of infrared saunas, or a particular type of infrared sauna, right?

Dr. Walsh:           Well, you know, no, actually. I don’t like steam rooms, because of the water that they’re potentially using. I think that you can have a lot of model organic compounds found in steam. Again, unless it was purified water. But, no, here’s the thing. Again, I try not to have much of an opinion, but base it off of what I’ve read in the literature. Interestingly, in the literature, when they collect the sweat they’ll have a cohort of people to collect their sweat to look at xenobiotic levels. But they don’t tell them how to sweat. So, whether it’s via exercise or in a sauna, it didn’t matter. That when you sweat, you excrete. There’s people out there that might split hairs about a far infrared sauna and a near infrared sauna or the old ones, which are called the radiate heat saunas.  Listen, from what I’ve read, I tend not to like to split hairs over things, just sweat, man. If all you have is an old coal one, and you pour your water on it, and that’s all you have. That’s fantastic, do it. I love near infrared, personally. I think far infrared are interesting. There’s some questions about the electromagnetic frequencies, and stuff, and some of those things. But the goal is to sweat. I don’t care how somebody … In fact, I have people contacting me about my program. They’ll say, “I don’t have access to a sauna, but what if I went up into my attic?” I’m like, “As long as it’s not filled with asbestos or all this toxic stuff up there, then fine. Listen, sweat. It doesn’t matter.”  I like how the near infrared saunas feel and the bright red lights. But, no, I think to say one’s superior is myopic, personally. I think just sweating, according to science, is the most important aspect.

Dr. Weitz:            Interesting. I got that from an interview you did with Mercola. Maybe it was Mercola who liked the near infrared.

Dr. Walsh:           Yeah, he likes near infrared more than far.

Dr. Weitz:            Okay.

Dr. Walsh:           But that’s splitting hairs. To me-

Dr. Weitz:            He didn’t like the EMF thing about it.

Dr. Walsh:           No, just to sweat is the most important aspect.

Dr. Weitz:            Let’s go-

Dr. Walsh:           I would say this … Sorry to interrupt. What’s nice about the sauna, though, is it’s controlled. You can control the temperature and the time, so that, in terms of knowing the quantity that you’re sweating. That’s why I suggest the sauna, but if someone doesn’t have access to it, just sweating is what’s important.

Dr. Weitz:            Let’s go over one more thing. This will be the final question. Is part of your program involves … I know you have a 10-day detox program and part of it includes a four-day version of the Fasting Mimicking Diet that’s been popularized by Dr. Valter Longo, who sells you this box, or his company, and people who are part of this program called, ProLon, sell you this box of pre-packaged foods that you open up and make soup and things like that. You basically have put together a program that involves using real food, but to create the same effects.

Dr. Walsh:           Yeah. The short version is, if someone’s never done a detoxification, just an average person, that maybe has never done one. I recommend doing what I put together, just my view on this, is a 10-day program. The first six days, because of what you talked about, is the very high nutrient … It’s low calorie. It’s hypocaloric, you have to mobilize, but it’s fairly high protein. It’s high protein to ensure that, whoever this average person is, that maybe wasn’t eating perfectly, isn’t particularly healthy, might be protein deficient, or I should say, amino acid deficient. That they have the sulfur groups, and they have the methyl groups, and they have the glycine and all the precursors, the glutathione, in order to really support those phase two detoxification pathways.

That’s why I recommend the 10-day program for somebody who hasn’t done it before. That’s the first six days. Then the last four days, or someone could do five, if they wanted. It is what I refer to as a modified fasting mimicking diet.  Now, I think the work that Longo did is … the papers are brilliant. I think they’re fantastic. The findings of these things are so interesting.  My concern, however, is that every paper that I’ve looked at, where any mammal goes hypocaloric, their xenobiotic levels go up, period. He’s looking at this from diabetes reversal, and autophagy, and mitophagy, and all these health promoting effects, and that’s great.  However, instead of … So the macro-nutrient ratios that he’s come up with are brilliant. The calorie levels, which I won’t get into, but I think that should be based on one’s weight, rather than just having set calorie levels.  So a very hypocaloric diet with very specific macro-nutrient ratios.

Dr. Weitz:            By the way, what are those macro-nutrient ratios?

Dr. Walsh:           It depends if it’s … According to the one paper that I use, that have the specific ratios. Honestly, it’s basically ketogenic.  It’s very low calorie, first of all, but it’s moderate carbohydrates, very, very low protein.  In fact, you can, in what I put together, you can reach your protein levels just by eating vegetables for that are required.  It’s very low protein, which there’s no additional protein that’s actually consumed.  The amount of protein found in the vegetables that I consume, you hit your mark.  Then a little bit of fat.  It’s like carbs, protein, and fat, so that somebody can be in a ketogenic state and not push themselves out. My concern with his work, however, is while really compelling stuff that he’s produced is what about this xenobiotic thing? What about these papers that I’ve seen that show that, if you lose weight, or if you mobilize, and that can cause some other chronic conditions or situations much later in life? Instead of just saying, “Here’s some soup or here’s some avocados and some tofu, or whatever it is to reach the macro-nutrient ratio level that he recommends.” I recommend specific food that, according to the literature, have been shown to support detoxification pathways.

I mean, again, what he’s put together is brilliant. I think it’s genius. I think it’s fantastic. I have no problems with it, other than, if you just eat rice and avocados to meet those macro-nutrient ratios, you’re basically doing nothing to help support detoxification pathways. And these people will have increased environmental pollute levels in their blood, period. I say, instead of eating foods to meet the macro-nutrient ratios, eat specific foods that, according to the literature, have been shown to support detoxification impact. That’s the 10-day.

Now, what I do recommend for someone, like yourself, however, if you’d really wanted to do a good detoxification program over the course of a few months, is not to do … You’re a healthy guy. You eat a healthy diet. You live a lifestyle. I think that you could do two four to five day fasting mimicking diets a month. In week one, you might do four or five of those days. Then, again, in week three do another four or five days. And the next month, do the same thing. So you don’t need to do the full 10 days, because arguably those last four or five days, where it’s really hypocaloric, that’s where you’re going to get the maximum, and it’s time restricted eating, you’re going to get the maximum mobilization. And if you’re eating the right foods … I have some evidence that this absolutely lowers xenobiotic levels.  For someone, like you, that’s already healthy, I don’t think you need to do the 10 days. I think four to five day, modified fasting mimicking diet, a couple times a month would be the most effective way.

Dr. Weitz:            Awesome. It’s been a great interview Dr. Walsh. How can we find out about your fasting programs and the other programs you offer?

Dr. Walsh:           Remember, I don’t agree just with fasting. I think we’re too sick to-

Dr. Weitz:            I’m sorry. I’m meant your detox programs.

Dr. Walsh:           I know.

Dr. Weitz:            How can listeners and viewers-

Dr. Walsh:           Yeah. If you go to drwalsh.com, D-R-W-A-L-S-H dot com, backslash detox, that’s all you have to do. Then there’s a funny little picture of me with two buttons. One says, “Practitioner,” and one, basically, says, “Non-practitioners,” because I created two programs. The practitioner version of this goes into great detail. They both go into the science. I show the studies on the screen. I walk people through the pathways on the whiteboard. Again, I don’t want to tell people what to do without having the reason why the recommendations are there. So that they’re knowledgeable and empowered and understand why they’re doing these things. Why everything is in the program that’s in there. I don’t just say, “Take these potions and detox.” I want them to know. The difference in the programs is the practitioner program is about nine hours. The non-practitioner is about four hours of video. The practitioner program goes in way more detail in the biochemical pathways of phase zero, phase one, phase two, phase three. I go heavier into the science. It’s more technically detailed, but they both have the same output, where it’s, here’s the program, here’s how to do it.

Dr. Walsh:           When I add on some of these additional, bonus, content features, both programs … And the practitioner program, if a practitioner gets the practitioner program, they also get the non-practitioner program for free.

Dr. Weitz:            Great. Any other points of contact you want to give out for people who would like to get hold of you?

Dr. Walsh:           No, that website is the hub.

Dr. Weitz:            Good. Good. Excellent. Well, thank you, Dr. Walsh.

Dr. Walsh:           It was my pleasure. Thanks so much.

 

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
How to Fix Your Fatigue with Dr. Evan Hirsch: Rational Wellness Podcast 076
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Dr. Evan Hirsch discusses how to fix your fatigue with Dr. Ben Weitz.

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

 

Podcast Highlights

2:51  What distinguishes fatigue from chronic fatigue is that fatigue is generally relieved by a good night of sleep and chronic fatigue goes no for an extended period of time, usually longer than 6 months. Dr. Hirsch has found 15 different causes of fatigue: 1. not drinking enough water, 2. not getting enough good sleep, 3. deficiency in adrenals, 4. deficiency in thyroid, 5. deficiencies in sex hormones, 6. nutrient deficiencies like B12, vitamin D, magnesium, 7. heavy metals, 8. chemicals, 9. molds, 10. infections, 11. allergies, 12. negative emotions, 13. EMFs, 14. hidden dental infections, 15. parasites.  One of the founders of Functional Medicine, Dr. David Jones once said that the key to health is finding what we don’t have enough of and providing it and finding what we have too much of getting rid of that.

8:45  Adrenal fatigue or dysfunction can be a common cause of fatigue.  While testing for adrenals can be helpful, you can tell from symptoms if there are adrenal problems. Dr. Hirsch likes to start by using Adrenal Px from Restorative Formulations, which he’ll have patients take every 3 hours until 4 pm and if they need to he will recommend up to 3 capsules per dose.  In addition, make sure they are sleeping well, eating healthy, drinking water, etc. Dr. Hirsch mentioned that one doctor analysed all the studies on cortisol levels and fatigue and there was no correlation at all. If his patients need more support, he’ll recommend Adrenal Px syrup and he may add in some licorice root.  If that hasn’t taken care of the problem, he’ll use a product called Adrenal Para-NS from Byron White formulas. And finally, that hasn’t helped enough, then he will recommend hydrocortisone. 

16:40  Thyroid is another important gland that affects energy levels. Low thyroid is really two conditions: 1. low thyroid prodicution by the thyroid gland and 2. an autoimmune condition in which the immune system is attacking the thyroid. And this is usually because of either heavy metals, chemicals, molds, infections, allergies, emotions, or EMFs. One infection that Dr. Hirsch sometimes finds is involved is Bartonella and getting rid of Bartonella with the Byron White formulas can sometimes completely reverse low thyroid.  To support the thyroid Dr. Hirsch may start with some thyroid glandulars or iodine or kelp, but he generally finds that prescription thyroid is the most effective.  He does not like using Armour or Nature-throid because some patients may bneed more T4 and some may need T3 and we have to figure out the right dose for that individual. You also need to support the thyroid by supporting the adrenals and there’s this beautiful dance between thyroid, adrenals, and the sex hormones.                                               

19:45  Gluten, dairy, soy, and genetically modified corn can all play a role in the causation of thyroid autoimmunity.

24:04  Dr. Hirsch will sometimes use 20,000 IU vitamin D if a patient’s levels are below optimal, since vitamin D will stimulate T regulatory cells, which can help autoimmunity.  Most of his clients take 10,000 IU for maintenance.

27:42  Balancing sex hormones can help with fatigue. He finds that a lot of times when he finds younger men with mold, which results in low testosterone levels and low libido and once we get rid of the mold, their testosterone and libido comes back.  He will test for mold with urine testing from Great Plains or Real Time Labs after taking 500 mg of liposomal glutathione twice per day for seven days. For heavy metals he will use the Doctor’s Data provoked urine test using DMSA and test before provocation for baseline and then test after DMSA provocation.  To screen for other chemicals besides heavy metals he will use the Great Plains Lab GPL-TOX urine test also with glutathione provocation. To get rid of metals and other toxins he will recommend saunas, coffee enemas and cilantro and chlorella and modified citrus pectin. Dr. Hirsch likes to use a combination of products by Byron White that open up the liver and kidney pathways and helps to open the lymph and the neurolymph. He finds that most of his patients require at least 6 months to a year of treatment and sometimes as long as 36 months.

39:45  To support mitochondria, which are the organelles in the cells that produce energy, and they produce 70-80% of our energy.  Our mitochondria can get damaged by heavy metals, chemicals, molds, infections, allergies, emotions, and EMFs.  Not only do we have to remove that crap off of the mitochondria but we also have to inject the mitochondria with some good love in the form of like Acetyl-L-carnitine, L-carnitine and D-Ribose, CoQ10.  Dr. Hirsch likes to recommend a product from Research Nutritionals called ATP Fuel for supporting the mitochondria and he sees a boost in energy from using it.  Dr. Hirsch is on a mission to help a million people resolve their chronic fatigue!

        

 



Dr. Evan Hirsch is an MD who is practicing Functional Medicine with a focus on treating patients with chronic fatigue.  His website Fix Your Fatigue  offers a free download of his best selling book, Fix Your Fatigue.

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



 

Podcast Transcripts

 

Dr. Weitz:            This is Dr. Ben Weitz with the Rational Wellness Podcast, bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to the Rational Wellness Podcast on iTunes and YouTube, and sign up for my free e-book on my website by going to drweitz.com. Let’s get started on your road to better health.  Hey Rational Wellness Podcasters. Thank you so much for joining me again today, Dr. Ben Weitz here. For those of you who are enjoying the Rational Wellness Podcast, please go to iTunes and give us a ratings and review, that way more people will find out about the Rational Wellness Podcast. Our topic for today is fatigue and what do we do about fatigue. Today we have Dr. Evan Hirsch, who’s a medical doctor who practices in Olympia, Washington, using a Functional Medicine approach and his practice is really focused on treating patients with various forms of chronic fatigue. He’s written a best-selling book, Fix Your Fatigue. Dr. Hirsch, thank you so much for joining us today.

Dr. Hirsch:           Thank you so much for having me on Dr. Ben.

Dr. Weitz:            So since you’re a conventionally trained MD, how did you veer off the path into functional medicine?

Dr. Hirsch:           So, when I grew up, my mom was really into natural stuff. So, I think I was about 10 when she first started down her path, and she had very high cholesterol genetically, and she was able to reverse it using oat bran. We went on this six months of oat bran muffins, oat bran this, oat bran that. I remember just being really disgusted by oat bran at the end of it, but she brought her cholesterol down significantly and I thought that was very interesting, and then when I went through medical school, I just am very curious, I ask a lot of questions, and I wasn’t happy with the answers that I was getting from all of my professors and doctors-

Dr. Weitz:            Just put people on statins, right?

Dr. Hirsch:           Exactly, and so I was saying, “Well what’s the cause of the cholesterol issue? What’s the cause of the high blood pressure?” And getting to the root, and I didn’t like the answers I was getting so I went off into holistic medicine. I got board-certified in holistic medicine, went into integrative medicine, functional medicine, environmental medicine and that kind of led me down that path and then my wife got chronic fatigue and then a couple of years later I got chronic fatigue, and so it was working through all that that I really became so in tune with what the causes were for fatigue and how to resolve them.

Dr. Weitz:            Great, so what are some of the most common causes of chronic fatigue? And by the way, what distinguishes chronic fatigue from other forms of fatigue?

Dr. Hirsch:           It’s a great question. So fatigue in general just means that you’re tired and it’s not resolved with rest, because theoretically you should be able to work out hard and then you sleep well and then the next day if you’re not well rested you sleep well the next night and then you’re fine, so it may take a couple days to recover depending on whether you ran a marathon or not but you should recover. Fatigue is when you don’t recover and then chronic fatigue is when it’s been going on for a extended period of time. Conventionally it’s usually longer than six months or so but usually if somebody is having an issue after just a couple of weeks I say don’t wait because there’s things that are happening that your body should be recovering and at that point you need to start going after it.

So that’s the answer to your second question there, and then the first one and around the causes, so I have found that there’s 15 different causes of fatigue but to be brief on it, and we can definitely get into those, generally I put them into two categories, one is things that need to be replaced or deficiencies, and so that’s things like not drinking enough water, not getting enough good sleep, deficiencies in hormones, adrenal, thyroids, sex hormones, deficiencies in nutrients like B12, vitamin D, magnesium. And then the second part is excesses, so we’re talking about things that need to be removed, the crap that’s in the body that needs to be removed out that’s causing problems, so we’re talking about heavy metals, chemicals, molds infections, allergies, negative emotions, electromagnetic frequencies, hidden dental infections, parasites, so a bunch of that crap that’s not supposed to be in the body that’s just draining the body and causing all these deficiencies.

Dr. Weitz:            Yeah, a famous Functional Medicine doctor basically said, “It’s pretty simple, what do I not have enough of and add that and what do I have too much of and get rid of some of that.” I think that was Dr. David Jones.

Dr. Hirsch:           Yeah, that’s exactly right. What I find with a lot of docs, they have that theory but they’re not looking enough at molds. They don’t have enough knowledge around mold illness, how to diagnose it in a person, how to diagnose it in a home to make sure they’re not living in a home, what that process looks like and then infections. You really have to dive in there in order to get that knowledge beyond just what Dr. Jones said.

Dr. Weitz:            Yeah, absolutely, and the tricky part is that you could spend a lifetime just studying mold, you could spend a lifetime just studying heavy metals, and so each time you get into one of these specific topics as a functional medicine practitioner it’s like jumping down a new hole of a whole new set of things to learn about, and that’s the tricky part. You tend to find what you’re familiar with, so if you’re really comfortable dealing with heavy metals it’s easy to find heavy metals, and most people have heavy metals so you fix those and you’re gonna get some improvement.

Dr. Hirsch:           Right, exactly, and that is a problem with being a clinician is we always have to catch ourselves and make sure that we’re just not leaning on what we enjoy treating or what some of these old patterns are and really trying to be as expansive as possible. And so for me what I have people do when they first come to see me is I have them run a whole bunch of labs because I know my clinical suspicion and I can diagnose some things clinically but neuropathy, fatigue, I mean a lot of these things it could be multiple things. And in fact, with everybody that I see I tell them, “There are 15 potential causes, you have multiple causes of fatigue and the causes that you have are different than the person in the next room.”  So we all have different multiple causes and they’re all different from each other which makes it so hard to treat, so it’s really important to get all of those things assessed, the heavy metals, chemicals, molds and infections, looking inside the body, making sure and seeing whether or not they’re there, putting them together with the symptoms and then coming up with a plan and having the right tools in order to treat them effectively.

Dr. Weitz:            And one of the things that I find challenging in Functional Medicine is when patients come in with the conventional mold, they’re realizing, “Well of course I realize it’s gonna be a little bit different,” but basically they want to take the test, they want to be told it’s this, they want to take those pills and that’s it, I’ll see you, and the problem is these are a lot of times complex cases and there are levels of dysfunction. So if the person has mold but they also have a leaky gut and they also have nutritional deficiencies, and you can’t address all these at one time so you sort of have to prioritize, deal with some of the most significant ones first and it’s a different model than you’re used to going to their medical doctor.

Dr. Hirsch:           Absolutely. I tell people this is a marathon, it’s not a sprint. This is a long-term proposition and it’s gonna require a lot of information or a lot of buy-in from them, and the people who come to see me have already seen 20, 30 doctors and so they’re probably different maybe than the people who come to see you but they’re usually a lot more bought in than when I was just practicing functional medicine now that I’ve ditched myself in this way and people are coming to me for chronic fatigue.

Dr. Weitz:            I see, interesting. I was reading your book which is an excellent read, lots of good information, easy to read and you talk a lot about adrenals in one of the first chapters, can you talk about how important adrenals are to fatigue? And how do we assess adrenals? And what do we do about adrenals if they’re burned out or not functioning optimally?

Dr. Hirsch:           Absolutely, and this is one of the things that I do at the first visit. Generally even without labs I can tell whether or not someone has the symptoms of adrenal dysfunction, and to answer your question-

Dr. Weitz:            Do you ever have patients do a series of labs before they even come in?

Dr. Hirsch:           I don’t.

Dr. Weitz:            Okay.

Dr. Hirsch:           Yeah, they could. A lot of people come with their own labs but I don’t because I want to make the assessment and I want to make sure that I’m ordering the correct labs for them, but the adrenals are really a universal problem. The adrenal gland produces lots and lots of hormones, cortisol is the big one that we talk about a lot that manages stress, it manages the immune system, it manages inflammation, everybody’s heard of prednisolone and cortisone, well guess what? They come from cortisol and that’s our body’s natural anti-inflammatory. So whenever there’s inflammation in the body like from eating gluten or eating dairy or having an infection or having mold, cortisol goes and some of the other adrenal hormones go and try to put out that fire, and as a consequence those hormones coming from the adrenal gland end up going down and people will have low blood pressure, they will crave salty and sweet things.  Generally they’ll say, “I can’t walk past a bag of potato chips without having to stop to eat it.” And then with the low blood pressure they’ll kind of have dizziness when they go from a sitting to a standing position too quickly. They will have low energy throughout the day, but typically they’ll crash usually at around eleven o’clock or at around three o’clock. Three o’clock is the big one where people are like, “Man, between 2:00 and 4:00 I have to take a nap. I have to get some chocolate, pick me up, caffeine, 5-hour energy.” Whatever it is, that’s really when they’re crashing, or they exercise and they have exercise intolerance where they exercise and then they’re crashed out for two days and they’re like, “I thought exercise was supposed to be good for me.” It’s like, “Yeah, but if your adrenals aren’t working well your body can’t manage the stress of that exercise.”

For those of you who don’t know, the adrenal gland is a little triangular gland, sits on top of the kidneys, produces cortisol and some of these other hormones which regulate so many parts of the body, so important and really the sentinel gland. As the adrenal gland goes, so goes the thyroid, so goes the sex hormones, so its really so pivotal, so important. So that’s the anatomy of the adrenal gland, the symptoms that you’ll get with it, and then in terms of testing like I said, I can tell really based off of their symptoms but sometimes you’re looking at a morning cortisol level which is what I do in blood but you can also look at saliva to look at four times a day, but those are kind of the big ones.

Urine can be helpful looking at urine metabolites from the adrenals, so all of those can kind of give you a glance. I do believe that looking at the symptoms are most important. And then in terms of treatment, I’ve tried lots of things over the last 10 years and I’ve dumped all of my protocols into the book, you can read more about this but I found that there’s this one product called Adrenal Px by Restorative Formulations that’s Eleuthero root, Hawthorn root, but mainly the Eleuthero root that’s super smooth and super strong that I have people take every three hours until 4:00 PM and it makes a world of difference in their overall function. It’s really the first thing that I do when you talked about the common causes, one of the most common causes is adrenal dysfunction, maybe it’s cortisol, maybe it’s some other components of the adrenal gland.  But starting to work on that adrenal gland, starting to work on sleep, behavior, food, those are kind of a lot of the big things that I do initially that can make a huge difference in people’s lives.

Dr. Weitz:            Cool, there’s a lot of discussion these days about checking the cortisol within like the first 30 minutes of waking up, it’s called the cortisol wakening response, and so now some saliva tests. You actually spit into a tube before you even get out of bed and apparently you get the most accurate assessment of cortisol apparently using that test now.

Dr. Hirsch:           Interesting. I’ve got a free Facebook group with almost 1,000 people in it and I just did a Facebook live review of some of the work that Ari Whitten did at the Energy Blueprint. He basically looked at all of the research on cortisol and its association with fatigue, and I think most of the research was on blood and on salivary, probably wasn’t on this new technology, but what he found, and time and time again, I mean he went over like, I don’t know, almost 100 different papers and meta analyses and there’s really no correlation between low cortisol levels and fatigue.

Dr. Weitz:            Interesting.

Dr. Hirsch:           Yeah, and so what I really think is happening is that there’s a number of these different components, these different hormones that are being produced by the adrenal gland, epinephrine and norepinephrine which are like the adrenaline hormones, maybe they’re playing a bigger role but utilizing just cortisol to determine someone’s adrenal function really hasn’t been proved and has been disproved in the research to be effective and functional. So we need some better tools but in the meantime I do use it and I combine it with symptoms, making sure that … Because those symptoms can be very specific for the adrenals.

Dr. Weitz:            How often do you actually prescribe cortisol itself?

Dr. Hirsch:           Great question, so like hydrocortisone, Cortef , some of those prescriptive agents?

Dr. Weitz:            Yes.

Dr. Hirsch:           So I have a tiered approach where I’ll start off with giving people Adrenal Px and then if they need I’ll ramp up to three capsules per dose, four capsules per dose. If they need more support I will put them on the Adrenal Px syrup which is a little bit stronger, and then if they need more support beyond that oftentimes and they have low blood pressure I’ll add in a little bit of licorice root and then I’ll move into a product called Adrenal Para-NS by Byron White Formulas, and then I’ll get into hydrocortisone. So there are problems with hydrocortisone, it is a steroid. I mean cortisol is also a steroid, we’re making our natural steroids but it can cause people to put on weight.  They get a little bit of this chipmunk appearance with the jowls and often times they may get a bit of a hump on the back and they do put on the weight and they do start craving a lot more food which causes them put on the weight. So it’s not perfect, there is a book called Safe Uses of Cortisol by William Jeffries where he did use it long term, and I have used it long term with some people but the goal is that it really is just a band-aid, because when we figure out what’s causing stress on the body and that could be a mental, emotional stress or it could be physical stressors like all that crap that’s in the body that I talked about before, once we remove those it allows the adrenal gland to relax. It doesn’t have to produce all these hormones and you shouldn’t need as much of the adrenal support.

Dr. Weitz:            Cool, now another important gland that affects energy levels is thyroid, can you talk about that a little bit? And how often is that playing a role?

Dr. Hirsch:           Absolutely. Thyroid dysfunction is huge and part of that has to do with the fact that low thyroid is really two conditions, it’s low thyroid production by the thyroid gland and then it’s also an autoimmune condition. So the immune system is attacking the thyroid, and usually it’s because one of those crap things, what I call the usual suspects, heavy metals, chemicals, molds, infections, allergies, emotions, EMFs, they’re all in the thyroid and so the immune system is trying to get rid of the stuff in the body that’s not supposed to be there. So it goes on over to the thyroid, calls its friend, starts attacking the thyroid to get at what’s in the thyroid, usually it’s mercury, maybe it’s Bartonella which is this particular kind of infection.

It grabs at it, tries to pull it out, oftentimes not successful because they’re so sinister but that’s kind of the process and in that process you’re destroying the thyroid and you get lower levels of thyroid.  So in order to fix it you have to remove the crap that’s in the thyroid, that’ll slow down the destruction of the thyroid or stop it.  Immune system is no longer gonna react to it and consequently you’re not decreasing your thyroid levels. Now, I do like to use prescription grade thyroid when I am replacing the thyroid.  I’ll start off with some natural things, some thyroid glandular or some iodine or kelp or some of these other things, but generally I find that I get the biggest shifts when I dive into using the prescription agents.

Sometimes people need more T4, sometimes people need more T3.  People who just use Armour or Nature-Throid or Westhroid, they’re missing the boat, that’s basically like a combination of T4 and T3 but everyone’s an individual and most of the time those people who come to me on Nature-Throid or Armour, they need more T4 or they need more T3. We have to figure out the right dose for that individual, and this combination product is not a one-size-fits-all, but thyroid plays a huge role. You also support the thyroid with the adrenals, and there’s this beautiful dance that happens between thyroid, adrenals and sex hormones, and they really all have to be present and accounted for in order for the whole system to work.  So somebody steps out of the dance like when you have stress with the adrenal gland and that’s gonna tax the thyroid and the sex hormones or you get above 50 and all of a sudden the gonads start to shut down and sex hormones start to go down. If the adrenals aren’t robust enough, they’re supposed to take over production of the sex hormones, but if they’re not robust enough, then both the adrenals and the thyroid will start to decrease their function as well, as they try to scramble and compensate for each other.

Dr. Weitz:            Do you find that gluten is sometimes playing a role where the body immune system attacks the gluten and then you get this cross reactivity with the thyroid?

Dr. Hirsch:           Yes, gluten definitely plays a huge role, gluten-

Dr. Weitz:            Soy.

Dr. Hirsch:           … dairy, soy, corn, genetically modified corn, those are kind of the big ones that I see but the only time I’ve ever been able to really reverse thyroid and to get people off of their thyroid medication has been going after infections and heavy metals. There’s one particular infection called Bartonella, this is a funny, serendipitous story where I had a patient who I had just put on a treatment for Bartonella. Now Bartonella is this infection that causes a combination of symptoms usually a combination of headaches, neck pain, problem sleeping, anxiety, depression, pain on the bottom of the feet, muscle cramps in the calves, stretch marks sort of rash on the body and thyroid issues, and so you don’t have to have all those you just have to have some of those. The big ones are like pain on the bottom of the feet usually misdiagnosed as plantar fasciitis and the muscle cramps.

But I put somebody on treatment for Bartonella and she comes back in like the next day and she’s in a thyroid storm. So she was on thyroid medication, I started her on this path and now she’s got too much thyroid, she’s like hyper thyroid. Her heart is beating out of her chest, she’s got tremors, she can’t sleep, she’s anxious, agitated, I said, “I don’t know what’s going on but we got to decrease your thyroid because you’re hyperthyroid.” So we decreased her thyroid and over time as we ramped up on treating her Bartonella we were able to wean her completely off of her thyroid medicine, which I’d never been able to do before.  I never heard of anybody being able to do this before, so it was very exciting.  And so I find that about 50% of people who have thyroid issues who also have Bartonella, I’m able to get them off or wean down off of their thyroid medication, maybe not all the way but a significant way down off of their meds.

Dr. Weitz:            Very cool. What kind of treatment did you use for the Bartonella?

Dr. Hirsch:           So I’m a big fan of Byron White Formulas. He’s just done an amazing job with his herbal complexes, and so A-BART is really one of my favorite formulas which has neem in it and poke root and a number of other things to break up biofilm, to kill the infection, to push it out of its hiding form.  It’s incredibly potent, so even just one drop can send people into a die-off or a Herxheimer reaction where you’re killing the bug and you feel worse, and so sometimes I even start people off topically, just rubbing it into their hands can make a huge difference for folks, but his formulas are really genius and I love to use them.

Dr. Weitz:            Interesting, yeah. I interviewed Darin Ingels who’s an expert on Lyme disease and he mentioned the Byron White Formulas as one of the formulas that he’ll use, and I guess Bartonella is often talked about as a Lyme co-infection.

Dr. Hirsch:           Exactly, yeah. Acutely it’s cat scratch fever, where people get big lymph nodes and they get fevers but chronically, yes it can exist in ticks and fleas and mosquitoes and all these things that transfer Lyme.  And I find that I don’t have to treat Lyme or Borellia as much when I’m going after these co-infections, whether it’s Bartonella, whether it’s Babesia that will cause people spontaneous sweating, shortness of breath, cough, awful panic and anxiety as well as depression and suicidal thoughts. I go after those guys and I don’t have to really go after the Lyme, Borellia as much because then the immune system will come back on board.  I get rid of the molds and the heavy metals that brings the immune system back even more, because you really can’t treat these infections until you get rid of the heavy metals, chemicals and molds that have distracted the immune system. So you got to bring that immune system back in order to bring these bugs back into check.

Dr. Weitz:            Cool, I noticed you were talking about using 20,000 units of vitamin D sometimes for patients with thyroid problems, that’s pretty high dosage, do you find that to be necessary to go that high?

Dr. Hirsch:           Yes, and it really depends on what we’re doing, but when we’re looking at the thyroid and we talked about it being an autoimmune disorder, one of the ways in order to modify the immune system and what’s called the Th1/Th2 balance. One of the aspects of the immune system is causing this autoimmune component, and you can adjust that by dealing with the T regulatory helper cells and you can do that with high dose vitamin D, you can do that with glutathione, you can do that with low dose Naltrexone.  So there’s a number of different strategies that we can use to bring that seesaw back into balance and decrease the amount of autoimmunity that’s happening to the thyroid.  And there’s been lots of studies on vitamin D and I know doctors who try to get people’s levels up to 100 or 150 units on the blood and I’m really looking for more 60 to 100 but people are so deficient that you can give them 20,000 and oftentimes it’s not gonna put them into excess of 100. Most people live at around 10,000 but yeah, 20,000 is also really great for colds, boosting that immune system so that it’s able to function at a higher level.

Dr. Weitz:            Yeah, you probably noticed patients who’ve been to their medical doctor who tested their vitamin D and they said, “Oh yeah, I’m taking plenty of vitamin D. I’m taking 1,000 units a day.

Dr. Hirsch:           Right, yeah it’s almost comical. And the levels when we’re looking at those labs, normal range is not a normal range. It’s not an optimal range, it’s a population-based range, so I’m always telling people … Because a lot of those labs say yeah, less than 20 is low for vitamin D and I’m saying less than 60.

Dr. Weitz:            Yeah, exactly. There was just a study that showed that women who got their vitamin D above 60 had the lowest risk for breast cancer. I noticed you mentioned PEMF which is a kind of electrical machine, right?  And you sometimes use that for patients with thyroid issues.

Dr. Hirsch:           I did. I was experimenting it for a while, probably around that time that I was writing the book. I don’t use it a lot, in part, because some of the ones that I’ve used have just been too strong for a lot of my patients. It opens up the capillaries where you’re able to absorb things a lot better and you’re able to detoxify and I really need more control over detoxification because a lot of my patients were feeling worse. It was also very dehydrating for them and when you have adrenal issues you don’t maintain your salt balance well and so consequently you’re chronically dehydrated, and so it was just a little bit too much. I was using the BEMER technology and some of those and it was just too strong on people.

Dr. Weitz:            You might look into using cold laser. There’s a research group out of Brazil that’s published several studies using cold laser directly over the thyroid, there’s a certain protocol and they’ve actually been able to show changes in the cells and actually reverse Hashimoto’s in some cases.

Dr. Hirsch:           Wow, I’m writing that down right now.

Dr. Weitz:            Yeah, I’ll send you a copy of one of the papers afterwards.

Dr. Hirsch:           Great, thank you.

Dr. Weitz:            So you also talk about trying to balance the sex hormones as something to look at when patients are suffering with chronic fatigue, maybe you could talk about that.

Dr. Hirsch:           Sure, so sex hormones, generally I’m looking at that for people who are over the age of 50, but when mold is introduced it’s incredibly common in any age, especially scratched my head for a while, I’ve had all these men that had low testosterone levels, low libido, stuff like that, turns out that most of those had mold and once we got rid of the mold then the libido came back, the testosterone levels came back up. So it really is about where’s the stress on the organism? How are the adrenal thyroid sex hormones playing a role? Can we do it with herbs? Sometimes I’ll use maca and different forms of maca to boost estrogen, progesterone, testosterone, but sometimes I’ll need to go …

I had a patient today in my office who I needed to give bioidentical hormones. So she’s 47 years old, she’s moving into menopause, she’s got hot flashes and sometimes in the interest of time and in the interest of helping somebody resolve their symptoms I’m like, “Okay, we’re gonna boost your adrenals and while we’re boosting those I’m also going to give you this symptom relief because this is gonna make everything work better as we remove these toxins out of your body.”

Dr. Weitz:            Cool, yeah. One of the problems I think is all these endocrine disrupting substances in the environment.

Dr. Hirsch:           Yeah, we tested her for toxins and we found that there were a bunch of organophosphates, so pesticides that were found in her urine in addition to some mycotoxins or mold toxins that were there too.

Dr. Weitz:            Yeah, I’ve tested hormones on about 20 men in the last several months and like 17 of them were low, especially in their free testosterone, even called up the lab and said, “Is there something wrong?” But I think it’s getting to be really common that these endocrine disrupting substances and potentially mold and heavy metals as well are interfering with testosterone production.

Dr. Hirsch:           You got it right there. Yeah, and they’re all stressing out the hormone system which is really … When it comes to options in the body, I tell people, “Does your body want to survive or does it want to procreate?” And right now it just wants to survive. It’s dealing with all that crap coming at it, it’s stressed out of its gourd and it’s gonna send as many of its resources as possible over to the adrenals, to the thyroid, and it’s not going to worry about the production of testosterone. You can actually see that also when you’re looking at the steroid hormone pathway, that half of it is kind of like adrenals and the other half is sex hormones and you can see how it would be diverted.

Dr. Weitz:            So let’s say you have a patient with chronic fatigue and you’ve looked at the thyroid and adrenal and maybe even addressed the sex hormones, and now you’re starting to think, “Okay, could there be an infection or maybe heavy metals or mold,” and there’s nothing really clear in their history, how do you decide which way to go?

Dr. Hirsch:           So that’s where the labs come into play, because I’ve definitely been proven wrong. And actually another person I had today, I was like, “Well there is no history of known mold exposure.” Now most people don’t ever think that they’ve had mold exposure unless it’s been on the wall, and so I have to ask them, “Okay, have you ever lived in a place that had a leak in the roof or had a flood in the basement or had a broken pipe?” And then people say no and then inevitably they’ll come back the next time and say, “You know what? I think I did.” But it’s so nebulous and it could be that it was a place that they were growing up when they were five and they don’t remember. And so it’s all about the testing, it’s all about having good tests in the urine mycotoxin which is looking at the mold toxins is really the best test out there.  Now you have to propagate it with glutathione so you have to make sure that somebody’s taking glutathione so that they can push all of the micro toxins out and make sure you get a good test.

Dr. Weitz:            Oh, interesting. How much and how long do they have to take the glutathione for before you do the urine test?

Dr. Hirsch:           So seven days, 500 milligrams of liposomal glutathione twice a day, so that’s like a teaspoon twice a day of the ReadiSorb glutathione or the Tri-Fortify liposomal glutathione by Research Nutritionals, and so either one of those should work but seven days or however long. If they can’t take it for seven days because they start to feel like crap because they’re mobilizing all this crap that’s in their body, then just have them take it on that day so that they don’t have to suffer, but generally seven days, twice a day, 500 milligrams and then they do that test but that’s the urine test for the mycotoxins, the urine provocated test for heavy metals utilizing DMSA, really the best ways to get these things out of the body so that you can test them and determine what’s going on.  The PCR tests are basically a DNA test for a lot of these Lyme type infections in the urine through DNA connections is the best test out there. So there are a number of different tests but you got to make sure you’re looking at the right one.

Dr. Weitz:            Which test do you use for the mold? Do you use the Great Plains mycotoxin test?

Dr. Hirsch:           I’ll use both of them, the Great Plains or the RealTime Labs but Great Plains, less expensive, does a great job, I really like what they’re doing. RealTime Labs is covered by Medicare, they also do a great job and they’re expanding their panel a little bit more but I’ll use either one but the Great Plains is less expensive.

Dr. Weitz:            Cool, and then how do you assess for heavy metals?

Dr. Hirsch:           So I’ll use Doctor’s Data, looking at the DMSA provocation test where people take 10 milligrams per pound of body weight, so if they’re 200 pounds or over they’ll take 2,000 milligrams. But I do a pre and a post, so you wake up in the morning and you check your urine and that’s the pretest and that tells you what’s floating around in the bloodstream, and then you take 2,000 milligrams or whatever your weight is of the DMSA and then that’s gonna start pulling out the heavy metals from the tissues, from the organs, because that’s where the heavy metals live. They don’t live in the bloodstream, that’s why when you do a blood test for lead it’s really worthless, blood test for mercury, worthless.

You have to pull it out from the tissues and then you check it in the urine, you collect the urine for the next six hours and then you compare the two and that can give you some really good information as to whether or not someone has a heavy metal. And then there’s a lot of nuances to it because if they’re detoxification pathways are really clogged up with molds or chemicals then they’re not going to have a very positive results or if you detoxify them for a period of time then all of a sudden they’re gonna be releasing a lot more mercury, so they’re going to be like, “Why is my mercury getting worse?” Well it’s not getting worse it’s just that when you were detoxifying initially you could only get rid of up to this amount of mercury, but now that your detoxification pathways are so much open now you’re able to get rid of so much more mercury out of your body. So there’s a lot of nuances to that and I do talk about some of that in my book.

Dr. Weitz:            Interesting. Is there a way to screen for some of the other chemicals besides heavy metals, like the endocrine disrupting substances.

Dr. Hirsch:           So I use the Great Plains Lab, they’re GPL-TOX tests which looks at kind of a hundred different chemicals and that’s a really great test as well, and also should be provocated with the glutathione.

Dr. Weitz:            Okay, great. And then how do you get rid of heavy metals?

Dr. Hirsch:           So that is a great question too, so there are some more aggressive techniques or some more gentle ones. You can use things like saunas and coffee enemas and cilantro and chlorella and modified citrus pectin. I use a combination of products by Byron White. A combination that opens up the liver and kidney pathways, helps open up lymph neurolymph so basically lymph that’s in the brain, and our lymph system is really our garbage can or trash system that really helps to move things through, and then a product that he’s got called Envi-Rad which helps to get the metals out as well as the chemicals.  And in a study that Byron White did on his patients, he found that over a 10-day period when he combined all of these products he saw a 300% increase in excretion of metals in the urine which is pretty darn equivalent to doing it with DMSA which has a lot more side effects and consequences, and you have to make sure that you’re replacing a lot of the minerals and a number of other things. You have to protect the liver and the kidneys while you’re doing that so it has a lot more nuances to it, and so I’ve been very pleased with using this Byron White protocol.

Dr. Weitz:            Cool, how long does that protocol typically take?

Dr. Hirsch:           So it depends on the person, generally the people who are coming to see me need to do it for sometimes six months, sometimes 36 months, so it really depends. I tell people, I say, “I’d like to get you better in a year but depending on the number of causes you have and your ability to tolerate these supplements that I recommend will determine on whether it’s a year or whether it’s three years.”

Dr. Weitz:            Now, do you look at the guy to make sure that they are not constipated, so they’re actually excreting these toxins to make sure they don’t have a leaky gut so they don’t get reabsorbed.

Dr. Hirsch:           That’s a very important point. Nobody should ever be doing any sort of detoxification unless they can get things out of the body, and that means that you’re peeing regularly, you’re pooping regularly, that you’re sweating regularly, that you’re able to exhale. Those are the ways that we detoxify our bodies and so you have to be able to be stooling on a regular basis, once or twice a day. And so I’ll use magnesium to bowel tolerance, but a lot of times when … Constipation has a cause, it could be thyroid and I kind of have a chapter, I’ll dedicate it to this in the book. It could be thyroid, it could be parasites, it could be yeast, it could be a number of these infections that I test.  I really like that GI-Map stool test, really works well.

Dr. Weitz:            Yeah, we’ve been using that a lot too.

Dr. Hirsch:           Yeah, and it gives you a lot of good data and then you can determine whether or not you need to fix it, but everybody that I see has got a leaky gut because they have all these causes of fatigue which also all damage the gut, so there has to be some leaky gut repair. But I found that I’m just wasting time and money to try to heal leaky gut when someone’s got heavy metals, chemicals and molds. I can heal the gut at the same time as going after the fatigue by going after parasites or yeast, but it just doesn’t make a lot of sense for me when I’m treating these really sick people to go after that leaky gut and spending a lot of time there.

Dr. Weitz:            Yeah, especially if their primary symptom is not gut related so you have to prioritize.

Dr. Hirsch:           Exactly.

Dr. Weitz:            Yeah, so the final topic I want to touch on is mitochondria which is that part of the cell that’s truly responsible for producing energy, can you talk about how we think about the mitochondria with respect to fatigue?

Dr. Hirsch:           Absolutely, so the mitochondria like you said is the energy center of every cell in the body except for red blood cells, they don’t have them, but it produces about 70 to 80% of our energy, our ATP as it is. And so the mitochondria comes from a bacterial ancestor, it has this very important mitochondrial membrane which can get damaged by heavy metals, chemicals, molds, infections, allergies, emotions, EMFs, like all these things are going to damage that mitochondria, and so not only do we have to remove that crap off of the mitochondria but we also have to inject the mitochondria with some good love in the form of like Acetyl-L-carnitine, L-carnitine and D-Ribose, CoQ10.

There’s a number of things that I really like to use but the most important thing I think is also to heal that mitochondrial membrane, because what people forget sometimes is that around that cell, that membrane, is the communication tool for other cells, so there’s these ion channels, there’s these messengers that need to be working, and so one of my favorite products is ATP Fuel by Research Nutritionals which does wonderful things for healing the mitochondria and then repairing that mitochondrial membrane. And they did a study on 58 people, and after the saturation you’ve got to boost it up, taking it twice a day for the first two months but after the first two months they saw a 30% average increase in energy.  So just a really nice bump of one or two points of someone’s energy just from doing that, now imagine if you’re also boosting the adrenals, boosting the thyroid, B12, vitamin D, magnesium and then also removing the crap out of the body, you’re gonna get a lot better energy and a lot better function.

Dr. Weitz:            Cool, I feel more energetic already doc. So thanks for the interview Evan, this is really good. How can listeners get a hold of you?

Dr. Hirsch:           So you can find me at fixyourfatigue.org, F-I-X-Y-O-U-R-F-A-T-I-G-U-E.org. You can also check out my free Facebook group which is Fix Your Fatigue With Dr. Evan, you can find that from my website as well. I do have a free download on my website of my book, so if you want to get it on Kindle or on Amazon as Kindle or paperback you’re more than welcome, but you can also download the PDF for free, and I’ve really dumped all of my protocols into there so you can figure out how to solve your fatigue. And I do have about 10 spots available for one-on-one and group coaching right now, so if people are interested I’ll be filling that up in the next month or so. But otherwise, I’m on a mission to help a million people resolve their chronic fatigue so thanks so much for having me on and helping me with my mission.

Dr. Weitz:            Cool, that’s great, that’s a great mission doc. Talk to you soon.

Dr. Hirsch:           Thanks so much.

 

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
EMF Radiation with Oram Miller: Rational Wellness Podcast 075
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Oram Miller talks about how to reduce EMF radiation in your home and office with Dr. Ben Weitz. 

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

 

Podcast Highlights

2:17  Oram explains that the building biology profession that he is a part of is geared towards helping people who have sensitivity to toxins in their home. This includes indoor air quality, mold, chemical outgassing, lead, asbestos, radon, natural gas, and carbon monoxide. There is also the outgassing from paints and finishes, flooring, carpeting, glues, and adhesives in building materials, as well as trapping of moisture in walls.  Oram is the co-author of a book called Breathing Walls that talks about the best building methods, available on breathingwalls.com  Oram is also concerned about the EMFs (electromagnetic fields), that includes four specific types: 1. magnetic fields from house wiring that we recognize in the building biology profession; 2. electric fields from house wiring; 3. dirty electricity, and 4. all the radio frequencies from cell phones, Wi-Fi, Bluetooth, smart meters, etc. 

5:57  If you go into a bedroom with a Gauss meter that only measures magnetic fields, you will miss the magnetic fields coming from wiring errors due incorrect connections of the neutral wires between circuits.The black, hot wire naturally has a magnetic field that goes clockwise around it that is supposed to be canceled by the magnetic field going counterclockwise around the neutral coming aback the other way when they they’re together and equal. But if you have a wiring error, which occurs in up to 50% of homes in Southern California is that they connect these neutrals together under one lug, which is a violation of the code. But the code inspectors don’t look for this because they don’t care about magnetic fields–they just want to make sure that the lights work and there won’t be a fire.

12:24  Another source of magnetic radiation is current that runs along metal water pipes under your home.  These pipes are actually meant to conduct electricity as a path for lightning to get into the earth and we don’t want to disrupt that but we can shield our homes by having an electrician put a 3 inch piece of plastic near the beginning where the water comes into your home which will stop this magnetic field.     

18:35  You could have a broken neutral coming from your power line and power lines are difficult to shield against.  It’s also very difficult to shield against strong radio frequencies from cell towers if they’re close by. We can shield against those but it’s very expensive.  And we are going to 5G, which will result in more exposure from more cell towers closer to our homes. 1G (the first generation) was voice, 2G added texting, 3G added cellular data, 4G (fourth generation) added data at higher speed and greater volume. But we are running our of bandwidth in the frequencies that are currently in use below 6 gigahertz (6000 megahertz), in the 800, 900, 1800 megahertz range and the industry would prefer to stay in this range because it penetrates walls easily, etc. But some of the range of frequencies is being held by the military for future use and they are running out of bandwidth in this range.  But this new 5G bandwith, including the super 6 gigahertz range from 20 gigahertz and up, doesn’t go through walls easily, so they have to aggregate and focus the beam to drill through our walls easily, which require cell phone towers every 2 to 10 houses. Fortunately, these 20 gigahertz and higher frequencies can be blocked by YShield paint and you can also put foil in your walls. There are also transparent films for windows and there’s metal mesh window screens.

30:20  While it would be safer not to use cell phones, given that we are going to use them, it is safer to text than to make a call. It is better to use a set of headphones and a microphone with an air tube in the last six inches that you can get from LessEMF.com.  At home, it is better to use your landline to make and receive calls with a hard-wired phone. When you use your cell phone it is better to speak through the speaker rather than hold it up to your ear.  There are shields you can put on the outside of your cellphone that can reduce the levels somewhat.

When listening to podcasts in the car, like this one, the best thing to do is to have the podcast already downloaded onto your phone by plugging it into your computer and downloading it from Itunes. Then plug your phone into your car stereo through a wire and make sure to place your phone in airplane mode.

37:17  Oram explained that when he inspects someone’s home he finds lots of sources of electric fields that can affect their health, esp. in the bedroom. People who have electrical hyper sensitivity should have a kill switch to shut off all the electricity going into their bedroom at night. Even if you plug an ethernet cable into your laptop computer, your will still be receiving radio frequencies unless you turn your wifi off. They may also have a Nest thermostat sending out a signal every five seconds or so. They may have a smart meter on the outside of their home. They may have smart speaker like the Echo sending out signals constantly. Your Bluetooth, your router, your cordless telelphone, when you hang up the phone and place it into the base unit, it’s still emitting radio frequencies 24/7, like an ashtray full of burning cigarettes. In fact, France has recently voted to ban wi-fi in day care centers and nurseries for children and they’ve banned cell phones in schools up the middle level.  So you want to avoid such sources of electric fields, esp. in your bedroom, and at least turn them off at night. Do what you can to reduce and limit them.

 



Oram Miller is a Certified Building Biology Environmental Consultant and Electromagnetic Radiation Specialist based in Los Angeles. Oram provides on-site & phone healthy home & office EMF evaluations for clients throughout Southern California who have electro-magnetic sensitivities, as well as those who want a healthier home or office. He also consults on the healthy design and construction of new and remodeled homes. His website has lots of great information createhealthyhomes.com and his phone is 310.720.7686.

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



 

Podcast Transcripts

Dr. Weitz:            This is Dr. Ben Weitz with the Rational Wellness Podcast, bringing you the cutting-edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field.  Please subscribe to the Rational Wellness Podcast on iTunes and YouTube, and sign up for my free eBook on my website by going to drweitz.com. Let’s get started on your road to better health.  Hello, Rational Wellness Podcast listeners. Thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness Podcast, please go to iTunes and give us a rating and review. That will ensure that more people find out about the Rational Wellness Podcast.

Our topic for today is EMF radiation, which is a very important topic. A lot of people are not really clued in to it, these are forces in your home, at work, in your car that can potentially negatively impact your health. Today with us today we have Oram Miller, Building Biologist, expert on EMF radiation. Oram, thank you so much for joining me today.

Oram:                   You’re welcome and thanks for having me.

Dr. Weitz:            Yeah, so why don’t you tell us a little bit about your background and how you got interested in this field.

Oram:                   I’ve always been interested in biology. I was interested in particularly the environmental aspects of this work and how they impact people’s health. So, I took training in the building biology profession. It is headquartered in New Mexico, although originally it was in Florida, because this knowledge was brought to America by an architect from Germany, Helmut Ziehe, who married an American woman 30 years ago and started the International Institute for Building Biology and Ecology in Clearwater, Florida.

He and his wife ran this and trained many people, and those individuals, 30 years ago, are now the faculty today and they trained me and now I teach with them as well. So, our profession is geared towards helping people who have sensitivity to toxins in their home, and that expands the gamut from indoor air quality, mold, chemical outgassing, lead, asbestos, radon, natural gas, carbon monoxide, and then the out gassing from paints and finishes, flooring, carpeting, glues, adhesives that you’d have in building materials, as well as trapping of moisture in walls.

I wrote a book called Breathing Walls that talks about building methods. Actually one of the writers for the principal author George Swanson who’s in Texas, a building biologist and builder, who is the principal person with that knowledge on how to build homes that don’t develop mold in their walls, that’s called Breathing Walls, and you can go to breathingwalls.com for information on that.

Then there are EMFs and that stands for electromagnetic fields, and that includes four specific types that we recognize in the building biology profession. That would be magnetic fields from house wiring, electric fields from house wiring, which most people don’t know exist, and then all the radio frequencies from cell phones, Wi-Fi, Bluetooth, smart meters, and so on, and then so-called dirty electricity. Those are the four EMFs that we focus on.

Dr. Weitz:            What’s the difference between the electric forces and the magnetic forces?

Oram:                   So, when we talk about EMFs, they’re really talking about two fields. The E of EMFs refers to the electric field, and the M of EMFs refers to the magnetic field and they’re actually … So, let’s start from the beginning and here we have a sine wave going from zero to maximum, to zero to maximum, to zero in a positive direction and negative direction. That’s one cycle, and there’s 60 of these per second.

I don’t know if you can see that on the camera, but that’s what we deal with with alternating current here in the world for the last 100 years. The voltage varies from zero to maximum, to zero to maximum in a positive, negative direction. That’s actually Tesla who convinced Edison to switch from DC to AC back in before they turned from the 1800s, so the 1900s, late 1800s that’s when that happened. Ever since, we’ve had alternating current, which allows-

Dr. Weitz:            It’s all Edison’s fault.

Oram:                   Well, in the sense that … In a way because the voltage varies, but it’s 120 times a second and it’s able to go down the wires for many miles because with DC, which is the way it was all distributed in the 1880s and 1890s, the voltage dropped within a block or two.

Dr. Weitz:            Okay.

Oram:                   There were little decentralized coal-fired power plants in throughout all urban areas in the world for 20 years or so, and they just couldn’t get industry to develop because everything had to be generated. All electricity had to be generated locally. So, when they switched over to AC, alternating current, then they could send electricity at 120 volts for many miles and that allowed industry to develop, but there are health effects from being in the field of these power lines within your home and from power lines that are outdoors.

So, what you have here is electric fields and magnetic fields at right angles to each other. I don’t know if you can see that, but see the red here going vertically and the beam here coming out horizontally, so you have these two fields and they’re either coupled or uncoupled. I won’t get into the physics of it, but when you’re in the near field which is three wavelengths within three wavelengths you don’t have couplings of the electric and magnetic field.  That means if you go into a bedroom with a Gauss meter that only measures magnetic field and it’s low, you could have low magnetic fields, and usually do in a bedroom especially on the second floor at night because most of the magnetic fields that occur in the home are either from power lines outside, in which case that would involve the second floor bedroom.

But if you don’t have the power lines there in the front or back of the house, then the other three sources of magnetic fields in the home are wiring errors, current on water pipes and other grounding paths and point sources like being near a refrigerator. So, the wiring errors are due to incorrect connections of neutrals between circuits that the electrician does, but the code inspector doesn’t catch because they’re not looking for them.  But that’s only there, the magnetic field from wiring errors are only there if you have loads on. So, at night, you turn all the loads off so there really aren’t any magnetic fields from wiring errors. That’s a day and evening time problem when the lights are on and current-

Dr. Weitz:            What is a wiring error?

Oram:                   It’s a misconnection between different neutrals, we call them. This is an example here, I know you can’t see this at home but it’s from a book by Karl Riley, who was a science teacher who worked with some parents in Southern California 20 years ago at the invitation of them and their electricians, and he helped them find the wiring errors that were causing the magnetic fields, and so he wrote a book about it called Tracing EMFs in Building Wiring and Grounding, which is available from lessemf.com, and also Southern California Edison the electric utility here outside of Los Angeles municipal.  For most of Southern California, except for San Diego, they have their own utility. Southern California Edison hired Karl Riley to come and do a video, a 22-minute video explaining wiring errors and that is available from Less EMF, 22 minutes there. The EMF consultants from Edison give that video to their customers who call up for EMF information.

Dr. Weitz:            Both have a positive, a negative, and a ground, is that right?

Oram:                   Well, you’ve got the hot wire.

Dr. Weitz:            Okay, so the hot wire is where the electricity is.

Oram:                  You’ve got the hot wire, which is the black wire here.

Dr. Weitz:            Okay.

Oram:                  That’s the hot wire.

Dr. Weitz:            Right.

Oram:                  Here’s the neutral, and here’s the ground, so the hot wire carries current to the loads when you turn on a light, and then the current goes through the light and comes back on the neutral wire, which is the white wire here, and there shouldn’t be any current on the ground. That’s just for safety in case you have a short, the ground will trip the breaker.  So, basically you have a magnetic field which is a circle of energy invisible around the flow of electricity through a single wire, and if you have two wires where the current goes out from your breaker panel or from your light switch, and then up the wire in the wall, so it would be the black wire in here going up to the light, and then the neutral carries the current from the light back down again, which is right next to the hot wire.  The magnetic field around any wire goes clockwise if you look from behind, the right-hand rule. These arrows are actually backwards, but the point is that the current, when it’s present, causes a magnetic field in every wire, in every circuit, in every house. The reason why you don’t have magnetic fields in the room is because the magnetic field that goes clockwise around the black hot wire going one way is canceled by the magnetic field going counterclockwise around the neutral coming back the other way when they’re together and when the currents are equal.

Dr. Weitz:            That’s good. That’s what you want?

Oram:                   When they’re equal, yes. But if you have what’s called a wiring error where you have two circuits in this particular case here in what we call the junction box, and they’re separated the blacks are separated because there is a chance, depending on which leg you’re on, that if you turn them both on or turn them on, they’ll trip the breaker if the blacks are connected. Every electrician knows this, although occasionally we still see that happening.  But what’s very common in up to 50% of homes in Southern California and 30% of homes throughout the country is that they’ll gain these neutrals together under one wire lug, which is a violation of this particular code in the National Electric Code. But the code inspectors don’t look for this, because they don’t care about magnetic fields. The lights work and they’re more concerned with making sure that fires don’t occur from having too much current on a wire that’s not rated for the amperage that it carries.

I’m not disparaging code inspectors. When they learn about this, it’s in the code, it’s just that they’re so understaffed and overworked that they just don’t have the time. They don’t care. Nobody looks for these. Now, these new arc fault breakers are mandated to prevent tripping or they trip the breaker when there’s fraying of the insulation, and that’s a safety feature to prevent fire.  Those arc fault breakers, which are now code required in the last two cycles, so every three years they update the National Electric Code, so the last two cycles so six years or so that’s been in there. All the homes built in America in the last six, seven years, some circuits need that.

Now in the most recent edition a revision of the National Code from what I understand all circuits require this, and they’ll trip the first time the electrician turns on that circuit when they do the installation if there’s a wiring error. Now, in France, they’ve had these variations on that for 30-40 years so they don’t have wiring errors in their housing stock going back half a … Maybe 50 years.

Dr. Weitz:            If the wiring’s not done properly, if the white wires are connected together like that, then you won’t have this balancing of the current.

Oram:                   Right.

Dr. Weitz:            Then you’ll get excessive amounts of electrical field-

Oram:                   Magnetic field.

Dr. Weitz:            Magnetic fields.

Oram:                   In this case.

Dr. Weitz:            And so those can affect us.

Oram:                   Yeah.

Dr. Weitz:            Okay.

Oram:                   Right, all right. So, that’s an example of one type of EMF, the magnetic field in your home when certain lights are turned on. It can be lighting loads or it can be things you plug in.

Dr. Weitz:            Right.

Oram:                   So, wiring errors are one of the important four types of, four sources of magnetic field. Another source is current on water pipes, and that’s a little bit hard to explain, but it’s all on my website www.createhealthyhomes.com, homes is plural. If you go there and click on articles on EMFs, then you’ll see an introduction to EMFs that I wrote, and then four separate articles on each of these types of EMFs.  So, click on the magnetic field EMF article, and then I explained the four sources power lines, wiring errors, current on these water metal grounding paths like water pipes and TV cables coming in and out of the house, and the last is point sources like transformers and motors that have a big field close up when you measure with a Gauss meter, but as you move away from the field, from the source like the back of a refrigerator, it drops off exponentially.  Instead of linearly, it drops off quickly so 90% of the reduction is in the first one flow, and then the last 10% takes another two feet to drop away. So, you’re okay, distance is your friend. The shielding is very difficult and expensive, and it doesn’t work very well because the magnetic fields will creep around the edges. So, it’s better to just distance your-

Dr. Weitz:            I’ve even seen paint that’s supposed to be a shield.

Oram:                  The paint is not for magnetic fields. It’s for radio frequency fields.

Dr. Weitz:            Okay.

Oram:                  And electric fields, which we haven’t talked about yet, if you ground it. That basically covers magnetic fields. If there’s current on your water pipe, and I explained in the article how that happens.

Dr. Weitz:            And the water pipes in most of our homes are made of copper.

Oram:                  Yes, so that they conduct electricity, and they’re meant to as a path for lightning to get into the earth. Their code requires for that, and we don’t ever disrupt that but if we do put a piece of plastic in the water pipe, we’ll put an earth rod in this place.

Dr. Weitz:            Right.

Oram:                  The point is that water pipe doesn’t end like an earth rod does eight feet in the ground. That water pipe keeps going and then connects to a water main that every other house is connected to so your house is electrically connected to the grounding system, to every house of every neighboring house, and so current which … So, if 8 amps comes in on the two hot wires overhead or underground from the utility transformer, that’s the only way that the electricity comes in. But when electricity goes back, it will take all available paths not just the path of least resistance. It does that primarily, but not exclusively. So, if you give it parallel paths, then it will take all of them.  So, 85% will go back on the path it should, which is on the neutral wire of the overhead service drop cable, but that means that there’s 8 amps coming in and 7 amps going back, so there’s a 1 amp net difference. So, there’ll be a magnetic field coming down into your yard and up the side of the house from that cable, two hot wires coming in, one neutral wire going back and that comes into your house and maybe a bedroom there.

But what’s most important is there’s that 1 amp will go from there to the water pipe, which could be in the front of the house under your living room floor right here into your kitchen, and there’s a big magnetic field coming up through the floor 24/7. If you have a bedroom on the first floor, it’s under your bed and under where you sit because that’s the way that that extra 1 amp gets out.

Dr. Weitz:            What can you do about that?

Oram:                  Plumbers can put in a piece of plastic outside that they dig down, and in California where it’s warm, it never freezes, the pipes come out of the earth right in front of the house and then turn 90 degrees and go in and there’s a valve for a hose and a valve to shut our hose bib and then they have a valve to shut the water off there and a pressure regulator.  The plumber will cut a three inch section and put a piece of plastic in there, a plastic dielectric union or copper brass with a ring of plastic and rubber in it to block the flow of electricity, and that takes care of that magnetic field among the entire right through the middle of your house. Just one fell swoop you take care of it that way, few hundred dollars and the problem is solved.

We also have a cable isolation filter for $15 that I can put in to the TV cable that the sheeting of that can carry current. That’s another parallel path because they’re all grounded in the house and at the utility pole, so they’re all connected. The cable company grounds the sheathing of their incoming coaxial cable to the electrical system at the utility pole or underground. So, there are several ways that that can happen so we now have-

Dr. Weitz:            Is that the same thing if you have your internet through a high-speed cable from the phone company?

Oram:                  Yeah, telephone lines tend not to have this phenomenon.

Dr. Weitz:            Okay.

Oram:                  Overhead.

Dr. Weitz:            So, cable lines but not phones lines.

Oram:                  If they’re underground, sometimes they can but we check for it.

Dr. Weitz:            Okay.

Oram:                  Usually it’s … And it’s not always the case with cable, and it’s not always the case with water pipes either because in Southern California, the municipal water departments like Los Angeles Department of Water and Power, and et cetera, have been putting in little pieces of plastic, these dielectric unions, themselves for decades at least up until recently.  They did it for completely different reasons to stop the leaking because if you have current on your copper pipe, then that means that the coppers are at one potential, the salts of the earth are at a different potential, when we watered our lawns before the drought there was some moisture of the soil and electricity and different potentials it caused little pinhole leaks, electrolysis caused little pinhole leaks.  So, the water would leak out like a sieve and the water pressure was dropping all over the neighborhood over the decades. To stop that, they had to stop the current. They understood that. They had no concept of magnetic fields being an issue as well, but by doing that they stopped the magnetic fields. But they didn’t get to all the houses and then they stopped the program.

Dr. Weitz:            Right.

Oram:                  Their EMF expert told me that, at least for DWP. So, about half the neighborhoods that I go to in Los Angeles County have this and half don’t, so in those that don’t we have to put that in. You could have a broken neutral, which causes a big magnetic field from your power lines.  Power lines are difficult because we can’t shield against that. That’s the one thing we can’t do anything about, and also strong radio frequencies from cell towers if they’re close by it. We can shield against those but it’s very expensive.

Dr. Weitz:            There’s more and more cell phone towers especially as we go from 3G to 4G and now 5G?

Oram:                  Yes, that’s true. 5G is a whole another can of worms we’re moving into, and 5G is not 5 gigahertz by the way, which many of us already have. It’s one of the two Wi-Fi frequencies there’s 2.4 gigahertz and 5.8 gigahertz, so you’ll see 5G which is an abbreviation for 5.8 gigahertz on your router, 2.4 and 5G and that’s gigahertz. But what we’re talking about here is fifth generation.

Dr. Weitz:            Right.

Oram:                  So, every 8 to 10 years for the last 40 years or so, the cell phone industry has moved from voice originally, which was 1G, second generation added texting, third generation, which was 20 years later or so, added cellular data, fourth generation or 4G plus LTE is the last most recent changed 10 years ago, and that added data at a higher speed and greater volume than 3G and ramped that up considerably.  So, we’re at the point now where we’re heading towards the fifth generation and the difference there will be we are running out of bandwidth in the frequencies that are currently in use below 6 gigahertz, which is where the industry is now and all of our phones have transmitters and receivers in frequencies that are less than 6 gigahertz or 6,000 megahertz.  So, we’re at 800 megahertz, 900 megahertz, 1800, 1900, 700, and this is where industry would prefer to stay because those frequencies get through walls and and we all have equipment that can pick it up. But some of that frequency is held by the military for future use and the FCC knows it’s going to have to free that up for the industry to obtain it through auction, and that’s where they prefer to stay.

What they’ve been talking about is expanding to the super 6 gigahertz range, which is the millimeter band from 20 gigahertz and up, and we’re not using that now and the problem … Oh, except we do use it, satellites use those frequencies 20, 30, 40, 50, 80 gigahertz and the wavelength is so short it’s called the millimeter band, because one way there’s only like a quarter of an inch or a few millimeters.  The problem with that for use by cell companies is it doesn’t go through walls easily at all. You don’t even have to have special shielding material like the paint we talked about or foil, or certain fabric like margin mesh here, which is a silver fiber and I believe this is rayon, and this blocks radio frequencies maybe 80, 90% but 5G is blocked by any wood wall, any plywood, piece of plywood or asphalt shingles or bricks.

So, they have to aggregate and concentrate and focus the beam to drill through those materials and they’re going to exceed FCC limits to do that, but they’re going to get a waiver in order to do that. But beamforming means it’s going to be certain when you have these small cell antennas that you’re planning to put in neighborhoods every two to 10 houses at lower power than legacy macro cell towers, which exist now using for fourth generation and LTE technology, which is at 800 to 1,000 watts that’s what those cell towers out there send out, and your cell phone is at three-quarters to one watt.  So, these small cell antennas are going to be … We don’t know yet what the power is going to be and they’re going to still send out 4G frequencies, right … You’re going to have like a mini cell tower right outside your neighbors.

Dr. Weitz:            So we’re going to have a lot more of these.

Oram:                   Yes.

Dr. Weitz:            So, we’re going to get more exposure, unfortunately.

Oram:                   Yes, yes, unfortunately. But they’re going to add to it the gigahertz signals up in the gigahertz above 20 gigahertz range, and those are not going to go through the wall so they’re going to focus them and use beamforming, which means the antenna’s going to search. That’s what everyone’s worried about because those are the frequencies that they don’t penetrate the skin, but they affect the skin greatly. Those are the frequencies that we use.

Dr. Weitz:            Is there any way we can block this?

Oram:                  Yeah, yeah. Okay, so here’s the-

Dr. Weitz:            I mean, society wise do we have to go to 5G?

Oram:                  The reason-

Dr. Weitz:            Are we running out of frequencies? Is that what it is?

Oram:                  Well, we’re running on a bandwidth even though they have technologies that they’ve been working on for decades actually, but they’re perfecting to increase the amount of traffic in the existing frequencies we have in the sub-6 gigahertz range.

Dr. Weitz:            Right.

Oram:                  Fifth generation, 5G is going to include sub-6 gigahertz. All the frequencies we have now we’re going to keep. We’re not giving them up, and then they’re going to open up the 20 gigahertz and above so everyone’s focusing on this but this will still be there. However, there’ll be more data push through those pipelines and those channels, but the difference is we can measure those with the radio frequency meters that we have.  There are frequencies that we already can measure now and we can shield them easily with materials that we have. The 20 gigahertz and higher frequencies will not be blocked by cloth very well, but they will be blocked by YShield paint, which is currently in use now for sub-6 gigahertz frequencies that we currently use for cell towers, and foil that you can put in your walls.

Then there are transparent films for windows, there’s metal mesh window screen, and well as I said for the 20 gigahertz and above a millimeter band cloth will not help with that, but the film should. The windows are your big Achilles’ heel because they’re a hole in the wall, even if you put YShield paint on the outside or inside as a primer and then cover it with whatever color you want and it’s a non-toxic paint or foil if you’re building a house or remodeling it, you could put foil in and then put your Sheetrock over that. I have done that before.  That will block the frequencies coming through the wall even in the millimeter band, even with the beamforming and the aggregation that they’re going to do. But your window, you’ve got to be very careful with windows. These meters, by the way, can’t measure up in the millimeter band but there are two people I know of, Rob Metzinger, who is at Safe Living Technologies, and a gentleman here in Southern California are both working on a version of this, something like this that can pick up these millimeter band frequencies of 20 gigahertz and above.

They’re just waiting for the industry to zero in on certain frequencies and then they’ll tune their crystals and chips to those frequencies and it will be affordable. Now, Rob Metzinger at Safe Living Technologies just released this called a Safe and Sound, which is only $140, very accurate radio frequency device and this is almost $2,000. This is from Gigahertz Solutions and he sells it.  This is from Safe Living Technologies, but this is only … It’s a fraction of the cost and it has sound, that’s your router. You’ve a router in the house here because that sound, which sounds like a very fast helicopter, well tick-tick-tick tick-tick-tick, that’s the sound of a router. So, I know when I turn my meter on what a person has in their house. That’s the sound of a router. That’s the sound that a router makes. Then you have this little guide.

Dr. Weitz:            Well, this is actually connected by wire, but there is a router in the house for sure.

Oram:                  Yeah. So, you see here where we’re at in the orange and so that corresponds to 100 to 1,000 micro watts per meter squared. That’s how this works. You get a little guide here, and you could have without sound or with sound. That’s about 100 to 1,000, so let’s see. That’s exactly what we’re getting here about 140. Now, if I turn it just right, it’ll go blank and that’s over 200. So, we’re right in the ballpark, okay?

Dr. Weitz:            So, basically if you don’t understand what we’re talking about, that’s because our brains have been totally fried by the Wi-Fi electromagnet radiation.

Oram:                  Right. Now, this is the new TriField Meter. This is the old TriField Meter, the 100 XE, which many of you have. We don’t recommend this because it’s not as accurate. It’s not at all accurate as far as we’re concerned to get into levels that we consider to be safe in the electric or radio frequency band, and the magnetic field settings it tends to overstate the case.  That was the frequency weighted model, so they came out with a model that has little magnets in it to dampen that effect, and they called it the flat frequency response model, and it says flat frequency response on the back if you have one of those. This is not that one, or one of those, so you don’t see that here. If you called up Less EMF or went to Amazon online and just ask for a TriField Meter, this is what you would get, the frequency weighted one.

Dr. Weitz:            I know there’s … Yeah, go ahead.

Oram:                  So, what TriField did was they came out with a new one this year, 2018, the TF2 TriField 2, and it’s excellent. I love it. It’s very accurate. You have standard mode or weighted mode in terms of the frequency response. So, Ben, you have a good magnetic field level in this room, less than one milligauss is what we’re looking for and it’s hovering around 0.6 to 0.9 milligauss, occasionally flipping up to one.  You have sound, you can hear the … You can turn that off from the back here, now it’s quiet. So, that’s for magnetic field, and then electric field it’s much more accurate, and then you can … We don’t use, in my profession, the weighted mode for electric or magnetic, we go with standard because that is similar to the Digital Gauss meters that we use.

Then we have RF, and this is … You hear the ticking here, which is not the ticking of the router. This is different. This is just a Geiger counter. These other meters, this one from Safe Living Technologies is called Safe and Sound, and this one which is the Acousticom 2, which is the little brother of the Acoustimeter from Alasdair Phillips in England, EMFields.  They both have the real sound. These both have the real sound of the radio frequency source in the room. This one is just a Geiger counter for the level, but still I credit Alpha Labs with the TriField 2, for being much more sensitive and so we’re getting numbers that are very similar to the numbers that we get from these other meters, in the RF mode for Wi-Fi, cell phones and so on.

Dr. Weitz:            I’d like to use the rest of the time we have to focus on cell phone and Wi-Fi radiation, because I know that’s something a lot of us are concerned about and I’d like to see what we can do about making some recommendations for some of the best choices we can make, given the fact that we’re going to use cell phones and then cell phones do emit this radiation.

Oram:                  Okay.

Dr. Weitz:            I know it’d be better not to use cell phones, but that’s not going to happen, so I wonder if you can give specific recommendations. When I’m using a cell phone, first of all, what are the best things to do? Is it better to text rather than call? Is it better, if I’m calling, to hold the phone here? Is it better to have a plug, a wire connected into my ear with a little microphone? Can you make some of those recommendations for us?

Oram:                  Yes, and everything you just said is accurate, spot-on. The general recommendation that my profession makes, based on European research, is reduce use generally.

Dr. Weitz:            Meaning try not to use your cell phone at all, but that’s very hard to do.

Oram:                  Well, increase distance.

Dr. Weitz:            Okay.

Oram:                  And then use hardwired connections whenever possible. When you’re home, for instance, don’t give up your landline just to save money because you’re going to be penny wise and pound foolish, because in the end your risk of developing tumors goes up.

Dr. Weitz:            But you know with all due respect, nobody is using a landline.

Oram:                   I have clients who do.

Dr. Weitz:            Very few. I mean we have one, we never use it.

Oram:                   Right. Right, okay.

Dr. Weitz:            Then when we were, we had a wireless phone which is just as bad, right?

Oram:                   It is. It is just as bad.

Dr. Weitz:            Okay.

Oram:                   The effects are cumulative, and so here this is-

Dr. Weitz:            If I hold my phone and speak through the speaker option, is that significantly better than holding it here?

Oram:                   Yes, and the reason is because the transmitter is now here instead of here.

Dr. Weitz:            Okay.

Oram:                   So, when it’s here-

Dr. Weitz:            So, the signals are not going through my head.

Oram:                   When you use a cell phone, and I forgot to bring my … It’s in the car but …

Dr. Weitz:            Yeah.

Oram:                   When you use a cell phone, the cell phone is transmitted 360 degrees.

Dr. Weitz:            Right.

Oram:                   Now, there are shields, there are technologies, Pong and many, many different shields and that redirect the energy that’s helpful, and again, I have in the car a shield that opens up and then you can start your call, close it up, and if you hold it here, which I don’t recommend but it is shielded. It does reduce, but the level that it reduces down to even if it’s 80, 90%, it’s still way above what we recommend.

Dr. Weitz:            Is it better to have a headphone plugged in to it rather than use the speaker part?

Oram:                  With an air tube in the last six inches, yes.

Dr. Weitz:            The air tube? What’s an air tube?

Oram:                  Well, I’m sorry, it’s in the car. I forgot to bring it in, but it’s called an air tube earphone, so it’s wire from you plug it into the phone and it’s a wire with a little microphone in it.

Dr. Weitz:            Right.

Oram:                  Then it ends with a little speaker that goes up through a clear plastic tube, sometimes it’s blue, where the sound just goes through the tube to a little diaphragm that you put in your ear and they call it an air tube earphone.

Dr. Weitz:            Okay, so it’s different than the typical one.

Oram:                  Yeah. Oh, yes. You don’t get one of those with your cell phone.

Dr. Weitz:            Where do we get this?

Oram:                  Less EMF and a whole host of other companies that sell these that are EMF.

Dr. Weitz:            One more time, best way to talk on your cell phone is to use …

Oram:                  Well, the best way to talk on your cell phone is to hold the cell phone here because the transmitter, which sends out a signal 360 degrees is this far from your body, okay?

Dr. Weitz:            Right, and so let’s say you have … Is it better to use the speakerphone or better to use this wire thing?

Oram:                  Well, that’s your choice relative to privacy and the ability of the other person to hear your voice.

Dr. Weitz:            Well, let’s say in terms of just radiation, is it better … I can either use my speakerphone here or I can have a wire, what’s better?

Oram:                  It doesn’t matter that much.

Dr. Weitz:            Okay, so those are both going to decrease.

Oram:                  Well, it does because there is some coupling of the radiofrequency onto the wire, but it stops here.

Dr. Weitz:            Okay.

Oram:                  Now, of course, there can be some effect.

Dr. Weitz:            Okay. But the bottom line is don’t hold the phone up to your ear, okay. How about in the car, what’s the best way to speak on the phone in the car? If I plug it into my radio on my car …

Oram:                  Most people have Bluetooth where they sync up, so then-

Dr. Weitz:            Let’s say I don’t use … So, one choice is it just syncs up with the Wi-Fi or what if I plug a wire into my phone and plug that into the car sound system, does that change anything? Does that make it safer, better?

Oram:                  What, through the earphone? That won’t work, because the microphone and …

Dr. Weitz:            It doesn’t go directly into the sound system?

Oram:                  No, no.

Dr. Weitz:            Okay.

Oram:                  Not that I know of. Not for years. There was a technology in the past that allowed that to happen, and then we also had access to a jack for an external antenna that we put on the roof of the car, but they don’t have those anymore.

Dr. Weitz:            Okay.

Oram:                  These new phones are completely sealed. You can’t take the battery out.

Dr. Weitz:            Okay.

Oram:                  The new generation of phones, you have one port and that’s for … Well, you have your charging port, your lightning port if it’s an Apple or your USB.

Dr. Weitz:            So, is it worse talking in the car using the Bluetooth than it is speaking through the speaker of the phone?

Oram:                  You’re getting strong signals no matter what. There’s no way around that, Ben, in the car.

Dr. Weitz:            Okay.

Oram:                  Let me take two steps back and say-

Dr. Weitz:            Okay, let me just ask one more question and get to that. If I want to listen to music or a podcast like this one in my car, and I have downloaded it onto my phone already, I’ve gone to my computer, I downloaded it to my phone. So, now the podcast is on my phone. I’m not getting it from Wi-Fi, and I plug that into the sound system, so now the sound system is just taking that recorded podcast-

Oram:                  Through the speaker.

Dr. Weitz:            Through the speaker, is that-

Oram:                  Or through the earphone jack.

Dr. Weitz:            Right, is that safer than receiving it-

Oram:                  Yes.

Dr. Weitz:            Is it a safer way to do it?

Oram:                  Provided you put the phone in airplane mode.

Dr. Weitz:            Okay.

Oram:                  Because if you don’t put the phone in airplane mode, it’s still sending out a beacon signal every minute or so.

Dr. Weitz:            Okay. I see.

Oram:                  Especially when you’re traveling, because then you’re in the mode where-

Dr. Weitz:            So whenever possible, put your phone in airplane mode.

Oram:                  Yeah, but then you can’t get a call.

Dr. Weitz:            Okay.

Oram:                  Now, I say that because people need to understand when I go to a person’s home I’m there for six or eight hours, because I spend the first hour going over what we’re talking about now, what EMFs are, where they come from, how they affect your health, and what we do about them. Then the other six to seven hours is spent going through the house with the client to each room where the client and their family sit, sleep, and stand to measure magnetic fields, electric fields, radio frequencies, and dirty electricity.  Now, some people tell me, “I know all about EMF, so you can skip that part.” I said, “No, no. You need me to go over it with you, because I’m going to show you things that you haven’t heard before.” Nobody knows about electric fields, which we haven’t talked about yet, and electric fields are very important. You must get them down where you sleep, because otherwise you’re not going to get the deep stage four rest every 90 minutes, and you’re not going to get the melatonin you should have.

Dr. Weitz:            Right.

Oram:                   We have clients shutoff breakers, and then eventually do it automatically with a kill switch. So, I can explain that to people at createhealthyhomes.com. They can call me and email me through my website, and there are articles on that. That’s the missing link. There are a lot of people who have electrical hypersensitivity, who come to me who’ve done everything right from all the EMF websites that they’ve looked at.  They’ve got chips and pendants everywhere stuck on every device, and including your cell phone. They’re still using their cell phone, which I can’t even fathom if they’re electrically sensitive that they don’t have a hardwired. Some of them can’t use a cell phone, so they have to go to a hardwired line, and they think that they’ve gotten rid of all the radio frequencies in their house.  But if they don’t have one of these little meters, then they don’t know for sure and they plug in an ethernet cable to their laptop and their router and say, “I’m hardwired.” I say, “Yeah, but you didn’t … Did you shut off the Wi-Fi?” They said, “No, it happens automatically, doesn’t it?” I said, “Let me show you,” and then I turn this on and then we get that and they say, “What’s that? I have an ethernet cable.” I say, “You didn’t turn off the Wi-Fi.” “I didn’t know I had to.” This is the dialogue I have with my clients, so they don’t know.

Dr. Weitz:            Right.

Oram:                  Or they have a Nest thermostat that sends out a signal every five seconds, or they have … Not just a smart meter. There’s so many things inside the home that are filled with radio frequencies now. We’re in the Internet of Things, the era of the IoT, the Internet of Things. So, there’s Wi-Fi and Bluetooth coming out of everything now.

Dr. Weitz:            Especially now you have the device like the Echo.

Oram:                  Yeah, yeah those smart speakers.

Dr. Weitz:            Yeah.

Oram:                   They’re constantly emitting Wi-Fi. Your Bluetooth, your router, your cordless telephone, when you hang up the phone and that base unit that’s in the kitchen or God forbid, next to you on the bedside table that has the cord that goes to the phone. That thing is emitting radio frequencies 24/7 like an ashtray full of burning cigarettes.  I’ve showed people where the cigarettes are. Now, people say, “Well, I have a chip. I have a pendant. I have a Home Harmonizer. I’m good. I have this round thing.” I don’t mean to cast aspersion on any of these manufacturers. There is evidence, and I believe it, I’m one of the few in my profession, because the other guys are engineers they poo-poo all those things, which is unfortunate because they do work. They do help people, by a technology we don’t understand, but-

Dr. Weitz:            They just don’t help us as much as we-

Oram:                   Well, that’s our opinion in the building biology profession. Here’s why, because it’s like someone having four ashtrays with burning that cigarettes filling the room with smoke who then brings a person in who says, “I have an air purifier that will clear the room of smoke.” It does, but the ashtrays are still producing the smoke.  So, we say let’s find the ashtrays and get rid of them, at least the ones you have control over in your house, and if necessary shield the ones the frequencies coming in from outside not power lines. We can’t shield the magnetic fields, they’re too vast but the radio frequencies, we can. So, depending on how sensitive the client is, we can do that.  But they still have stuff inside their house, or they can’t get their family to give them some safe space. I always work with family members to get them to understand what this person who brings me in needs for them to be more comfortable and healthy.  What we do is we educate people and say if you want to best help yourself, reduce these sources and find hardwired alternatives and learn how to disable the Wi-Fi on your laptop there and your cell phone and switch over to corded telephone, why hard lines ethernet cables and telephone lines, and then you can still use the chips and pendants. We’re not opposed to those.

Dr. Weitz:            Right.

Oram:                   But we don’t recommend them as the sole way of protecting yourself.

Dr. Weitz:            They’re beneficial, but they’re not really fully protecting you. They’re helping a little bit, but you need to do a lot more.

Oram:                   Right. So, in Europe, France has voted to ban Wi-Fi in day care centers and nurseries for children under three, two years ago, and now they’ve completely banned cell phones in all schools up to the middle level and it’s voluntary in the senior level as of this year, this month.  In England, the benign tumors went down over the last 20 years, aggressive tumors went up on the side where the cell phone is used. They balance each other out so all that gets reported is tumors are unchanged in England. That’s what gets reported. You can’t win.

In 2015, in Brussels, electrical hypersensitivity and multiple chemical sensitivity is being declared in a scientific declaration, they care about that sort of thing. This was in the Nation magazine last March, “How Big Wireless Made Us Think That Cell Phones Are Safe: A Special Investigation by two investigative reporters. It’s been a year. Great, great article and follow-up interviews on Democracy Now, and so on. That’s on my website, createhealthyhomes.com.

Scientists warn a potential serious health effects from 5G, fifth generation cell technology, over 200 scientists. Here, we have the FCC which says on page 67 of this bulletin from 1997, “Evaluating compliance with FCC guidance for human exposure to radiofrequency electromagnetic fields,” and they say one milligauss excuse me, one milliwatt per square centimeter is safe.  But if you look at the table here, the one milliwatt per square centimeter, which is a thousandth of a watt striking a half inch by a half inch, so that’s a square centimeter, is equivalent to 10 million micro watts, which is a millionth of a watt per square meter, which is three feet by three feet. That’s the unit of measurement that Europe uses, and therefore, the unit of measurement here is micro watts per meter square because this is a German meter from Gigahertz Solutions.  So, the international … This is Powerwatch Alasdair Philips website from EMFields who makes the Acousticom 2 and the Acoustimeter, and he says here if you have a link in my RF radio frequency article, he has a table here that shows the FCC at the top, and look at all these other countries that are lower than that in terms of recommended levels, going all the way down to 100 micro watts, not 10 million like the FCC. But all these other countries Belgium, Italy, Russia, China, Switzerland, that consume they’re all 10, 100, 1,000 times lower.  My profession is way down here, six orders of magnitude less. Then it went from 10,000 down to 1,000, I’m sorry to 10 in four years, because more and more research came out showing that there was evidence of harm and that was included here in the Parliamentary Assembly of the Council of Europe. This is seven years ago, potential dangers have left magnetic fields and their effect on the environment. This would be like the FCC in America saying, “Take precautions.” I won’t take the time to go over this, but this is a stunning document, and in every newspaper in-

Dr. Weitz:            That’s not really surprising that these European countries are more proactive on this. On many health issues, they’re more proactive. A lot of these countries have already banned-

Oram:                   GMOs.

Dr. Weitz:            GMOs, require labeling, and we don’t even require labeling.

Oram:                  Every newspaper in every capital in Europe carried an article about this, this Parliamentary Assembly of the Council of Europe in 2011, not a word in the United States.

Dr. Weitz:            Isn’t it the case that even though none of us read our cell phone contracts when you get your cell phone, there’s actually specific warnings?

Oram:                  I had a little booth at the Vitamin Barn in Malibu, and this guy came by and I told him this sort of … He said, “I’m a producer and I live here in Los Angeles and New York. I have a friend who’s a producer who was hired by one of the big cell phone companies based in Europe to film seven TV commercials for the European market, and they said, ‘Your models have to hold the cell phones at arm’s length. You cannot show any model with the cell phone next to the head.’  He said, ‘Okay, I’ll follow that instruction, but I’m just curious, why did your company have you tell me that?’ The guy said right now flat out, ‘Because they cause cancer.'” These companies know this. They know this, and so-

Dr. Weitz:            Doesn’t it even say on your contract that the cell phone company cannot be held liable?

Oram:                  Right, because insurance companies will not write insurance for cell companies.

Dr. Weitz:            Right.

Oram:                  They’re in for a big train wreck, a big collision down the road but they’re all … They have money set aside. If you listen to George Carlo, he was a keynote speaker at our conference 10 years ago this year, and back then he already knew about this. Because he was the one, and this is saying that Nation magazine article from last March, they interviewed him extensively. Also, I forgot to mention the documentary Generation Zapped, go to generationzapped.com and you’ll see a link that you can download it.

Dr. Weitz:            Is it now available?

Oram:                  Yes, and also at the top of my homepage at createhealthyhomes.com, I have links to, you can get the DVD, iTunes, Vimeo, Apple, or Google Play. It’s all available there for streaming or purchase, and it’s a hour and a half documentary. I’m one of the contributors to it. I gave the …  She’s a client of mine, Sabine El Gemayel, and four years ago she said, “I know we can do better,” not that there was anything wrong with the documentaries that were out at that time but she said, “I’m a Hollywood documentary filmmaker, we need a Hollywood quality film on this topic, but I don’t know who to interview, and I don’t have the money for it.”  So, she crowdsourced it for the next four years or three years and released it a year ago in beta, and I gave her the names of all the people she needed to contact within the industry. Then she contacted them, flew all over the world, and they gave her more names. So, those are the people, she has the top people in this field in that documentary, Generation Zapped.  It came out, and they had screenings all last year, and she was trying to get a distributor and ended up doing it herself. So, it’s now out as of July, as of two months ago. It’s really a game changer, that and this article in the Nation magazine last March.

So, the word is getting out, and with fifth generation cell technology where they’re going to blanket both outside the home and inside the home with more and more radio transmitters that the industry just completely thinks is safe because that’s what they’re told. That’s what they’re told by their own scientists and by the FCC that there is no evidence of any harm.  It’s all swept under the carpet, but it’s front and center as far as Europe that there are at least a dozen countries that have banned Wi-Fi or are in the process of banning Wi-Fi in public places, in schools, hospitals, and libraries. France, Germany, Switzerland, Austria, Ireland, Italy, India, Russia, Australia, China, they’re all contemplating this or have done it.

So, what do they know that we don’t know? What evidence are they seeing that we don’t see? For one thing, they don’t have the same campaign finance laws that we have, where the lobbyists provide money and all of our Congress people need a lot of money to get reelected. In these other countries, elections are quick, they’re all publicly funded, and industry does not have a toehold or foothold in that process.  They all have government-funded health care delivery systems, so there’s no profit motive. So, if they see something, this is the fourth or fifth health crisis in 60 years, the first being asbestos, tobacco, and lead in gasoline, and then the next one was GMOs, and now this, and they’re looking at what happened.  They know what happened in the past, and they’re already seeing an uptick in disease in people who are of childbearing age and so on using these technologies and having many symptoms including not being able to hold a job. That’s a serious problem, and they expect some Alzheimer’s and dementia to develop in midlife in some of these people who use these wireless devices exclusively.

Dr. Weitz:            Wow, that’s amazing information or we could talk for hours about this, but thank you so much for what you’ve provided for our audience.

Oram:                   You’re welcome.

Dr. Weitz:            I know you mentioned your website several times.

Oram:                   Www.createhealthyhomes, with an S, dot com, all one word.

Dr. Weitz:            Right, and for anybody who lives in the Los Angeles area, you’re available to come out and do it.

Oram:                  Throughout Southern California, Santa Barbara to San Diego, and then I get a lot of calls and emails from people outside of this area, I occasionally will travel and I have been brought to other places. I do a lot of work over the phone. I have people have a building biologist come to their home, if they have one in their area and we just finished a training program. We do this once a year and I help teach it last week in New Mexico where we gather together and train 20 to 30 students every year in the beginning entry level.

Then every other year, we have the advanced next coming up later this year, a training program to make more of us so that we have people all over the country in Canada to do this work. If there’s nobody nearby, then my clients can … They’ll get meters and then they’ll take readings on their own, and I’ll guide them. They’ll give you the data and then they know how to use the meters, which is helpful.

Dr. Weitz:            Right. Thank you, Oram.

Oram:                  Okay, you’re welcome.

Dr. Weitz:            Talk to you soon.

Oram:                  Thank you.

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Insulin Resistance with Dr. Ritamarie Loscalzo: Rational Wellness Podcast 74
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Dr. Ritamarie Loscalzo talks about insulin resistance with Dr. Ben Weitz. 

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

 

Podcast Highlights

0:53   The topic of this episode is insulin resistance. When you ingest sugar or carbohydrates, this raises your blood sugar levels. The body reacts to elevated blood sugar by having the pancreas secrete insulin, which signals the muscle cells to take in the sugar, thus lowering blood sugar levels. High glucose levels are inflammatory in the blood stream. If you regularly consume sugar and high glycemic carbs (carbs that cause a large spike in blood sugar levels) and thus your pancreas is secreting a lot of insulin, the cells will become resistant to insulin, which we refer to as insulin resistance. This requires the pancreas to secrete more insulin to have the same blood sugar lowering effect. Eventually, the pancreas will burn out and not be able to produce ever increasing amounts of insulin, which is what we diagnose as type II diabetes.

3:00  Dr. Loscalzo explained that as her chiropractic practice was developing, she realized that some of her patients had blood sugar dysregulation.  She had her patients buy glucose meters and test their own blood sugar every 15 minutes after a meal and they found out that they were having blood sugar and insulin problems. She feels that when you eat, your blood sugar should go up, but not to more than 110.  But many of her patients were on high carb diets, even though some of them were eating whole wheat bread and brown rice, and their blood sugar would peak at 140 or 170. Dr. Loscalzo had one client who was putting raisins on her salad, who’s blood sugar would go up to 220 after eating that. She feels that ideally after a meal, the blood sugar should not go up to more than 110 at the peak, which is usually 45 minutes to an hour after the meal. This patient may have normal fasting sugar levels, even though their sugar level after a meal shoots up too high. She finds that insulin levels will start to rise before fasting blood sugar levels go up, which is an early sign of blood sugar problems.  Insulin damages blood vessels, so Dr. Loscalzo likes to test levels of insulin and Hemoglobin A1c, which will go up before fasting blood sugar levels go up.

7:21  Dr. Loscalzo said that rather than ask her patients to do a standard glucose challenge test by going to a lab and getting their blood sugar tested and then having them drink a 100 gm of glucose and then get their blood drawn every 30 minutes for six hours, she has them do a home version of this test. She has them purchase a home glucose meter to test their glucose and then eat their highest carb meal and then monitor their blood sugar after regularly for 5 or 6 hours. Some patients discover that their blood sugar drops 20 points or so below their normal fasting level, which indicates hyperinsulinemia.

10:17  Stress causes cortisol to rise, which raises blood sugar levels for your muscles to use.  Our stress response is to help us run away from a lion on the savannah, so a spike in sugar provides fuel for our muscles.  If you were going to be running away from a lion, we would burn that glucose, but if you’re sitting at your desk and worrying about the stock market or about your kids grades, then it’s raising your blood sugar, your blood pressure, your heart rate, your breathing rate and it’s happening consistently day after day, hour after hour, this has negative impacts on our health and results in insulin resistance and heart disease. Dr. Loscalzo likes to use a target fasting glucose level of 75-85 with 75 being ideal. For hemoglobin A1c, she likes to see it a bit below 5, because at 4.5-4.8 it means your average glucose is in the 80s. At 5 it means your average glucose is in the 90s. At 5.6, where MDs consider it normal, it means your average glucose is around 117, which is way too high. 

16:26  Dr. Loscalzo prefers her clients with pre-diabetes or diabetes to be on a whole foods, plant based diet that is rich in plant based fats, like avocados, olives, nuts, seeds, and coconut.  They should be consuming a lot of fiber. She personally is vegetarian, but she is ok with a small amount of organic, grassfed meat. But 75% of your plate should be vegetables. She pointed out that a cup of spinach has 5 grams of protein and she advocates eating 10 cups of green leafy vegetables per day. As far as legumes, they don’t work for some people, but she has her clients test them out and see if they raise their sugar levels too high.

20:33  The negative effects of high blood sugar and insulin resistance include peripheral neuropathy, which is damage to the peripheral nerves.  Dr. Loscalzo said that studies show that when blood sugar goes above 120, you start to damage those nerves. The nerves get glycosylated, they essentially get a sugar coating and they can function. You get retinopathy, which is one of the leading causes of blindness in the US. The endothelium of the blood vessel walls become thickened and damaged and less elastic.

21:58  Dr. Loscalzo doesn’t like the idea of patients eating every 2 to 3 hours to balance their blood sugar and thinks that this is the worst advice anybody could give. She recommends going at least 4 hours between meals, preferably 6 hours. She likes them fasting overnight for at least 12 hours and preferably 16 hours.  Healing happens during fasting and not feeding.  She is a big fan of water only fasting.

25:58  Rita-Marie likes using certain supplements to help her patients combat insulin resistance, including chromium, magnesium, and omega 3s, esp. DHA, which she calls her craving crusher supplements. She also has used cinnamon, berberine, olive leaf extract, and lipoic acid.

28:43  Exercise is also very important for balancing blood sugar and Dr. Loscalzo likes burst training, where you do some exercise very intensely for 30 seconds. Some weight training is also helpful to increase your muscle mass and trained muscles are more resistant to insulin resistance than untrained muscle.

30:15  Sleep is important, since a ton of studies show that even one night of bad sleep in an otherwise healthy person will induce a temporary insulin resistance.

30:34 For stress reduction Dr. Loscalzo likes meditation using a device called The Muse, which measure your brain waves. She also likes Heart Math, which is this breathing appreciation combo that you do throughout the day for 30 seconds at a time.

 

 


 


Dr. Ritamarie Loscalzo is Dr. Ritamarie is a licensed Doctor of Chiropractic and the founder of the Institute of Nutritional Endocrinology. She can be contacted through her website http://www.drritamarie.com/ where she offers online courses, including her program for blood sugar balancing, The Sweet Spot Solution as well as a program for health care practitioners on helping patients to improve insulin resistance, Insulin Resistance Solution Practitioner Training.

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



Podcast Transcripts

Dr. Weitz:                            This is Dr. Ben Weitz with The Rational Wellness Podcast bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field.  Please subscribe to The Rational Wellness Podcast at iTunes and YouTube. And sign up for my free e-book on my website by going to drweitz.com. Let’s get started on your road to better health.  Hello, Rational Wellness podcasters. Dr. Ben Weitz here. Thank you so much for joining me again today. For those of you who enjoy the Rational Wellness Podcast, please go to iTunes and leave us a ratings and reviews so more people can find out about the Rational Wellness Podcast.

Our topic for today is insulin resistance. When you ingest sugar or carbohydrate foods that are turned into sugar in your body, your pancreas secretes insulin, which is a hormone that stimulates the muscle cells and liver to take in the sugar. The body doesn’t like having high sugar levels. And as the cells take in the sugar, that lowers the sugar levels in the bloodstream. And if you regularly consume a lot of sugar and carbohydrates that cause your blood sugar to spike, what we call high-glycemic carbohydrates, over time, your cells will become resistant or less sensitive to insulin. This is what we refer to as insulin resistance. And this will slowly become more severe. And this is the process that eventually leads to type 2 diabetes.

Today we have Dr. Ritamarie Loscalzo who’s a licensed doctor of chiropractic and the founder of The Institute of Nutritional Endocrinology. She specializes in using the wisdom of nature to restore balance to hormones with a special emphasis on thyroid, adrenal, and insulin imbalances. She’s a best-selling offer. Her latest book is Unstoppable Health. She’s a speaker and internationally recognized nutrition and women’s health authority with over 25 years clinical experience. Dr. Ritamarie, thank you so much for joining me today.

Dr. Loscalzo:                       Thank you so much. I’m very excited to be here. This is one of my favorite topics to talk about, so.

Dr. Weitz:                            Good. So how did you, personally, become interested in insulin resistance as an area of focus for your practice?

Dr. Loscalzo:                       Well, it just kind of found me. It’s like I started practicing back in back in, I don’t know, 19 whatever it was ’92, when functional medicine wasn’t as well known as it is now, and nutrition. And there’s wasn’t an internet. And there weren’t summits. And there weren’t podcasts. And there wasn’t any of this. So I started out. And I just started out getting people in, and some people came to see me because they had back pain. But I would quickly educate them to what their various aches, and pains, and other things … you know, you do a comprehensive health history, find out they don’t just have back pain, they have irritable bowel, and fatigue, and brain fog, and all this. And so as I worked with people more, I just used the common logic of knowing how the body works and what it could be going on that’s causing their symptoms because we’re all about root cause, not about, “Well, what herb is good to treat this symptom?” Or “What nutrient treats that symptom?” It’s more about going to the underlying cause.

And the more and more I found it, I just got that these people had blood sugar dysregulation. It wasn’t at the point where it could be clinically diagnosed yet as insulin resistance. So I started to actually have them buy glucose meters and test their own blood sugar because I suspected that even though they’re fasting glucose was low, that they were having big spikes based on what they were telling me the were eating and based on other things in their life. And so I just started doing that, and watching, and going, “Oh, my gosh.” And I had the, what’s the word? It’s not ammunition. I had the influence of being able to have these numbers and say to them, “Hey, you don’t have diabetes. You don’t even have clinically diagnosable insulin resistance. But you have something that comes before that that is eating away at your body for 30 years before all those complications of that stuff comes up. Would you like to address that?” And they’re like, “Well, I’m looking at these numbers, and yeah.”

So I just started, more and more, doing it with a clinical practice and seeing great results. Like when people shifted and they kept their blood sugars in a manageable level, I personally think their highest peak of blood sugar, the 45 minutes to an hour after you eat where the blood sugar actually peaks before the insulin brings it back down, should not be any more than 110. And most people who were on these high carb diets, typical, even the ones that are educated and just doing whole wheat bread, and brown rice, and all this, were actually having these peaks that were 140, 150, 170. And even one lady who put raisins no her salad. She’d been eating her salad and she’d been testing and everything looked good. She put raisins on her salad and her sugar shot up to 220.

And then they started telling me that when they found their blood sugar is the highest is when they felt like they had low blood sugar. You know, people will say, “I’m hypoglycemic. I can’t go more than two hours.” What I was finding was in any of those, their blood sugar was actually high, not low. So this just got me into really doing the research. And the more I thought about it and looked back, I really felt like this was the straw that broke the camel’s back, so to speak, for my parents who died very young of heart disease. That the heart and the vessel stuff was happening for decades before they even realized it, and they actually died of heart attacks before it was even clinically recognizable.

Dr. Weitz:                            Why is it important to focus on insulin resistance rather than just looking at blood sugar levels?

Dr. Loscalzo:                       Yeah. So the typical way that they test is, right, fasting blood sugar. That’s actually the last thing to shift. It’s usually … there’s a lot of other signs beforehand that there’s something problematic. And insulin actually goes up … I actually look at it as a spectrum. And I think high insulin is actually the very first step. It’s like, but most people are adapting to it. And there they go. The insulin works, and it brings it down, and it brings it down. But those high levels of insulin are what’s causing problems. And insulin damages blood vessels. Insulin causes restriction of arterials. Insulin causes all kind of damage in the body that nobody’s seeing or attributing to it. So I think testing insulin levels early on, not waiting for somebody to be diabetic to see what their … or to see if their pancreas is failing. But no. Check it real early on to see if they’re over-producing.  So that and hemoglobin A1C, I think, should be routine blood work that’s done on people with any kind of history, with any kind of brain fog, fatigue, belly fat, all those sorts of symptoms that indicate that there’s probably a blood sugar imbalance going on. They should be tested for insulin and hemoglobin A1C because those are going to shift way before the fasting glucose does.

Dr. Weitz:                            Do you do a glucose challenge test or an insulin challenge test?

Dr. Loscalzo:                       What I do is I teach people how to measure their own glucose. And I have them do a kind of a variation of a glucose tolerance test, but at home. I dare not send these folks off to a lab to be taking 100 gram solution of pure sugar and watch them feel miserable for the next couple of days, and flair up, and whatever else. Because most of them are educated, and then you been bringing you down. So I have them do it at home. And I have them get their own glucose meter. And they measure. They measure their fasting right before their meal. And then they measure every 15 minutes to catch the spot, the peak, so we know when they catch the peak. Because some people peak at a half an hour, some people 45 minutes, some people an hour, some people an hour and a half. So it does vary, although the average is somewhere around 45 minutes.

So I help them to figure out what their peak is. So when we’re doing this challenge, I just have them eat a meal that’s the highest carbohydrate meal that they would typically eat. So for some people, that might be popcorn and orange juice. Right? For other people it might be toast and orange juice. For other people it might be a piece of pizza. For other people it might be a salad with a bunch of raisins on it. Right? So wherever they are in their evolution of diet, I want to see how their diet is impacting them so they can clean up their own diet. And so we have them do this challenge over the course of six hours, and we’re measuring it. The one meal over the course of six hours to see where did they peak, how high did they go, and how low did they go. Now, do they just go back down to baseline and stay steady out to five or six hours? Or do they drop down below 20 points or so, indicating that the hyperinsulinenemia probably caused a hypoglycemia.

So that’s how I do it. And I teach people to do it at home. And people love the fact that they can do it at home, and they don’t have to go sit in a doctor’s office, spend several hundred dollars, or fight the insurance company to get it paid for, feel miserable. Like I did a glucose tolerance test, and I got cold, and I got shaky, and my blood sugar went down real low. And I was like, “Oh, I don’t want to put people through that. I can tell if they have a problem, and they need to know that they have a problem.”

But further, I teach them how to do that kind of testing on an ongoing basis. Not with a challenge meal, but more with their own meals. And they go, “Wow. I had this salad today and it just was this beautiful salad with all kinds of veggies, and coconut, and whatever else, and my sugar stayed nice and steady.” And, “Oh, today I had that with a bowl of brown rice, and my sugar shot up.” So I try to teach them how to identify the foods in their diet that are causing them to go up.  But it’s more than food, too. So, as you know, it’s a lot more than food. It’s the food, but it’s also the stress, the kind of exercise they’re doing, how much sleep they’re having. So I have them map all these things out. And it empowers them to know what behaviors they’re doing that’s throwing their blood sugar out of balance.

Dr. Weitz:                            Can you explain how stress impacts blood sugar?

Dr. Loscalzo:                       Sure. While stress causes an increase in a hormone called cortisol. Cortisol’s job is to help you get away from those tigers, and the lions, and anything else physical that’s chasing you that’s creating this fear. And in order to do that, you need to use your muscles. You need to be able to fight, and run, and jump, and all that. And it basically breaks down stored glucose into blood sugar so that you can use that to get away from tigers. So that’s how it impacts it. And when you do this once in a while to get away from a tiger, no big deal. Right? Because you’re actually running, and you’re burning that sugar.  But if you’re sitting at your desk, like worrying about the stock market, or your kids grades, or your aging parents, and you’re getting all stressed out, that same cortisol response is happening. And in addition to raising your blood sugar, it’s raising your blood pressure, it’s constricting your heart, it’s increasing the rate of your heart, and it’s increasing your breathing. So if that happens once in a while like in the olden days of tigers chasing us, didn’t matter. Right? But if it’s happening consistently, day after day, hour after hour, those levels just, they stay high and they create an insulin resistance.

Dr. Weitz:                            What kind of target level do you shoot for for fasting glucose and also hemoglobin A1C-

Dr. Loscalzo:                       Great question.

Dr. Weitz:                            … that are ideal?

Dr. Loscalzo:                       I consider ideal, I like 75 to 85 as the range. I really like to see it at the 75 because I think that that’s a healthier long term. But it’s different from person to person and all. For hemoglobin A1C, I like to see it at 5. 5 or a little bit below 5 because at 4.5, 4.8, it means your average glucose is in the 80s. At 5 it means your average glucose is in the 90s, which accounts for the after the eating and then the all night fast, which is a good level. But at 5.6, where the medical puts it, that means your average glucose is around a 117. That’s not good. That’s way too high.

Dr. Weitz:                            From testing a bunch of people, do you see a lot of people under 5?  I don’t think it’s that common.

Dr. Loscalzo:                       It’s not that common. But I do see after they’ve gone through the program I see them get down to 5.2, 5.1, 5, 4.8. Now, if it’s below 5 and they have not followed the diet, then I’m suspicious that what’s happening is a lot of periods of hypoglycemia. And I’m suspicious of hyperinsulinenemia. So I’m also testing their insulin. Because what will happen is that they may be waking up in the morning with 75, 80 as their fasting glucose. And then they’ll eat a meal and it goes up.  Maybe it goes up to 180, and then it drops back down to 50. And then they get the shaky and irritable and all that. So I’m a little suspicious if somebody comes in off the street without having been through the education and the program with that 4.8 to 5. I’m suspicious that they’ve got this other situation going on, and I check for it. But after they’ve been on the program?  Yeah, they’re good.

Dr. Weitz:                            Now, what about target ranges when you’re dealing, say, with type 2 diabetic who’s on, say, oral medication?  And maybe you could address the same issue with a type 1 diabetic.

Dr. Loscalzo:                       Yeah. So you can’t really create a target range. You have to see where they’re at, right?  So they’re on the medication and they’re maintaining at this.  With a type 2 diabetic, if they go on and they change their diet like we recommend, then what you see is that it starts to drop.  And if they’re on medication, then I’m much more careful.  If it drops below 80, I’m careful because they can overshoot because they’re on medication, especially if they’re on insulin.  So I’m more likely to want to keep that fasting 80 or above. And the after meal, well, as low as they can get it. Right? Because if they’re at a fasting glucose of 120, and they’re diagnosed, and then they’re put on medication, and they get it down to 90, then it’s harder to keep them in that range of 90 to 110.

So it may be higher. But we’re always looking at like what does this meal or this activity do to your sugar levels? Does it raise it more than 25 points? It’s probably something to consider that you don’t want to be having something that’s raising you more than 25 points. So whereas I try to keep my regular people that are new to the program and I’m just working with below 110. With a diabetic I’m telling them, “I want you to watch your meals, and anything that causes your sugar to go up more than 25 points after that meal, it’s in the suspect column.” And we write lists. Right? Good stuff, absolutely bad, and then the suspicious ones in the middle. So that’s how I do it with them.

With a type 1 diabetic, much more careful. But with a type 1 diabetic, the chance of getting them completely off of insulin is probably slim unless they’re very young. If they’ve been type 1 and on insulin for many years, there’s a lot of damage done and you probably won’t. But I also do, with them, because they’re on insulin, much more careful about the low. Right? And so I’m watching that really carefully, that they don’t go too low. But we can control it and we can control the amount of insulin.  And the goal with a type 1 diabetic is to get them down to the minimum amount of insulin possible because insulin has its downsides. Insulin causes weight gain, although, in type 1, it generally doesn’t because they’re not making any of their own.  But it also, like I said, stiffens those arterial walls and creates a breeding ground for cardiovascular and stroke.  So I’m real careful with type 1s, but I’ve seen that it goes way down.  Type 1s, they need the exercise.  And they need consistency because they’re on insulin. Right?  So consistency in exercise, and daily rigorous exercise is important. And if they miss a couple of days, they’re going to need more insulin. Right? So it’s good information to take back to type 2s or pre-insulin resistance folks as well.

Dr. Weitz:                            So what kind of dietary regimen do you find to be most effective for patients either with pre-diabetes or diabetes, for managing their blood sugar?

Dr. Loscalzo:                       Well, it depends on the person. But I find that a whole foods diet is mandatory. So no processed food. I find that a lower carb, for most people. And I, personally, find that the best results I get for myself and for others is a whole foods, plant-based diet that is good and rich in whole food fats, whole food fat, plant-based fat. So yeah. If they want to do meat or chicken or whatever, it’s a small amount of their diet. And the majority is vegetables and plant-based fats like avocados, and olives, and nuts, and seeds, and coconut, and I said avocado. I’ll say it twice because it’s my favorite.  So those sorts of things are super important. And a lot of green leafy vegetables, and a lot of vegetables. The fiber tends to slow down the absorption of sugar. And if they are going to eat fruits, then I have them do it with a big plate of greens or with a green smoothie where they’re having a bit of fruit, a bunch of the greens, and then a couple of bites of fruit. And I find that people who on like a mango by itself will shoot their sugar through the roof. When they do it with this bed of greens, it slows it down enough that they can deal with it and not raise their glucose too much.

Dr. Weitz:                            So when you say plant-based diet, people usually think of vegetarian. But you’re talking about a plant-based diet with meat?

Dr. Loscalzo:                       Well, it depends on the person. Personally, I don’t do meat. Haven’t done it for 35 years.

Dr. Weitz:                            Oh, okay.

Dr. Loscalzo:                       But some people do a small amount of organic, grass-fed, et cetera. But when I say plant-based, I mean plant strong, the majority of the diet. Like 75% of your plate should be vegetables. Right? And that’s where I get the most results. And then on top of that, there’s the whatever, the nuts, the seeds, the avocado, all of the … the whole food fats. I’m not a big fan of oil. I just don’t think it’s a good food. It’s kind of empty calories, and it’s kind of filler. And some people need it because they have high metabolic rate, and they’re real thin, and you have to give them something that they can not take up too much room in their stomach that they can tolerate. But yeah, that’s how I work it.

Dr. Weitz:                            And how do you get your protein as a vegetarian?

Dr. Loscalzo:                       From my foods. From all my foods. Right? I mean, spinach. A cup of spinach has about 5 grams of protein. And that’s just representative of any green leafy vegetable. I probably eat 10 cups of green leafy vegetables in the course of a day. That’s 50 grams of protein. Now you add that hemp seeds, and pumpkin seeds, and chia seeds, and all the seeds, which have a little bit more protein per calorie, well, not even per calorie. I think there’s more protein per calorie in the greens. But more protein per unit that you’re willing to eat. Yeah. That’s where it comes from. Right? The protein is, it’s just this crazy myth that people don’t get enough protein. People don’t absorb their protein. That’s more of a problem. Low stomach acid and digestive incapability, that they can’t actually absorb their protein, and so they require higher amounts. And so they move to meats or fish or whatever.

Dr. Weitz:                            Do you recommend eating legumes?

Dr. Loscalzo:                       Depends on the person. Like they don’t work for me. They work for some people. I think if you’re going to do them, they’re better off that you soak them really well. Maybe start to germinate or sprout them and then lightly cook them. And mix them with tons of vegetables. So yeah. Yeah. I mean, it depends on the person. That’s why we do the testing. Some people try the legumes, and some people, it shoots their sugars up too high.

Dr. Weitz:                            And then, so people with gut problems with legumes, it-

Dr. Loscalzo:                       Exactly. Exactly. It could be lectin sensitivity. There’s a lot of things, leaky gut, that would create problems with that. And they get gas and bloating.

Dr. Weitz:                            Can you talk about what is some of the negative affects of having high blood sugar insulin resistance?

Dr. Loscalzo:                       Absolutely. Well, high blood sugar, we know that the end range complication of diabetes are peripheral neuropathy. Right? So it’s damage to the peripheral nerves. So studies I’ve found show that when the sugar goes above 120, you start to damage those nerves. 

Dr. Weitz:                            How do those nerves get damaged?

Dr. Loscalzo:                       They get damaged by the sugar. They get glycosylated. They get coated with the sugar and then they can’t function. The red blood cells get coated. And that’s what hemoglobin A1C is a glycosylation or a sugar coating, and they can’t function properly. So the nerves get damaged by the high sugar. The retina, retinopathy, one of the leading causes of blindness in this country is diabetic retinopathy. But people think, “Well, I’m not diabetic. I’m not diabetic.” They think that the damage starts to happen when they cross the line and become diagnosed as diabetic. But, seriously, its been happening for decades with these sugar highs and lows, and the insulin highs and lows. And insulin causes an increase in C-reactive protein. It, like I said, thickens the cell, the walls of the endothelium of the blood vessels, so it makes them less elastic. So instead of them flowing and, “Oh, yeah.” You need a sudden burst of energy, more blood flow. They can’t go. And that’s part of the cause of ischemic attacks.

Dr. Weitz:                            What do you think about the timing of meals? Should we be eating every two or three hours to keep an even blood sugar? What do you think about intermittent fasting, which, essentially, is like skipping breakfast, or a fasting mimicking diet, which a lot of people are doing now for anti-aging purposes?

Dr. Loscalzo:                       Yeah. So I think eating every two hours is the worst advice anybody could ever get. There are exceptions to it. There are times when a person needs to be weaned and the meals slowly separated as you’re rebuilding and restoring their system. When you eat every two hours, you have insulin in your system every minute of the day. Insulin is a catabolic hormone. Insulin causes the lay down of fat. Insulin is damaging blood vessel linings. Insulin interferes with growth hormone which we need for growth and repair and laying down of lean tissue. So eating every two hours is, I think it’s a nutritional nightmare, time bomb. I love the fact of having longer periods. I recommend people do at least four hours between meals, preferably six. And then I also recommend a long overnight fast. So at least 12 hours, but 16 hours is even better, so the intermittent fasting concept.

I don’t equate intermittent fasting with skipping breakfast because it doesn’t have to be that way. For some people, they do really well with having breakfast. And they have breakfast and lunch, a later lunch, and then they don’t eat again until breakfast again. And some people do better by skipping the breakfast and eating later. And some people just eat moderately early, like a breakfast at maybe 10:00 AM, and then skip 8 hours and eat a dinner at 4:00, and then that’s it. So intermittent fasting is just giving the body a rest, a real rest in between. And healing happens during fasting and not feeding. Feeding is when we’re doing all this metabolic stuff, generating metabolic waste. But healing happens during fasting. So I’m a big fan of that.

I’m a big fan of fasting. Like I look at intermittent as that’s one method of intermittent fasting. Another method is the 24-hour fast where you have one meal in a day. You pick dinner or breakfast or lunch, it doesn’t matter which, and then you go all the way around to that meal. And the studies who that that elevates level of growth hormone, decreases levels of insulin without decreasing metabolic rate. Now, if you do multiple days, more than five days or so, it could decrease the metabolic rate, which counteracts the whole process of weight loss.

But if you just do it for 24 hours or these longer periods, it actually has been shown to work better than long-term caloric restriction because caloric restriction, over time, will definitely lower the metabolic rate. “Oh, you’re only going to give me 1,000 calories? I’m only going to burn 1,000 calories. Thank you very much.” And then its like, “Okay. Now I got to decrease it further, and further, and further.” Whereas, fasting is very healing. And so the fasting mimicking diet is very low calorie diet over the course of four or five days once a month where you’re actually getting the benefits of fasting without actually having to fast. Personally, I’d rather fast. I just fast four or five days a month. And it’s easy for me because I’ve done it many times. And if you can, get amazing healing benefits when you do a fast.

Dr. Weitz:                            And do you consume anything during your fast?

Dr. Loscalzo:                       Water. Yeah.

Dr. Weitz:                           That’s it?

Dr. Loscalzo:                       Yep.

Dr. Weitz:                            Yeah.

Dr. Loscalzo:                       That’s what fasting means. People think that fasting is juice cleansing, or drinking sauerkraut juice, or drinking coffee with butter in it. That’s not fasting. Right? Let’s find a different name for that. That’s fasting mimicking maybe. But that’s not fasting. Fasting is water. And dry-fasting is without it, but I haven’t seen any benefit. I haven’t studied it much, but the whole idea of that turns me off, so I don’t do that.

Dr. Weitz:                            Do you ever use nutritional supplements to help patients balance their blood sugar?

Dr. Loscalzo:                       Absolutely. Yeah. Absolutely. In fact-

Dr. Weitz:                            What are your favorite supplements for that?

Dr. Loscalzo:                       Sometimes what I do is before I even tell them to start doing the diet stuff because that’s real hard and they’re having cravings that are related to their insulin imbalances, so what I’ll do is I’ll put them on chromium, and magnesium, and some omega 3s, a DHA. Especially DHA because that has the most profound, the DHA-EPA is very helpful. And I’ll start with those three. And I call them my craving crusher supplements. You go, “Oh, I’ll take the craving crusher supplements.” Because people say that after a week or two, they’re like, “Oh, I don’t have my sugar cravings as much anymore.” Then, I can start with the diet. But because if I start with the diet, which I used to do, they’re like, “Oh, but I need. And I need.” And they’re always falling off.  But this way, they feel really good. I use cinnamon. I’ve used berberine, olive leaf extract, lipoic acid. But my main core three that I start with are those, the magnesium, chromium, and DHA.

Dr. Weitz:                            What do you think about some of the resistant starch products on the market? You know, there’s powders with resistant starch, medical foods?

Dr. Loscalzo:                       I’m not a big fan of powders and potions. That said, I haven’t really tested them much. I mean, the research looks like if you take potatoes, which are very high glycemic, and you cook them, and then you put them in the refrigerator, that it’s better. I haven’t actually tested it on myself just because I haven’t eaten potato in like six or seven years. And I really have no interest. But I could do an experiment with some of my clients. A lot of my clients find is that if they do that and then they ferment that, like take a sweet potato, and cook it, and then put it in the fridge. And then they take that sweet potato, and they blend it up, and they put in probiotic organisms, and they let it ferment, like make a yogurt, make a sweet potato yogurt, that that lowers the glycemic-

Dr. Weitz:                            Sweet potato yogurt?

Dr. Loscalzo:                       Yep. I have a friend how makes lentil yogurt.

Dr. Weitz:                            Really?

Dr. Loscalzo:                       I haven’t tried these things. I’ve tasted them, but I haven’t really tried making them. I stick to coconut yogurt. I do cashew yogurt. I do a combination of hemp, and brazil nut, and cashew. I do all kind of nuts and seed type yogurts and kefirs, but I haven’t tried those yet. It’s just I have to stay away from the starchy foods, personally, for me.

Dr. Weitz:                            Yeah. The grains and beans et cetera. Okay. So I think that’s all the questions I have. I think that was … You gave us some good information. Any other topic, any other final thoughts you want to give us about improving insulin resistance?

Dr. Loscalzo:                       Yeah. I would say it’s not just about the food. So you really have to look at these five lifestyle factors that I teach. You have to be moving. We have to move. It’s so-

Dr. Weitz:                            Oh, yeah. We didn’t really talk about exercise. What kind of exercise you think is most effective for blood sugar balancing?

Dr. Loscalzo:                       I like burst training. I think that’s the most effective-

Dr. Weitz:                            Burst training?

Dr. Loscalzo:                       Burst training.

Dr. Weitz:                            Explode, you know?

Dr. Loscalzo:                       Where you just explode 30 seconds of really intense exercise. And then you stop. And you could either do that as part of an aerobic routine where you’re running along, and then you go way on, and then you run back to normal speed. You can do stair, up and down the stairs. You can do jumping jacks. I have a little stair-climber thing that I get on there and I just go, “Err,” as fast as I can. And that helps to really burn. It’s been shown that that increases growth hormone as much as a half an hour of aerobics in 30 seconds. So it’s very effective. And I know people who have … They eat something, you go, “Oh, my God. My sugar just went up.” And they’ll just go do some bursts and bring it back down.

Dr. Weitz:                            Is that part of your exercise program? Do you also do steady state aerobic?

Dr. Loscalzo:                       Oh, yeah. I do. Yeah. I do. I run or I swim. I do weights. I mean, it’s part of it. But that’s something to add to. Yeah. And then, for some people who are not that fit, walking. Just get out there and walking in 10 minutes at a time, plus the burst training. And you can really reverse things dramatically. Trained muscle is much less resistant to insulin than untrained muscle.

Dr. Weitz:                            Right. I think doing some weight training probably helps stimulate muscle in the body.

Dr. Loscalzo:                       And weight training is great.

Dr. Weitz:                            Yeah.

Dr. Loscalzo:                       Because you increase muscle. Right.

Dr. Weitz:                            Yeah.

Dr. Loscalzo:                       And yes. You increase the metabolic rate by increasing the muscle. Right. And sleep is super important. Tons of studies that show that even one night of bad sleep in an otherwise healthy person will induce a temporary insulin resistance. So I find that on days when I haven’t gotten enough sleep, I’ve stayed up, I’ve flown, whatever the reason, that I’m ultra careful the next day with my food. Yeah.

Dr. Weitz:                            For stress relief?

Dr. Loscalzo:                       Stress release. My favorite is Heart Math. And I also mediate using a device called The Muse, which kind of measures my brain waves. You wear a little band around your head and it measures your brain waves. It’ll give you like “Tweet, tweet, tweet,” on the birds if you’re in calm state. And it’ll do these like, “Whish, whish, whish,” to show you that your mind’s just gone off and come on back.

Dr. Weitz:                            What’s that called, The Muse?

Dr. Loscalzo:                       Muse. M-U-S-E.

Dr. Weitz:                            Oh, okay.

Dr. Loscalzo:                       Yeah. Yeah. It’s really cool.

Dr. Weitz:                            You wear this thing on your head?

Dr. Loscalzo:                       Yeah. I do it for 20 minutes a day in the morning. And it’s my meditation. I’ve always had a hard time meditating because it’s like, “Am I done yet. Am I done yet? Am I done yet? How’s the timer?” And then I do Heart Math, which is this breathing appreciation combo that you can do throughout the day in 30 seconds at a time. So I’m into quick-fix stress relief. And it’s helped me dramatically from that.

Dr. Weitz:                            Right. Great.

Dr. Loscalzo:                       Yeah.

Dr. Weitz:                            Good. Okay.

Dr. Loscalzo:                       Yeah.

Dr. Weitz:                            Okay.

Dr. Loscalzo:                       Yeah.

Dr. Weitz:                            So how can listeners and viewers get a hold of you?

Dr. Loscalzo:                       Yeah. So my main website is drritamarie.com. I have a couple of free things I could tell you about that they can get that are related to this. One is called hormonehackingbreakfastmenus.com. For those of you who don’t want to skip breakfast or want that really balancing, hormonehackingbreakfastmenus.com, and it’s just little 20-page booklet that has 5 different menus, and, I don’t know,, 12 different recipes, and guidelines for how to put together a breakfast that’s going to keep you steady throughout the day.

Dr. Weitz:                            Okay. And I understand you have some courses for-

Dr. Loscalzo:                       Yes.

Dr. Weitz:                            … for both patients and practitioners, for blood sugar insulin balance.

Dr. Loscalzo:                       I do. I do. I have a program called The Sweet Spot Solution. It’s thesweetspotsolution.com, and that’s where people who want to get their own blood sugar under balance do. It’s like a three-month program. And we guide people through. And we have a Facebook group. And they really get to learn the process and go through the steps. And we guide them and we coach them. And then we have for practitioners, we have the Insulin Resistance Practitioner training which is at insulinresitancepractitioner.com. And we take them through, and they get a free seat in our individual programs. They can actually go through themselves or take a client through. And we teach them all the ins and the outs and the tracking. And we have coaching calls where they get on and ask questions so they can bring their client cases and that sort of thing. And that’s a certification program.

Dr. Weitz:                            Okay. Cool. That’s great. Thank you for spending the time with us. And I’ll talk to you soon.

Dr. Loscalzo:                       Thank you very much. Bye.

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Women's Heart Health with Dr. Felice Gersh: Rational Wellness Podcast 73
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Dr. Felice Gersh talks about how to improve heart health in women with bioidentical hormone therapy with Dr. Ben Weitz. 

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

 

Podcast Highlights

1:52  Prior to menopause, women tend to have a significantly lower risk of heart disease then men because estrogen is protective of the heart.  This is one reason why many doctors were prescribing estrogen and hormone replacement therapy (HRT) to women after menopause. But then in 2002 the Women’s Health Initiative Study was published that showed that HRT was dangerous and raised a woman’s risk of heart attack and stroke, as well as breast cancer, and many doctors stopped prescribing HRT. 

2:58  Dr. Gersh explains that this study was really disastrous for women’s health and amounted to a roadblock in the developing story of estrogen and women’s health. First of all, they did not study human estrogen. The compound studied is Prempro, which is derived from the urine of pregnant horses. It’s not even the estrogen that the horses wanted. It’s the estrogen that they excreted, which is why it is known as conjugated equine estrogen. And the form of progesterone used in this study is Provera, which is a synthetic form of progesterone known as progestin, or medroxyprogesterone acetate, which is actually an endocrine disruptor.  It’s a chemical that binds to progesterone receptors, but it has variable effects, and it turns out in the uterus, in the uterine lining, it acts as a big blocker of estrogen, but when you look at the other parts of the body, you look at the cardiovascular system, and the brain, and so forth, what you find, it actually is a progesterone blocker. The same in the breast, so it actually is like an anti-progesterone. And these were also women who were in their 60s, so most of them already had some pre-existing cardiovascular disease since they were often more than 10 years out from when they actually went through menopause, which we know is a big risk factor for cardiovascular disease.  It turns out that Premarin increases the risk of blood clots by 400%, so it is really disastrous for women’s health!

7:30  Estrogen is very protective for the heart, especially estradiol more so than estriol.  Estradiol protects our arteries through stimulation of the endothelial nitric oxide synthase, which produces nitric oxide, which maintains the dilation and the health of the endothelium (the lining) of our arteries. Without estrogen you get reduced levels of nitric oxide. There are estrogen receptors in the gut, which is why that after menopause you tend to get leaky gut. There are estrogen receptors on the immune cells, like macrophages, neutrophils, and mast cells, which are part of the gut-associated lymphoid tissue, so this sets up systemic inflammation, which is a major factor in arterial problems in heart disease. Also, estrogen reduces platelet aggregation and blood clotting. Without estrogen you have the perfect scene for trouble–platelet aggregation, reduced dilation of your blood vessels, leaky gut, and inflammation. You also get more oxidized LDL because estradiol maintains an enzyme system called the peroxidase 1, PAN1, which reduces the oxidation of LDL. Without estrogen you also get an increase in ADMA, which further reduces nitric oxide. All this is happening very rapidly as women proceed through menopause, which is why women have higher rates of stroke than men and women tend to die more commonly than men from their first heart attack and they actually start to surpass men in terms of percentages of women dying from cardiovascular compared to men, and none of this is recognized by our conventional medical world, and they fear estrogen.  Dr. Gersh said that she fears lack of estrogen and this is just the tip of the iceberg. There are also estrogen receptors in the mitochondria that keep the heart beating properly, so without estrogen you’re more likely to get arrhythmia, atrial fibrillation, and heart failure.  2-methoxyestradiol is an estrogen metabolite that helps to maintain heart function. Basically, the entire cardiovascular system is reliant on estradiol, not estriol. It is shocking that renowned cardiologists are denouncing estrogen and telling women to stay away from estrogen and they are equating issues with birth control pills, which are estrogen endocrine disruptors. They are the evil twin of estrogen. Everyone, unite to defend our hormones.

17:22  Many doctors, especially Functional Medicine doctors, who recommend bioidentical hormones to women tend to prescribe a combination of estradiol and estriol (Biest) in the belief that estriol is a weaker form of estrogen and that this will balance the stronger effects of estradiol and that this will reduce the risk of breast cancer and have other beneficial effects.  Dr. Gersh explained that these doctors are basing this on data that is 30 years old, but at that time, we didn’t know that there were alpha and beta receptors of estrogen and we didn’t know about membrane receptors.  For generally healthy women who are hitting menopause, estriol is really not a good tool. There can be some specific uses for estriol if you’re treating specific condition, maybe even breast cancer or autoimmune disease, like multiple sclerosis. But estriol, which is a very dominant estrogen in pregnancy, only works on the beta receptor.  The B cells of the immune system have primarily beta receptors, while the innate immune cells primarily have alpha receptors. During pregnancy, the estriol down-regulates the immune system so that you don’t reject the baby. This is why if a women has autoimmune disease, it will often go into remission during pregnancy. This is also why women who are pregnant are more likely to die if they get the flu or chickenpox. This is why it may be useful to use estriol in women with MS because it down-regulates the immune system, like a biologic drug like Humira.  Prior to menopause, women tend to survive septicemia at higher rates than men because they tend to have a stronger immune system than men.  If you give women estriol instead of estradiol, you will be down-regulating their immune system, which is generally not a good thing.  In addition, alpha receptors are in the brain in the hippocampus, and women already have three times the rate of Alzheimer’s as men, so if you give estriol you will not be stimulating the brain to function as well as estradiol does.  Also the beta-receptors tend to up-regulate the appetite center in women, which is good in pregnancy but not in menopause, so giving estriol may encourage women to gain weight. And if you give estradiol, the body will make some of it into estriol.

We also should consider the interplay of various hormones in the body and the importance of estrogen and progesterone for allowing the other hormones to work properly.  For example, when you have the normal surge of estrogen that occurs during part of the month up-regulates thyroid receptors, so thyroid hormone works properly.  That’s why so many women in menopause have symptoms of low thyroid. Low T3 is associated with heart failure. If you have no estrogen and no progesterone, then you will have worse thyroid receptor function. If we get estrogen, progesterone, and testosterone right, then thyroid, oxytocin, and growth hormone will all work better. 

28:18   Progesterone, which is estradiol’s sidekick, also has receptors all over the body. The key is having the right amount of hormones in the right rhythm. We should not give a small static amount of estrogen and progesterone every day.  We want to try to mimic the rhythms of hormones that occur in a healthy 25 year old woman, though we to do need more research on this. Even pulsing the progesterone so that you do it 14 days a month is better, and there is some published data that that lowers the risk of breast cancer.  Progesterone is not just there to counteract estrogen’s effect on the uterus.  Progesterone has amazing effects all over the body and it’s very neuro-protective. It actually down-regulates estradiol receptors. It’s all a beautiful balance of proliferation and anti-proliferation. As far as the appropriate dosage, Big Pharma has recommended either 100 or 200 mg, but we don’t have enough data on what the optimal dosage should be. Dr. Gersh said that she is working with a nonprofit doing research to answer the question of what is the best dosage of progesterone to be used for each woman. 

35:50  For the 60 or 70 year old woman who decides that she would like to take hormones, we should start with a lower dosage because the receptors have been in hibernation and work our way up. 

39:40  Testing for women with cardiovascular disease is often different than men.  Coronary calcium scores are less important and have less predictive value for women.  Many women who die from heart attacks don’t have severe atherosclerosis. They tend to die from spasm.  Checking their blood pressure is very important. Echo stress tests have virtually no predictive value for women, though echo cardiograms can be helpful.  She will often see patients who return from the cardiologist with mild diastolic dysfunction, which they are told is normal. But this is not normal and it indicates that your heart is stiff and is deficient in energy.  This is a sign of mitochondrial dysfunction in the heart muscle and such women will have higher rates of conduction defects and will have higher rate of arrhthmias and Afib. For such women, having more estrogen can be very helpful.  Estrogen controls the enzyme matrix metalloproteinases, which are involved in tissue remodelling and hyperplasia of the heart muscle. It can result in heart valve problems.  Dr. Gersh prefers to look at carotid intima media thickness. It is important to look at labs for inflammation. 

44:43  Since women have so many mitochondrial problems with their hearts, then statin medications, which are known to negatively impact the mitochondria, probably are not a good medication for them. The two areas of the body that have the most energy needs are the brain and heart, which is why they both are so dense in mitochondria. One of the better supplements for managing lipids in women is citrus bergamot. We should remember that as women age, low cholesterol is more associated with higher mortality than high cholesterol. What you want is to do to reduce cardiovascular disease risk in women is to drive down oxidized LDL, which we know is controlled by the enzyme PAN1, which is controlled by estradiol.

 

 



Dr. Felice Gersh is a board certified OBGYN and she is also fellowship-trained in Integrative Medicine. Dr. Gersh is the Director of the Integrative Medical Group of Irvine and she specializes in hormonal management. Her website is http://www.felicelgershmd.com/ and she is available to see patients at 949-753-7475, she lectures around the world, and she will be releasing her first book on PCOS in November 2018, which is called PCOS SOS: A Gynecologist’s Lifeline to Restoring Your Rhythms, Hormones, and Happiness.

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


 

Podcast Transcripts

Dr. Weitz:            This is Dr. Ben Weitz with the Rational Wellness Podcast, bringing you the cutting-edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to Rational Wellness Podcast on iTunes and YouTube, and sign up for my free e-book on my website by going to drweitz.com. Let’s get started on your road to better health.  Hello, Rational Wellness Podcasters. Thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness Podcast, please go to iTunes and give us a rating and review so more people can find out about the Rational Wellness Podcast. Normally, I introduce the topic first and then the speaker, but today, I’m going to introduce the speaker so I can tee up the first question for her when I do a short intro on the topic.

Our guest speaker today is Dr. Felice Gersh. She is a board-certified obstetrician and gynecologist. She’s fellowship-trained in integrative medicine. Dr. Gersh is the director of the Integrative Medical Group of Irvine where she sees patients. She also lectures around the world on various topics relevant to women, and her first book on PCOS will be released very soon. Hi, Dr. Gersh.

Today, our topic is heart disease in women. We all know that heart disease is the leading cause of death for men, but what about women? Well, you might be surprised to know that just as many women die of heart disease each year in the US. Prior to menopause, women tend to have significantly lower risk than men, and we have known for a long time that estrogen is protective for the heart.  However, after menopause, heart disease rates rise in women. This is one reason why prescribing hormone replacement therapy became popular to not only deal with the problematic complaints of menopause like hot flashes and night sweats, but to reduce cardiovascular disease risk.  And there were quite a number of studies showing reduced risk of heart disease in women taking hormone replacement.  But then, in 2002, poof, a bomb went off in the hormone replacement world when the Women’s Health Initiative was published. This large study showed unequivocally that women who took estrogen and progesterone replacement therapy after menopause had an increased risk of heart disease. Doctors stopped prescribing hormone replacement therapy for women in order to reduce their risk of heart disease. Is this the end of the story, Dr. Gersh?

Dr. Gersh:           Well, it actually is, what you might call, a deviation in the story. It’s a big bleep, and it’s been really disastrous for women’s health and really, for moving forward the whole conversation because of this … Well, I call it a gigantic roadblock. Right? We’ve got to really detour around this, and what they studied in the Women’s Health Initiative was not human hormones, and there’s so much more to it than even just that. But again, if you just start with what they actually studied, it was a compound called Prempro, and that was really what they mostly studied. They had in the women who’d had hysterectomies say, “Just use Premarin,” and they actually had somewhat of a better outcome, but Prempro itself has some really bad things about it.

First of all, there’s no human Prempro. It doesn’t exist in any female anywhere on this planet. Premarin is actually derived from the pregnant horse’s urine, which has the actual … sort of the unwanted parts of estrogen. It’s actually metabolized estrogen. It’s really what it wanted to get rid of. It’s not the actual good estrogen that the pregnant horse even wants. It’s after it’s metabolized and it’s gone through conjugation. It’s all out. That’s why they call it conjugated estrogen. It’s actually altered to get rid of by the lovely pregnant horse. Of course, there has been some concerns about mistreatment of horses as well, which is a separate topic.

Then, the progestin. Progestin is a man-made-up word for a chemical endocrine disruptor for progesterone, the real human hormone, so medroxyprogesterone acetate, which is what is Provera, is really an endocrine disruptor. It’s a chemical that binds to progesterone receptors, but it has variable effects, and it turns out in the uterus, in the uterine lining, it acts as a big blocker of estrogen, but when you look at the other parts of the body, you look at the cardiovascular system, and the brain, and so forth, what you find, it actually is a progesterone blocker. The same in the breast, so it actually is like an anti-progesterone, and that’s why they call them endocrine disruptors.

Depending on where they are, they can be agonist or antagonist, and so we have a completely foreign substance that’s being put into women’s bodies, and these were generally speaking a little bit older women. They were in their early 60’s was the median age, and they already had some pre-existing cardiovascular disease because after all, they were … Many of them, at least 10 years or they were more than 10 years out from when they actually went through menopause, which we know is a big risk factor for developing cardiovascular disease, and it turns out that Premarin increases the risk of blood clots about 400%. Then, of course, what is a heart attack or a stroke? It’s really a piece of blood clot that breaks off of a ruptured piece of plaque, so you’re going to have dramatically increased blood clotting.

In fact, thrombophilia, when you have increased clotting, which happens as women age and men as well, is a very bad thing, and a lot of people look at cardiovascular risk as directly reflective for heart attacks and strokes of how clottability, the clottability factor of the blood. Here, you’re taking a drug that increases it four times, so it’s a big problem. Prempro is disastrous for women’s health, and even then, it actually didn’t kill as many women as you might think. Over time, women seem to adjust to it, so as you move further out, like more than a year out, it seemed like you knocked off the women that were going to get knocked off, and then it kind of seemed to adjust, but it was really disastrous for moving the whole conversation of women and cardiovascular health forward.

Dr. Weitz:            What is the answer about when and … What is the appropriate type of hormone replacement that women should consider using if they choose to do it after menopause?

Dr. Gersh:           Well, it’s a personal decision, but as many of you know, I love estrogen. I defend estrogen and progesterone too, when it’s needed. Progesterone doesn’t get quite as maligned as estrogen does.

Dr. Weitz:            By the way, can you explain how estrogen is protective for the heart?

Dr. Gersh:           Oh, yeah. Estrogen actually mediates most every function in the entire body. It’s really quite phenomenal as you learn more and more about estrogen, and the estrogen we’re talking about really is estradiol, and that’s really important because a lot of people are using estriol.  And estriol has very beneficial effects, particularly when you’re pregnant, but it’s really not … It’s going to create some problems if you use a lot of estriol in menopausal women, which I can explain if we have time, but …

Dr. Weitz:            Yeah. Well, I think a lot of the Functional Medicine doctors and people who prescribe estrogen bioidentical hormones tend to use estriol in the belief that it has a lower risk of cancer, of breast cancer.

Dr. Gersh:           Well, we definitely want to touch on that, for sure.

Dr. Weitz:            Okay.

Dr. Gersh:           If we jump on estradiol, so it turns out that estradiol is very key if we just start with the blood vessels. Okay? Arteries. There’s this magical substance. It’s a redox signaling agent called nitric oxide, and nitric oxide is made in various places all over the body. One of the ways that it’s made is through an enzyme system, nitric oxide synthase, and one form of that is endothelial, which obviously suggests it’s in the endothelium of arteries, which it is, and estrogen is very key to making that enzyme work.  Okay. You need estrogen. You need estradiol, and without that, you tend to get reduced levels, and nitric oxide really maintains the health of the artery and all the different layers of the artery. It maintains dilatation, health of the endothelium, so loss of nitric oxide occurs, dramatic decreases when you lose your estradiol production from your ovary, so that’s very important.

Then, estradiol has … It’s so complex because estradiol has receptors in the gut, and we all know now in functional medicine how key the gut is in every aspect of health, and without estrogen after menopause, leaky gut actually happens. We know that there’s a change in the microbial environment, the microbiome changes, and you get dysbiosis. You lose that protective mucus coating, and you lose the tight junctions, and you end up getting leaky gut.

The other thing that’s very key to this is that estrogen has receptors on every one of the immune cells, including the innate immune cells like macrophages, neutrophils, mast cells, which we know are in heavy numbers lining the gut and the gut-associated lymphoid tissue. Now, you have the perfect setup for systemic inflammation. You have leaky gut and you have powder kegs because I call them like weapons of mass destruction with no control like you have all these mast cells that contain tumor necrosis factor alpha and histamine. All this, which is designed to attack randomly any invader, right? Only now, you’re having … The least little thing is triggering them because they’re not controlled.

Women in menopause are inherently inflamed, so you have the perfect situation for arterial problems. You have loss of your nitric oxide that’s declining. You have leaky gut. You have inflammation, systemic inflammation, which we know is the trigger to most bad things that happen in the body, including cardiovascular events, and then it turns out that estrogen maintains blood … reduce blood clotting, so through these different enzymes and like the precursor of prostaglandins, the enzyme prostacyclin, which actually maintains reduced blood clot ability. It maintains healthy platelets and reduces the aggregation of platelets.  Estrogen controls platelets, so now you have the perfect scene for trouble. You have platelets that are becoming more aggregating. You have more clottability. You have more inflammation. You have reduced dilation of your blood vessels. You have inflammation rampant everywhere, so of course, that’s the perfect recipe for developing cardiovascular disease, and then on top of that, we have oxidized LDL. We have more inflamed or rancid LDL because estrogen maintains another enzyme system called the peroxidase 1, PAN1, which reduces the oxidation of LDL.

Without estrogen, you’re going to have more oxidized LDL, and when you have more oxidized LDL and you have more inflammation, you increase this product called ADMA. Okay? ADMA then blocks even further the production of nitric oxide, and without estrogen there to come to the rescue, you have this perfect recipe for a cardiovascular disaster, and all of this is happening very rapidly as women proceed through the menopause. We know that in menopause, women have higher rates of stroke than men do. They tend to die more commonly from their first heart attack, and they actually start to surpass men in terms of percentages of women dying from cardiovascular compared to men, and none of this is recognized by our conventional medical world, and they fear estrogen.

I fear lack of estrogen, not having estrogen, and you can see, and this is just the tip of the iceberg. I didn’t even touch on … We can go into that that there are estrogen receptors in mitochondria that keep the heart beating properly. Without estrogen, you’re more likely to get arrhythmia as an atrial fibrillation and heart failure. The myocytes, the heart muscle themselves have estrogen, and even more than that, they have receptors for what they call estrogen-related receptors, which are all about creating energy. Even the metabolites of estrogen, one that’s called 2-methoxyestradiol has its own receptors. It’s so important. It’s an estrogen metabolite that helps to maintain heart function itself.

Basically, the entire cardiovascular system is reliant on estradiol. These are all estradiol, not estriol, mediated events, and that’s like another important take-home message, and then we’ll get into estriol whenever you’re ready, but I just am … Obviously, I’m exploding. I’m a powder keg. I am trying to get the word out, and it is shocking that even “renowned,” we’ll put that in quotation marks, “renowned” cardiologists all over the world are denouncing estradiol and saying women should stay away from estrogen, and they’re equating issues with estrogen and, for example, oral contraceptives, which of course are not healthy for a heart.  We wouldn’t give someone who just had a heart attack a birth control pill, and then they … So, they’d maligned estrogen because of the evil twin, right?  Estrogen endocrine disruptors are being called estrogen, and progesterone endocrine disruptors are being called progesterone, and we have to defend this.  Everyone, unite to defend our hormones.

Dr. Weitz:            Great, so I want to get into estriol in a second, but you mentioned 2-methoxyestradiol, and I just interviewed Dr. Berkson, and she talked about taking 2-methoxyestradiol.

Dr. Gersh:           Wow, how funny.

Dr. Weitz:            What do you think about using that particular compound?

Dr. Gersh:           I am very simple. I say do what nature designed us to do. We are not smart enough to micro-manage much of anything. That’s why we can’t micro-manage receptors. We can’t micro-manage estrogen metabolites.  Give estradiol. Okay? Let the body make … Do everything to have a healthy gut, and that, of course, includes a liver, right, because it’s all part of the same process.  Try to have the systems working as best we can make them work so do as … I like to use like a 25-year-old as my goal.  If I can do things to try to mimic what goes on in a healthy 25-year-old, and some of them are not healthy at 25, but if you get the healthy 25-year-old woman, that’s my gold standard for what I’m trying to mimic, so I’m not going to give anyone metabolites.  I don’t want to give pieces of anything.  I want to give the whole.  Right?  It’s like the whole food, right?  I try not to … I love to use supplements, but I see them for what they are.  They’re pieces of the whole, right?  If I give a polyphenol, that can be helpful, but what if I give the whole food, right, and it has not only the polyphenol magic, but it has the fiber magic, and it has the other antioxidant magic?  Right?  I give estradiol magic and let the body make its own metabolites and so forth, and work the magic that it does in the female body, but you have to have the systems working, of course, or else you’re not going to get the right metabolites. That’s why the estrobolome exists. That’s why livers exist, but we have to nurture them so that the body will do its thing. We are not smart enough to try to break it into little pieces. Start with the whole and let the body do its thing. Oh, I’m not smart enough anyway.

Dr. Weitz:            That’s great. We mentioned estriol, and it’s common among doctors who prescribe bioidentical hormones to give a compounded product that contains a combination of estriol and estradiol with the belief that estriol has a lower risk of breast cancer.

Dr. Gersh:           Right, and I understand that that is data that goes back maybe 30 years, and in its time, it was very … No, extremely forward-looking, recognizing that there were different forms of estrogen, but it missed a lot because they didn’t know a lot. You can’t blame anyone for coming up with something without knowing. At that time that that idea came out, we didn’t even know there were alpha and beta receptors of estrogen. We didn’t know about membrane receptors. All they knew is that if you gave estriol, it seemed to reduce breast cancer, but now, we know that it really is not a good tool, and I’ll explain why, for generally healthy women who are hitting menopause. There can be some unique uses of estriol if you’re treating a specific condition. Maybe even breast cancer. Maybe things like autoimmune disease like multiple sclerosis, but that’s not replacement. That’s different. That’s treatment.

It turns out that estriol, which is a very dominant estrogen in pregnancy has only beta receptive functions, so it only works on the beta receptor. Now, there’s alpha and there’s beta receptors, and they’re both very critical, and then we won’t even get into membrane receptors, which actually trigger kinesis, I mean, and it turns out that alpha and beta, which we used to think were purely nuclear receptors are not. Everything is much more complicated than we ever thought. It turns out that they also have membrane receptor function, and they also up and down regulate each other, so everything … That’s why I say we can’t micro-manage because everything turns out to be more complex than we ever thought.

Beta receptors tend to cluster in certain areas. Nothing is exclusive. They tend to be in the lining of the gut, in the enterocytes. They’re in the lining of arteries. They tend to be in certain other areas like in the vagina, and if you think about pregnancy, you’re going to have a lot of beta, and that would want to be in the vagina so that you have this incredibly stretchy vagina. For example, if you were suddenly magically a woman … Not you. If a woman were magically pregnant and she had no estriol, normal amounts, but not the amounts that you’d have in pregnancy, and suddenly, she had to deliver a baby, she just rip apart because she wouldn’t be stretchy. I always think of it like a snake swallowing a big pig or something.

Dr. Weitz:            Yeah.

Dr. Gersh:           It’s like, “How does it do that?” But because of all the estriol. Okay, and the estriol helps block some of the estradiol effect in the breast or women would probably be size quadruple Z or something. Right? It would be impossible, so there is this beautiful balance between estriol and estradiol in pregnancy, but it turns out that it gets more complex because if you think of pregnancy, it’s a very special immune state. Right? You do not want to reject the fetus. It is a foreign tissue, so it turns out that the beta receptor is the receptor that’s primarily on the B cells, and the alpha receptor is the primary receptor on the innate immune cells, like I mentioned, like mast cells, and the macrophages, neutrophils, macrocytes, and so on.

Those are primarily alpha, and B cells are beta, so it turns out that in order to basically dismantle the innate immune system to down-regulate it, you have a lot of beta. It turns out that beta down-regulates alpha, so in pregnancy and a lot of people know this that if a woman is pregnant often and she has autoimmune disease, she goes into a remission only to flare afterwards, but why is it? Has anyone ever thought about like why is it that in pregnancy, women often have a remission?

Also, women who are pregnant are more likely to die if they get the flu, if they get chickenpox. I’m sure a lot of people know that. They are more at risk if they get an infection that they may die, but they’re less likely to have flares of their autoimmune conditions than they often go into very dramatic remissions. It’s because the beta, which is estriol, is down-regulating the alpha receptors, so basically, it’s like an immune modulator that you’re getting. This big dose of estriol is like an immune modulator. That’s why I do some research on using it, for example, in MS. It’s down-regulating just like a biologic, just like an immune modulator like ramicade and humira. It’s down-regulating your innate immune system, but it’s …

Dr. Weitz:            That’s good because women have such a high risk of autoimmune, and in fact, depending upon how you look at it, heart disease is an autoimmune disease.

Dr. Gersh:           But the problem is that women, for example, pre-menopause have dramatically higher survival rates if they become septic and they … Women have higher survival rates than men across all ages when especially though the difference is very dramatic pre and post-menopausal. There are some innate benefits that’s actually built into the X chromosome. That’s why even girl children tend to outsurvive boy children if they get an infection, but it’s dramatically increased with the reproductive years when they have estradiol on board, so it really … Women have a very robust immune system. Much, much more powerful than males at fighting off sepsis.

Women survive septicemia much higher rates, but not after menopause, so this is the problem just like if a woman is on an immune modulator like humira, ramicade, and so on. It says on the fine print you may die like of an infection, right? “Do not take this if you have a fever. Blah, blah, blah.” Right? What you’re doing to women in the menopause, if you keep them like in this pregnancy state where their immune system is down-regulated. You’re making them much more susceptible to die if they get pneumonia, if they get the flu. I don’t think that’s a really good idea, so the alpha is part … You’re taking out your immune system, your innate immune system, so that …

Dr. Weitz:            Right, and that’s going to put you at higher risk of cancer as well.

Dr. Gersh:           That’s right. You need an innate immune system. If you have estradiol, you will make estriol, and they’ve actually shown that you do … Of course, it’s part of the equilibrium, so you will make the right amount that your body needs. In addition, alpha isn’t just on the immune cells. Alpha is in the brain big time in the hypothalamus, in the hippocampus. You’re down-regulating your memory centers when you take just estriol, and women who are pregnant, often they say they have pregnancy brain. Oh, why is that? Because they’re down-regulating their alpha. It’s affecting the hippocampus. You’re affecting memory.

Women already have three times the amount of Alzheimer’s as men. Please stop doing us in. Okay? Don’t do that to us, and it also regulates the appetite center. Nature did this on purpose. Women who are pregnant are supposed to want to eat more, right? Especially think about ancient times when food was scarce, right? Women’s appetite is up-regulated so that they can gain weight, so you want to do this to your post-menopausal women. You’re down-regulating their appetite control centers. Don’t do it, so stop playing like you’re in charge. Stop being in charge. Give the body what it’s designed to have and stop micro-managing this. You’re micro-managing receptors. You have no clue what you’re doing, and that’s just the tip of the iceberg, I’m sure, of what we’re doing here, so we don’t want to give all this estriol and down-regulate all your alpha receptors. You’re doing harm.

If your patient dies of an infection, you may be responsible. If your patient gains weight, you may be responsible. That’s really not what we want to do, and I used to use bias too because I didn’t understand, but now we understand. I would never touch it because it’s really … It’s not what nature wants us to have, and we want to protect our women from infections, and that’s a big cause. Pneumonia is a big cause of death. We want to keep women on hormones for their lives. I mean, I don’t see any reason to stop it. I’m never going to stop mine unless they claw it out of my hands or something, but I think we should recognize our limitations, and there’s so much we can do just to help women to be healthy and have healthy cardiovascular systems without trying to be super clever. Just give the body what it would have when it’s a healthy 25-year-old.

Remember, think about a heart muscle. The heart turns over, and you get a new heart about every four years. Right? Every heart muscle in a woman’s body and yours as well is somewhere between just born and four years old on average. Those heart muscle cells don’t know how old you are. They’re born with the same set of genes that when you’re 20, or when you’re 50, or when you’re 70, every heart cell that’s created has the same genetic programming. If you give it what it needs to do its job, it will perform the same at any age, so that’s my goal. It’s recognizing that every heart muscle, every cell in the body is not the same age as you. Right? It was born later, and it doesn’t know how old you are, so give it what it needs, and it will behave the same as it did when you were young.

Now, of course, we can’t truly do that because it’s much too complex, but we can come a lot closer than we have been if we just do everything to feed those cells what it needs, the nutrients, the foundation, so it can run its machinery. Right? So it has the foundational tools, and then we give it the foundational hormones. It will do its job at any age, and that’s what we call health span. Right?

The thing that stops us from living forever is that at some point, our cells can no longer replicate, and then as they die, we can’t replace them, but until that point comes, there’s no reason we can’t be really healthy. I mean, not perfect because we can’t replicate a 25-year-old’s body, but we can come so much closer, and our society does not recognize it. Of course, we know that we’re always playing whack-a-mole. “This problem, we’re going to replace this joint. This problem, we’re going to do this surgery. We’re going to give this drug.” If we just give the cells what they need, they’ll keep performing for us, and that’s every cell in the cardiovascular system.

Dr. Weitz:            Great, and what about the progesterone part of the story?

Dr. Gersh:           Progesterone. I call it like estradiol’s sidekick. Progesterone has receptors all over the body as well. The thing about these hormones is that, and this really … We desperately need more research is that it’s not just having hormones. It’s having hormones in the right amount and in the right rhythm. We’re learning this with food. Right? Everybody is knowing that it’s not just what you eat, it’s how much of it and when you eat it. Right? You can’t just say, “I have one vegetable bite a month.” That’s not going to do it, so why is this whole idea of you have the smallest amount of estrogen possible to keep you alive? What is that all about?

You don’t want the smallest amount of anything. You want the right amount, and we are rhythmic. Women are so rhythmic. They have circadian rhythms, and lunar rhythms, and seasonal rhythms, and ultradian rhythms. That’s the rhythm through the day like the pulses, so we have just one giant rhythm, and when we give hormones the way we give them traditionally along with progesterone, we’re not recognizing the rhythms of progesterone. Let alone the rhythms of estrogen, but certainly, we’re not recognizing the rhythm of progesterone.

Progesterone is often given the same amount every day. Now, even if you don’t truly rhythmic hormones, which is probably really what we should do, whatever we should do, we want to, like I said, mimic a healthy 25-year-old. A woman who’s 25 not on birth control pills, thank goodness, a healthy 25-year-old woman has this incredible rhythm, the lunar rhythm of her hormones. She doesn’t have static dosing. Right? She doesn’t have a little bitty bit of estrogen and a little bitty bit of progesterone the same amount every day. That is not physiologic.

Even if we aren’t mimicking and menstrual cycle, which is where I think we should go, but we definitely need more research, but even pulsing the progesterone so that you do it 14 days a month is better, and there is some published data that that lowers the risk of breast cancer. We are not meant to have a little bit of progesterone every day. Progesterone is not just there to counteract estrogen’s effect on the uterus. We know that. Right? Progesterone is all over the body. It’s very neuro-protective. It has amazing effects all over, but it needs to be in a rhythm.

Progesterone is not supposed to be present every day, and we know that when progesterone in a normal luteal phase when progesterone is at its peak, it actually down-regulates estradiol receptors, so it helps to … It’s all a beautiful balance of proliferation and anti-proliferation. Right? We don’t have that balance when we just give the same thing every day. Also, receptors can get resistant. It’s just like, “Blah, blah, blah, blah,” you stop hearing. Right? The receptors stop listening after a while, and what’s not recognized is thyroid. A lot of women in menopause have symptoms of low thyroid, but they get to the doctor, and they test their levels, and they say, “They’re normal. You’re fine. You’re not a crazy lady.” Right? “You have all these imaginary symptoms. Go home and read a magazine or whatever.” They just brush them off.

It turns out that you can have plenty of thyroid hormone. It doesn’t matter if it isn’t working in the receptor. We all know that was insulin. Right? You’re getting high levels of insulin, but your blood sugar is sky high because it isn’t working. Well, the same can happen with thyroid. For thyroid hormone to work properly, you actually need the rhythm of estrogen and progesterone, so when estrogen spikes, which precedes ovulation, that estrogen spike opens up or up-regulates thyroid receptors, so the thyroid actually works. That’s why so many women in menopause have symptoms of low thyroid.

Now, is thyroid important for the cardiovascular system? You bet. Right? We know that low T3 is associated with heart failure and has a high mortality rate associated with it. That’s the last thing we want is low T3, but it doesn’t matter if you have it if it doesn’t work on the receptor, right, and you need this beautiful rhythm of hormones. If you have no estrogen produced by the ovaries and you have no progesterone, then you’re going to even have worse thyroid receptor function, so we need this. That’s why I like to look at the top tier: testosterone, progesterone, and of course, estrogen. If we can get them sort of right, then we get this, the downward cascade, so thyroid will work better. Oxytocin will work better. Growth hormone will work better. All the like next tier hormones will work better if we get the top tier working.

Dr. Weitz:            How do you determine how much progesterone to give?

Dr. Gersh:           That is the question of the year. There was no data. We have no data. That’s why I’m actually working now with a nonprofit that is going to be doing research in Mexico because it’s a lot cheaper to do human research in Mexico to look at those very questions. No one has looked at that. Big Pharma came out with these random doses, right? It’s like you can use 100 if you’re using oral, which of course, metabolized also, but if you use 100 or 200, oh, that’s only a double dose. I mean, like what is that?

Dr. Gersh:           The answer is we don’t know. That’s what’s so terrible. That’s why the Women’s Health Initiative set us back decades in terms of women’s research. We can use progesterone cream, but we don’t know what we’re doing. I mean, the bottom line is that we are all now, either ourselves or our patients, a little bit are guinea pigs because we don’t have published data on any of this. What we have to start with is just making it clear that women’s health matters and that we have to get more research on this. Otherwise, we’re just flying by the seat of our pants because we don’t have data on any of it.

Dr. Weitz:            What about trying to measure uterine lining thickness?

Dr. Gersh:           Well, that is something that can be done, but what’s interesting is how variable that response is in women.

Dr. Weitz:            Okay.

Dr. Gersh:           You can give the same dose to women and get quite different responses. Certainly, if you get a level, a thickness that’s like three centimeters, you did something wrong. A lot of times, like if you’re doing rhythmic hormones, what you end up looking for is clinical results. You end up looking for a woman having a regular period like lead, and it’s about the same amount. It’s at the right time, so you’re almost using clinical guidelines more than any kind of blood, urine, or salivary measures because we really don’t know what we’re doing, and I have to be honest with my patients about that too that I can’t create data if it doesn’t exist.

A lot of times, we do end up treating clinically and saying … which is not optimal, but it’s what we have like, “How do you feel? Do you feel like you felt when you were 25? Are you having periods like when you were 25? Are they regular and so forth?” because we’re having to use human metrics rather than lab metrics for some of these because we don’t know what we’re doing. We don’t even know what the correct lab test is. It’s that bad.

Dr. Weitz:            What about the 60 or 70-year-old woman who avoided hormones and now wants to consider taking them? What advice to give then?

Dr. Gersh:           Well, number one, you have to always people that whatever you’re doing, you’re not standard of care, and so the standard of care is terrible care, but it’s very difficult when standard of care is women should have no care. It’s really how I see it. You have to be telling women that. Also, we do know that estrogen receptors do shrivel with time. The serotonin receptors, which are actually estrogen-dependent in the brain and also in the gut are very much going to shrivel. We don’t know how to bring things back when they’re too far gone, when they’re too off. They’re dead.  It’s like hair follicles. You can do so much to restore hair, right, with like PRP. If the hair follicle is dead, it’s not coming back. If you have some neurons that are really gone making serotonin, you have estrogen receptors that have really shriveled up and they’re gone, then we’re not going to bring them back to life, but we know from vaginal treatment. I use this as my beacon of hope. Okay? If you take a woman at any age and you give her vaginal estriol or vaginal estradiol, she’s going to have improvement.

What that tells me is that receptors are not dead, and you could do this in a woman who’s 70 or 80. You’ll still have some improvement. You won’t have a vagina that’s like a 25-year-old, but it’s not going to be maybe the 70 or 80-year-old one that it was before, so there is still hope. I tell women, “Is it optimal? No, but the receptors are not all shriveled up. Some of them are still there, and we can work if you want to and give it to them.”

We know that Dale Bredesen certainly at every age to try to do his Alzheimer’s reversal program has been giving estrogen to women at every stage in order to help their brains because there’s estrogen receptors all over their brain, every different part of the brain.  I felt that that was really encouraging for us because we’re less out on a limb. If we can say, “Well, you have some memory issues like who doesn’t, right?” and then you say, “Okay. Well, this has already been established by Dale Bredesen, and he has very big clinical status and so forth. He’s respected, and he’s giving estrogen to women at any age to help their brains, so now, I have at least a leg to stand on.” As long as my patients understand that, I will start, and because the receptors are pretty much in hibernation, we might say, I usually with an older population, I will start low and work my way up like we would do with thyroid, right?  If someone is severely hypothyroid, we don’t start them out on the physiologic final dose. We start them low and work our way up, and that’s what I do. Do I have any guidelines? Do I have clinical data? No. I have just my own experience for this, but for older women who’ve had a big gap, and certainly, that’s not what they did in the Women’s Health Initiative, of course, I would start them and try to build up their receptor function and work my way up rather than starting high. Whereas totally different if a woman is pre-menopausal or right at menopause. I’m not going to start them low. I’m going to start them at physiologic levels.  I mean, this whole idea of the smallest dose, that’s crazy.  We want the right dose, and the right dose is a physiological dose, so I’m going to go with higher dose. It’s not high, high. I mean, talking about this whole low dose notion is junk science.  That’s not … but I do different things in different age groups.  Certainly.  Older people, I’m going to be generally starting.

Dr. Weitz:            I know it’s a big topic, and I know we only have so much time, but what about testing for women with heart disease?  Should it be different than testing for men?

Dr. Gersh:           Well, I tend to not do so much in terms of calcium scores. I don’t think that they’re as useful in women as in men, and they just look at the calcium, and women as we know … Many women who die from heart attacks, they don’t even have severe amounts of atherosclerosis. They die from spasm. Right?  Sometimes, it’s called broken heart syndrome. I really want to know what their blood pressure is, how it responds.  I think that’s really, really important.

We know that by age 75, 85% of women, especially if they’re not on hormones, they are going to be hypertensive, and women have very, we’ll say, very powerful autonomic nervous systems, and emotions can cause spasm of their arteries, so just getting a calcium score doesn’t really have very much predictive value, and we know that doing echo stress tests has virtually no predictive value in women in particular. I like to do carotid intima media. I like to know what the status of their arterial health is and if they have inflammation in the intima and if they also have a lot of plaque, recognizing the limitations of that as well because plaque never kills anyone. It’s ruptured plaque, and it’s arterial spasm, and it’s having that extra clottability. That’s really where it’s at.

I definitely want to look at inflammation, so I use labs that look at inflammation because we know that without inflammation, you’re not likely to have ruptured plaque, and so for women, we want to work with their emotions. We want to have them have the tools so that when they feel stressed, they know what to do even if it’s simple yoga breathing because stress kills women. We know that, and so I want to know the status of their arteries, and I’d like to do echo cardiogram. This is something that isn’t really talked about.

Women have very different hearts because of all the estrogen receptors and the loss of estrogen, and it really changes the heart muscle dynamics. One of the earliest signs of cardiac problems, actual heart muscle problem, a deficiency of energy in the heart is what’s called mild diastolic dysfunction. It’s really a stiff heart. You can actually see it on an echo cardiogram. The heart has two basic functions, contract and relax.

Well, we always have focused on the contract part, right? That doesn’t pump out the blood. Well, it turns out the relax part, when it feels is really key, and that has been ignored, and it’s even … I see patients coming from cardiologists with echo cardiograms, and on it, it says, “Mild diastolic dysfunction.” I’ll say, “What did your cardiologist say about this?” He said, “Oh, it’s normal.” No, it is not normal. Your heart is deficient in energy. You have a stiff heart. This really matters, and it’s really a sign of mitochondrial dysfunction in the heart muscle itself and loss of energy.

Of course, this all relates to loss of estrogen, and we need to get some estrogen going into that heart muscle because women often with mild diastolic dysfunction, they’re going to have higher rates of conduction defects within the heart go into more arrhythmias, which we know that’s what kills people is the arrhythmias, and they’ll get Afib, which we know is now at epidemic levels. It’s like the whole world seems to be getting Afib, and they’re more likely to get heart failure itself, so we need to like look at these warning signs.

I believe that it’s really important and as well, looking at the echo cardiogram, you can look at the heart valves because one of the things that estrogen controls is what’s called the enzyme matrix metalloproteinases. These are about tissue remodeling, and the heart muscle actually can remodel and not in good ways. It’s not like remodeling your house. This is like bad, bad, and so you get this hyperplasia of the heart muscle. You get remodeling, and it can actually move the heart valves so that they don’t fit together properly, and you can start seeing that on echo cardiogram.

I think the echo cardiogram is the very underutilized tool, very non-invasive, completely non-invasive to get a really good view of what’s happening in the female heart in the menopausal years so that you can really gauge what’s going on, and then hopefully, do something about it, but at least you need to let people know what’s going on with their hearts, and this isn’t even happening in the cardiologist’s office. They’re ignoring all this stuff. They’ll say, “Oh, you have a little regurge. Oh, you have some mild diastolic dysfunction. That’s normal.” It’s normal to have problems. I guess you could say that, but normal is like having cataracts. Well, people don’t ignore cataracts, so having heart dysfunction and calling it normal doesn’t work for me.

Dr. Weitz:            If women have mitochondrial heart dysfunction, then probably, one of the worst things you could do would be to prescribe a statin which is going to block your Coenzyme Q10, which is necessary for the mitochondria. Right?

Dr. Gersh:           Oh, absolutely and this … The two areas of the body that have tremendous energy needs and lots of mitochondria, of course, the brain and the heart, and we know that both of them are impacted by statins, especially in women, and women are much more prone to develop diabetes as well. It’s just statins have no place probably in very much of anybody, but certainly, the data in women is really bad. I mean, the number needed to treat to do anything is ridiculous. The number needed to harm is not very high. You don’t need to treat very many women to harm women.

I see no benefit in giving statins, and we even went through these committees. It was almost a tie. I mean, it’s not like it was overwhelming, and they looked at the people who were on the committees. They were all … Almost all of them were on the payroll. If they weren’t then, they became afterwards. We now know that the committees that approve pharmaceuticals are very uncontrolled, and many of the participants … I’m not going to say all, but many of them receive humongous amounts of money after the fact. There isn’t even any law regulating what happens after they approve the drug. None, or the recommendation that they give for how it’s used.

There is no control, so they could say, “I have no ties to the industry,” now. But then, after they approve it or they make recommendations, like two months later, they could be on the payroll of the big pharma company that makes that drug, and actually, that’s considered completely legal. We have a crazy system, so there’s been a lot of problems, we’ll say, with statins.

In terms of herbals, while you’re trying to get things right by giving hormones and lifestyle, one of my favorites is bergamot. I’m sure you’ve probably heard of bergamot. It’s from a citrus fruit, and there’s actually published data on it that bergamot can help to regulate abnormal lipids, and so that’s good. Remember, as people age, which is more associated with a higher mortality, low or high cholesterol, it’s actually low cholesterol because low cholesterol … I defend estrogen. I also defend cholesterol. I defend the defenseless.

Cholesterol is essential for life. It’s driving down … LDL is crazy. What you want is to drive down oxidized LDL, which we know is controlled by the enzyme PAN1, which is controlled by estradiol, so it’s like … This is like a dying duck. If you have estradiol, you don’t need to have low LDL because you’re not going to have oxidized LDL, and that’s what harms people, not LDL. LDL, if without enough LDL, your immune system doesn’t work properly. I mean, excuse me. Cholesterol is not there for no reason. Cholesterol is so precious to the body that we have a recycling mechanism in the gut to pull it back in so that we save it. That’s how precious cholesterol is. We want to keep it. We’d like to have cell membrane’s brain and steroid hormones.

Dr. Weitz:            Well, it is an amazing conversation. Unfortunately, I have to bring it to a close because I have patients coming up. I love talking to you though.

Dr. Gersh:           Yeah, me too. We could go on all day, but probably other people have things to do as well.

Dr. Weitz:            How can listeners get a hold of you?

Dr. Gersh:           Well, if people want to be my patient, I’m an old-fashioned doctor. I have a brick-and-mortar practice in Irvine, California called the Integrative Medical Group of Irvine, and the practice website is integrativemgi.com. I also have a little personal website where I put out … I attach like things like this, and other articles, and blogs, and you can find out information about my PCOS book, and that is just my name. It’s felicelgershmd.com. It’s pretty easy to find my practice or to find my own website, and if anyone wants to follow me, I welcome it. I just love educating, and having fun chats, and trying to get the word out, and defending the defenseless.

Dr. Weitz:            You’re such a wealth of information, and when is your book going to be published?

Dr. Gersh:           Probably, it will be out in November.

Dr. Weitz:            Okay.

Dr. Gersh:           It’s called PCOS SOS: A Gynecologist’s Lifeline to Restoring Your Rhythms, Hormones, and Happiness.

Dr. Weitz:            Great, great. Talk to you soon, Felice.

Dr. Gersh:           Bye-bye. Have a wonderful day.

Dr. Weitz:            You too.

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Hormonal Health with Dr. Devaki Lindsey Berkson: Rational Wellness Podcast 72
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Dr. Devaki Lindsey Berkson talks about the benefits and issues with using bioidentical hormones with Dr. Ben Weitz. 

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

 

Podcast Highlights

2:23  Dr. Berkson first got interested in natural medicine from hearing a lecture by Scott Nearing, who was the father of the back-to-the-land movement, which is what organic gardening was originally called.  Unlike many stories of people who were eating the standard American diet and got sick and found natural medicine, Dr. Berkson was eating healthy and teaching yoga and she still got multiple forms of cancer and had 7 organs removed.  The key for her to regain her health was taking bioidentical hormones, which allowed her to combat hormone altering chemicals that damage your tumor receptor genes. 

9:10  Since the 2002 Women’s Health Initiative, many doctors stopped prescribing hormone replacement therapy after menopause. Dr. Berkson disagrees with this position. Also, the North American Menopause Society now is saying that hormones are ok if used for only five years after the onset of menopause. The re-analysis of the Women’s Health Initiative found that the estrogen only arm of the trial found that women on estrogen only had 33% lower risk of breast cancer and heart disease, even with this horse metabolite of urine.  It is only when they added this synthetic progestin that breast cancer rates and heart disease increased. And this is for women who were past menopause for at least ten years before starting them.  Doctors in Europe did not stop giving hormones like we did here because they mostly give estriol and more natural hormones most of the time.  It’s important to initiate hormones as close to the beginning of menopause as possible and hormone replacement is as close as we have to the Holy Grail of slowing down aging.

15:31  Dr. Berkson said that every hormone you take should be tested and tracked. A woman shouldn’t have heart disease if she initiates bioidentical hormones. You should have a fast CT scan of your coronary artery. You should have an ultrasound of your carotid artery. You should have a vaginal ultrasound of your endometrial stripes, the thickness of your endometrium, so after you’re on hormones for 6 mths to a year you can monitor it and make sure it’s not growing out of control.  Some hormone specialists say that you should not take progesterone if you don’t have a uterus, but there are other reasons to take progesterone since there are also progesterone receptors in the brain, the gut, and the vagus nerve.  There are some forward thinking neurologists today using progesterone to tamp down inflammation in the nervous system. It’s very hard to find practitioners who know what the heck they are doing with hormones.  Our hormones are all under attack from endocrine disrupting substances in the environment.

18:57  In January 2017 there was a public forum put on by Harvard in the Huffington Post and these scientists agreed that the three major threats to humanity were: 1) nuclear war, 2) global warming, and 3) hormone altering chemicals. 

20:28  There is definite scientific, reproducible studies showing that young men in their 20s now often have the testosterone levels that men had in their 60s. There are androgen disrupters just as much as estrogen disrupting substances.  It’s a big deal because hormones are not just for sexuality. Hormones run our brain, run our central nervous system, and they run our gut.  We have receptors for estrogen, progesterone, DHEA, estriol, cortisol, all throughout the gut, let alone thyroid and hunger hormones and satiety hormones.

23:15  I asked Dr. Berkson in her own hormone therapy, what percentage of estriol versus estradial does she use?  She said it depends upon the person.  Estriol signals mostly the Estrogen receptor beta, which controls growth, while Estrogen receptor alpha stimulated growth. One of the new theories about cancer is that if estrogen receptor beta signals are shut off, that cell is more prone to cancer. Because women have less ER beta receptors in their lungs than men do, they are more at risk of lung cancer from second hand smoke. This is why soy is not such a bad food, because soy is the only food that turns the estrogen receptor beta on.  We also have the rhubarb product from Metagenics that stimulates the Estrogen receptor beta known as Estrovera.

25:58  Dr. Berkson said that she learned about hormone testing from Dr. Jonathan Wright, one of the fathers of Functional Medicine, and she used the 24 hour urine test for hormones for four decades. But she has worked with good Functional Medicine doctors who successfully use serum testing, like Dr. Block in Tulsa and David Brownstein, and with Dr. Jack Monaco in Nashville, who uses saliva. You have to listen to the patient more than the laboratory results.  When we measure serum or urine we measure hormones produced endocrinologically by our glands, but it doesn’t measure whether they are utilized by the receptors.  It also only measures hormones produced endocrinologically.  But a lot of hormones are produced intracrinologically, in the periphery, which are produced by post-menopausal women.  We have no test to measure these hormones produced in the periphery.

31:30  There’s not only the importance of the level of the hormones but also the issue of receptor functionality, which can be affected by chemicals and also by nutrient status.  If you don’t have optimal levels of zinc or magnesium or B vitamins, your hormone receptors cannot function properly and those hormones will not have the desired effect no matter what the serum levels are.

35:07  It is important that women have a healthy gut and that they are pooping daily and ideally twice per day, so they excrete their excess estrogen, so that it does not accumulate. If you are constipated, then estrogen will be reabsorbed instead being pushed out of the body.  You want to have this healthy flow of estrogen and then you want to get rid of it.

49:45  The final metabolite, 2-methoxyestradiol, nobody knows about that, but it’s what saved Dr. Berkson from more cancers. She takes that as a biodentical hormone. It has many applications, including for cancer patients.

 

 



Dr. Devaki Lindsey Berkson is a Doctor of Chiropractic, Certified Nutritionist and Functional Medicine practitioner.  She has specialized in gut disorders and hormones and she has authored over 25 books, including Healthy Digestion the Natural Way, Hormone Deception, Safe Hormones Smart Women, and her newest book, Sexy Brain.  Dr. Berkson has taught hormones to doctors for A4M and she is a formulator and inventor of nutraceuticals and pharmaceuticals.  She consults with both patients and providers and she can be reached at her website at  https://drlindseyberkson.com/  She also offers a series of online courses that are available on her website, including her new Sexy Brain: Redefining Hormones course.

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


 

Podcast Transcripts

Dr. Weitz:                            This is Dr. Ben Weitz with the Rational Wellness podcast bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to the Rational Wellness podcast on iTunes and YouTube and sign up for my free ebook on my website by going to drweitz.com. Let’s get started on your road to better health.  Hey, Rational Wellness podcasters, thank you so much for joining me again today. For those of you who enjoy Rational Wellness podcast, please go to iTunes and give us a ratings and review so more people can find out about the Rational Wellness podcast.

Today we have an interview with Dr. Devaki Lindsey Berkson. She’s been in practice in functional medicine with an emphasis-

Dr. Berkson:                       For a long time. Longer than most of you have been alive.

Dr. Weitz:                           Not me. I’m old, too.

Dr. Berkson:                       How old are you?

Dr. Weitz:                           I’m 60. I just turned 60. I just turned 60.

Dr. Berkson:                       No, it’s not longer than that. You look good, real good.

Dr. Weitz:                           Thank you. Her practice is focused on nutrition, hormones, digestion. She’s one of the thought leaders in natural medicine. She’s trained many doctors in the science behind natural medicine. She’s published original research. She’s taught for functional medicine programs. She’s a best-selling author. She enjoys a beer when she gets home from work. She’s written a number of books including How Beer Creates … no, Healthy Digestion the Natural Way, Hormone Deception, Safe Hormones, Smart Women, and her newest book, Sexy Brain. Dr. Berkson thank you so much for joining me today.

Dr. Berkson:                       Oh, it’s really great to be here. I think your audience is about ready to be blasted with molecules from every portal of existence.

Dr. Weitz:                           Okay. Can you tell us your personal story? How did you become so interested in natural, Functional Medicine?

Dr. Berkson:       Natural, Functional Medicine just made sense to me. I heard when I was 17 or 16 1/2 years old a lecture by Scott Nearing, which many people will not remember Scott Nearing. He was the father of the back-to-the-land movement. That’s what organic gardening was originally called was back-to-the-land movement. He had been a professor of economics at Penn State. He saw that children were being abused in the workplace. He fought for child labor laws. He became blackballed to teach. He had to figure out what the hell to do if he couldn’t teach. He had a PhD. Went through all that trouble and now, because he fought for the rights of children, he couldn’t teach. So he went to, first, Vermont. He started a maple syrup business. He started gardening without chemicals. He was the first guy.

And then he gave some land to Eliot Coleman. The two of them are really credited with the whole organic gardening movement. I heard a lecture by Scott, who was very famous. He wrote 55 books. His very famous book was called Living the Good Life. And then when he was 100 years old, he always said when he was no longer a contributing member to society, he would fast himself to death, so at 100 years he fasted himself to death. His wife wrote a book called Loving and Leaving the Good Life. They became best friends to me.

I heard a lecture at the Theosophy Society when I was 16 1/2 or 17 by him. He wrote the foreword of my very first book, and we have all kinds of things that happened between our lives together. They said you are what you eat. This was in the early 1970s. He said you are what you eat. What you eat is going to create your future. Well, that made a lot of sense to me, so I started eating organically. My mother was a major athlete. She was one of the very first women in the United States to be a state champion and athlete and also a dancer. I was exposed to that when I was very young. So I did all those things. I’m the totally different story than you hear.

You hear stories that people were living the standard American diet, get ill, get terribly ill, see the light, do everything better, and get well. That was not my story. My story was I heard Scott, so I ate organically. My mother was an athlete. I became a yoga teacher. The Beatles came back from India from following the Maharishi. I said, whoa me. I’m going to go to India. I went to India, and I learned Ayurvedic medicine. I was a yoga teacher for many years. I kept getting cancer after cancer.

Dr. Weitz:                           Wow.

Dr. Berkson:                       And illness after illness doing everything right. Food isn’t the whole answer for everything. That is not the answer for everything. It’s certainly what drives our microbiome and a lot of our consequences, but it’s not the only thing that’s involved in wellness. My path, my karma was that I was doing the things that people are getting the memo on now: food and nutrients and meditation and forgiveness and detox. I was doing all that. I was getting cancer after cancer and tumor after tumor after tumor.

Dr. Weitz:                           How many forms of cancer did you have?

Dr. Berkson:                       I had breast cancer, then was diagnosed with kidney cancer. I lost seven and a half organs before I figured out what the heck was going on. I had to hack my own health out of the mountainside. Now in my older age … Can people see us? Am I on video as well as-

Dr. Weitz:                           Yeah, there’s going to be a YouTube video version as well as the iTunes version.

Dr. Berkson:                       I’ve been in practice for 47 years.

Dr. Weitz:                           You look great.

Dr. Berkson:                       So I’m not a spring chicken. In my older age I now can enjoy the youth that I never was able to enjoy in my younger age and the looks and the vitality and the energy, because I figured out what to do. It’s not just food. I got so enticed by Scott Nearing, by Bernard Jensen, by Paavo Airola, the early speakers, Jeff Bland. I was just enthralled with natural medicine, but it wasn’t because I was ill because I was already doing all the things that natural medicine said to do. Thus, my path took me on hormones, because hormones were my answer and how to combat hormone altering chemicals that damage your tumor suppressor genes and reboot them. I couldn’t go to any Functional Medicine internist or any chiropractor or any nutritionist. There was nobody who could give me that information.  All that was offered to me was that you have a very complex case. You keep having cancers. Let’s whip out those organs.

I have such an interesting tale because I now am I professor for A4M and PCCA, which are the … If an MD or a nurse practitioner wants to go further after allopathic medicine, they can take these further higher board certification courses, which are usually about four years long and cost about 50 to 60 grand. Now I’ve become a professor on those. Usually when the number of the professors … I’m on the gut module and on the hormone module and environmental medicine module. A lot of the docs talk about being a straight doc until they get ill, and then they have to clean up their diet, clean up their food, and they get better, but that wasn’t my story. My story is the story of hormones. So my book Sexy Brain and a lot of my books are the story of hormones. Based on one of my very first books on the environment, Hormone Deception, which came out about 24 years ago, which was one of the very first books on how things in our environment are futzing with our hormones. That came out a long time ago.  I was invited based on that book, which took me six years to write because nobody knew about that stuff back then. I was invited to be a scholar at an estrogen think tank at Tulane Med School. I got to work with the number one scientist in the world, Elwood Jensen, who discovered how hormones even work and Jan-Ake Gustafsson, who was the second scientist who discovered how the second estrogen receptor, ER beta, works. So it’s unusual to learn hormones from your own health story and then learn hormones from the guys who are making the field and then be in practice to have the honor with which to navigate that and explore that with patients.

Dr. Weitz:                            Now, since the Women’s Health Initiative, most doctors are telling their patients not to take estrogen replacement and hormone replacement therapy, but you have a different opinion about that, right?

Dr. Berkson:                       Well, I don’t think that’s really true anymore. The North American Menopause Society, NAMS, which is the most well distinguished society and sends all the data downstream to the gynecologists and endocrinologists, they’ve been coming out and saying, well … In their last several consensus statements they’ve come out and said hormones are okay if used for a period of five years for symptoms. They’re okay in breast cancer and high risk women if they’re given vaginally. They’re fudging the lines a little bit. But honestly, it’s stupid. Stupid. I just can’t take it anymore. If you read my book, Safe Hormones, Smart Women, which I actually have a book that I already updated but unfortunately the first molecule I discuss in the new updated book, the FDA is having an issue with, so I didn’t publish that book yet. The Women’s Health Initiative came out with bad news in the beginning of July 2002 saying that hormones really didn’t do anything that we thought they did and you should, doctors and women, throw them out the window because they’re going to cause breast cancer. At the re-analysis that began fervently because it was the number one selling med over proton pump inhibitors and antidepressant meds at that time, so there was lots of re-analysis by very prestigious statisticians at Yale and all over the world.

They saw very quickly that the women who were used within those trials, the estrogen only trial and the estrogen and progestin, synthetic progestin, the Prempro trial, were older women who had been out of menopause for over 10 years. Most of them were obese. They used a synthetic hormone. After you looked at all the data, all the data, and even the guy that wrote the fertility gynecology book that all the gynecologists say. I’m trying to think of his name. Leon. I can’t think of his name right now. He’s a professor at the University of Oregon. He said you can’t throw the baby out with the bath water. The clinical experience and hormones makes such a difference based on this trial. The reanalysis of this trial ultimately said that the estrogen only arm when re-analyzed showed that women on estrogen only had a 33% less increase of breast cancer and ultimately the arm, that means the group of women, that had estrogen and progesterone, it was the synthetic progestin that actually, if a woman had a preexisting cancer, really ratched that up or gave her a higher increase of stroke. So, first of all, doctors in Europe did not stop giving hormones like we did here, because they mostly give estriol and more natural hormones most of the time. Not all of the time.

Doctors who read the data and listen to the data or read my books or listen to my podcast gave up what the Women’s Health Initiative was saying or didn’t even listen to it. So there was a group of doctors who said that’s based on synthetic hormones. That’s based on women who were off hormones for at least 10 years. Because there’s a window of the best time to initiate hormones. The younger the woman, the healthier the woman, the less or zero the heart disease, the better the outcome of taking hormone replacement. But hormone replacement is as close that we have to the Holy Grail of slowing down aging of anything. Anything, anything, anything, anything.

When I used to work at the family practice clinic here at Wiseman Family Practice, Dr. Wiseman, who started the practice … I love to work with doctors who have been in practice 50, 60 years before they retire, because they’ve been around for so long, they’ve seen so much. They’re such rich resources. At the water fountain he and I would have these great conversations. He would say, “You know, Lindsey, if you have 100 people in a room and they all got the memo to do exercise, to eat right, but half of them are on hormone replacement or doing some intervention to balance their hormones, which there’s a debate about those interventions and the delivery modes and which way you take your hormones and how you assess your hormones, you could cherry pick them out.” Out of the 100 people where everyone’s doing, “everything right”, the people on hormones would have shinier hair, have bigger posture, be talking faster. If you have a lot of women sitting right here on your radio show about my age, they will not be speaking the way that I’m speaking right now. They won’t be. They won’t be as upwardly lilting as I am. They won’t look as I am. I want them to be this. I don’t want to be the only one on the block being like this, but hormones make a difference.

I had breast cancer 24 years ago.  A lot of doctors will never give a woman hormone replacement if she’s had breast cancer.  I’ve come to realize that that’s not true. It’s hormones out of balance that put your genes at fear of disregulating to put you more at risk of your tumor suppressor genes not working. You have to have somebody who knows all this, which aren’t a lot of people.  In fact, I just created an online course last year called Redefining Hormones in Today’s Toxic World.  It’s a 30-hour plus hormone course on what is really going on with hormones in light of hormone altering chemicals and all the new stuff we know, because doctors aren’t given this.  Whether you’re a naturopath or whether you’re an MD, you’re not trained in this in school.  I thought mostly smart patients were going to take my course. I had gynecologists, family practice docs, and internists, and everybody was saying to me why don’t we learn this in med school?  This information just has not yet entered the academic curriculum of docs.  It hasn’t trickled down yet into the clinical arena.

Dr. Weitz:                           Now, do you personally take natural progesterone along with the estrogen?

Dr. Berkson:                       Well, every hormone that you take should be tested and tracked. A woman shouldn’t have heart disease if she initiates bioidentical hormones, because in some women, and those are the women that it could be dangerous. I never see any patients whose doctors have done this. You should have a fast CT scan of your coronary artery. You should have an ultrasound of your carotid arteries. You should have a vaginal ultrasound of your endometrial stripes, the thickness of your endometrium, so after you’re on hormone replacement, after six months and a year, you can monitor it and make sure it’s not growing out of control. You got the right mix.

Dr. Weitz:                           And that’s the benefit of having a progesterone to keep the endometrium from over growing, right?

Dr. Berkson:                       Right, exactly, but a lot of doctors still feel if you don’t have a uterus you shouldn’t use progesterone.  Tori Hudson, who leads the female health department at National Naturopathic College, where I went when I was going to chiropractic school in Portland, she teaches at her conferences, if you don’t have a uterus, you don’t need progesterone.  Progesterone doesn’t just have receptors in the lining of the uterus. It’s got receptors in the brain. It’s got receptors in the gut. It’s got receptors in the vagus nerve.  Forward thinking neurologists are using progesterone to tamp down inflammation in the nervous system.  It has a lot to do with the health of the nervous system.  So it’s very hard to find practitioners these days that know what the heck they’re doing with hormones.  And then that leaves the woman or the man, because there’s manopause was well as menopause.  We’re all, all of our hormones are under attack, younger and younger.  Harvard just came out with a study. The pediatricians at Harvard just did this shocking study.  It was in February of this year. They looked at girls who had problems with body image, anxiety, over exercising.  We’re such an obsessive society about beauty and thinness and all that stuff. They measured their estrogen levels. They found many of the to be deficient. They slapped an estrogen patch on girls from 14 years old to 20 years old.  I’m kidding you not.  Fourteen years old to 20 years old because these women were insufficient in estrogen. The majority of those people felt totally better, lost their body dysphoria, did a lot better in school, and functioned better. These pediatricians in Harvard diagnosed hypoestrogenism in young girls.  Why in the heck would that be?

Dr. Weitz:                            Because of the toxic estrogens in the environment that are glomming onto the estrogen receptor sites and preventing their natural estrogen from working.

Dr. Berkson:                       That is definitely one of the reasons. And too much stress, cortisol, can promiscuously block estrogen receptors or if people have bulimia and eating disorders and eat too little. Fat makes estrogen, so if you get too thin you stop making estrogen because you have less fat cells and you conserve your energy. There’s multifactorial reasons today between stress and the demands on a young girl. So many young girls hate their body and hate themselves.

Dr. Weitz:                            Anorexia, bulimia.

Dr. Berkson:                       Right. In January 31st of 2017 there was a collaborative public forum put on by Harvard in the Huffington Post.  A lot of the guys that I worked with at Tulane were on that forum.  They said that there are three major threats to humanity.  The first one is nuclear war.  Everybody agrees to a nuclear war. The second one is global warming.  Most of the scientists agree with global warming.  Trump’s base doesn’t agree with global warming.  We won’t go there.  The third one they said, which is really huge, because it’s making issues with pregnancy, issues with milestones of reproduction.  When a young girl goes into menarche, she starts menstruating.  When a woman goes into menopause, it’s changing the pattern, the template of the human race, are hormone altering chemicals.  That’s what I wrote Sexy Brain about was hormone altering chemicals and its effect on intimacy in the brain.  They actually said this was the third threat to humanity.

Dr. Weitz:                            Wow. Yeah, endocrine disrupting substances, which include BPA in the plastics and mercury, which is spewed into the air by coal-fired power plants, and pesticides and chemicals in personal care products and phthalates. There’s so many endocrine disrupting substances, it’s amazing that anybody’s hormones are even halfway normal.

Dr. Berkson:                       Well, there is definite scientific, reproducible studies showing that young men in their 20s now often have the testosterone levels that men had in their 60s.

Dr. Weitz:                            Yeah, I just called one of the labs that we use.  We’ve been using Spectracell.  It’s 75% of the men of all ages have low free testosterone.  I said is your lab wrong.  They said no, we double checked them.

Dr. Berkson:                       There’s androgen disrupters just as much as estrogen.  When I first was going to write Hormone Deception, which stands as well today if you want to understand endocrine disruption.  You go to Amazon.  You get Hormone Deception. You will learn everything about what we’re talking about.  When I first tried to sell it, even with an agent, people said, “What the hell is this?”  Nobody had heard of endocrine disruption.  They said this is only worth a little teeny magazine article.  This is not worth a book.  Until McGraw-Hill believed in me. Judith McArthur, my agent at McGraw-Hill believed in me.  Now it’s on everybody’s lips.  Is it in lipstick?  Is it in makeup?  Is it in personal care products?  Is it in the air?  It’s a real deal because hormones aren’t just about sexy and reproductive things.  Hormones run our brain.  They run our central nervous system.  They run our gut.  We have receptors for estrogen, progesterone, DHEA, estriol, cortisol, all throughout the gut, let alone thyroid and hunger hormones and satiety hormones.

I have a new textbook coming out that I haven’t finished yet, about an 800 page monster. I put huge amounts of the unappreciated role of hormones in the gut. Hormones are like our physiologic internet system that send emails to little satellite dishes called receptors that run a lot of who we are. Being that our environment is rife with hormone altering chemicals, especially in the womb and in this egg and the sperm, that’s being attributed to the increasing rapidly incidents of diverse diseases in kids, behavioral issues, autism, cancers, et cetera. That’s a lot about what I discuss in the class is trying to put that together. How often when you go to see a doctor if you have an issue with your hormones, they say go see the gynecologist. Go see the endocrinologist. They’re not trained in any of this. Who does the patient go to if that’s influencing their health or they want to really caretake their hormones? That’s become my mission. In my own experience I had to do that for myself to get well. And my passion.

Dr. Weitz:                            Interesting. As far as your own hormone therapy, what is the percentage of estriol versus estradiol in what you use? Do you use a formulation that has a higher percentage of estriol?

Dr. Berkson:                       It depends completely on the person. Estriol signals mostly estrogen receptor beta. When women think of the bad estrogen dominance, they think of growth out of control, gaining weight, feeling bad in your premenstruum, all the negative things. Everyone has heard about the bad estrogen dominance.  But estriol signals the good estrogen dominance. It signals estrogen receptor beta, which controls growth.  In fact, the new theory of cancer is that you have estrogen receptor beta signals that are being signaled that protect a cell from turning into a cancerous cell.  If the estrogen receptor beta signals are shut off, that cell is more prone to cancer.  A hormone delivers a signal to a set of proteins in the shape of satellite dish called a receptor.  Hormones signals into a receptor, simplistically.  Estriol signals to the estrogen beta signal and that controls cancer.  So women have a lot less ER beta receptors in their lungs, which is why they are much more at risk of lung cancer from second hand smoke or primary smoke than a guy is. Because we don’t have those protective receptors in our lungs like guys do.  That’s why soy is not a bad food, because soy is the only food that turns the estrogen receptor beta on.  In fact, the guy that discovered the estrogen receptor beta, who I worked with at Tulane, Jan-Ake Gustafsson, he’s been wooed over to a pharmaceutical company in Houston.  So now he’s a big, tall Swedish guy with a cowboy hat on trying to make an analog patentable drug that acts like the estrogen receptor beta, but he keeps finding herbs and nutrients that do that, like milk thistle and flax seeds and things that naturopaths and chiropractors have been talking about for a long time.

Dr. Weitz:                           Rhubarb extract, right?

Dr. Berkson:                       Rhubarb extract. Exactly. That’s what Metagenics came out with their-

Dr. Weitz:                           Estrovera, yeah.

Dr. Berkson:                       … Estrovera product. There’s a lot of ways to do it. I don’t believe that there’s only one formula for estriol to estradiol. In the olden days people gave all three. It was called tri-es. Estrone, estriol, estradiol. Most people do not give estrone because that can have pro carcinogenic actions. I think you have to look at somebody’s blood work or urine or 24-hour urine or saliva, whichever way.

Dr. Weitz:                           What do you prefer for testing for hormones?

Dr. Berkson:       Well, Jonathan Wright, who’s the father of bioidentical hormones was my mentor. Alan Gaby, when he was a student … Alan Gaby is considered the father of nutritional medicine, so to speak, along with Jeff Bland. Alan Gaby was a student. Both of us took our first rotation in integrated medicine with Jonathan in 1977. Jonathan fixed Alan and I up on a date, which is a whole other story. Alan and I have become lifelong friends. All of us that have started functional medicine have been really close from early on. Jonathan taught me to run 24-hour urine tests. That’s what I used for decades. So I’ve been running for four decades 24-hour urine tests, but I’ve worked now at many clinics studying under other very smart docs. I love to learn older smart docs that have been around for a long time. I worked with Dr. Block in Tulsa who taught at two different med schools and was triple board certified. He only used blood. David Brownstein, who’s a really good friend of mine in Michigan, he only uses blood. At the family practice here they only use blood, even though they do pellet insertion.

Dr. Berkson:                       I lecture a lot with Jack Monaco, who’s a OBGYN who’s now gone rogue and is a gynecologist and one of the smartest, nicest guys I know in Nashville. He wants me to move to Nashville, but I don’t want to move to Nashville because I love living here. But I love Jack. Jack only uses saliva. You can use anything to monitor hormones. I’ve come to learn that there is no one best way. It’s the way that you feel works. Because hormones aren’t just what’s in the blood that you can pick up, it’s not just a test. It’s also the patient. The real true doctor-

Dr. Weitz:                           In how the patient feels, you mean, right?

Dr. Berkson:                       Exactly. You listen to the patient more than the laboratory. The reason is is the study of hormones in the blood stream that we pick up on saliva or blood or urine is called endocrinology because the prostate or the ovaries make a hormone and it travels throughout the body. Everybody knows that’s endocrinology. But a lot of hormones are produced intracrinologically. Men mainly produce their hormones intracrinologically. A women, when she’s becoming peri and post menopausal mainly produces her hormones that way, which means they’re produced in the periphery. They’re produced in the periphery, and we have no test at this moment to pick that up. We have a whole contributing system of our hormones which we now know is true intracrinologic endocrinology, but we don’t have an assay, a test, yet for that, so a really smart dude of a doc or a lady will listen to what the patient is saying in how they feel along with whatever assay or testing method that they decide and their comfy with using. It’s unfortunate that today in training it’s mostly by algorithm because the insurance companies are what run everything. They want a doc to only run these tests and only do these meds. You become a smart person. You learn how to take all those tests, and you go into practice and you stop thinking.  And you stop listening to the patient.

Dr. Berkson:                       Most doctors are burned out because they know that this is true. They’re unhappy along with the patient. That’s why there has to be a revolution where people have the time to think, the luxury to think, and they don’t have to have a high volume practice with all these rules. We’re being regulated to death.  Everybody’s being regulated to death.  Our hormones are being regulated to death, and the patients are being regulated to death, the doctors … It has to get to where people are enjoying their life, because otherwise your hormones stay ill no matter what you do for them.

Dr. Weitz:                            Right.  Essentially what you’re saying is is that the hormones that get measured in the blood or the urine are not necessarily indicative of how much of the hormones actually get to the tissues and the organs where they’re really needed.  How much is being absorbed and utilized, we don’t know that.  We’re just looking at this measurement of what’s in the blood, and that’s not really representative of what’s really being utilized.

Dr. Berkson:                       You said that really well.  That is really true.  Once you really grok that, Vulcan mind-meld that, it’s shocking.  The other reason that’s true is you could, let’s say, have a perfect level. You go. You’re a guy, and your wife has badgered you to go get your hormones tested because she heard a podcast somewhere that testosterone will suppress the expression of the ApoE4 gene. Your family has had dementia.  She doesn’t want you to get dementia.  She happens to really love you, and she wants you to go see your doc. Your doc looks at your level of hormones and he goes, “You’re fine. It’s within normal limits.”  But that doesn’t mean anything because some men might operate better at high normal than other men.  So there’s that issue.  Then there’s the issue where it isn’t really representative of the intracrinological or local production.  But there’s another issue, Ben, and this is the issue that’s not taught anywhere.  That’s that the level in your blood or whatever way you assay it isn’t telling you if that could really deliver its signal to the receptor, the proteins in the shape of a satellite dish. That’s where hormones, where the rubber meets the road, is receptor functionality.

Receptor functionality is based on a tapestry of things.  Are those receptors clogged with chemicals from the environment or from other hormones, like a stress hormone? Those DNA binding sites have to be flush with nutrients. That’s where your diet makes a difference is in the binding capability, like a parking lot, for your hormone car to pull into the parking lot of your hormone receptor and be able to do a great job of parking and deliver its signal to the gene. You have to have magnesium and zinc and B vitamins. That all affects how long the signal is delivered, how effectively the signal is delivered to the gene. That’s where your eating choices make a difference is where hormones can or not deliver their signal. And then that depends on digestion because if you’re eating great choices but you’re not digesting, you still won’t get the nutrients there. So hormones tend to be this bigger tapestry that somehow for some reason is not taught there. But when I was at Tulane we put on 33 years. I was only there for about 12 years of the 33 years of estrogens in the environment.

The last six or seven years of symposia were called e.Hormones. The last two or three sounded like naturopathic conventions, because they were, well, B6 has a lot to do with how long estrogen gives its signal and the zinc fingers need to pull the whatever. It sounded like you were at the nutritional symposium because nutrition and hormones are absolutely intimately intermingled. But nobody seems to know about this. It’s in the textbooks. But the patient misses out. The doc says your hormones look great. I can’t give you to them. Or you’re on hormones and I don’t know why you’re not feeling better. It’s because there’s all these nuances. You have to check this and check this. There’s the bullet list to check to see if your hormones are working well or not. And then there’s the peripheral production of hormones that we don’t have a way yet of testing other than your symptoms.

Then just one other thing and I’ll shut up. When I wrote Sexy Brain I had a consultant. He has written all the estrogen books for the medical books. His name is Michael E. Baker and he’s the scientist from UC Davis. We had an interplay of 50 to 60 emails of writing my book, Sexy Brain, which is all about how estrogen came on the planet and what testosterone did and how you interpret that up into the bedroom and what does that have to do with your brain. Nature design didn’t enlist you to protect our brains. But with hormone altering chemicals that wonderful design of nature is being attacked. He’s discovered in some new papers a few years ago that a healthy microbiome actually produces hormones, too. So your microbiome, which of course is this explosion of research and flurry about it, is intimately related to your hormone health. But if you go to your gynecologist and say, “Should I take hormones,” you’re 98% of the time going to get a wrong answer. The answer isn’t going to include checking off all of these different nuances of what might be glitching your own hormones. That’s my passion is to try and pass that forward.

Dr. Weitz:                            Sure. You mentioned the importance of the gut and the health of the gastrointestinal tract. You look at the percentage of people who are constipated. If you’re constipated, you’re not excreting your estrogen. It’s getting recirculated. Having a healthy gut is so crucial to having healthy hormone balance.

Dr. Berkson:                       That is so right. When I wrote Healthy Digestion, the Natural Way, it was published by Wiley and one of their best selling books.  It came out about 25 years ago. I talked about the studies.  I’m trying to remember the name of the authors on the study.  I can’t remember it right now.  It came out in about the ’50s where they took women that had normal breasts but they aspirated their nipples. They forced liquid out of their nipples so they got some cells, some liquid and some cells.  And then they looked at the women’s bowel habits. It was such a great study.  It was done on several thousand women.  And then they replicated the study, which of course is the hallmark of science.  I don’t remember if it was replicated by an independent laboratory, which is more the hallmark of science. They found that if women went to the bathroom twice a day, had a bowel movement twice a day, they never had any abnormal cells that were able to be aspirated out of their nipples.

Dr. Weitz:                            Fascinating.

Dr. Berkson:                       If they went to the bathroom once a day, they had five percent abnormal cells. If they went to the bathroom every other day or had constipation, they could go anywhere up toward 30 to 40% of abnormal cells. Exactly for the thing you just said, estrogen accumulates. When you poop twice a day, it tends to rinse out of your body. You make estrogen. You get rid of it. You make it. You get rid of it. You want to have this nice flow, this tai chi flow of estrogen throughout your body and out of you. Part of the way you do that is through two bowel movements. I tell all my patients our goal is two poops a day. The larger the poop, the smaller the hospital.

Dr. Weitz:                            And how many women have one bowel movement every two or three days and consider that normal? They don’t even think that’s a problem. It’s very common.

Dr. Berkson:                       I’ve noticed this that in a lot of my patients, more and more today people are eating well, exercising and even being on hormones and they’re still very ill. They’re doing everything right, and they’re not getting well. When you go in, my intake is several hours long. When I go in their intake, often they will say my gut’s always been my problem or I was constipated for 20 years until I learned about magnesium and chia seeds and so forth. But they have a history of many years of things not being wiped out of them. Do you see that in your patients?

Dr. Weitz:                            Very common, yes. There’s probably I think 75% of the people out there have some problem with their gut. You really have to probe them because you ask them how’s your gut. Oh, it’s fine. You ever get gas and bloating? Yeah. How about constipation? Well … You get reflux? Well, sometimes, but I’m fine. Really?

Dr. Berkson:                       But gastroenterologists don’t believe that food has much to do for the gut other than fiber and probiotics. They really don’t. They’re nice guys. It’s not like they’re jerks.

Dr. Weitz:                            I know. it’s unbelievable.

Dr. Berkson:                       They’re making their money in those colonoscopy banks. It’s extraordinary.

Dr. Weitz:                            No, it’s really amazing. Just shocking, that the tube that the food goes through, food has nothing to do with it. Well, I think it’s changing a little bit. I know some of the local GI docs are actually buying machines to do their own SIBO breath testing. Maybe LA is a little different because Dr. Pimentel is here.

Dr. Berkson:                       I think LA is a little bit ahead of the times. When I lectured in Chicago at A4M and the Gut Module, there was a fabulous gastroenterologist from LA who I’ve fallen in love with. If he wasn’t married, I’d be-

Dr. Weitz:                           What’s his name?

Dr. Berkson:                       I’d be on it. I’d be in LA. I’d be on it. He was so marvelous. He was so great. His name is Dr. Sam Farshad. He runs the Los Angeles Gastroenterologist-

Dr. Weitz:                           Yeah, he’s a friend of mine. I had him on the podcast a month ago.

Dr. Berkson:                       He’s fantastic.

Dr. Weitz:                           He’s great.

Dr. Berkson:                       I use his breath test. We talk all the time now. He wants me to come down to LA and talk to about 500 gastroenterologists, but they didn’t want to pay me anything. I was, wait a second. These guys are making $30,000 a day in their colonoscopy banks. They want to make me come down. Just something stinks in Denmark. I don’t know. But I love him. He’s such a great guy.

Dr. Weitz:                           Sam is great, yep.

Dr. Berkson:                       My two specialties, I do see a lot of complex patients. That what I love to see are people that have been everywhere, seen everybody, and no one can help because I love to see if I can put a fresh set of eyes on it and help them as I’ve done with myself and many patients. I tend to see more of breast cancer patients probably because I’ve been there and inflammatory bowel disease patients. I’ve had quite a number of patients that either were told they had to stat get a colectomy and get their colon removed or they’ve had their colon removed and they’re still not doing well. Now after working with me for three to six months, it’s usually very fast. This isn’t a two to three year program. I add hormones to the mix. I add estriol to the mix. I add totally different things. I have pre and post colonoscopies of people who have saved themselves from getting rid of their colon. Usually they’re women in their early 20s or they’re somebody who had a colectomy 15, 20 years ago and they’re still ill. And then we now finally get a normal scoping.

I’ve gone and had a visit with the guys at Austin Regional Gastroenterology and I showed them four cases of pre and post colonoscopies.  Gave them the lay of the land of what I was doing. They laughed at me. They said there was no way we would ever do any of this. Hormones belong to the endocrinologist. They don’t belong to the gut, even though there’s gut receptors for hormones in the gut. If we were going to do nutrition, we would hire a dietician and they don’t know anything about this.  I said, but look it.  You wanted this woman’s colon out stat, and now there’s no evidence of disease.  No, we honestly don’t think that food has anything to do with the gut.

Dr. Weitz:                           You know who’s a great gastroenterologist in Texas is-

Dr. Berkson:                       Brown.

Dr. Weitz:                           … Ken Brown. Exactly, yep.

Dr. Berkson:                       I had him on my show. He’s a really great guy. He designed Atrantil.

Dr. Weitz:                           Exactly.

Dr. Berkson:                       I don’t know if he’s really a functional doc though in the same sense where he-

Dr. Weitz:                           No, not as much as Dr. Rahbar. No.

Dr. Berkson:                       He doesn’t approach it like Dr. Sam Fahid who is a true … In fact, when Dr. Brown heard that I was going to be lecturing with Dr. Fahid, he got all in a tizzy. He said can you please connect us. He’s my hero. He’s really doing functional gastroenterology like nobody in the world is. You’ve got him right there. You lucky ducky you. If anybody has any kind of gut issue, you’ve got the best doctor right in the world right there. And he’s your good friend?

Dr. Weitz:                           Oh, yeah, he’s great. He was on the podcast. We talked about IBD. I organize a monthly meeting of Functional Medicine docs, and he came and spoke. We got to chat. It’s great. Yeah, he’s a great resource.

Dr. Berkson:                       One of the things I appreciate about him, which I feel in you, too, which is so nice, is he’s very centered. In today’s world where everyone’s so spinning out of control, it’s so exhausting.  You just speak with him for a few minutes and you start having both sides of your brain resonate at the same speed and your chakras, if you believe in them, are lining up.  I tend with my closest friends to try and seek out people who feel grounded.  When I talk to patients and they’re trying to get well and they’ve seen 15 doctors and they’re spinning all over, I go, “You know, you’re not occupying yourself.  We have to talk about how you can not abandon yourself and maybe become more solid and in sync with your own self. That’s part of your healing, because our society pulled you away.  How can we pull you back? Because if you’re not occupying your own body, then how can any intervention you pay any amount of money for with any doc you use heal you?”  He just resonates that centeredness, which is why I found him such a delicious person on so many levels.  The real deal.

Dr. Weitz:                           Cool. Well, I think this has been a great podcast. We haven’t got to talk about your book.

Dr. Berkson:                       You got to go buy my book. You’re crazy if you don’t.

Dr. Weitz:                           I have your book. I bought your book. I have a digital copy of it. Everybody should buy her book, Sexy Brain. It’s a great read.

Dr. Berkson:                       It really is. Although, every single scientist and mentor, doctor I’ve sent it to, the first thing they go is go to the sex chapters. Look, I have to be honest with you. I just went to the orgasm chapter first.  We have all this crazy science and translating estrogen and testosterone.  No, I went right to the A spot, the B spot, the C spot.  Okay, you’re a guy. You’re a guy. It’s okay.  I’m not a woman who doesn’t like guys. I think the American male is in such an interesting position today, because there’s the Me Too Movement and women have been reading books and taking exercise classes and becoming bigger, stronger, better. Wow. Guys, we need to have some iconic figures with guys to help them feel more comfy inside themselves. The definition of the male today is somewhat confusing as it’s been with women, so we forged our living out loud to embrace it. This is great that you’re having a show like this. Maybe you can be an iconic figure for some guys.

I hired a guy to come build a closet in my office. My kits, my gut kits and my DNA kits, my office is overrun with kits. Turns out that he had done a book on photographs of men and their sons but with famous men, with Presidents and their sons. He was on Oprah. He was on Joan Lunden, if you remember her. He was on all these shows. I said, “You should be doing this now. Men need you now. I want to get you on my show now.” We got into this whole conversation. We have such a gender confusion and a gender exploration where a lot of young kids today, teenage kids, are saying I’m not the right gender. I want to be a different gender. That’s really trendy at the moment. I go into that quite a bit in Hormone Deception.  

Sexy Brain is more for hetero couples, but I talk a lot about what might be contributing to that. It’s an interesting thing finding out who you are and how to really connect with another human being. The whoever you are, you can have the hormones that turn on your brain and allow you to be who you want to be. But if hormone altering chemicals are suppressing that and you don’t want a lot of intimacy because so many people today, young kids even, don’t care about intimacy. That’s with Sexy Brain.  It takes you on an exploration that is a story that needs to be told.

Dr. Weitz:                           Awesome.  So for our listeners who want to get a hold of you, what’s the best way for them to contact you?

Dr. Berkson:                       I have a website, drlindseyberkson.com. That’s D-R-L-I-N-D-S-E-Y-B-E-R-K-S-O-N.  There I’ve got my radio show, Dr. Berkson Best Health.  I’ve got my blog.  I do all kinds of fun things in my blog.  In fact, this week I’ve got a new thing coming out about the new a2 Milk.  I don’t know if you know about a2 Milk.  In fact, DABSE just said they were going to publish that in their journal.

Dr. Weitz:                           Oh, yeah. I know a little bit about that. Right.

Dr. Berkson:                       I talk about a lot of stuff.  My last blog was on the heavy metals in prenatal vitamins and how you should know-

Dr. Weitz:                           I saw that article, yeah.

Dr. Berkson:                       And the one right before that is why do we hate older women and three ways to stop that. With all the research about the bias against … Now that we’re turning women on, we’ve left out a group of the women.  We’ve left out the older women. We’ve left them in the dust. I wrote an article on that, because in that dust clumping myself.  They can also, if they want to feel like they want to have a consult with me, I consult with people all over the world. I work with your own medical team.  My number is 512-507-3279. My intake and the notes I write up and everything, it takes about five hours all together.  It’s all personalized for you.  You get my 47 years of experience and of writing 21 books and of having radio blah, blah, blah, blah. I get that focused onto you for hours to try and see if we can tease apart how to really get you well from another viewpoint.  Nobody can help everybody, but I have a good track record of helping very complex cases because those are the ones I like the best because I love to think.  Let’s see.  Is there any other way people can get a hold-

Dr. Weitz:                           You have some online courses that are available as well. Right?

Dr. Berkson:                       Oh, thank you. I have a little growing Berkson University. I’ve got a 30-hour course called Sexy Brain, Redefining Hormones. And then I’ve got a course called the New Estrogen because nobody knows all about the new estrogen. There’s many things that estrogen does that the new academic research … Did you know that estrogen drives epigenetics?  Did you know that estrogen protects mitochondria from damage?  It has a lot to do with mitochondrial health.

Dr. Weitz:                           Interesting.

Dr. Berkson:                       That’s a course on that. Then the final metabolite of estrogen called 2-methoxyestradiol, nobody knows about that.  That’s what saved me from more cancers. That was the molecule that I couldn’t talk about because the FDA … Anyway-

Dr. Weitz:                           I see. And that’s the benefit of measuring hormones with urine, because you get the estrogen metabolites, the two, four and the 16.

Dr. Berkson:                       Right, but we give the final metabolite, we can give that as a bioidentical hormone. It has so many applications, but it’s-

Dr. Weitz:                           Ah, interesting.

Dr. Berkson:                       … very people know about that.

Dr. Weitz:                           Yeah, I didn’t know about that.

Dr. Berkson:                       It’s very useful in cancer patients, in many cancer patients. That’s what stopped me from having cancers is 2-methoxyestradiol.

Dr. Weitz:                           Wow.

Dr. Berkson:                       That’s what stopped me. That’s one of the main hormones I take.

Dr. Weitz:                           And you get that formulated by a compounding pharmacy?

Dr. Berkson:                       There’s only one compounding pharmacy right now that sells it. It’s called Key Pharmacy, and Jonathan and I have been using it for about 15 years in hundreds and hundreds of patients. That’s the only pharmacy at the moment that sells it.

Dr. Weitz:                           Wow, okay.

Dr. Berkson:                       I called the FDA. I said, “How come more compounding pharmacies can’t sell it?” They said, “There’s not a monograph.” I said, “Can I write the monograph?” They said, “Who are you? You need to be a researcher.” The Center for Bio and Environmental Research where I worked at Tulane had closed down, so I applied to become a researcher at the Health Sciences Collegium. I became one, and I just haven’t written the monograph yet, because that all took a period of time. I’d like to make 2 MEO available for doctors to decide to prescribe and make it available. Right at the moment it’s not so available. It’s quite extraordinary.

Dr. Weitz:                           Interesting. Fascinating.

Dr. Berkson:                       I have a course on that that’s available. I have a course called Hormones, Biomes, and Breasts, Oh, My. Hormones, and Biomes, and Breasts, Oh, My. I’m going to have new courses. I have Oxytocin, the Love Hormone, and the Role in the Gut. I’m going to be publishing that soon. I’ve got a course on birth control. What is really going on with birth control? What is it doing? What should you take when you’re on it? Who shouldn’t take it? What are the options for birth control? I’ve got a course like that. I’ve got a number of courses coming out. The Unappreciated Role of Stomach Acids and the Dos and Don’ts of Stomach Acid. I’m going to be populating all these courses. If people want them, they could just take them for so much money, and then if they want to get them and download all the slides, they could pay a little bit more money and get the slides.

Dr. Weitz:                           Cool. Awesome. Thank you. Thank you for your contributions to Functional Medicine in the world.

Dr. Berkson:                       I’ll have a sip of beer to this.

Dr. Weitz:                           Talk to you soon.

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Spore-Based Probiotics with Kiran Krishnan: Rational Wellness Podcast 71
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Kiran Krishnan, microbiologist, talks about the benefits and research on Spore-based Probiotics with Dr. Ben Weitz. 

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

 

Podcast Highlights

5:49   When Kiran was researching which strains of probiotics are most effective and have the most research, he kept coming back to the spore-based bacillus species. Because these probiotics are encased in a spore, they have the capability to survive through the acid in the stomach and the bile salts and the pancreatic enzymes in the small intestine.  This is why most other, non-spore-based probiotics are killed by the time they end up in the colon.   

6:59  The difference between soil based and spore-based probiotics is that most of the bacteria in the soil have no benefit for us in our gut as probiotics.  Only a few of the bacteria in the soil are bacillus species and have endospores and these are the ones that can survive the trip down our digestive tract and are native to our gut.

9:35  If you do a Google search for spore-based probiotics, mostly negative articles come up that claim that they are new and that there are very few studies on them.  This is the opposite of the truth. Some of the spore-based probiotic strains, like bacillus subtilis, have been used in most of the world (in Europe, Asia, and Latin America) as prescription drugs since 1952 and have thousands of studies on them. In fact, if you go to Pub Med you’ll find that some of these bacillus strains are the most well-studied of all probiotics.

15:32  Kiran explained that it is interesting to note that most people think that the strains like lactobacillus and bifido bacteria that you see in most conventional probiotics are the natural strains found in our guts. But this is not true, since the particular strains of lactobacillus acidophilus in the stores are different than the strains found in your gut.  Many of these strains were first pulled out from a human volunteer 35 years ago and since then, they’ve been growing in a factory and the strain has completely changed and has adapted to life in the factory. And each of us have a unique set of bacteria strains that we first got from our moms.

18:26  Like conventional probiotics, spore based probiotics do not permanently colonize the gut. They do colonize the gut and adhere to the wall and outcompete bad bacteria, but they only last about 20-21 days. Then they form spores and leave the body through defecation and then find another host through being eaten in some dirt. Our primitive ancestors were consistently eating dirt since they could not wash their food before they ate it, so they were constantly getting exposed to these bacilli. Not only do these bacilli crowd out pathogenic bacteria, but they increase microbial diversity in our gut.

22:15  I asked when we do a stool analysis on our patients, why don’t we see these bacillus strains listed as commensal bacteria?  Kiran answered that some of the panels will list bacillus subtilis under dysbiotic flora due to a misunderstanding. The resolution of some of the tests is not good enough to easily pick out the exact species and since we often have over 1000 species in our guts, but the tests usually do not list more than 15 or 20 commensal species, so they are not really a good representation of what’s in our gut. Stool tests that use culture are not very accurate, since 98% of the commensal bacteria are not able to be cultured in vitro outside of the body.

26:51  Bacillus subtilis produces a number of antimicrobial compounds that help get rid of pathogenic bacteria, including H. pylori. During World War II when the German army was in North Africa many of the troops were dying of dysentery. They noticed that when the locals would get sick that they would consume dried camel dung and that would cure them, so they started to do the same thing. After the war, they studied this camel dung and isolated the bacillus subtilis from it and in 1952 a German pharmaceutical company patented it as the first probiotic treatment for dysentery and gut infections. The bacillus gets into the gut, does quorum sensing, which is the ability to read the other bacteria signatures, and and produces more than 20 different antibiotics to precisely kill off specific pathogenic organisms.

30:31  One study has shown the bacillus clausii strain to be effective against IBS/SIBO.

37:03  These bacillus endospore probiotics produce various nutrients in our guts. Bacillus subtilis produces the enzyme nattokinase, vitamin K2-7, methylated B vitamins, and CoQ10. The bacillus indicus produces 12 different carotenoids: alpha carotene, beta carotenene, astaxanthin, zeaxanthin, lutein, lycopene, all at RDA levels and they will be absorbed 100%.

   



Kiran Krishnan is a microbiologist and researcher on Soil Based (Spore-based) Probiotics and designed the formulation in MegaSporeBiotic from Microbiome Labs. https://microbiomelabs.com/   https://microbiomelabs.com/products/megasporebiotic/ 

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


 

Podcast Transcripts

Dr. Weitz:                            This is Dr. Ben Weitz with the Rational Wellness Podcast, bringing you the cutting edge information on Health and Nutrition from the latest scientific research and by interviewing top experts in the field. Please subscribe to the Rational Wellness podcast on iTunes and YouTube and sign up for my free ebook on my website by going to drweitz.com.   Let’s get started on your road to better health.  Hello, Rational Wellness Podcastors. Thank you so much for joining me again today. And for those of you who enjoy listening to the Rational Wellness podcast, please go to iTunes and give us a ratings and reviews so more people can find out about our podcasts.

Our topic for today is spore-based probiotics. Probiotics as most of us know are live micro organicisms, usually bacteria, but sometimes also a fungi and other organisms that naturally grow in our colon, the rest of our digestive tracts, and other areas of our body. There’s increasing evidence that the healthy bacteria that live within us are crucial to our health for so many reasons, including for immune function, the production of various vitamins, cardiovascular health, brain health, we can go on and on about all the amazing benefits of probiotics for which the researches is proliferating.  Today, we’ll be talking about a particular category of probiotic, known as soil-based probiotics that contains one or more species of bacillus, such as bacillus subtilis. Despite the fact that most of the probiotics on the market contain the more conventional species like lactobacillus acidophilus and bifidobacteria, spore-based or soil-based probiotics have actually been around for a long time, and have actually been studied quite a bit. Today we’re going to be speaking with microbiologist and researcher, Kiran Krishnan, who has been doing a lot of research on these spore, soil-based probiotics.  Thank you so much for joining us today, Kiran.

Kiran Krishnan:                  Thank you for having me. It’s a pleasure to be here and always fun to talk about bugs, and dirt, and probiotics.

Dr. Weitz:                           Exactly. Tell everybody to eat some dirt, right?

Kiran Krishnan:                  Exactly. Go back to nature, back to nature.

Dr. Weitz:                           Exactly. Before we get into some of the technical questions, can you tell us a little bit about your background and how you became interested in soil-based probiotics?

Kiran Krishnan:                  Yeah. I’m a microbiologist by training and I did a lot of research work. University of Iowa is where I came from. When I was at the University, I focused a lot of my research work on virology, on viruses, studying viruses. In fact, I got to work on HIV vaccine project with using live virus. I worked on some … But then I also ended up working on a project on E. coli. E. coli such a fascinating organism in many ways we know our gut is heavily populated with E. coli. It’s a common commensal bacteria, but we also know that there’s the E. coli that causes disease. And so when people hear about E. coli, they immediately think that, when there’s numerous, very beneficial, healthy E. coli species in your gut. In fact, if you’re trying to eradicate it, it would actually cause way more problems and than any benefit.

This dichotomy of having the species that are typically talked about in a negative way, like E. coli, versus the reality of them being actually really important beneficial is what drew me into the realm of probiotics where I wanted to focus on organisms that theoretically from a microbiologist standpoint would be very beneficial. But the perception in the market was that there’s something bad about them or unknown about them. That brought me to the bacillus endo spores. The bacillus endospores really was a set of probiotic strains that we came across doing probiotic research for a large multinational. I had a research company which I still do have and we still do some research trials through that, but we were hired by a large multinational to study the probiotic industry for them, study the products that are on the market, look at the way products that develop, they’re formulated. Does it make sense to be refrigerated versus non refrigerated? Do we need 100 billion, or 50 billion, or 200 billion? Do we need 17 strains or five strains? And there’s so much variety out there in the marketplace.  They wanted us to figure out what is really backed by science and what is really the right approach to probiotic use, and we came back to these spores, because we started looking that … We found that the vast majority of products in the market didn’t really have any scientific substantiation to them. There wasn’t any studies that showed that 100 billion CFUs was better than 50 billion, or that 200 billion was better than 100 billion. There’s no dose dependency in that way. There was also no studies that showed that 15 strains is any better than seven, or five, or three.

As it turned out, it was pretty much all marketing. When we dug deeper into what types of strains could really make a significant difference in the gut with measurable clinical outcomes, we kept coming back to these spores. Because the biggest thing about them is they have the capability to survive through the gastric system, so that passage through the stomach acid, the small bowel with the bile salts, which are very strong antimicrobials, and then even the pancreatic enzymes in the small bowel, that passage kills 99% of the bacteria that are used as probiotics.  The vast majority thinks that dying these are getting through and it’s my tendency to always look at evolutionary biology for answers. So in my view, they were designed to be able to get through the system and go and function in the gut. Because of that, my inclination was that they would play a significant role in the gut, and as we’ve been doing our studies and looking at all the other studies that have been done, our inclination was sure that these are significant players in the gut, in the microbiome.

Dr. Weitz:                            Just to clarify. Can you explain what the differences between soil-based and spore-based probiotics?

Kiran Krishnan:                  Yeah, that’s really important. I’m so glad you mentioned that because a lot of people are familiar with soil-based organism products. There have been a few prominent products on the marketplace in the last decade or more. There is a significant difference between a soil-based product and a spore-based product. Soil-based product is typically a product that has a whole bunch of bacteria from the soil that are typically not very well characterized. They have some genus and species mainstream, but these bacteria aren’t very well characterized, and then they put them in a capsule and utilize them as a probiotic.  The problem with that is the vast majority of bacteria that live in the soil really don’t do anything for us in the gut as a probiotic. Their job is in the soil. Their job is to break down plant matter, fix nitrogen for the roots, break down decaying animal matter, and so on. Now, exposure to them can be beneficial, because it up-regulates the immune system as it’s moving through, but those bacteria also die in the stomach, die in the small bowel, and you put them out 12 hours later. Now, spore-based organisms are unique in that you do find them in the soil. But the spore-based organisms actually live in the gut.

The difference is they use the soil as a vector to transfer from host to host, so when they leave the body, when they know they’re going out into the outside environment, they will cover themselves in this spore coat, which is basically a protein calcified coat that protects them from the elements outside the body. That allows them to exist indefinitely in the outside environment until they get swallowed again by a human or another mammal. They pass through the gastric system with this armor-like coating around themselves. The moment they get past it and they get into the small bowel, they will actually break out of this spore coat and become a live functioning probiotic cell.  When we were looking at the environment for answers to probiotics, we basically went and refined it and dialed down to the types of bacteria in the environment that can actually survive the journey of being swallowed and then function as a probiotic in the gut. That’s how we came across these spore-based organisms as being more than likely the ones that will do most of the probiotic function.

Dr. Weitz:                            When you go on the internet and if the average person just does a search on Google for spore-based or soil-based probiotics, even if you put scholar in parentheses, there’s not a lot of good research that tends to come up. I saw several articles including one that looked like it was written by somebody from Scientific American claiming that there’s only one small study and there’s really no research on these things.  Then I went to PubMed and you put in some of the specific names of the spore-based probiotics like bacillus subtilis, and you find out there’s thousands and thousands of studies there. What is the story about these spore-based probiotics. How long have they been around, and is there really good research on them?

Kiran Krishnan:                  Yeah. And I’m glad you bring that up, because I get that question a lot from people, because the vast majority of people, like you said, when they’re researching something, and the word research is a loose term when you use Google, right? When they’re researching something, they will go into Google and they will type it in and see what the first … Usually they’ll read only the first three or four things that come up. One thing that’s important to note about Google is that the first few things that come up aren’t based on their relevance or their accuracy in any way at all. It’s really based on the people who are behind it, doing good search engine optimization, so they’re back linking that link to many different websites and so on, and they’re putting a lot of content on the blog.

What I came to find out when I started looking into what is the market saying about the bacillus spores and finding all of these unfavorable write ups which, and I’ve read through vast majority of them, they’re all blatantly inaccurate in how they describe organisms, how they describe the microbiology of things, how they describe the microbiome and so on. I started digging into why are these out there, where are they coming from, and then you come to find out that many of these things are from companies that sell conventional probiotics and they basically pay people to put up articles about competitive types of probiotics to try to gain market share. And in fact, that was the main reason why we were hired by the large multinational company to do the research on the probiotics because they were looking at going into the soil-based or spore-based area and we’re seeing a lot of this misinformation on the web and wanted us to give them an overall real scientific review.

Now, when you look at the real science, which is like you said in PubMed and places where you can actually find scientific studies and papers, you’ll find thousands of research studies on bacillus subtilis. It is well known in the world of microbiology. They’re two of the most well studied bacteria in the world. We know more about these factor than any other bacteria that’s ever been discovered, and that is E. coli and bacillus subtilis. Bacillus subtilis is one of the most utilized bacteria in microbiology research. We use it in all different ways as bacteria transferring genes to another bacteria or as a way of testing things to grow on and exclusion media, all kinds of stuff that we do in directed evolution we use bacillus subtilis. It’s one of the most well known bacteria that have ever been discovered.  The thing about the spores is they have been in the prescription drug market since 1952 in Europe, Asia, and Latin America. In two thirds of the world, the spores have been prescription drugs for well over 60 years. Their use is actually far wider and greater than the vast majority of probiotics that we’re familiar with in the US because they’ve been used in hospitals, clinics, doctors offices and so on as prescription drugs. And when you start looking at the number of studies that are behind the spores, it’s staggering. These are some of the most well studied organisms on the market with respect to their probiotic function in the gut.

Dr. Weitz:                            That’s really amazing, mind blowing. I don’t think most people are even aware of that. To just clarify, these spore-based probiotics are typically forms of bacillus bacteria including bacillus subtilis, bacillus indicus, bacillus coagulans, bacillus clausii, whereas the conventional probiotics are species like lactobacillus acidophilus, bifido, Saccharomyces boulardii, these are the conventional probiotics.

Kiran Krishnan:                  Yeah, and I would actually put Saccharomyces more in the bacillus subtilis category, closer to that. Saccharomyces is a fungal probiotic, but when you look at the environment we would actually naturally pick up Saccharomyces from the environment, because you naturally find it on the outer skins of fruits and things like that, that our ancestors and early humans would have just consumed on a regular basis. Same thing with the spores. Our ancestors got huge amounts of exposure of the spores just by living on the earth, eating dirt, not sterilizing their environment, drinking water out of rivers and streams. These are ubiquitous organisms in the outside environment. So as humans, we naturally gain a huge amount of exposure to them.

It’s interesting to note from a microbiology standpoint, the things that we consider to be conventional strains like lactobacillus acidophilus, reuteri, bifidobacterium, and all of these that you see in 99% of probiotics. Out there, people say, well, those are the natural strains. The difference is the versions of lacto and bifido strains that you see in products are not the native strains in the gut. Even though they have the same name lactobacillus acidophilus, your lactobacillus acidophilus that you have in your gut, my lactobacillus acidophilus I have my gut are completely different than the ones that you find in the products in the stores. Those are not native strains to the gut. Not to say that they don’t have any benefit of the gut, some of them do, some of them do up-regulate the immune system, can control diarrhea, and things like that. But this concept that those are native commensals strains is totally erroneous, because they’re not.  The moment you pull out a strain like that from a human volunteer, 35 years ago, whenever they first isolated the strain, and since then they’ve been growing it in a factory, the strain has completely changed. It’s adapted to life in the factory than life in the gut. And as it is, we all have a unique set of lactobacillus and bifidobacteria in our microbiome anyway, right? No two individuals have the same distribution of those types of bacteria and our type, our version of the bacteria we got from our mom, and she got from her mom, and she got from her mom, and so on. Even identical twins born in the same mother will have up to 50% difference in their microbiome.  All our strains in our gut are completely unique. And so to think that the lacto bifido stuff you see at the store on the shelf are natural native bacteria, they’re not out there. They’re outside bacteria just as much as any of the bacteria are.

Dr. Weitz:                            Interesting. Now, we’ve learned that despite the fact that a lot of people don’t necessarily understand this, is probiotics don’t typically colonize the gut. They’re just temporary visitors there. Even though sometimes functional medicine practitioners will do a stool analysis and see that the person is low in a particular type of probiotic and may have the person ingest a product that has that particular species and even strain, those that you ingest actually are just there for a short period of time.  Now, we know that they help with developing a healthier microbiota, but they don’t permanently colonize our gut. What about sport based probiotics? How do they work?

Kiran Krishnan:                  Yeah, and you’re right that they don’t permanently colonize. Most of them just kind of move through like food does. Spore-based probiotics are interesting because they are designed by nature to leave the body, spend some time outside, and then come back in through the oral route, so through being consumed. They are perfectly adapted for that type of cycle, leaving through defecation and then re entering through oral consumption. Now, they do survive through the gastric system. They do get in the gut, and they do colonize, but as it turns out, they are transient in a way that they only colonize and stay within the gut for about 20 to 21 days. And when we initially discovered that, through some of the research we were doing, we were actually surprised, but then when you think about it, it makes complete sense.

The question I had in my mind is okay, if they’re so good at colonizing, meaning they’re really good at attaching and out competing bad bacteria and kind of changing the environment that they exist in. Why is it that they don’t just stay? Why do they leave? Well, two reasons. Number one, it’s we’ve developed this long term symbiotic relationship with them where we provide them a home and then they basically clean up the home for us. And in order for them to get transferred from host to host, to propagate themselves, they actually have to go out into the environment because they use the environment as a vector to transfer from host to host. And when you look at epidemiological studies and other types of environmental studies, they find that these bacillus spores are found in every corner of the earth and have been for millions of years.

Glacial ice core studies, for example, where they put long pieces of cores of ice out of glacial ice that measure few million years back into the Earth’s atmosphere, they found these spores in high abundance in the Tibetan plateaus in the South Pole in the North Pole. They’re virtually everywhere. And the way they get around is they use the environment, the air, the wind, the water to transfer to all of these regions. They need the environment as a vector to move, and so that’s one of their motivations coming out. The second thing is our ancestors if you imagine, would have gotten huge exposure levels to them on a regular basis. And if they never left at some point, they may be too many of them in the gut. What we want to do is promote the diversity within the gut and not have too many of any one species and so they’ve designed their own threshold level in the gut that they will not exceed. If any given area of the gut exceeds a certain threshold level of these spores, they will sporulate and they will leave.

Once they achieve what they think is their healthy balance, they will just continue to leave at the same rate that they’re coming in. And that’s very interesting, because as it turns out, once they get into the gut, one of the big effects of having these spores in the gut is a dramatic increase in diversity of the rest of the microbiome, and that’s never been shown with other probiotics. No one has ever published a research study showing that when you add any of these other conventional probiotic products, that it actually has any impact on the diversity or the population of the microbiota. We are submitting a paper for publication this year, showing that when you add the spores, in some cases, that almost doubles the diversity of the rest of the organisms.

Dr. Weitz:                            Wow.

Kiran Krishnan:                  Yeah. They get in there, and they affect change so much that they increase the growth of all of these underrepresented beneficial organisms.

Dr. Weitz:                            Interesting. How come when I get a stool sample back, that functional medicine based stool analysis that looks at the range of commensal bacteria, I don’t typically see these bacillus strains listed among them?

Kiran Krishnan:                  Now, some of the tests will, but some of the tests will list them under dysbiotic flora. When you look under the dysbiotic flora category, they’ll show bacillus subtilis, which again is just kind of misinformation and inaccuracy. And they don’t look for any of the other bacillus species. They just don’t know enough about them. There’s a lot of issues with stool testing. The ability to be very accurate with stool testing is really poor. Recently, the head of the American microbiome research which is based out of University of California in Davis, University of California, Davis, Rob Knight, he heads up American gut project. He’s a top microbiome researcher in the US. He came out with the papers and findings that the type of sequencing that’s used in pretty much all of the commercial stool testing systems is incredibly inaccurate.

The resolution is really poor is the problem. You can get down to this genius level, but you really can’t get down to the species level that accurately, so it’s very hard for those tests to identify all of the different species that could exist in the gut. And then their relative abundance as well. That’s another problem because you could have 1000 different species or 1500 species in your gut, you don’t get a stool test report back listing 1500 different species bacteria. You might get 15 or 20 that show pluses and minuses. It’s not a great representation of what’s actually going on in the bowel to begin with, and so certainly it doesn’t pick up on the vast majority things that actually in the bowel.

Dr. Weitz:                            Does it matter if we ordered a stool test that’s culture based versus PCR based?

Kiran Krishnan:                  No, it doesn’t matter because the culture based ones are severely limited because 98, 99% of the commensal good bacteria in your gut are not culturable in vitro outside of the body. They’re really hard to grow them because they’re strict anaerobes. The moment you pull them out, they start to die being exposed to oxygen. The PCR DNA based ones still use something called 16 S sequencing, which is low resolution and you can get a lot of false negatives. Just because it doesn’t show it on the test doesn’t mean it’s not there.

The other issue with the stool sample is the bacteria in the stool is not homogeneously distributed, right? That 15, 20, 25 grams sample that you’re taking is not a representative sample of the rest of the microbiome because you’re just looking at what’s in that sample. If you had taken a sample from a few inches away, it could look completely different. And you’re also looking at bacteria that’s being shed. Not necessarily bacteria that’s sitting in the mucosal well attached proliferating. The other thing is if you look at the manual for the stool testing, you’ll see that even in their manuals, they say that stool tests are representative of the micro flora and the distal colon. So it’s really a distal colon sample and it’s a snapshot in time of the distal colon. It doesn’t tell you anything about the ascending and transverse colon, it doesn’t tell you anything about the small bowel and so on.

It can be a tool to use. I in particular like the functional side of the stool test when you can look at things like short chain fatty acid production, secretory IgA, fatty acid degradation products, protein degradation products, that gives you a little bit more insight into what’s actually happening in the bowel. The microbiota component, what backers there, and what’s at high level, what’s at low level. That stuff is still very much in its infancy, and it’s almost never used in clinical trials for that reason, because it’s really hard to make any sense of it.

Dr. Weitz:                            Wow, interesting. Interesting. In some of the reading I did, I understand that bacillus subtilis strains can produce a variety of antibiotic, anti microbial compounds that can help crowd out potential pathogens in our gut including H. pylori. Can you talk about that?

Kiran Krishnan:                  Yeah, actually there’s an interesting story behind that, and the way this was discovered is actually, that’s where the interesting story comes from. During World War II when the German army was in North Africa and they had a whole campaign in North Africa, the vast majority of German soldiers were dying of dysentery because of the food and water in that part and their bodies weren’t used to it, their guts weren’t used to it. But they also noticed that the locals when they would start to get sick, what they would do is they would look for dried camel dung and they would consume the dried camel dung, and that would basically heal them of the gut infection. They took a bunch of this dry camel dung back and started studying it in Europe to figure out what is it within the dried camel dung that was curing the dysentery and they isolated the bacillus subtilis strain.

The bacillus subtilis strain from further research that they did was shown to have this capability of getting into the gut and then doing something called quorum sensing, which is the ability of bacteria to read other bacteria signatures, and they can find pathogenic or unfavorable organisms. They’ll sit next to them, and they’ll produce upwards of 20 different antibiotics to kill off that organism. But it does it in such a precise position manner versus when you think about taking an antibiotic prescription, which is like an atom bomb for your microbiome, right? It basically kills everything and it kills everything very quickly. And so, this is like a precision SEAL Team Six type of attack to those pathogenic bacteria. From that very research in the late 1940s, by 1952 a big German pharmaceutical company launched the first probiotic treatment for dysentery and gut infections from that work and that product is still in the market today. It’s been over 60 years and it’s still prescribed and used because it’s so effective.

Dr. Weitz:                           That’s amazing, and you just hear all these spore-based probiotics, they’re new, they just came on the scene, we hardly know anything about them. It’s pretty much the opposite.

Kiran Krishnan:                  Absolutely. They’re the most widely used probiotics in the rest of the world, and they’re using it in the medical setting, not even so much in health food stores and things like that. Their use has been very well documented because they’ve all been prescription drugs, and as prescription drugs, we know that there’s something called post market monitoring where all the adverse events and all of the negative issues that could about when a product is in a health food store, you might never know about it. But when it’s a prescription drug and doctors managing it, those are all reported and it’s all made public.  The fact that these strains have been used as prescription drugs for over 60 years and there’s so few adverse events or reports to them is really fascinating. It means that their level of safety and efficacy is unparalleled.

Dr. Weitz:                           I understand that there is at least one study using these spore-based probiotics for IBS/SIBO.

Kiran Krishnan:                  Exactly, yeah. In fact, bacillus clausii, one of the species that we work with in our product MegaSpore has a great published study showing that the bacillus clausii can reduce the overgrowth of organisms in the small bowel just as well as any antibiotic can, but it does so in a way that doesn’t disrupt the rest of the microbiome.

Dr. Weitz:                           I understand that you helped design and formulate the strains in the MegaSporeBiotic?

Kiran Krishnan:                  Yeah, exactly. When we came across these bacillus endospores and started to really understand their value in probiotic therapy and also manipulation of the microbiome for favorable outcomes, we saw that on the market in the US there was really only one strain that was marketed and used widely and that was bacillus coagulans. And then bacillus coagulans strain and product had actually been in the retail market for 10 years or so at that point. It was the one and only used one, but then there’s so many other useful spores that we went ahead and created the first multi spore probiotic product on the market and that’s the MegaSporeBiotic product.

We made that available only through physicians and health practitioners because it requires education. The product is really powerful. It has a lot of therapeutic benefit.  It’s really stuff that only healthcare practitioners, physicians, can understand and convey to their patients. And so we made it available only through physicians.  Now, we’ve engaged in a significant amount of research because in our view, when you have a multi spore product, and assuming you have the right spores, and they are in spore form, and they can survive through the gastric system and do colonize.  And that’s something important to talk about because there are differences among spores as well.  I’ll mention that after this part.  But what we saw was there could be significant therapeutic benefit to having a multi spore product. And as it turns out, we published our first study on the multi spore product in August of last year.

We have completed five other studies this year, which are all being written up right now and submitted for publication. And we have five or six other studies going on at the same time. In total, we’ve got 12 clinical trials either completed or ongoing on the multi spore product. From what we’re seeing so far, it’s quite fascinating, and our goal has been the moment we formulated this product, was to quickly become the most well researched probiotic formulation on the market because we want to dispel these myths. We want to dispel these nonsensical assumptions that are being made out there and we want to show through research that these spores have such important and significant functions within the gut. One thing I want to mention, so then, now we’ve seen other spores coming out and we’ve been testing them, so other companies are saying, “Hey, we want to do a spore product too and they’ve been coming out.  What we find is that there’s a couple of issues with the types of spores that they’re selecting. Number one, their spores are not completely in spore form in the product, right? That’s part of the technology that it took us almost seven years to develop was, when you grow these bacteria, they’re not in spore form. When they’re in spore form, it means that they’re metabolically inactive. They’re not multiplying, they’re not doing anything really, they’re just kind of sitting there inertly waiting to be consumed, to come out of this spore state, to becoming a live, functional, vegetative bacteria. When we were growing them in a fermentation tank to multiply them, we are growing them as a vegetative bacteria not as spore bacteria. They go into the spore form under conditions of stress and duress. That’s their way of protecting themselves.

What we found is that we’ve developed a way to be able to take this big 15,000 liter tank growing with trillions and trillions of spores in there, and then add a stress to that environment so we can get them all to go into the spore state, and then extract them in the spore state, and we were able to extract them 100% as in a spore state. What we see in other spore-based products is that about 50% of the strains in there are not in spore state, they’re in vegetative cells state. Now the problem with that is when spore forming bacteria is not in its spore state, it’s in its vegetative state. It’ll also die in the gastric system, like any other bacteria will. Only the spore state protects it. So some of these other products coming out, we’re seeing that they’re dying in the stomach, like any other probiotic product would and they’re not necessarily selecting spores that have shown the ability to colonize. Because there are spores that you can find out in the environment that will also move right through because they don’t express the right proteins in order to adhere to the mucosal layer and actually colonize.  Those are two very important things that one needs to look at when they’re trying to find and develop a spore for product for use as a probiotic.

Dr. Weitz:                            Interesting, interesting. How do you create stress in a spore-based probiotics? Do you show them clips of the News or something?

Kiran Krishnan:                  Exactly, yeah. That’s all you have to do, right? Just show them two or three News sources.

Dr. Weitz:                           Just show a loop of Rudy Giuliani.

Kiran Krishnan:                  Right. Let them go on Facebook for 10 minutes and they get stressed out. We do it through manipulation of the nutrients that are in there because the thing is you don’t want to stress them too much too fast or you will kill some of them. You want to create a really calculated stress where you give them a chance to go into their spore state and then you can extract them out into that spore state.

Dr. Weitz:                            A couple of other things I saw in some of the reading I did it that I thought was particularly interesting is bacillus subtilis helps to produce natto, which is one of the best sources of vitamin K2, particularly MK7 version, which is so important in reducing arterial calcification.

Kiran Krishnan:                  Yeah. In fact, one of the things that’s really interesting about the spores to me, which some of my earlier work, I was the first guy to bring nattokinase, if you remember that enzyme, to the US back in 2000. I was working with the Japanese company to make nattokinase from bacillus subtilis, actually, the natural fermenting bacteria and then develop ways to extract the nattokinase and then bring it into the US as a fibrinolytic enzyme.  One of the fascinating thing about the spores is that they are nutrient factories as well. When they get into the gut, they basically sit there, like the bacillus subtilis does, and when food comes in, they start fermenting and breaking down the food and converting them to things like vitamin K2-7 like you mentioned, but also methylated B vitamins. They produce ubiquinol. They produce CoQ10.  And one of our strains, which is a unique strain called bacillus indicus, produces 12 different carotenoid antioxidants in the gut for you, which is fascinating. It produces alpha carotene, beta carotene, astaxanthin, zeaxanthin, lutein, lycopene, all at RDA levels. Right at the site of absorption, right? They are the most bioavailable antioxidant, carotenoids that you can get into your diet, and they’re produced by bacteria sitting in your gut.  It’s a fascinating role that these bacteria play and the mutualistic relationship we have with them with this in this regard is really fascinating to me as a microbiologist because somehow we have created this communication with them that, “Hey, go into our gut. We’ll give you a home. Our immune system recognizes you as a normal part of the flora.” Our body is not trying to attack them, and so we give them a residency and in turn, of course, they kill the bad bacteria and get rid of them. They increase the growth of the good bacteria. They seem to be sealing up leaky gut, which is the study we published last year, and then at the same time, they produce the all of these nutrients for us that are directly absorbed into our intestinal lining, so it’s a really fascinating relationship we have with these bacteria.

Dr. Weitz:                            Wow, amazing.  Are you going to consider looking at the relationship between the indicus and macular degeneration because all those carotenoids have been well studied as helping to reduce the risk of chronic macular degeneration, which is one of the most common degenerative eye diseases.

Kiran Krishnan:                  Yeah. In fact, the rates of them are increasing the US and there is some talk that all of this blue light exposure that we get on a regular basis from screens and things like that are accelerating some of that and those are all theoretical, as I understand them right now, and not proven yet, but kind of makes sense when you think about it. But we are working with a neuro-ophthalmologist and we are looking at designing some studies around that. Because when you study carotenoids as a supplement, what you find is that the bio-availability of carotenoids as a supplement is less than 10%. It’s really hard to absorb carotenoids that are trying to pass through the gastric system, the small intestines, and actually gain exposure to the intestinal lining for absorption. Studies have been done on pure beta carotene, and they find that pure beta carotene by availability is a little less than 10%. When you compare beta carotene from the spores, it’s 100% bio available, because it’s produced right at the site absorption, past the gastric system.  I really believe that they are the most important sources of these carotenoids and antioxidants that we’re supposed to be getting in our diet.

Dr. Weitz:                            Wow, really amazing.

Kiran Krishnan:                  Yeah. Is that fascinating? And here’s what’s interesting. This indicus, that strain, one of the ways it was discovered was a huge European consortium study called The Color Spore Consortium. There was, I think, 14 different research institutes involved. They spent about five and a half million euros on funding this and what they were looking for are bacillus strains that produce carotenoids in the gut. And the reason they even thought of that is when you look at certain animals in the animal kingdom that express a lot of carotenoids on their skin, like flamingos are pink on their feathers because of a carotenoid. Salmon skin is pink because it’s of carotenoid stream, with the orange bands, those are carotenoids that they’re expressing.  The question is where do they get their carotenoids from, because they don’t eat colored fruits and vegetables, right? The investigation showed that these animals all have a probiotic bacteria in their gut that produces such high levels of carotenoids for them that it shows up on their skin. And then they said, “Okay, if those animals have those bacteria, there’s a good chance that humans have similar bacteria and are humans supposed to get our carotenoids from bacteria or we’re supposed to get it from the diet?” So they started looking at dietary carotenoids both from foods and supplements, and the bio availability of them had found that those were dramatically lower than we thought, and then they started looking, are there strains in the gut that produce carotenoids? And they found indicus in a couple of the strains that actually do.

Dr. Weitz:                            Fascinating. Really, really interesting information. Well, it’s been a great podcast, Kiran. Thank you so much for bringing us such great information. Anything you want to say about the products you’re working on and the availability?

Kiran Krishnan:                  Yeah, absolutely. And then again, thank you so much for having me. I love any opportunity to try to dispel myths and clarify rumors and things like that. I think accurate information in our world today is a rare thing as we know in every facet of our lives, and especially when it comes to your health and wellness, having the right information is really empowering.  The product that we work with healthcare practitioners and physicians with is called MegaSporeBiotic. You can find a lot of information about it and also about our research and webinars and all that stuff if you go to our website at microbiomelabs.com. That’s labs with an S at the end of it, and microbiomelabs.com. And of course people can get the mega spore product through their physician, through their practitioners such as yourself.  We believe you should always be working with a health professional with your supplements anyway. Because they have the capability of vetting the nonsense from the stuff that really makes sense, and so you’ll get your best bang for your buck. You will get your right nutritional therapy from your health practitioner.   We thank you for this opportunity and the ability to talk to you about this product.

Dr. Weitz:                            Awesome. This has been great. I’d love to catch up with you again sometime in the future.

Kiran Krishnan:                  Yeah, let’s do it again. I look forward to it.

Dr. Weitz:                            Sounds good. Keep up the good research. Talk to you soon.

Kiran Krishnan:                  Thank you.

Dr. Weitz:                            Okay.