Ask Dr. Soram

On this podcast I am delighted to interview my new friend and colleague, Chef AJ. Chef AJ is the author of the book “Unprocessed”.

She was the executive vegan pastry chef at Sante Restaurant and has been a chef and culinary instructor in Los Angeles for the past 12 years.

You can get her book at Amazon here

or the kindle version here

She is the creator and co-producer of the annual Healthy Taste of LA event held every year in Redondo Beach, California. This year it is being held on November 3.

I first met Chef AJ over a year ago at an event for Colin Campbell that was held at the USC school of medicine. She was the main chef there and the food was absolutely delicious. In fact many non-vegans said it was the best food they’ve ever had!

Then recently, AJ invited me to a vegan whole food plant based cooking class which she held at her house. I was totally inspired by this class and how easy it could be to cook in a whole food unprocessed plant based fashion that I went on to take some private training with her so I could make my own food! (My wife was delighted!)

Chef AJ’s primary focus is to encourage us all to eat UNPROCESSED food. Ideally this will be whole food plant based but even if it’s not she encourages us all to eat only or mostly unprocessed.

In this, Part One of our interview Chef AJ talks about the Healthy Taste Of LA event which will be held in Los Angeles in November. You can find a link to the event here.

Also at that event Dr.Caldwell Esselstyn will speak about why we all should be eating a whole food unprocessed plant based diet. Dr. Essestyn wrote the book entitled Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition – based Cure.

His book is available here

or on Kindle here

His most famous patient is President  Bill Clinton who came to him about his own heart disease when drugs and surgery were not enough. You can watch President Clinton‘s interview about his diet program at this link.

So in this the first part of my interview with Chef AJ, after we talk about the Healthy Taste of LA event , we go on to talk about “Unprocessed” and I ask AJ what is Unprocessed?

She references Jack Lalane who said “If God made it, eat it. If Man made it, don’t eat it!” She also notes Margaret Mead said  “It is easier to change a man’s religion than to change his diet” and I would agree with that as a doctor that works with sick patients and talks to them about diet!

Chef AJ talks about making your own food at home.

Most Americans eat 70% of their calories from processed foods.

She talks about what the problems are with processed foods. They cause inflammation which my readers know is the underlying cause of many diseases.

She says that even in Whole Foods, be careful because 90% of what is there, is processed food.

The End of Overeating by Dr David Kessler the former Surgeon General reviews the processed food industry and the problems resulting from it.

You can get it on kindle here.

Processed food is so addictive because it contains sugar, fat, and salt . In combination these 3 foods are highly addictive.

Now we have unprecedented rates of diabetes in kids. But our genes do not change that fast, so it has to be diet she points out!

I then direct our talk to “what is wrong with sugar”. Simple sugars are micronutrient poor foods and that leads to the problems from it.

I then go on to ask Chef AJ to talk about the problems with oil. And we will be discussing that in the next podcast.

Thank you for joining me in my podcast. Remember you can send me questions at [email protected],  or you can call our hotline for questions at 310-499-0275.

Please do leave your comments below and if you like my podcasts please do rate me on iTunes!

In this show I am happy to be back after my 10 day meditation retreat in the mountains of New Mexico. We had a record 2400 people come this year and it was extremely powerful that so many people were meditating simultaneously together.

In this day and age when the stresses of the world weigh upon all of us, it is time for all of my listeners to start meditating. I feel very grateful that I found my spiritual teacher Yogi Bhajan, many years ago and have followed the meditation path of Kundalini Yoga. However there are many types of meditation and each person needs to find what is right for them.

In Los Angeles now, I encourage many of my patients to try out Mindfulness Based Stress Reduction which is a powerful and rising form of meditation that is practical for everyone no matter how busy they are.

I mentioned in my podcast a DVD that will lead you in the meditation at home. I  often refer my patients to this, which you can find here, or buy the download  of the video here

As most of you know, I was made the recipient of the Daniel J Wallace Founders Award for Lupus LA, this year. On May 24 as I’ve mentioned in my blog there was a huge party at the Beverly Wilshire Hotel in Beverly Hills where over 450 people came. I was indeed honored to be selected for this award and I was humbled by how many of my patients  and other friends came out to honor me. It was a beautiful evening and there were many stars there which was fun!  I was especially touched that Natasha Bedingfield dedicated her song which I really like “A Pocketful of Sunshine” to me when she sang it.

So for this week, for the podcast I’m replaying my speech to this large group of people. I was honored that all 450 people gave me a standing ovation of many minutes after my speech. The theme of my speech was the need for integration and looking at the environment in our approach  to lupus.

In my speech I am introduced by Adam who is the president of Lupus LA, and then I am personally  introduced by my dear patient Meredith Pegula, who gave me a most heartfelt introduction.

For those of you who would rather watch the video of my speech you can find it here.

I am also putting a transcript of my speech below for those of you that would rather read than listen or watch.

In this show I also ask you that if you feel that my podcasts are adding a solid contribution to your awareness of integrative health, to please write me a review on the iTunes Store so that my podcast can go up in ranking so more people can become aware of it. I normally don’t ask for support in this way and just let people do what they want to do. However in my efforts to get the word out on the importance of integrative medicine for all medical conditions, I am asking for your support.

As always please leave your comments below. You can also contact me at my e-mail at  [email protected], or leave a message at my voicemail answer line at 310 499 0275

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Adam: I am very pleased now to introduce a very strong and dedicated mother of three, who also happens to be a jazz singer, songwriter, therapist and a lupus patient of both Dr. Wallace’s and Dr. Culsa. Ladies and gentlemen, please welcome Meredith Pegula.

Meredith Pegula: What an honor it is for me to stand before all of you very generous lupus supporters to tell you about one of the most important men in my life. A man whose voice is in my head daily as if he were just sitting on my shoulder almost kind of annoying, telling me to make positive choices to impact the course of my healing. A man who knew since he was six-years-old that it was his that it was his calling to be a doctor when all of his friends in Ohio wanted to be firemen and police officers. A man who authored a wonderful book called The Vitamin D Revolution.

A man whose dedication intuition and expertise has helped thousands of people to heal and lead more vital and full lives through his work integrated medicine, blending the research and knowledge of both east and west with his brilliant mind and keen insight, a man who I consider to me my family. I met Dr. Soram when I was 11-years-old, 11. I had moved recently from Rockway Peach, New York to Santa Monica, didn’t know what to expect and my mom had find this brilliant doctor she said, this integrative doctor who is using vitamins and supplements to heal and she said he graduated, he went to Yale and he was also an MD. She was very excited about that.

So I remember going into his office and I’ll never forget Dr. Soram looking into my eyes with the kindest blue eyes and taking my hand and I just keep looking at him and thinking why is he wearing all white. Why is he wearing a turban? Is this what they wear in L.A.? I am really fortunate to have a very strong belief that out of adversity come many blessings. Dr. Soram is that blessing for me and for many people. I know a lot of you are his patient here and you know what I’m talking about. He is that silver in human form who tenaciously helps us to heal and take better care of ourselves with love and kindness and to be attuned to our bodies.

He creates a personalized health program for his patients with lupus. I’m assuming for other patients as well. But I only know from my own experience, combining herbal supplements and vitamins to improve our energy because our energy can really be diminished greatly having lupus. It’s kind of like having the flu you all had the flu. You know what that feels like. So imagine going through that every day, feeling like you have no live energy whatsoever. With his supplements and his alternative therapies, I’ve actually had a life and I have three kids and made it through graduate school and have a full life, which is quite remarkable. Lupus is a very painful and scary disease, it is. But really believe from my own life experience that having the right support team is critical in terms of what the disease outcome will be.

I’m so lucky to have the exquisite experience of two amazingly talented men; both Soram and Dr. Daniel Wallace who’s my lupus doctor collaborate together to join their incredible minds and their thoughts and their opinions. I’ll be in their office and they will literally just kind of hash it out. ‘What do you think? What should we do? She’s on this much prednisone.’ La-la, la, la, and whole thing. They really come to conclusions that really benefit me quite beautifully and they include me. Even though I’m pretty stubborn about my western medicines. But Dr. Soram is always the first to tell me when he feels that he needs to defer to the side of west when it’s time to take medicine.

It is remarkable to see collaboration in this way. I really owe my life to Dr. Soram. I think you. I absolutely love you. So please can you all join me with your open hearts and your compassionate presence to give this wonderful award the Daniel Wallace Founders Award to my wonderful doctor, my mentor, my friend, Dr. Soram.

Dr. Soram: Wow. Thank you all. Thank you so much. Thank Lupus L.A. for picking me this year. I’m so honored, humbled by the generosity of so many of my patients all of you who are here tonight. Over 100 of you and for the many patients of mine who were not able to come because they’re elsewhere, who have so generously given donations or put beautiful pages in this program tonight, which I’ve only started to look at. Dan Wallace I want to thank you for the beautiful work we’ve done all these years together. I want to let you know that even though you’ve never told me this, I know you say to some of my patients, I don’t know what Dr. Soram’s doing. But those herbs and spices he use sures make people feel better.

Just for the record Dan, I have never actually prescribed a daily dose of parsley or gotten cumulative cumin levels on my patients. My friends tell me that I am full of surprises. Forty years ago if you had told me I’d be up here tonight when I was graduating from Yale, dressed as seek, being a seek, I would have said you’re crazy. What a surprise and people always want to know does your seek way of life have to do with how you work. The answer’s no, not really. The same forces of illness that I had that led me to finding the seek path, which with daily yoga and meditation brought me back to health, were the same forces that brought me to recognize the power of these natural medicines, combined with western medicine that we call integrative medicine.

I’m very honored tonight to be selected as the physician to receive this award because I am the first physician awarded this, who is not a rheumatologist. Moreover, I am an integrative doctor. I work in my practice combining both sides of the coin, pharmaceuticals and surgery with the other side of coin, which I want to talk with you tonight about, natural medicines, herbs, acupuncture, dietary changes. You know there was a time when to suggest two sides to the medical coin was a surprise also.

Over the last many years more and more of doctor, colleagues are calling me up and saying, ‘Soram, now I’m knowing what you’ve been doing all these years. I have a patient with back pain. What can you recommend? They can’t take Advil anymore.’ Or joint pains and over these last about ten years through patient demand, integrative medicine is being used more and more. Dr. Oz’s show on television is all about the natural ways for us to get well. I am so happy to tell you that there are now over 40 medical schools in our country that have at least a course in integrative medicine.

Another secret, which I found out, is that my staff behind my back calls me the White General. Now, when I heard this I thought my God, is that a compliment or an insult? But I realized in my office I am a general because I must marshal all of our resources to help people in this war on lupus. We must use everything that we have to help people with lupus. In my practice, I don’t treat only lupus, other illnesses and as an integrative doctor, I have the advantage of being able to use lifestyle changes, diet, herbal medicines, acupuncture, yoga, and meditation to help people to increase their well-being. Patients don’t experience underlying causes. Dan maybe you’ve had a patient do this. But I’ve never have, no patient’s ever walked in and said, ‘Dr. Soram my leukotrienes and my cytokines are producing so many pro-inflammatory molecules, I don’t know what to do.’ No, no, no, patients don’t live there. Patients come with symptoms of joint pain, fatigue, malaise, many gastrointestinal problems, sleep disorders. These disorders although they are addressed by drugs are often not completely resolved by drugs. This is where the modalities of integrative medicine is able to look at a patient as Meredith said in her introduction as a unique experience that the patient has had with their own individual biochemistry.

Rather than being reactive, we in integrative medicine are able to be predictive, personalized, and proactive to help patients achieve a proactive state of well-being. We now know that our genes are not burned into stone. We used to think, oh, my God I got this bad gene, I’m going to get XYZ. With the new science that’s been around for the last ten years called epigenetics. Epi means above, we now know that environmental factors directly impact our genes and are able to turn on or off certain genes. Heredity is not necessarily destiny. In fact, almost ten years a group of rheumatologists published Decennial paper in which they said we used to think lupus and autoimmune diseases were exclusive hereditary. But we now know they said that only one-third of the cause is genetic, two-third environmental.

At the time by environment, they meant bacteria and viruses. But now, in last ten years so many articles are coming out that show for example elevated levels of mercury in blood as well as thiolates, which are in our personal care products, the shampoos and the cosmetics that women use are associated significantly with antinuclear antibody, the primary antibody and hallmark of lupus. We now know that genes are activated by the things we do. Our food is information that talks directly to our genes. The chemicals we apply to our body that we call cosmetics and personal care products with their thiolates are endocrine disruptors talk directly to our genes. Supplements and herbs talk directly to genes.

Vitamin D, my favorite vitamin and when you have enough vitamin D you all know it’s like a pocket full of sunshine. Vitamin D talks to over 200 of our genes. The genes that it particularly effects are the genes that promote inflammation. So vitamin D is very important and able to—is directly talking to our genetics. Now for a moment I want to turn to the other side of the coin and thank the people from Pfizer for the amazing that they do and the other companies that were mentioned tonight. These medicines that you are developing are able to attack the basic biochemistry of lupus and help the patients to feel better and improve their health and not be such an aggressive disease. You are truly a global company because your drugs are able to help people all over the world. But just as globalization is affecting everything, all of us economically so too should we be globalized medically.

What do I mean by that? Our children are all becoming multi-lingual. Children are now learning two and three languages. They’re learning Chinese because they know they’re going to have to talk to their competitors in China. If they are multi-lingual, we too as physicians should be medically multi-lingual. We should be able to talk as a physician talk about drugs. But medical doctors should have a familiarity and an awareness that these natural modalities are able to help patients in ways that sometimes drugs are not. Similarly, I say to my colleagues in naturopathic medicine chiropractic and acupuncture that you too should recognize the other side of the coin. Sometimes drugs and surgery are the best answer for patients.

Thank you for the direction of this award. Not only is it an award to me but a recognition that the country is moving in an integrative direction. For the cost of non-integration to the patient is unnecessary suffering, lack of well-being, lost wages and indeed lost lives. Integration is not just a great idea in theory. For the cost, that someone pays if both sides of the coin are not addressed is huge. So even though I am here with you tonight as a medical doctor, I would like to close tonight with a political statement. Just as we now have an African American president, which shows we have made progress on integration, we all know that racism has not been completely eradicated in America; progress on integration, yes, an end to the work, no.

So too in medicine, has there been progress in integration? Yes. Is my presence up here tonight an indication of that? Yes. But is the work finished? No. I ask all of you to join me in finishing that work. Thank you so much.

Adam: Ladies and gentlemen, Dr. Khalsa. Thank you Dr. Khalsa. Thank you.

In the second part of my interview with Dr Quiqley we continue to discuss the value of probiotics for our health.

We start with my question on how effective are probiotics for digestive health especially irritable bowel syndrome (IBS). He feels the most benefit of probiotics proven so far is for people with digestive problems. 

We then talk about Small Intestinal Bacterial Overgrowth (SIBO) and whether people with this condition should use or avoid probiotics. You will remember I talked about this in my podcast interview with Dr Mark Pimental and he implied people with SIBO should avoid probiotics. 

Dr Quigley certainly reminds us after using antibiotics for SIBO, probiotics might provide benefit for the patient. 

We then talk about possible side effects of taking probiotics. He points out there may be an adjustment period when you first start probiotics. Dr Quiqley says he has never seen anybody allergic to probiotics. 

We talk about using probiotics in children and animals.  He points out that probiotics prevents and treats “Day-care diarrhea” in children. 

Like the good scientist he is Dr Quiqley is really insistent that studies be done on probiotics to prove that they provide benefits. But I believe that since there is no harm in giving probiotics that it is worth a trial in patients with the relevant symptoms.

We talk about Rifaximin in the treatment of SIBO. He points out that there is a lot of trial and error in the treatment of SIBO.

The low FODMAP diet is used a lot in people with gas and bloating. Diet and IBS is discussed and Dr Quigley calls for more research in this area. 

Everybody has their own set of friendly bacteria in their intestines when you get down to the details.

We also talk about fecal transplantation and its use in hospitals especially for the treatment of C. Difficile infections.

Dr Quigley has done a lot of research on Bifidis Infantis and talks about his research. This organism seems to be able to reduce inflammation. It does this by working with the cytokines which are the inflammatory molecules in our body. 

We talk about his book and the DVD on Microwarriors-The Power of Probiotics –see below 

His website:  For more information about Dr Quigley’s work go to the Alimentary Pharmabiotic Centre.

You can get Dr Quigley’s book Probiotics and Digestive Health here

and on Kindle here

and the DVD called Microwarriors-The Power of Probiotics that he consulted on is here

You can watch a trailer of the DVD HERE

Dr Quigley does have a financial relationship with Proctor and Gamble.

Please leave your comments below or send questions which I will answer on my podcast to me at [email protected] . You can also leave voicemail questions at 310 499 0275.

Dr. Soram: Well welcome everybody today I have a very special guest coming speaking to us from Cork Ireland, Dr. Eamonn Quigley. Dr. Quigley is a Professor of Medicine in Human Physiology at University College in Cork Ireland; he's a Principle Investigator at the Alimentary Pharmabiotic Centre, at the National University of Ireland, he's past President of the World Gastroenterology Organization in American College of Gastroenterology. His areas of research include; Motility, Functional Gastrointestinal Disease which you and I will call Irritable Bowel Syndrome, Neurogastroenterology, Gastro esophageal Reflux Disease which we call GERD and Probiotics in Health and Disease. Dr. Quigley is the author of several books on probiotics including his most recent one called ‘Probiotics and Digestive Health; A Gastroenterologist Perspective’. He also was the chief medical reviewer for a new DVD that is out called ‘Micro Warriors; The Power of Probiotics’. So with that introduction Dr. Quigley welcome to my podcast today.

Dr. Quigley: Well thank you very much it’s a great pleasure to be with you.

Dr. Soram: You’ve done tremendous amount of work throughout your career on probiotics and today we are going to focus on probiotics. Tell us what is a probiotic?

Dr. Quigley: Well for now we have to use the definition that is developed by the FAO which is a branch to the World Health Organization a number of years ago, and that definition defines a probiotic as a microbe which is live and which when given to man transfers a health benefit. Now that very definition deserves careful scrutiny because first of all it insists that a probiotic organism should be live which I interpret to mean that it should be live for the duration of the shelf life of that product.

Dr. Soram: Yes.

Dr. Quigley: And secondly it also means that there should be good evidence which to me means from good clinical studies that any health benefit that is claimed for the product has actually been demonstrated.

Dr. Soram: Excellent, excellent so tell us how exactly do probiotics work and are they safe?

Dr. Quigley: Well these are two separate questions so I’ll take them separately the first with regard to how probiotics work, the answer to that is actually a very complex one and my simple answer will be the probiotics work in many different ways and the way in which they work will differ for different probiotics and also for different indications. So for example if we are talking about a probiotic in diarrhea in day care centers; in this particular instance the anti-bacterial, anti-viral, anti-pathogen effects of probiotics maybe most important. However if we look at another situation like in an inflammatory condition it maybe derails specific effects of probiotics in the immune system that are more important or if we take another example the growing interest in probiotics in metabolic conditions, it maybe the metabolic activities of these probiotic organisms that are most important. So I think we need to be very careful here in trying to dissect out different effects of probiotics in different situations and also different effects for different species and strains of probiotics.

Dr. Soram: Yes so I’ll just for my audience because most of my audience is lay people I just want to say that commonly you don't know what probiotic is, it’s what some people call acidophilus which is a specific probiotic but in America it’s used generically like go get some acidophilus. I just wanted all our users to understand that but probiotics is a bigger word that encompasses many of these different strains of friendly bacteria, that we kind of summarize as “oh go get some acidophilus”. Now Dr. Quigley, are probiotics safe for us to take?

Dr. Quigley: The answer is with very few exceptions yes but there are some exceptions for example if you have a severe Immune Deficiency particularly…

Dr. Soram: Such as AIDS or something?

Dr. Quigley: Well AIDS is one that may not be a good example but I'm thinking here of children who are born with severe deficiencies in their immune system to is theoretically possible but never proven that probiotics could be harmful in that situation. With regard to AIDS probiotics has actually been used to treat diarrhea and patients with AIDS I don’t know how beneficial they were but certainly it didn't seem to be dangerous. The other situation which is very unusual one is a report recently from a groups of researchers in Holland who used probiotics to try and prevent infections in patients who are critically ill with pancreatitis; inflammation of the pancreas gland, now these were a very extreme group of patients in that they were all in the intensive care unit they all needed ventilator support, these are gravely ill people and they were given a probiotic cocktail through a tube directly into their intestine and they actually had a higher mortality than those who are not given the probiotic. And why they died is from an unusual complication which is very difficult to explain in terms of the probiotics so I just mentioned that because you will find it out there in the literature and in the lay press, whether this is really related to the probiotic it is unclear but one needs to know about it. But apart from these rather unusual and very rare circumstances probiotics seems to be very safe.

Dr. Soram: Excellent, now I'm a healthy person why should I take probiotics?

Dr. Quigley: Well that's the most difficult question of all, it is much easier to deal with evidence for or against use of probiotics in specific health conditions with regards to ‘boosting’ your immune system or preventing you from getting infections the data here is a lot trickier. It’s very difficult to make a healthy person more healthy; the first thing you have to say. And secondly well there is some evidence for example a very nice study which is done in a group of factory workers which show that you are less likely to get the common cold. So there are some pieces of evidence out there to suggest…

Dr. Soram: Could you say that one more time Dr. Quigley, it broke up?

Dr. Quigley: This was a study done in a group of factory workers in Europe, one group is given a probiotic, the other group were given a dummy; and the group with the probiotic had a lower likelihood of getting colds and flu’s during the winter season. 

Dr. Soram: Very interesting, you see a lot of that talked about on the internet in the lay articles.

Dr. Quigley: But there aren’t a lot of those type of studies so I guess I would be fairly cautious in terms of the evidence for immune boosting effects now having said that, we ourselves here in Cork recently published a study in normal people where we showed that a protective probiotic could boost your immune system through stimulating chemical transmitters which suppressing inflammation so there are strands of evidence t which suggest that probiotics might help to boost your immune system to stay off infections but the data is not as complete as you would like it to be.

Dr. Soram: Okay but it sounds like your study that you did in Cork was encouraging in that direction.

Dr. Quigley: Correct but there are other studies out there that provide similar data but you need to do very big studies in large number of people before you can conclusive you say that everybody should be taking probiotic because it w ill do A, B or C.

Dr. Soram: Yes, so now are all probiotics the same we see in America we have so many brands of probiotics and they are all advertising now they are even on TV you go to the store you see an entire wall of probiotics with all sorts of claims, are they all the same?

Dr. Quigley: Absolutely not.

Dr. Soram: Okay.

Dr. Quigley: If there is anything that I’ve said that is of any importance today it is this that no two probiotics are the same. And I’ll give you a very good example; one of my colleagues here in cork who is a molecular microbiologist he took a probiotic which we’ve studied at [large] which we have shown has anti-inflammatory effects which we have shown is beneficial in some gastro-intestinal conditions, he took this probiotic and he deleted just one gene from the genome of this probiotic and showed that it had lost all of its effects.

Dr. Soram: Oh my gosh, was that the Bifidus…, was that the Infantis?

Dr. Quigley: Bifidobacteria Infantis 35624 yeah, So that’s an example of how the most subtle change in a probiotic can alter its function, and I think this is one of the big problems of the consumer faces that as you said they’re deluged with claims some of which are based on the actual probiotic that they’re looking at, some of which are extrapolated from other probiotics, not even from the same strain from a different species and that’s totally inappropriate.

Dr. Soram: Okay, yes I just want to explain to my audience that what your colleague did was to change one gene in that particular strain of probiotic and just with that one change in one gene it lost its effectiveness?

Dr. Quigley: Correct.

Dr. Soram: So that’s how subtle these differences are. So if they’re not all the same, how do I differentiate probiotic strains and what do I do when I go to the health food store?

Dr. Quigley: Well I think unfortunately right now because of the way these products are regulated the consumer has a tough time. We know also and this may sound scary that researchers have gone out there to stores, taken samples of probiotics or claimed to be probiotics off the shelf, taken them to the laboratory and studied them and found that first of all they didn’t contain any live organisms which they were supposed to.

Dr. Soram: Wow.

Dr. Quigley: And secondly that they didn’t even contain the strain that they were supposed to contain.

Dr. Soram: Oh my Gosh, okay.

Dr. Quigley: So like the only words of advice I can tell you are; firstly I think if you stick to reputable manufacturers or reputable companies. 

Dr. Soram: Yes

Dr. Quigley: My feeling is that they’re unlikely to risk having a faulty product out there.

Dr. Soram: Right.

Dr. Quigley: Because it will be a damage to their reputation and secondly try and get as much information as you can about a particular product from reputable sources, and there are reputable sources out there, whether they’ll be medical organizations, consumer organization that give you some background information.

Dr. Soram: In our country there’s just not a lot of regulation of the natural food industry and as my listeners know, I wrote a book on vitamin D and have my own brand of Vitamin D and the Multiple Sclerosis Consortium in America bought 10 brands of vitamin D, just a simple vitamin D from the health food store and found that none of them contain the amount of vitamin D stated on the label, and they average 34% of the label. So this regulation is very challenging to make sure we’re actually getting what the label says, so Dr. Quigley do probiotics- we‘ve touched on this- so what are your thoughts about its ‘stimulating the immune system’? If you have a proper probiotic can it do that? 

Dr. Quigley: Well again, it will depend on the particular strain and it will depend if the strain has been studied under proper scientific situations, if it has been studied and if it’s been shown to affect the immune system, then yes, but again one has to be very careful, one has to look at this very critically and one has to be absolutely sure that the proper studies have been done and that the effects which are claimed were demonstrated.

Dr. Soram: Yes, so now are there particular strains that you are able to mention to us that have had demonstration of their effectiveness?

Dr. Quigley: Well I will just mention some of the strains that are being worked on here in Cork, which have been Bifidobacteria Infantis, Bifidobacteria breve, but even within those there have been individual strains which have been studied more than others and a number of these have been shown to have effects on the immune system. But it would involve getting in to a lot of details to really lay this out completely so I think it’s just… I feel the bottom line is that, yes specific strains have been shown to have effects on human immune system and in some cases that has been to translate in to clinical benefits, but they’re very restricted examples.

Dr. Soram: Fantastic yes and in your book which I loved, it’s actually a booklet, so it very concisely says Probiotics and Digestive Health, there are some specific strains mentioned which have been shown to be effective and I will put a link to Dr. Quigley’s book in the short notes for today, so people can finds it easily. Now we can also get probiotics from food sources such as yoghurt, is it more effective to get probiotics from food, or is it more effective to get it in supplements?

Dr. Quigley: Well again it comes back to the particular strains, some strains are delivered optimally in certain formats, others are delivered optimally in other formats. And here again we get in to a lot of technical issues, you know?

Dr. Soram: Yes.

Dr. Quigley: Has the manufacturer shown that the probiotic survives in that particular format that they’re selling it in, have they shown that it will survive under refrigerated conditions only or on the shelves and at room temperature or in the extremes of temperature. So as long as the manufacture has shown that, that is the optimal condition in which that for which to present that particular probiotic to the consumer, that’s fine. So yes probiotics can be presented in whole variety formats, buy the question I would always ask is, and have they actually done the quality control? 

Dr. Soram: So basically what I’m getting a picture of this is that, we take a probiotic whether it’s in the food or capsule, there’s a lot of variables between the time we put it in at hand to take it, and the time that it reaches the large intestine, which is its ultimate goal, is that correct?

Dr. Quigley: Correct.

Dr. Soram: Okay so…

Dr. Quigley: It actually could be the smaller intestine or the larger intestines, that’s one of the areas that needs a lot more study, but it is possible.

Dr. Soram: For my listeners lets look at the areas where things could perhaps not work out not work out. For example you said that the product they bought in the store doesn’t have any living organisms obviously dead on arrival so to speak…?

Dr. Quigley: Correct, we’ll put.

Dr. Soram: But other things, for example suppose it has some living organisms and they swallow it, what happens for example with stomach acid, is it possible you can get deactivated by stomach acid?

Dr. Quigley: Very good question, not only stomach acid but bile or the normal digestible enzymes, all of these can destroy organisms. So one of the fundamental parts of the process of development of a probiotics product is to demonstrate that it will survive stomach acid and bile and digestive enzymes, the term that we use for this, we say it will survive transit through the intestine. 

Dr. Soram: Yes okay and so then it reaches the small intestine perhaps which I want to talk a lot about with you and then but ultimately the large intestine where they normally lives and then does it have o be in a particular form for the large intestine to receive it or to utilize it, or once it gets to the large intestine its home free? 

Dr. Quigley: Well again it depends on-that’s a very interesting question-, and there’s quiet a lot of science I hope behind the answer I will give you. 

Dr. Soram: Yes.

Dr. Quigley: Here when it gets to the intestine, a lot of it’s properties will vary, if for example you want the probiotic to engage with your immune system and to boost your immune system or affect your immune system or decrease information, then obviously it will be very important that the probiotic gets directly onto the lining of your intestine. 

Dr. Soram: Yes okay.

Dr. Quigley: So its ability to do that would be critical.

Dr. Soram: Yes okay.

Dr. Quigley: In other circumstances where you want the probiotics to perhaps affect your digestion or ability to deal with the products of food that will happen in what we call the lumen and other words in the fluid of the intestine, so attachment will not be important. So again it will depend on the specific effects but once the probiotic organism reaches the lower parts of the small intestine or the colon the large intestine, then the biggest you’d have to deal with are all the bugs that are normally in there. Can it survive there, can it have the right conversation with the other bugs, without the other bugs kind of knocking it out, these are important issues.

Dr. Soram: Yes, now what about things that people eat regularly like yoghurt and kefir? We’re always told get our probiotics take yoghurt, I have some of my colleagues will tell their patients when they give an antibiotics for sinuses, eat some yoghurt or have some kefir, is that helpful? Does yoghurt and kefir and those kinds of fermented products have bacteria which are likely to get through and be able to affect the lower smaller intestines and the large intestine?

Dr. Quigley: Some of them will some of them won’t.

Dr. Soram: Okay.

Dr. Quigley: Again it will depend so we get back to the same story it depends on how well studied they are and whether they have been well studied et cetera.

Dr. Soram: Okay and do at least in Ireland or in Europe have you seen- I have not seen it in America-the yoghurt companies study this type of thing or they just tell people to assume it’s getting through?

Dr. Quigley: Oh absolutely like some of the yoghurt companies have extensively studied their products. I’m not going to mention particular companies but I know of a number of companies that have done extensive studies on a number of strains and shown not only that they survive and get all the way to where they are supposed to but actually have clinical benefits. 

Dr. Soram: Fantastic so I would encourage my readers those kinds of studies which certainly show up on the websites of these yoghurt companies they would be proudly talking about them and so people eating yoghurt and kefir for the benefit of the probiotics might want to look things up before they buy a particular brand?

Dr. Quigley: Absolutely, it involves a little bit of work but I think it’s worth it. 

Dr. Soram: Yes now Dr. Quigley how effective are probiotics for actual digestive problems and here I particularly I want to talk about the ubiquitous and so common Irritable Bowel Syndrome and that so many people have IBS. How effective are probiotics for that? 

Dr. Quigley: Well I’ll start with maybe just saying a few words about probiotics and digestive disorders.

Dr. Soram: Yes.

Dr. Quigley: By making a simple statement I think overall the best evidence for clinical when I say clinical I mean for benefits for probiotics in people with symptoms, with complaints, with problems isn’t digestive disorders.

Dr. Soram: Yes.

Dr. Quigley: Which makes sense.

Dr. Soram: Of course.

Dr. Quigley: If you think about it.

Dr. Soram: Yes.

Dr. Quigley: Now with regard to Irritable Bowel Syndrome I will make a few simple statements again. Overall as if you take all of the data out there from all of the probiotic studies in Irritable Bowel Syndrome and throw them all together you’ll find that overall there is the benefits from probiotics.

Dr. Soram: Okay.

Dr. Quigley: But that’s an over simplification because when you throw them all together you’ve got some studies which are positive some which are negative, some which were very positive and some maybe kind of so-so. But overall and this has been done there is a scientific way that this is done it’s called a meta-analysis.

Dr. Soram: Yes.

Dr. Quigley: And there have been several meta-analyses done on probiotics and IBS and they have all come up with the same answer.

Dr. Soram: Yeah.

Dr. Quigley: They seem work.

Dr. Soram: Okay now a big subject tied in with the Irritable Bowel Syndrome. I treat many patients for what's called Small Intestinal Bacterial Overgrowth we abbreviate it SIBO and I’m on the staff at [Cytosiner] and I have been taught by the doctors at [Cytosiner] who specialize in this they tell patients never to take a probiotic because they say it can start up their SIBO again. But based on what we’ve been saying so far that may not be true and I’d really like your thoughts about this. Do you agree with this or there are some probiotics that might actually help these patients with SIBO?

Dr. Quigley: Well first of all I’m struggling to think of any scientific basis for that contention.

Dr. Soram: Okay.

Dr. Quigley: Like Small Intestinal Bacterial Overgrowth and the symptoms that relate to that arise from the presence of certain bacteria in the small intestine which actually can damage the small intestine. 

Dr. Soram: Yes.

Dr. Quigley: Whereas probiotics by definition shouldn’t do that.

Dr. Soram: Okay. So a bacterium is not a bacterium that is what you’re saying?

Dr. Quigley: Yeah it’s just not all bacteria are the same which is the same thing so the issue with Small Intestinal Bacterial Overgrowth is that, yes probiotics that actually been studied in the Small Intestinal Bacterial Overgrowth.

Dr. Soram: Yes.

Dr. Quigley: They haven’t been particularly effective but I think they at least theoretically could be effective. Where I would think and I will emphasize here this is purely theoretical I have no evidence to support this. 

Dr. Soram: Yes.

Dr. Quigley: Where I would see that if you have somebody with Small Intestinal Bacterial Overgrowth and you treat him with an antibiotic then of course you have to stop the antibiotic at some stage.

Dr. Soram: Right.

Dr. Quigley: And it would make sense to me that giving a probiotic at that stage might be a good idea because it might prevent the bad bacteria from coming back.

Dr. Soram: Okay.

Dr. Quigley: But I will emphasize that that is purely my hypothesis I have no data to support that. So I would have thought that the antibiotic probiotic sequence would make a lot of sense in bacterial overgrowth.

Dr. Soram: Okay. Excellent to know and the probiotics because they are not going to be the strain of bacteria that’s in the Small Intestinal Bacterial Overgrowth should not be harmful or kind of reignite the bacterial overgrowth in your body?

Dr. Quigley: Unless they know something that I don’t know but I have never heard of this before.

Dr. Soram: Excellent, I think that would be very information for all my listeners and also for my patients because we have gone round and round on this in my practice so to continue on. Are there any side effects from taking probiotics?

Dr. Quigley: Very good question. I wouldn’t say side effects but what I would say is that when you go on a probiotic which means that you’re possibly introducing a new strain of bacterium into your intestine or you’re introducing more of a strain that you normally have there maybe what I would call an adjustment period. In other words, for…

Dr. Soram: Yes. What does that mean?

Dr. Quigley: What I mean and this has been our experience is that for a couple days or so there maybe a little bit more gas a little bit more bloating et cetera. As your system gets used to the new bacterium but that is usually very short lived and I wouldn’t call it a side effect I would call it an adjustment. 

Dr. Soram: Okay great. Have you ever seen anybody ‘allergic’ to a probiotic?

Dr. Quigley: Never.

Dr. Soram: Okay I wouldn’t think so either but patients asks me that question.

Dr. Quigley: Yeah.

Dr. Soram: Now how safe and effective are probiotics for children and even for pets?

Dr. Quigley: Actually we have done quite a bit of work in animals. 

Dr. Soram: How great, yes.

Dr. Quigley: For probiotics and one of the reasons for this is that one of our research partners here in Ireland is the National Animal Research Facility of our Department Of Agriculture.

Dr. Soram: Beautiful.

Dr. Quigley: So they do if they mostly do work on farm animals but they also do work on domestic animals and so they are very interested in probiotics and factored some lovely data to show the probiotics for example can help to treat and prevent mastitis in cattle diarrhea in other farm animals et cetera. And in fact we did work a few years ago to show that probiotics have benefits for dogs.

Dr. Soram: Wow! Fantastic.

Dr. Quigley: Yes so that one response. The other side of it with regard to children,

Dr. Soram: Yes

Dr. Quigley: Probiotics are certainly safe for children and there are two pieces of evidence I would like to talk about with regard to children and probiotics.

Dr. Soram: Yes.

Dr. Quigley: The first is probably of all the conditions which probiotics have been tested. The best most consistence evidence is in the treatment or prevention of daycare diarrhea. 

Dr. Soram: Yes.

Dr. Quigley: There have been many studies which have looked to this and they show that probiotics can shorten the duration of diarrhea and all these viral infections that kids pick up in daycare and can prevent them from getting severe so that’s the first thing. The second thing which is completely different and at the totally end of the scale in terms of severity of illness is in a very severe and often tragic condition that occurs in tiny little infants that are born prematurely and that the condition called necrotising enterocolitis.

Dr. Soram: Yes.

Dr. Quigley: And it’s a devastating condition.

Dr. Soram: Yes.

Dr. Quigley: And there is no very good evidence that probiotics can help to reduce the mortality and the illnesses related to this condition in these infants. So there are two examples from children. 

Dr. Soram: Fantastic so now for pets because a lot of my listeners have pets and dogs and cats I would it be the same strains that would give a human or would there be different pet probiotics so to speak? 

Dr. Quigley: Again I’m going to say boring here but I just said it’s almost like a mantra like it could be it is you have to see what strains have been tested in that animal and have been shown to be beneficial and as I mentioned earlier some work that we did in conjunction with a company that makes animal food in the US and show that a particular strain was beneficial in dogs and that strain is available commercially but again I don’t want to mention specifics because I don’t want to sound as if I’m pushing any particular product.

Dr. Soram: Yes re you able to mention the strain without saying the brand name?

Dr. Quigley: It won’t mean anything without mentioning the brand name unfortunately.

Dr. Soram: Okay, good fine. Now do you have any other thoughts on SIBO Treatment, standardly now in America we’re using Xifaxan, sometimes we combine it with Neomycin if the patients have a lot of methane gas in their small intestine.

Dr. Quigley: Yes.

Dr. Soram: Do you have any other thoughts on the treatment of SIBO since you’ve studied …your research in your neurogastroenterology and so on; I’d really like your thought on that Dr. Quigley.

Dr. Quigley: First of all the first point I have to make is that Rifaximin which is the scientific name for Xifaxan is not available in most countries in Europe. It has not yet been approved; it’s available in Italy where the drug was originally developed and its available in Spain but not in Ireland or Britain or the rest of Europe. So my experience with Xifaxan is very limited, and unfortunately one of the problems with Small Intestinal Bacterial Overgrowth is that there have been very, very few good studies of any regime so when I’m treating Small Intestinal Bacterial Overgrowth I test something to see if works. If it works fine, if it doesn’t I try something else. So unfortunately there’s a lot of trial and error here.

Dr. Soram: Yes.

Dr. Quigley: I mentioned the benefit of probiotics but I have to immediately say that I don’t have any scientific evidence to back that up.

Dr. Soram: Yes and any particular diet, in America we have what’s called Low FODMAP diet, any particular diet that you recommend for people with SIBO?

Dr. Quigley: Well the Low FODMAP diet, I don’t know that there’s any link between that and Small Intestinal Bacterial Overgrowth, the FODMAP diet was developed in Australia by a dietician and a gastroenterologist that freed bloating and gas related symptoms in Irritable Bowel Syndrome. That could be related to bacterial effects I don’t know but I certainly have used that diet n people with a lot of bloating, not very extensively because at this moment in time in Ireland we don’t have a lot of dieticians who are trained in the use of this diet so my experience again has been limited but certainly I think this is very interesting. I’m convinced that diet is an important aspect of IBS, but it’s a complex issue.

Dr. Soram: Yes.

Dr. Quigley: And I think interactions with the gut microbes could well be important but we need a lot more research on the whole issue and Irritable Bowel Syndrome in terms of its role in causing symptoms, in terms of its role in treating people, in terms of its interaction with other treatments. There’s a lot we need to know about this.

Dr. Soram: Yes indeed and you’re doing research in that area, I’m I right?

Dr. Quigley: Yes, correct.

Dr. Soram: Fantastic. Now I’ve been reading in some of my literature about people with Ulcerative Colitis and Crohn’s disease, receiving bacteria from other healthy people’s colons. So I’d like you to comment on that and maybe tell us a little about that research and also this brings along the idea that kind of everybody has a unique set their micro-biome which is the friendly bacteria in their intestines is it unique to them or is there overlap between people? Please let us know some more information about that.

Dr. Quigley: Sure, okay. Well this is a very interesting question; the first issue is about the differences or similarities between bacteria from one individual to another.

Dr. Soram: Yes.

Dr. Quigley: There are some broad similarities but when you get down to the details, everybody is probably a little bit different but there are broad like if you look at bacteria are categorized in a very complex way into strains and species and phyla et cetera. In the same way that the animal kingdom is … and when you get to the very big categories then you do see similarities between groups of people. When you get down to the details you will, see it’s almost like a fingerprint.

Dr. Soram: That’s the way I think of it. Okay.

Dr. Quigley: That’s the first point. Now this whole… people call it fecal transplantation; this fecal transplantation issue has been around for sometime, it was originally developed by actually somebody who is good a friend of mine and we actually did work together many, many years ago, his name is Tom Borody and he works in Australia. And he came up with this idea and initially the idea is supposed to be used to treat people who had persistent infection with this Clostridium difficile bug which is such a problem in all of our hospitals.

Dr. Soram: Indeed.

Dr. Quigley: And it’s a cause of colitis, it’s unfortunately it’s a type of colitis that arises in people who get antibiotics. And it’s as if you knock out the good bacteria with the antibiotic and then these bad bacterium kinds of sneaks in and takes over and causes illness. And some people respond dramatically well to specific antibiotics for this treatment, some unfortunately do not how they keep on getting recurrent infections. So Dr. Borody came up with the idea that how about if you just change their bacteria completely and he did this and in fact several other research groups including number in the US have shown that this works in this particular instance. So obviously the question was asked well if it works in these particular situations could it work in other situations. And while it is certainly an attractive idea, my understanding at this moment in time is that there is not enough scientific evidence to recommend this as a treatment for any other condition other than this Clostridium Difficile colitis at the moment. But it’s a very interesting idea.

Dr. Soram: Yes, and in my own practice I’ve used Saccromyces boulardii with great results for C. difficile infections.

Dr. Quigley: Yes and there is considerable scientific data, there’s probably more data to support Saccromyces boulardii than any other probiotics in that arena.

Dr. Soram: Yes now…

Dr. Quigley: But I think the people who are doing intestinal transplantation, they’re really looking at a group of people who failed everything including Saccromyces boulardii it’s a small population but that’s really going way beyond the group.

Dr. Soram: Our conversation yes.

Dr. Quigley: Exactly yeah.

Dr. Soram: Okay, now I know you’ve spent sometime in researching Bifidobacteria Infantis with a special number I think it’s 3654 or … 

Dr. Quigley: 35624.

Dr. Soram: That’s it, can you tell us a little about that unique very special probiotic?

Dr. Quigley: This is a probiotic which was isolated or which was discovered here in [IB] many years ago and it was actually an organism that was found in the intestine of a normal… it came from the small intestine of an individual. And over the years my microbiology colleagues had extensively studied this organism and looked in the laboratory at its ability to resist acid and bile and digestive enzymes but also its ability to engage with the immune system and to alter the immune system. And what has been shown in a variety of laboratory studies and also in human studies is that this probiotic organism seems to be capable of anti-inflammatory effect in other words it can reduce inflammation. In a situation of inflammation it can switch off the chemicals that are driving inflammations and switch on chemicals that will suppress inflammation. 

Dr. Soram: And that has to do with interleukins, is that right?

Dr. Quigley: Exactly it is these…

Dr. Soram: 10 and 12.

Dr. Quigley: These interleukins these cytokines… particularly it seems to be particularly effective t increasing the levels of interleukin 10 or IL-10 which is an anti-inflammatory cytokine.

Dr. Soram: Yes.

Dr. Quigley: And at least we’re suggesting this may be the basis it’s benefits in Irritable Bowel Syndrome because we’ve done a lot of research over the years and shown that kin Irritable Bowel Syndrome there is a very slight but very definite switching on of the inflammatory system.

Dr. Soram: That’s interesting, excellent. Well Dr. Quigley I personally have learned from you today and I know my listeners as well have learned about probiotics from our conversation today and I want to thank you so much. Is there a way for listeners to find out more about you, do you have a website or anything like that?

Dr. Quigley: Well the website to go to would be the website or our research centre, Alimentary Pharmabiotic Center and it’s a very simple website it’s  HYPERLINK "http://www.apc.ie." www.apc.ie.

Dr. Soram: Great I will put that in the show notes and your research and information about what you’re doing is on there?

Dr. Quigley: Exactly.

Dr. Soram: Okay, fantastic now as far as your books I saw that you’ve written several books for lay people. the one I mentioned at the beginning of the show is just recently up; Probiotics and Digestive Health; A Gastroenterologist Perspective, will they be able to get your books on that website or they can get on Amazon or where would they go?

Dr. Quigley: They’re on Amazon.

Dr. Soram: Okay and what…

Dr. Quigley: I just want to correct you it’s actually www.apc.ucc.ie.

Dr. Soram: Okay say that one more time then please.

Dr. Quigley: It’s www.apc.ucc.ie.

Dr. Soram: Okay.

Dr. Quigley: But if they just put in Alimentary Pharmabiotic Center, they’ll get it.

Dr. Soram: Okay, I will have a link in the show notes for my listeners. Now also this video; Micro Warriors- the Power of Probiotics which you were the medical advisor I think on; tell us just a little about this DVD.

Dr. Quigley: Well this is a very accessible and very well produced video which interviews a number of really the world experts on probiotics; I ever gave some advice with regard to this I’m not interviewed so I can say that there for people without sounding pompous but they really are world experts in the basic science and in clinical aspects of… and I think your audience will find it very exciting; very well presented.

Dr. Soram: Yeah, I personally enjoyed it very much.

Dr. Quigley: And a lot of very good information.

Dr. Soram: Yes and I understand there is a Micro Warriors2 coming out next year which I think you are interviewed in, is that right?

Dr. Quigley: I hope so.

Dr. Soram: Okay.

Dr. Quigley: I look forward to that.

Dr. Soram: Okay fantastic. Alright Dr. Quigley well I’m so grateful and I know my listeners are going to be so grateful for this wonderful interview and learned so much, I really appreciates so much your coming on all the way from Ireland for this interview and I hope to be able to remain in touch with you thank you so much for coming on with us today.

Dr. Quigley: It’s been my pleasure I really enjoyed and I say a big hello from Ireland to all your listeners.

Dr. Soram: Thank you so much very best wishes.

Quigley May 2012 Probiotics

In this podcast I interview world renowned Gastroenterologist Eamonn Quigley M.D. He is a Professor of Human Physiology at the University College in Cork Ireland. Our interview is all about Probiotics.

We all know that probiotics are so important to our health and more and more research is coming out to show that. Health food stores are packed full of many different brands of probiotics and this sometimes makes it hard to decide which one is best to use. 

In this interview we start out by my asking Dr Quigley “What is a probiotic?” and his answer is very straightforward “It is a microbe which is alive and which when given to man transfers a health benefit.” He then goes on to point out that the microbe must “make it” through our gut to get to the large intestine where it is meant to work. 

We talk about how probiotics work and I ask him why we should take probiotics. I also ask if all probiotics are the same and how safe are they to take.

We discuss a lot of the medical research on probiotics, which Dr Quiqley is very familiar with. He mentions research in which factory workers were given probiotics and they had less colds as flus than the workers who did not take probiotics.

He points out that researchers have bought probiotics at the health food store and analysed them at the lab and found that they contained NONE of the organisms on the label, or they have different organisms than the labels stated.

He also mentions several strains of probiotic which have been researched to prove their benefit for the immune system. Specifically a lot of research has been done on  Bifidobacteria Infantis and Bifidobacteria Breve.

We discuss if it is better to get probiotics from food sources e.g. yoghurt or from supplements. The yoghurt companies do study the strains of probiotics that are in their products to prove their benefits and with some research you can decide which ones would be best for you and your family.

Disclosure: Dr Quigley does have a financial relationship with Proctor and Gamble.

Other references on these friendly bacteria include

Reference 1

Reference 2

You can get Dr Quigley’s book Probiotics and Digestive Health here

and on Kindle here

and the DVD called Microwarriors-The Power of Probiotics that he consulted on is here

You can watch a trailer of the DVD HERE

Dr Quigley does have a financial relationship with Proctor and Gamble

Please leave your comments below or send questions which I will answer on my podcast to me at [email protected] . You can also leave voicemail questions at 310 499 0275.

On this podcast, I am delighted to have my colleague Dr. Walter Crinnion back for part two of our interview about the importance of our mitochondria.

I ask Dr. Crinnion some additional questions including:

1. What can I do with my diet to optimize my mitochondrial function?

2. Are there supplements that will help?

3. Can these help if I already have mitochondria that are not working well?

4. Can I increase the mitochondria that I have and can I make them work better?

We also go on to talk about other questions as well. Dr. Crinnion presents a patient with neurotoxicity in which the patient’s mitochondria were actually poisoned by pesticides and you will find interestingly in the podcast how this patient got so many pesticides.

As I mentioned too, I was just at the Pregnancy Awareness Month event in Los Angeles and I was on a panel with Ken Cook and Alejandro Junger talking about how women can prepare to detoxify before they get pregnant and most importantly to stay clean while they are pregnant. Videos from this event will be on the Pregnancy Awareness Website soon and I will put a link to them when I know that they are up. This podcast has a photo of Ken and I being interviewed by Anya Sarre of Entertainment Tonight show.

Also, at the end of May, I am being honored with the prestigious Daniel J. Wallace award by Lupus LA.  Lupus LA is the organization in Los Angeles that supports lupus patients. They’re having a gala fundraiser called the Orange Ball at the end of the month. I look at this honor  as not just of me, but also for integrative medicine. It will be the first time that they have given this award to a physician who is not a rheumatologist. I  look forward to putting some pictures from this event on my blog. More information is HERE

In this podcast I talked about the “Dirty Dozen” of the most pesticided  fruits and vegetables, and the Clean 15 and you can find that list HERE

I also refer you to Dr. Walter Crinnion’s book which is available in hardback HERE

And for your kindle HERE

As you know I am having my podcast transcribed. Please let me know if you like this and if it is helpful to you?

Please remember write your comments in the box below-and now it is below the transcript so scroll way down!

You can e-mail me questions that [email protected]

Or you can leave a voicemail for me with question for me at 310-499-0275.

Dr. Soram Khalsa – Dr. Crinnion Podcast on Mitochondria, Part 2

DR KHALSA :L So is there anything, what can we do with our diet to optimize mitochondo-function?

DR. CRINNION: Well, two things really. One is avoiding things that would rob your body of glutathione.

DR. KHALSA: Ok

DR. CRINNION: So skip off of the most toxic fruit and vegetables, you know, the dirty dozen. Let’s stop eating the dirty dozen.

DR. KHALSA: Yes, and what are a few of the dirty dozen, just for our listeners?

DR. CRINNION: Non-organic strawberries, non-organic apples, lettuce, spinach, celery, potatoes, bell peppers, nectarines. These are all the top ones that I can think of.

DR. KHALSA: They are listed in your book, Walter?

DR. CRINNION: Now, I should tell you that I just had a patient with chronic neuro-toxicity, you know, chronic neurological problems.

DR. KHALSA: Yes

DR. CRINNION: And I was checking him for toxicants, because I figured something has to be going on.

DR. KHALSA; Yes

DR. CRINNION: And it turned out, I did a urine test on him, and he had horrendously high levels of organophosphate pesticides. Now, when I look at the CDR. CRINNION values, they tell you kind of what pesticide loads the average American has. They put them in percentiles.

DR. KHALSA: Yes

DR. CRINNION: Fiftieth percentile, seventy fifth percentile, ninetieth and ninety fifth. This means that at the fiftieth percentile, 50% percent of the country has that percentile and 50% are above it. At the ninety fifth percentile, if your level is at the ninety fifth percentile, this means that 5% of the country has less than you, so you are in the top 5% most affected. This guy had three organophosphate pesticides that were way above the 95th percentile.

DR. KHALSA: Whoa

DR. CRINNION: One was ten times the 95th percentile. 10 times. Another was 3 times.

DR. KHALSA: Was he a farmer?

DR. CRINNION: Another was 5 times. You’ll love this one! Well d-uh, if he has got those levels of organophosphate pesticides that are potent neuro-toxicants,

DR. KHALSA: Yes

DR. CRINNION: You’d think that it may be a factor in his brain not working right! Hello!

DR. KHALSA: I know

DR. CRINNION: So, I am quizzing him. He’s not a farmer, he does not have a rose garden that he tends and uses diathanol on.

DR. KHALSA; Yes, right

DR. CRINNION: but every morning, for the last like five years, which is about how long he has been having this problem, he’s been doing, every morning, celery and spinach juice.

DR. KHALSA: Oh, my gosh. So juicing, concentrates it?

DR. CRINNION: And, guess where he was getting them from?

DR. KHALSA: Where?

DR. CRINNION: Whole Foods.

DR. KHALSA: Oh yes.

DR. CRINNION: At the juice bar at Whole Foods. By they don’t use organic. You know, you walk in to Whole Foods and you think you are buying whole foods and I am being very healthy, but, they have a lot of produce which is not organic.

DR. KHALSA: Yes

DR. CRINNION: They don’t use organic at the juice bar!

DR. KHALSA: Wow! So he was doing himself a service, getting all this juice,  but…

DR. CRINNION: He was, so I said, ok, that has got to be the source, so stop the juice and let’s retest your urine in two weeks.

DR. KHALSA: Yes

DR. CRINNION; Two weeks later, not and organophosphate pesticide in sight!

DR. KHALSA: Wow! So they can clear themselves out pretty quickly?

DR. CRINNION: Yes they do and all you need to do is to avoid them.  So, any pregnant mom, should not be doing this stuff.

DR. KHALSA: Hmm mm, hhmm mmm

DR. CRINNION: Anybody, I mean, anybody…How many people come in to you Soram, saying I really wish my brain could work better, I am not as sharp as I used to be?

DR. KHALSA: Yes, all the time, especially the baby boomers who have had a chance to accumulate these bio-toxins.

DR. CRINNION: Yeah!

DR. KHALSA: Yes

DR. CRINNION: You know we have got to stop the exposure to these things.

DR. KHALSA: Yes, yes. I have a patient that I just saw this week, 60 year old gentleman with MS, multiple sclerosis, which is a progressive type of MS and I was asking him if he had had any exposures to pesticides. His wife was with him and his wife is very organically oriented. She said that he has never eaten a vegetable in his life by washing it before he eats it.  So he just buys the apples and it. In addition, he has been spraying a cottage he has up in the mountains, for heavy pesticides, for the last twenty years.

DR. CRINNION: oh my goodness.

DR. KHALSA: So, I said to them, do you think that these might be related because these things you are describing are neuro-toxins and they were just saying why didn’t anyone mention this to me before?

DR. CRINNION: Hmm mmm

DR. KHALSA; So, we are going to get the pesticide levels on him and we’ll see. Are all the pesticides easy to wash out or just the organophosphates?

DR. CRINNION: The organophosphates and tri-etheroits , which are the two classes in current use…

DR. KHALSA: Hmm mmm

DR. CRINNION: Are rapidly cleared from the body, so we just have to stop exposure. The older ones that are chlorinated,

DR. KHALSA: Yeah, like Chlordane

DR. CRINNION: Those you have to do something else to get out, they are persistent.

DR. KHALSA; Yes and are houses still being termite-proofed with Chlordane?

DR. CRINNION:  They are but not with Chlordane, not since the mid-80s, since about 1986.

DR. KHALSA: Right

DR. CRINNION: So now they are using organophosphates for that, which is why the companies want to keep coming around because it is not a one-time application for the life of the home.

DR. KHALSA: Right, yes, yes.

DR. CRINNION: But your end, you know, Los Angeles area down there, which is probably you know….what is the average age of the home…

DR. KHALSA: Probably, 40-50 years.

DR. CRINNION: Yes, so they all have Chlordane in them.

DR. KHALSA: yes, I know.  Are we able to get Chlordane measurements with the tests we do?

DR. CRINNION: Yes, for that part of the blood level for the pesticides.

DR. KHALSA: For the pesticides, yes.

DR. CRINNION: Yes.

DR. KHALSA: Yes, great, great. Wow. Very, very interesting. So now, we have talked about a couple of the supplements, specifically Co Q-10 and glutathione or NAC. Are there any other supplements that can help our mitochondria?

DR. CRINNION: Yes there are. And it’s all the anti-oxidants.

DR. KHALSA: Right on.

DR. CRINNION: And the flavonoids in herbs, and fruits and those things, are dramatically helpful for the mitochondria.

DR. KHALSA: Right, so what are flavonoids and where can we get them?

DR. CRINNION: Flavonoids are a really interesting group of compounds. The flavonoids are…you have heard the term – nutraceutical

DR. KHALSA: Of course

DR. CRINNION: …things in foods that have really dynamic health power. And flavonoids are this huge pooling of compounds that are common in all our foods and in most of the botanical medicine that we use.

DR. KHALSA: Yes

DR. CRINNION: And flavonoids….you know, we take all of these other anti-oxidants, Vitamin C, Vitamin E, selenium, all these great anti-oxidants and they boost our ability in the body to a certain degree. And then flavonoids are also anti-oxidants but they are organ or tissue specific anti-oxidants. So, you take as much Vitamin C and E and all the things you can and crank up that dial of anti-oxidants up to 10…

DR. KHALSA: Right

DR. CRINNION: …ok. And if you take more, you can’t get any higher.

DR. KHALSA: Yes, exactly.

DR. CRINNION: But if you take flavonoids, those then can take that anti-oxidant function in that specific tissue or organ up to a 100! So, an example of this is Gingko biloba…

DR. KHALSA: Yes

DR. CRINNION: …which we know help the brain. Well, the flavonoids in Gingko are tissue specific for the brain.

DR. KHALSA: Ok

DR. CRINNION: The flavonoids for milk thistle which is specific for the liver, flavonoids for bilberry is tissue specific for the eye.

DR. KHALSA: Hmm mmm, yes.

DR. CRINNION: So, flavonoids are fantastic compounds. Now, the flavonoids in blackberry, good old blackberries,

DR. KHALSA: Yes!

DR. CRINNION:…have been shown to restore mitochondria that have been chemically damaged.

DR. KHALSA: Oh wow!

DR. CRINNION: So, the more flavonoids you can take, it’s all the big fruits and vegetables…

DR. KHALSA: Yes

DR. CRINNION: …where you want to go. And there is a group of compounds in the berries that do the berry…the anti____, the more of those you take; well that helps the mitochondria as well!

DR. KHALSA: Yes… yes. Beautiful. And this is what makes the color in all of these fruits and vegetables, isn’t it?

DR. CRINNION: Exactly.

DR. KHALSA: The flavonoids.

DR. CRINNION; It’s like what am I telling people to do for the mitochondria? Eat organic fruits and vegetables and eat a lot of organic fruits and vegetables.

DR. KHALSA: In every color.

DR. CRINNION: In EVERY color!

DR. KHALSA: Laughs

DR. CRINNION: Exactly!

DR. KHALSA: Yeah, great.

DR. CRINNION: So those things work really, really well.

DR. KHALSA: Hmm mmm. Quite beautiful. One thing we do is that I have my patients take, either a good multi-vitamin but as separate, as you mentioned Vitamin B and Vitamin C, those are kind of the precursors for the manufacture of ATP.

DR. CRINNION: Hmm mmm.

DR. KHALSA: And I think this is why the Myers Cocktail intravenous is so powerful, so it just full of B and C, it’s got calcium and magnesium, which are the precursors of ATP production inside the mitochondria.

DR. CRINNION: Right, and magnesium, let’s just talk about that for a moment, not only is needed for ATP production but it is needed to make glutathione.

DR. KHALSA: Hmm mmm

DR. CRINNION: You take your whey protein, you take your NAC and you are magnesium deficient you are not going to be producing glutathione.

DR. KHALSA: Yes, yes.

DR. CRINNION: So, magnesium is a mineral that is rapidly depleted from the body when you are exposed to toxicants.

DR. KHALSA: Yes, and also, stress dumps magnesium from the body.

DR. CRINNION: Yes, whenever your urine gets more acidic, from eating the standard high protein American diet, or alcohol, or a host of other things, your urine gets acidic, the magnesium just gets sucked out before you know it.

DR. KHALSA: hmm mmm, yeah. And we need that for the glutathione to be able to work.

DR. CRINNION: Absolutely. It’s very important that it be there.

DR. KHALSA: Yes, interesting. And I encourage all my listeners to ask their doctors to do red blood cell magnesium if they want to get a blood level to check their magnesium. Because most of the magnesium in the body is inside the cells as Dr. Crinnion is telling us. And, if you just get a serum, that’s what’s floating around in your blood serum, those will usually be normal, but the red blood cell or RBC magnesium, is not expensive, shows how much magnesium you actually have inside your cells. At my office, that is a routine test I do. And I would say that of my new patients, 50% of them are deficient in magnesium.

DR. CRINNION: Yes, doesn’t surprise me at all.

DR. KHALSA: A very, very common deficiency.

DR. CRINNION: I am actually amazed at how many people walk in to our clinic with chronic health problems and I am talking to them, and I am like, these guys are magnesium deficient.

DR. KHALSA; yeah

DR. CRINNION: And I say, would it be ok if we did a little IV of Mag on you, today? I just want to see. And I am blown away by the number of people, after a 20 minute I.V., they are going, wow…

DR. KHALSA: I feel so much better!

DR. CRINNION: I feel so much better!

DR. KHALSA: And all of this muscle-aching is gone.

DR. CRINNION: And people walk in in chronic pain, you know. They can’t turn their neck, the kind of turn their whole body or they have got heart palpitations, or asthma

DR. KHALSA: Or constipation

DR. CRINNION: You give them magnesium, and I am thinking, am I nuts?

DR. KHALSA: Yeah, I know.

DR. CRINNION: I am thinking, why don’t people, why don’t doctors know this? Why am I seeing it? I must be nuts!

DR. KHALSA: I understand. Well, it’s just a question of learning these extra things, because I have patients that will like go to their doctors, or will come to me from Kaiser and they want to get and RBC – Magnesium. So they will go to their doctor in Kaiser, who will order the regular magnesium, they have never heard of an RBC- Magnesium.

DR. CRINNION: Hmm mmm

DR. KHALSA: And they will say, well, your level is fine. So, ultimately, we will draw the RBC-Magnesium at my office so we are sure to get it on that patient. And very often, with this set of symptoms, they are quite deficient in their magnesium.

DR. CRINNION: Yeah

DR. KHALSA: Yeah, so, great. Well, this is just wonderful information. Now, can all of these supplements, these foods, the flavonoids help even when a person has mitochondria that are not working well?

DR. CRINNION: Yes, that’s the beauty of it. Like these things, like the flavonoids help to restore mitochondrial functions.

DR. KHALSA: Fantastic, fantastic.

DR. CRINNION: So, now, a big thing here is also the avoidance. So, make sure, you are avoiding the things that are mitochondrial poisons as much as possible. So that includes making dietary and lifestyle changes.

DR. KHALSA: Yes

DR. CRINNION; I think I might have talked to you before, Soram, and told you that when the CDR. CRINNION forth report came out, I opened an Excel spreadsheet, because I had nothing better to do…

DR. KHALSA: Laughs

DR. CRINNION: …and I put down all the toxicants that were found in everybody and the levels.

DR. KHALSA: Yes, yes

DR. CRINNION: And, then, I just added up the total, and I looked at all the ones that are easily avoidable by lifestyle and dietary changes.

DR. KHALSA: Yes

DR. CRINNION; So, the plastics,

DR. KHALSA; Yes

DR. CRINNION: The phthalates that are in our personal care products,

DR. KHALSA: oh yes

DR. CRINNION: The foods, the organophosphate pesticides and all this, and if people would make diet and lifestyle changes, within two weeks, they can reduce the toxicant level in their blood and urine by 85%.

DR. KHALSA: Wow, that was the number you came up with!?

DR. CRINNION: 85%!

DR. KHALSA: In two weeks!

DR. CRINNION: In two weeks.

DR. KHALSA: Wow! That’s fantastic!

DR. CRINNION: This is without ataclonic(?), without a sauna. This is just avoidance, the main thing.

DR. KHALSA: And it is something everybody can do and I refer our listeners back to our podcast that you and I did some months ago about phthalates and where they are found and what they are.

DR. CRINNION: Yes, and in the book that I did, “The Clean, Green and Lean”, I’ve got step by step worksheets in there about how to look through your kitchen, through your house…

DR. KHALSA: Great, room by room.

DR. CRINNION: Room by room, that you clear all of this stuff out. You know, what’s in your pantry, in your medicine cabinet, the stuff that you need to clear out so that you are putting less toxicants in to your body.

DR. KHALSA: And thereby making your mitochondria not work well, which makes you get the symptoms or diseases that you have.

DR. CRINNION: Exactly, because, you know, mitochondrial disorder, or dysfunction…

DR. KHALSA: hmmm mmm

DR. CRINNION; when you look at all the things, when your mitochondria don’t work so well, it’s what we consider ageing.

DR. KHALSA: Yes

DR. CRINNION; and in fact, it is known that as people age their mitochondria get lower, and lower and lower.

DR. KHALSA: Wow! Lower in function?

DR. CRINNION; You know, there was just an article out on Alzheimer’s and it showed the people that just did daily activities, cleaning the house, playing cards, doing things…they did not progress to Alzheimer’s like people who just sat and did nothing.

DR. KHALSA: Hmm, mmm

DR. CRINNION; It was beyond exercising. Mitochondria dysfunction is what we think of as getting old.

DR. KHALSA; Yes

DR. CRINNION: Oh, I don’t have enough energy, my joints don’t work right, my memory is not working right, I’m gaining weight, blah, blah, blah…well, and that is mitochondrial dysfunction. You can change that.  I am convinced, more and more…

DR. KHALSA: Yes,

DR. CRINNION: it is not that we are adding more years to our lives, or more birthdays to our resume, it’s that we are adding more toxicants in to our bodies. And if we would stop that, take a tremendous amount of anti-oxidants from our foods, from our supplements, from our botanicals etc., of different kinds of antioxidants, not just Vitamin C, but all the berry pigments and all of that. And we really get our mitochondria cranking and start to some exercise, which make you produce more mitochondria…

DR. KHALSA: Right

DR. CRINNION: Our mitochondrial biogenesis, which happens in exercise, you know, and then we could really end up feeling a whole lot better!

DR. KHALSA: Wow, that’s so interesting. This is especially relevant to the baby boomers. Because, right now, the numbers I have been told are 10000 new people turning 65 everyday, that’s the baby boomers…

DR. CRINNION: Wow

DR. KHALSA: …are marching through their medi-care years. They are marching in to their medi-care years. So, you mentioned mitochondrial biogenesis, which is a great expression, so exercise does that. Are there other things that can increase, actually increase the number mitochondria that we have?

DR. CRINNION; Well, there is some interesting evidence out there about the polyphenols, the berry pigments, the anto-sianadins, resveratrol – there is interesting evidence out there about those kind of compounds that appear to also help mitochondrial biogenesis.

DR. KHALSA: Yes, right. Right, I have been hearing that a lot of information is coming about resveratrol coming out. So, I think with all of these things, I know what I wanted to ask you. The dirty dozen that you mentioned, that’s the 12 dirtiest fruits and vegetables, right?

DR. CRINNION:  hmm, mmm

DR. KHALSA: Is that in your book?

DR. CRINNION: Oh yes.

DR. KHALSA: Ok great!

DR. CRINNION: Absolutely.

DR. KHALSA: So our readers can…

DR. CRINNION: And we have recipes, that my wife, Dr. Kelly Crinnion,

DR. KHALSA: Yes

DR. CRINNION: She did a whole bunch, a whole month’s worth of breakfast, lunch and dinners.

DR. KHALSA: Fantastic

DR. CRINNION: You know, for how to cook this way. And the recipes are good. They call came out of the kitchen I am standing in right now.

DR. KHALSA: Laughs, that’s great! And it’s the food you eat every day.

DR. CRINNION: Yeah, yeah. So, basically, you look at that and that is kind of the way we live.

DR. KHALSA: Yes, and that’s beautiful.

DR. CRINNION: It’s a very practical book.

DR. KHALSA: Fantastic. Yes, I have really enjoyed it and I hope our listeners will. I refer it to my patients all the time. I hope our listeners will be interested in reading it. They can get it on your website or at Amazon?

DR. CRINNION; Oh yes, there is a link, right through on my front page, drcrinnion.com, they can click on that.

DR. KHALSA: How do you spell that?

DR. CRINNION: d-r-c-r-i-n-n-i-o-n-dot com

DR. KHALSA: Great, I just wanted them to know that there is a double “n” in the middle. Well, Walter, are there any closing comments you want to make about mitochondria?

DR. CRINNION: You know, it’s just such an important aspect for us to be aware of and when you understand that all of these toxicants are around, it makes it easier to understand why in all the epidemiologic studies around, looking at people who work around the various toxicants, the biggest complaint is fatigue.

DR. KHALSA: Yes, indeed.

DR. CRINNION: So, we just have to start protecting ourselves.

DR. KHALSA: Yes. And the mitochondria are the energy generating centers in our cells.

DR. CRINNION: And again, the good news is that this stuff, if you just have to start making lifestyle and dietary changes, your level of toxicants in your peak, can drop by 85% in two weeks.

DR. KHALSA: That’s a fantastic number.

DR. CRINNION: And you start doing the supplements, you are going to get your mitochondria working again. Two of the most common comments I got from my patients, over the years, when I am working to reduce their toxic burden, I got my brain back and I feel 20 years younger.

DR. KHALSA: Yes, yes.

DR. CRINNION: That’s mitochondria. It’s easy to get back.

DR. KHALSA: That’s beautiful and a great final message for all our listeners. Walter, this has been most informative and as always, so much fun. We have to please be thinking about what other topic we would like to talk about a future podcast. And I invite our listeners to send in suggestions about aspects of environmental…

DR. CRINNION: Excellent! That would be excellent.

DR. KHALSA: Aspects of Environmental Medicine which is what Dr. Crinnion’s area of specialty is. You can send them to me at [email protected] and Walter and I will discuss them and see if there is enough material directly have a whole show about some of the questions.

DR. CRINNION: Sounds perfect!

DR. KHALSA: Great. Well, Walter this has just been such a pleasure. I enjoy chatting with you and letting our listeners listen as you and I chat and I am very, very thankful and grateful to you for taking the time today to do this podcast and look forward to our listeners giving us any feedback that they have from their own experiences of cleaning out for two weeks.

DR. CRINNION: Oh you are so welcome, Soram. It is always such a joy to spend time with you on the podcast here.

DR. KHALSA: Thank you so much, Walter. Very best wishes to you. I know that I will talk with you personally very soon.

DR. CRINNION: Thank you

DR. KHALSA: Thank you, Bye bye!

On this podcast, I am delighted to have my friend and colleague Dr. Walter Crinnion, ND,  back to talk about how environmental toxicants actually do their damage to the body.

This podcast is about our mitochondria, the little organelles which are the energy factories of our cells.

In this show I’m going to be asking Dr. Crinnion the following questions:

1. What are mitochondria and what do they do for us?

2. How can I tell if my mitochondria are working or are not working?

3. Are there certain diseases that are associated with mitochondrial dysfunction?

4. What kinds of things “poison” my mitochondria?

In preparation for this interview I reread Dr. Crinnion’s excellent book called Clean, Green and Lean, which I encourage all of you to get and read. It tells you the practical steps to help keep your own body clean, and to keep the environment where you live and work, clean. This is especially important for people who already have a chronic illness such as diabetes, heart disease, or cancer. It is also very important for young families who are starting to have children which can be more easily affected by the chemicals in our environment.

You can get the hard back version of the book here

or the Kindle version here

In his book, Dr. Crinnion gives excellent suggestions for practical things you can do without needing to necessarily see a doctor. There are a few cases when it would be best to see a doctor who is experienced in integrative medicine and he clearly delineates those cases.

Dr. Crinnions ‘s website is located at Crinnion Medical

I really encourage you to read his recent articles about pesticides and their and the effects on child development.

Also mentioned in the podcast is the Endocrine Disruptor website (TEDX ), which shows how endocrine disruptors that are in our environment affect the development of the fetus in the womb. This is a most informative site. Please note it takes a few minutes to load as it is a very sophisticated site.

Also the dirty dozen list that we talked about-the fruits and vegetables with the MOST pesticides is here:

http://www.ewg.org/foodnews/

I’m delighted to announce that I am now starting to get my podcasts transcribed! I found an excellent transcription service and starting with this podcast, as you’ll see below, all my podcasts will be available for you to read if you prefer that way of getting the information. At this time I’m not doing PDFs of the interviews. If you are interested in the PDF’s please do let me know.

 As I’ve mentioned, leave comments below (you’ll need to scroll past the transcript) and/or you can contact me at my voicemail hotline 310-499-0275 or by e-mail at [email protected] 

Dr. Soram Khalsa – Dr. Crinnion Podcast on Mitochondria, Part 1

Well, greetings everyone. I am so happy to have my longtime colleague and dear friend Dr. Walter Crinnion, back with us today, to talk about a new subject. Dr. Crinnion is a professor at the Southwest College of Naturopathic Medicine in Tempe, Arizona. He is the chairman of the Environmental Medicine Department there. He’s been on TV. many times; he practiced for many years in the upper Seattle area and has tremendous experience with chemically poisoned individuals and detoxing people to improve their health and well-being.

Most recently, he is the author of the wonderful book , “Clean, Green and Lean – Get Rid of Toxins that make you fat”. And today, we are going to be talking about another aspect of Environmental Toxicity and I am going to let Dr. Crinnion tell you about that:

Dr. Khalsa: So, Walter, welcome back to my podcast Dr. Crinnion. I am so honored to have you here.

Dr. Crinnion: Soram, it’s always such a joy to talk with you, and especially fun on these podcasts.

DR. KHALSA: I love it! So, today, Walter, we are going to talk about mitochondria, and can you tell us what mitochondria are? What do they do for us?

DR. CRINNION: Well, mitochondria are actually the little furnaces or engines in every cell of our body. They are the things that take our nutrients from the food we eat, the sugar and the fat, and take that and make it into energy.  So each cell in our body can do its job.  Then, we as a body, as a whole being, has energy, our brains work right, everything in our body works right when the mitochondria in the cells are able to reduce the energy so that everything works.

DR. KHALSA; Perfect, excellent explanation, and so why, since we are talking about Environmental Medicine, have you chosen to talk with us today about mitochondria? How does that affect us in regards to our exposure to environmental chemicals and toxicants? Where does that fit in?

DR. CRINNION: Well, you know Soram, we know that the Environmental toxicants pose a whole host of medical and health problems in people and over the last 10 or so years, a great amount of information has come out pointing to the fact that these environmental toxicants that are in the air, food, and water cause their damage to a great extent by poisoning the mitochondria.

DR. KHALSA: Oh wow, ok.

DR. CRINNION: So, solvents for instance, you know, kids sniff glue. It makes them high. Well, what is the mechanism there? It’s the mitochondrial damage in the neurons. So, the neurons in the brain do not work so they get this high. So, working with the mitochondria, understanding that and ways to protect it all becomes crucial in helping us protect ourselves from the classic health problems that our environmental toxicant load provides to us.

DR. KHALSA: Yes, and remind us what are the spectrum of health problems we see that are related to our exposure to environmental toxicants.

DR. CRINNION; Well the major systems in the body that are damaged by the toxicants are first the brain. So a lot of neurologic things, like mood swings, the classic one are brain fog, where you cognitive abilities just don’t work like they used to, ability to think, understand, to remember. It can also lead to neurological diseases; Parkinson’s is a classic one associated with a lot of environmental toxicants. The immune system is also damaged, where you get a lot of allergies, asthma, and auto-immunity, can’t fight off infections, so you get chronic infections, chronic viruses, chronic fungi. The endocrinal/hormonal system lots of problems with that. Low thyroid, adrenaline balance, infertility is a big one, and diabetes is the new one so strongly associated with it. And overall the big symptoms that show up are fatigue, and mood problems.  These are very, very common. So, those are like the big deals that go on. I guess we can mention some of the bone marrow cancers as well.

DR. KHALSA: Yes, yes there have been a number of articles which I have been accumulating which I hope that you and I can talk with on future podcasts  about the role specifically of mercury with respect to damage to the auto-immune system. Recent studies showed within the Haynes evaluation the connection of mercury with auto-immune thyroiditis and also with anti-nuclear antibodies and anti-nuclear clear antibodies which are the hallmarks of lupus.

DR. CRINNION: Hmm, yes.

DR. KHALSA: So, these are becoming more and more visible to the general population now with these studies coming out. So, to go back to our mitochondria, how can I tell if my mitochondria are working or not working?

DR. CRINNION: Well, let me give you one example. Many people have probably experienced low blood sugar at some point…

DR. KHALSA: Yes, hypoglycemia.

DR. CRINNION: So, when you have hypoglycemia/low blood sugar you know, your brain doesn’t work right, you don’t have energy, you’re really tired, you’re cranky and all that. Well, that is the mitochondria in your brain cells, not able to function because they don’t have enough sugar to make energy.  Well, it’s those kinds of symptoms, and the big ones that people complain of is fatigue. I don’t have enough energy. Well, what makes energy? The mitochondria are what make energy. And people who are obese, they have a lot of fuel, but they are not able to burn it.

DR. KHALSA: Yes, right.

DR. CRINNION: Why is stored instead of burned. The mitochondria are what burn it up. IF the mitochondria are not working, you are going to be overweight.

DR. KHALSA: That is so interesting.

DR. CRINNION: If you are having these kind of problems and there are some of the classic illnesses that are in epidemic proportions now, that are strongly associated with mitochondrial dysfunction. Obesity being one of them, and chronic fatigue, diabetes, is known to be mitochondria dysfunction. Parkinsonism is known to be mitochondrial dysfunction. In heart failure, the mitochondria in the heart is not working right.

DR. KHALSA: Yes, yes, it’s interesting.

DR. CRINNION: So, these are some classic presentations.

DR. KHALSA: Yes, and that’s why, for example, in Parkinson’s we know that if we give them intravenous glutathione, literally, their tremors stop for several days, or markedly reduced and glutathione is like one of the fuels that the mitochondria is using.

DR. CRINNION: It’s actually one of the few, I guess you would call it a nutrient that’s actually inside the mitochondria. It’s the only antioxidant present inside the mitochondria and it’s critical for the functioning of the mitochondria. Now the other nutrient in mitochondria is Coenzyme Q10 and that dosing Co-Q10 has also been shown to slow the progression of Parkinson’s.

DR. KHALSA: yes, indeed. High doses used.

DR. CRINNION: So, it’s mitochondria.

DR. KHALSA: yes, yes. And I don’t think that conventional medicine understands the ideology of why Co-Q10 helps in Parkinson’s but this certainly explains it. I think it is just used empirically by conventional neurologists. Great. So those are some good ways for us to be aware. Fatigue is certainly rampant in our society and everybody attributes it to stress but of course stress can affect our mitochondria as well.

DR. CRINNION: Yes.

DR. KHALSA: So, you’ve mentioned certain diseases that are associated with mitochondria dysfunction. What kinds of things poison the mitochondria?

DR. CRINNION: Well, the whole host of environmental toxicants that we’re exposed to, you know the CDR, the Center for Disease Control, has been doing ongoing studies about what are the toxicants that are in all of us. They are up to their fourth report now. It’s available right on the web at drcrinnion.gov

DR. KHALSA: Great

DR. CRINNION: And so what I did with the last report, Soram, the fourth report, is I just sat down and looked at all the toxicants that they are finding in basically everybody and I just go to Pub Med, the National Library of Medicine, the National Institute of Health, a database of all published articles and I would just put in the search. I’d do whatever the toxicant was that CDR found in everybody and then I would do AND mitochondria!

DR. KHALSA; Laughs

DR. CRINNION: And literally, all the ones that are in all of us have been shown in scientific laboratory studies that poison mitochondria.

DR. KHALSA: Wow! Wow, wow, wow. So all that is in the medical literature?

DR. CRINNION: Yes, the mitochondrial damaging these things is an overwhelming burden. We don’t have just one mitochondria poison in our body. We’ve got literally hundreds!

DR. KHALSA: Yes

DR. CRINNION: The weight is overwhelming.

DR. KHALSA: Indeed, and we know from the environmental working group study that newborns are born with 280 of these chemicals in their bodies already that have been flowing through their system, while the mother was pregnant.

DR. CRINNION: Yes, yes! Leading to a whole host of problems. And knowing that the mitochondria prevent proper functioning of all our cells – immune cells, brain cells, the hormonal producing cells. Problems in those areas are what bring 90%-95% of your patients to you. When you are out driving and you’re wondering why people are driving so strange, well, they are loaded with solvents. They’re neuro-toxins. Their mitochondria are damaged.

DR. KHALSA: Yes, yes. That’s very interesting. To just divert for a second on newborns, I’m just thinking out loud with you for your perspective, so the babies do not have a formed blood-brain barrier in the womb or for the first six months of their life. So, all these toxicants that are affecting the mitochondria, can be affecting the mitochondria in the neurological tissue. That’s…

DR. CRINNION: Oh clearly are. The research has clearly shown that. I just did a little blog on my website, drcrinnion.com

DR. KHALSA: Good, I will put that in the show notes, Walter

DR. CRINNION: There was, the great journal, Environmental Health Perspectives, that I love so much,

DR. KHALSA: Yes, me too.

DR. CRINNION: they had three articles in a recent edition, all about exposure to a growing fetus, of organophosphate pesticides. Now, these are what we all have, when we don’t eat all organic foods.

DR. KHALSA: Yes, right.

DR. CRINNION; SO, if we are eating commercial apples, a peach, lettuce, potatoes, celery, spinach; their mom’s got organophosphate pesticides, which were developed in Germany, after WWI, for a nerve gas warfare agent.

DR. KHALSA: That’s interesting

DR. CRINNION: And these kids, these three studies in Environmental Health Perspectives, showed that the kids, who are exposed, inside mom, to levels that are commonly found, according to the CDR. CRINNION data, in US residents, come out with ADHD, lower IQ, mood disorders. And that’s just from mom eating an apple a day!

DR. KHALSA: From my point of view, that’s what’s been documented so far. And I am hoping that someday, they can take a look at that exposure, it’s called the expososome now. It actually has a name now, the amount of exposure we get from the environment, and if it has a relationship with the epidemic of autism.

DR. CRINNION: Mhmm, yeah.

DR. KHALSA: Because, I am very suspicious that there is a connection there. But, are you aware of any literature that has looked at that? I don’t think they have. It is harder to study autism.

DR. CRINNION: Yeah, I have not seen any articles about that yet that I remember. But, Theo Colburn,  the great doctor who wrote the book , “ Our Stolen Future”, he’s got a new website, called TEDx, it’s for endocrine disruption,  it’ll show you, it has a little interactive thing on there, it takes a while to load because it has a lot of information on there. It will show you prenatal exposure to a variety of compounds, and some of the end results. I have not looked on that site yet, for autism.

DR. KHALSA: Yes, yeah.

DR. CRINNION: So, I have not really looked at that.

DR. KHALSA: Yes, I don’t think that the literature supports that. But certainly, with this epidemic, and the recently announced market increase, 1 in 88 children, were born, are getting autism. There should be some forthcoming research. But it won’t surprise me if it’s tied in with the same mechanism.

DR. CRINNION: Oh, yeah, yeah.

DR. KHALSA: Yes

DR. CRINNION: Not at all.

DR. KHALSA: So, now, we are getting exposed to these poisons, our mitochondria are getting affected. Are there ways to protect our mitochondria?

DR. CRINNION: And that is an excellent question. And the answer is thankfully, yes. Again, it’s natural medicine to the rescue.

DR. KHALSA: Yes. Great.

DR. CRINNION: We talked a little bit about CO-Q10, and Glutathione being molecules that are in the mitochondria. There has been a tremendous amount to show that Glutathione replacement is one of the real big deals in helping mitochondria work right.

DR. KHALSA: Hmm mmm

DR. CRINNION: And protect them against this toxicant damage. So, that’s typically supplementing either the nutrient NAC enacetolcysteine or whey protein.

DR. KHALSA: Hmm mm

DR. CRINNION: Those are the two sources of amino acid cysteine, which you need, to make glutathione.

DR. KHALSA; Yes, it’s a precursor.

DR. CRINNION: Yes, if you have been around a lot of environmental toxicants then you have probably depleted your glutathione store. And so, you will have to make sure that you have an extra source of that. NAC is not that expensive.

DR. KHALSA: I know.

DR. CRINNION: If you are going to do that whey protein, you will have to do the higher quality, higher cost whey proteins that are manufactured under high pressure rather than higher temperature.

DR. KHALSA: Great and what dose of NAC and N-acetyl cysteine would you suggest?

DR. CRINNION: You know, in a lot of the studies they are using around 1500mg.

DR. KHALSA: Hmm mm, yes, that is what I have seen as well. And this is easily available at health food stores.

DR. CRINNION; Yeah

DR. KHALSA: and, also, for our listeners to know there are new companies now that are making lypospheric glutathione.

DR. CRINNION: Yes, yes, yes. And prior to these liposomal glutathione molecules, all the studies where people have taken reduced glutathione from the health food store doesn’t work. It doesn’t raise your glutathione. Your body has to break the glutathione back down to cysteine and so, then after the cysteine rises, and then you get glutathione. It’s cheaper just to take the cysteine. These new liposomal forms are looking very, very promising,.

DR. KHALSA: Yes, indeed. I have been using them in my practice for patients that have need for this and they are very, very effective. Maybe, Walter, why don’t you tell our audience what is liposomal.

DR. CRINNION: Well, I can’t tell you the actual stereo-chemistry of it, but it binds the anacetolcysteine within a lipid soluble or fat soluble sphere and that’s the best I can say.

DR. KHALSA: And they use Phosphatidyl Choline for that.

DR. CRINNION: Yes, and I don’t know how they make it.

DR. KHALSA: Laughs

DR. CRINNION: How they plug it in there that I do not know.

DR. KHALSA: And I am just going to correct you said, NAC. Actually, they are putting in a glutathione molecule.

DR. CRINNION: Oh yes, I am sorry. They also have a liposomal NAC; they have done it with Vitamin C. But yes, I think we were talking about glutathione. Thank you for the correction.

DR. KHALSA: Sure

DR. CRINNION: And that gets picked up with fat and your intestines are very good at sucking fat out of the intestinal lining, and that way it gets picked up intact. Otherwise, the reduced glutathione you have been taking is going get broken down because that is how you absorb amino acids. You don’t absorb whole amino acid combinations which are, in larger forms, called proteins. You break them down in to the component amino acid.

DR. KHALSA: Yeah. The way I explain it to my patients is the way you did. The glutathione is captured inside a little fat globule and these are all microscopic.

DR. CRINNION: That’s a great way to say it.

DR. KHALSA: And then the intestine sends it directly right to the liver because it is a fat molecule. The liver strips off the fat coating and bingo, the glutathione goes shooting in to our bloodstream.

DR. CRINNION: And the liver is the main place where the glutathione really gets made, put together the cysteine and other amino acids and the released in to the bloodstream for the rest of the body to grab and utilize and pull in to the cell.

DR. KHALSA: Yes, exactly, exactly.

In this episode, I am proud to announce that I have been chosen to receive the prestigious Daniel J Wallace Founders Award at this year’s  Lupus LA event on May 24. The event will be held at the Beverly Wilshire Four Seasons Hotel. This award is given to individuals who have exemplified excellence in their profession, and as a result of their work and service, have improved the health and well-being of our community and its citizens. I am indeed very honored to be the recipient of this award this year. To my knowledge it will be the first time that this award is being given to a Integrative Medical Doctor.

Here is a link to the website.

I am also delighted to announce that the Pregnancy Awareness Organization is sponsoring an event in Los Angeles on May 6 at the Skirball Center. It is from noon to 4 PM. Ken Cook, the president of Environmental Working Group, and Alejandro Junger,  and I will be on a panel entitled “Cleaning up for Pregnancy”. We will discuss how to clean out before a woman gets pregnant. If you or one of your girlfriends are in the greater Los Angeles area and are thinking about getting pregnant soon this event would be most informative for you.

I then take several questions. We had a phone call voice message call from a gentleman in Canada inquiring about a person near to him with breast cancer. He was asking about a product called  MGN3 and its benefit for use in people with cancer. I reply to his question and explain that supporting the immune system is only one part of getting to the underlying causes of breast cancer. I also emphasized that integrative medicine is NOT a replacement for traditional medicine in the treatment of breast cancer.

He also asked about a possible consultation with me professionally. For those of you who are interested in seeing me as a physician, you may contact me directly at the clinic at 310-274 6200  or you can contact me by e-mail at my office at [email protected].

I then take a question from Ross regarding vitamin D2 versus vitamin D3, and I explained that I prefer using vitamin D3 in all my patients.

I then reply to Natalia who has written to me from the UK, regarding her daughter and the difficulty of getting her vitamin D level up. I gave several suggestions including repeating her vitamin D blood test another lab as well as checking on the quality of the vitamin D that she is giving her daughter to get her levels up. I also talk about diagnosing celiac disease in her daughter and what to do if there is an absorption problem with the vitamin D taken orally.

I received a very interesting question from Veena in Tanzania about autoimmune thyroid disease. It is very difficult for her to get blood tests of vitamin D there, and I’ve advised her to take 2000 units a day which we know to be safe for all adults if they cannot get a blood test. I also refer her to my video on YouTube which in 1 min. gives you full information on replacing your vitamin D. I also talk about autoimmune thyroid and its newly recognized relationship with levels of Mercury. I talk about the treatment of autoimmune thyroid which is also called Hashimoto’s thyroid.

Please send me your questions at [email protected] or you can phone in your questions to 310-499-0275.

I also appreciate your comments below and look forward to our continuing dialogue.

In this episode I talk about the current controversy regarding BPA, also known as bisphenol A. The FDA just rejected a petition from the Natural Resources Defense Council to ban BPA in food packaging.

BPA has been found in the urine of more than 93% of Americans tested. It is a synthetic estrogen that was developed more than 70 years ago and has been widely used since the 1960s specifically to make polycarbonate plastic for things such as baby bottles. It's also been used to line metal cans such as soup cans. It can be found in dental sealants and eyeglasses as well as a coating for cash register receipts and hundreds of other household items.

BPA is an “endocrine disruptor” (EDC) and as such disrupts our endocrine system. It is been linked to neurological defects, diabetes, breast and prostate cancer, and heart disease.

Just recently Campbell’s Soup company announced that they would be removing BPA from the inner lining of their soup cans. This was brought about by pressure from consumers.

See this site for more information:

I then go on to talk about the exciting new article that was published in Endocrine Reviews. This article showed that even low doses of environmental chemicals which can disrupt our hormone system can have serious effects on human health. The researchers say that this points to the need for basic changes in how chemical safety testing is conducted.

Currently safety data is evaluated by giving animals high doses of chemical compounds and seeing if they get cancer or die. This study changes all that. In this article, by reviewing over 800 other articles it is recognized now, that you do not need high doses- and specifically very low doses of these environmental chemicals -can affect our body leading to chronic disease. This ability of a chemical in a very low potency to affect our system is called  "Hormesis", because these chemicals are acting like a hormone on our body.

In this new report, researchers, who were led by Tufts University’s Laura Vandenberg, concluded after they studied hundreds of studies that health effects "are remarkably common" when people or animals are exposed to low doses of endocrine disrupting compounds. The authors of the article concluded that scientific evidence "clearly indicates that low doses cannot be ignored." They point out a wide range of health effects in people from fetuses to aging adults including now known links to infertility cardiovascular disease, obesity, cancer, and other disorders.

In the article they wrote "Whether low doses of endocrine – disrupting compounds influence human disorders is no longer conjecture, as epidemiologic studies show that environmental exposures are associated with human diseases and disabilities."

They go on to say that "current testing paradigms are missing important sensitive endpoints for human health. The effects of low doses cannot be predicted by the effects observed at high doses. Thus fundamental changes in chemical testing and safety determination are needed to protect human health."

Here is a link to an audio interview with Dr. Vandenberg the chief researcher of this article. I really encourage you to listen to it.

Here are links to other websites where the article is reviewed and discussed.

Scientific American

Environment 360

Original article here

In this podcast I then go on to discuss (which is most probably related to the article I just discussed) the burgeoning epidemic of autism. In the year 2000, 1 in 150 children was diagnosed with autism. In 2008 the FDA has just announced that one in 88 children is now diagnosed with autism. Even more shocking, the data currently is that one in 54 boys or almost 2% of all boys are being diagnosed with autism.

On April 2, 2012 World Autism Day was held in New York City to push for official recognition of autism as a national public health emergency and to analyze the federal health authorities’ failure to respond.

http://www.autismspeaks.org/what-autism/waad

I encourage you to look at the Autism Action Network website which you can find here.

I had intended to get to some of your questions on this podcast but time did not allow. I will be answering your questions that you've e-mailed and phoned in, in the near future in my podcast. Thank you for sending them and being patient!

Please write your comments below or send me an email at [email protected]. I really want to know what your thoughts are about all this and how you or your family may have been affected by all this.

I also want to invite all my listeners who are thinking about getting pregnant, (or your family and friends who are thinking of getting pregnant) and who live in the greater LA area to a Pregnancy Awareness Month (PAM) event being held at the Skirball Cultural Center in Los Angeles on May 6, 2012. My friends and colleagues Ken Cook and Alejandro Junger and I will be talking about “Cleaning up for Pregnancy”. You can get more information about this event here. 

I hope to see you there!

This is part 2 of my interview of noted Ob-Gyn Dr. Suzanne Gilberg-Lenz.

We pick up in part 2 of the interview talking the nutrients she recommends during pregnancy. Brain development and Essential Fatty Acids during pregnancy and nursing are reviewed. 

Then we move on to talk about bio identical hormones for menopause. We review the herbs that are helpful for menopause. What is the definition of bio-identical?  Dr. Suzanne defines it. 

Is it risky for a menopausal woman to take bio identical hormones? This depends on several factors in the woman’s life and personal history. 

Dr Suzanne definitely recommends bio identical hormones for women that want to take hormones at menopause. She reviews the new data from the Women’s Health Initiative that women with low risk for breast cancer actually had a lower risk of breast cancer when they took the horse hormone brand Premarin. 

Furthermore I am happy to learn that a new study of hormone replacement in women who had breast cancer is also in progress, to help with symptoms including bone loss. 

Yam cream is NOT bio-identical hormones. The risk of soy derived hormones containing GMO’s is also a consideration. 

The typical menopausal woman may be having hot flashes, heart palpitations and not able to sleep. This can really affect a woman’s quality of life. 

Also sexual and vaginal health is also relevant in thinking about hormone replacement in women. Most menopausal women do need vaginal estrogen to keep their vaginal lining healthy.

I ask Dr Suzanne if she thinks estrogen causes breast cancer and she gives a great answer. 

Progestin vs Progesterone is discussed and Dr. Suzanne explains the difference. The estrogen/progesterone balance is very important for a menopausal woman’s (really all ages of women) health. 

How can we benefit by looking beyond our comfort  zones and beyond conventional medicine to create wellness and balance?  Dr. Suzanne gives great answers to this very important question. She reminds us “We are part of Nature”! 

To close, we talk about Dr Suzanne’s converting her 70 year old LA house to a “green” house with the help of a great architect she knew. She describes the materials they used to make this transformation. From paint to air filtration she describes what they did. 

Her parting advice, which I agree with, is to find a practitioner who you can partner with and start simple in improving your health and go step by step. 

You can learn more about Dr. Suzanne from her practice website 

Soon, her own website will be up as well 

www.thedrsuzanne.com

You can reach her on twitter @askdrsuzanne

And on Facebook

Please put your comments in the box below or send me an email at [email protected]

I am delighted to have on this podcast my colleague and friend, Suzanne Gilberg-Lenz  M.D. Dr. Suzanne applies integrative medicine to Obstetrics and Gynecology , the way I apply it to Internal Medicine

Dr. Suzanne is fully trained in Ayurvedic Medicine and uses it in her practice. We talk about “what is Ayurveda” and how does it compare with Traditional Chinese Medicine. Ayurveda is one of the oldest healing systems and comes from India. 

Ayurveda means the science of life and is directly related to Yoga. 

We talk about the main modalities of treatment that are used in Ayurveda. And she points out that lifestyle management is a big part of Ayurveda.

 Marma therapy  is part of Ayurveda and is analogous to acupressure in Chinese medicine.

Dr. Suzanne brings in many aspects of integrative medicine to her practice and works closely with other integrative practitioners and that is how I met her. She provides a safe environment for women to talk to her about their lives and health.

We discuss how she uses Ayurvedic  medicine in Obstetrics. The idea that “you are not in control” is a big lesson during pregnancy and we discuss this.  Pregnancy lets a woman learn to let go! We talk about yoga and safe yoga practices during pregnancy. I am happy to see that Vitamin D is part of her basic prenatal blood panel. 

We talk about Vitamin D in pregnancy and the prevention of diabetes in children and I mention the study by Elona Hyponnen and Vitamin D in pregnancy and early life in the prevention  of childhood diabetes , which is becoming epidemic.

http://www.ncbi.nlm.nih.gov/pubmed/11705562

Dr. Suzanne teaches the Ob-Gyn residents at Cedars Sinai about the use of integrative medicine so they are familiar with it. 

We talk about the use of safe supplements and lifestyle in obstetrics.

Then we talked about treatment of endometriosis. And the use of high dose vitamin D for menstrual cramps. 

We then discuss HPV and the use of Green tea Extract topically and even orally for the treatment of HPV (Human Papilloma Virus). She may do some research with Cedars Sinai on this.  

I ask her about the HPV vaccine, its effectiveness in preventing cervical cancer and its limitations.  Pre-cancer vs dysplasia. Guardisil vaccinations do not guarantee never getting an abnormal pap test. We talk about  why.

The role of boys and men in spreading HPV is discussed and now boys are getting the Guardasil vaccine as well.

Head and neck cancers are now connected to HPV contracted during oral sex, as well. 

In the next podcast we will finish our interview with more information on bio identical hormones, menopause, and breast cancer.

You can learn more about Dr. Suzanne from her practice website

Soon, her own website will be up as well 

www.thedrsuzanne.com

You can reach her on twitter @askdrsuzanne

And on Facebook .

Please put your comments in the box below or send me an email at [email protected]