Dr. Jason Hawrelak speaks about Parasites with Dr. Ben Weitz.

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Podcast Highlights

6:49  Gut parasites used to be considered a more common cause of gut infections 20 years ago, whereas in the last 5 or 10 years in Functional Medicine circles we have come to focus more on conditions like Small Intestinal Bacterial Overgrowth, H. pylori, dysbiosis and fungal overgrowth. What should make us suspect that a patient with digestive symptoms might have a parasite?  The symptoms do overlap with symptoms from conditions like IBS, SIBO, functional dyspepsia, and inflammatory bowel disease.  We have to distinguish between parasites like Giardia and Entamoeba Histolytica that clearly cause serious gut infections from more debatable ones like Blastocystis Hominis and Dientomoeba Fragilis. You might get some history like they have recently travelled overseas and then got a case of traveler’s diarrhea.  We have to do some testing to see what is causing the symptoms and not just stool testing for parasites. If you find Giardia, you can be fairly confident that this is responsible for that patient’s symptoms. But if it is Blastocystis Hominis or Dientomoeba Fragilis we can’t make that assumption, because of the prevalence of these microbes in healthy populations.  Dr. Hawrelak recommends doing a suite of tests to determine what causes these symptoms including not only a PCR stool test but a microbiome analysis stool test, fecal calprotectin or lactoferrin for inflammatory bowel diseases, a fecal occult blood, and SIBO breath testing.

12:00  If you have a patient who has digestive symptoms like gas, bloating, diarrhea or constipation, and they have a positive SIBO breath test and they also have a protozoan organism like Blastocystis and/or Dientomoeba that shows up on a stool test, you should treat the SIBO.  Such protozoans are extremely common and are generally irrelevant to that person’s symptoms.  15-20 years ago SIBO wasn’t that well known and we used to treat such patients for Blastocystis and we would get some results but it would generally not resolve completely. He talked about one patient who he treated for Blastocystis and got somewhat better and then 12 months later was diagnosed with fructose intolerance and went on a low fructose diet and all her symptoms completely resolved and Dr. Hawrelak was upset that he missed that diagnosis.

15:15  It is interesting to consider whether there could be SIPO or Small Intestinal Protozoan Overgrowth as a cause of IBS.  We should probably think of certain protozoans like Blastocystis and Dientomoeba as commensal, as a normal part of a healthy gut.  In fact, Dr. Hawrelak noted that he personally has elevated levels of Blastocystis Hominis on a stool test and no gut symptoms.  Perhaps we’ll be taking protozoan probiotic supplements one day.  On the other hand, taking certain antibiotics like Metronidazole, Flagyl, the most common antibiotic used to kill protozoal organisms, it tends to awaken the pathogenic potential of Blastocystis and increases its capacity to actually cause gut damage and to interact negatively with precancerous cells and become much more virulent. 

20:54  There are 17 different subtypes of Blastocystis Hominis but only 9 have been found in humans and the rest in other animals, like chickens, pigs, cows, etc..  For humans the most common subtypes are 1, 2, 3, and 4, esp. 1 and 3. There is no consistency in the data around which of these subtypes may be more pathological than the others.  Dr. Hawrelak wants to emphasize that when he has a patient who shows elevated Blastocystis or Dientomoeba...

Dr. Tom O’Bryan discusses Preventing Cognitive Decline with Dr. Ben Weitz.

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Podcast Highlights

17:28  When a patient presents with Mild Cognitive Impairment (MCI), such as forgetting where their keys are, where they parked their car, etc.  Dr. O’Bryan explained that his website, TheDr.com is a platform that provides the roadmap that helps to make it easy to take the journey back to health.  Brain deterioration is a condition of inflammation.

22:15   While we can use questionaires to assess the level of cognitive function, the first thing to recognize is that brain deterioration is a state of brain inflammation.  Then we can run some testing to help us identify some of the triggers for this inflammation, including the Neural Zoomer Plus from Vibrant Labs that looks at 48 different antibodies in your brain.  The second test Dr. O’Bryan recommends is the Wheat Zoomer, which is the most sensitive marker for intestinal permeability.  The intestinal microbiome modulates your brain function, so having good balance in the microbiome is important for brain health. 

29:41  Dr. O’Bryan likes using the BiomeFx stool test to assess the microbiome health.  So the basics of reducing mild cognitive impairment is to heal leaky gut, create intestinal microbiome balance, and avoid environmental toxins.

 

                         

 

Dr. Tom O’Bryan is a Doctor of Chiropractic, a best-selling author, a professor for the Institute of Functional Medicine and an internationally recognized speaker focusing on gluten and other food sensitivities, environmental toxins, and the development of autoimmune diseases. His 2016 book, The Autoimmune Fix won the National Book Award and the docuseries he released the same year, Betrayal: The Autoimmune Disease Solution They’re Not Telling You  has been seen by over 500,000 people worldwide. He also organized the highly successful The Gluten Summit – A Grain of Truth. His website is www.theDr.com  His second book You Can Fix Your Brain: One Hour a Week to the Best Memory, Productivity, and Sleep You’ve Ever Had was released in 2018 and it is another huge hit.

Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.

 

 

Podcast Transcript

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

Dr. Joel Kahn speaks about Lipoprotein (a) with Dr. Ben Weitz.

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Podcast Highlights

4:18  Lipoprotein (a) is a particular type of cholesterol particle that can be measured on a blood test.  We know that only 50% of those people who have a heart attack have elevated conventional cholesterol levels, so there must be some other risk factors and elevated levels of Lipoprotein (a) is one reason in some of those cases.  Lipoprotein (a) has at least three dangerous properties: 1. It is called the sticky cholesterol because it promotes blood clotting. 2. Lipoprotein (a) causes atherosclerosis and it may be found in the plaque that closes your carotid artery, your heart arteries, your sexual organs or your kidney arteries. 3. Lipoprotein (a) causes inflammation. All three of these properties promote heart disease and Lipoprotein (a) is found in one out of every four Americans.  A celebrity case is Bob Harper, the trainer from The Biggest Loser television show, who was in tremendous shape and yet suffered a major heart attack. It turns out that Lipoprotein (a) was his main risk factor.  In fact, elevated levels of lipoprotein (a) increases the risk for coronary artery disease, heart attack, stroke, thickening of the aortic valve, and even heart failure.  If you have elevated lipoprotein (a), you are 2 to 4 times more likely to have a stroke, heart attack, or scarring of the aortic valve. It causes inflammation and foam cells and plaque.

12:04  Since we are in the midst of the COVID-19 pandemic, having elevated levels of Lipoprotein (a) is liable to increase the likelihood of a more severe case if you get infected.  It would be interesting to know if actor Nick Cordero, who had severe blood clotting and who died from COVID-19, had elevated Lipoprotein (a).

13:31  The clotting associated with Lipoprotein (a) seems to be an evolutionary disadvantage, so why would it be there?  There must be some evolutionary advantage for it to be present in so many people, which was hypothesized by the late, great Dr. Linus Pauling.  It turns out that 40 million years ago we developed the ability to produce Lipoprotein (a) at about the same time we lost the ability to make vitamin C.  Most animals can make vitamin C, except humans. Perhaps we were eating so many leafy greens and fruits that we just didn’t need that enzyme to make vitamin C. If you are deficient of vitamin C, you can develop scurvy.  And you’re going to bleed in your skin and your gums because your collagen and your tissues are super weak, including your arteries. Well, it turns out that lipoprotein (a) tries to prevent breaking down clots. So if you had weak arteries 40 million years ago from scurvy or something close to scurvy, it might be an advantage to have lipoprotein (a) when you have a baby or when you got cut chasing a saber tooth tiger because this would keep you from bleeding to death.  Lipoprotein (a) is considered elevated when it is over 30 mg/dL, though some labs measure it in nm/L where the normal range is less than 75.

18:57  If a patient has elevated Lipoprotein (a), you should listen to their heart with a stethoscope to hear if there is a murmur from the aortic valve.  You might want to get a heart calcium CT scan (Coronary Calcium Scan) to see if there is any calcified plaque in their cardiac arteries.

22:55  What can you do if you have an elevated Lp(a)?  For one thing, statin medications do not lower Lp(a) and they may even raise it.  CoQ10 and ground flaxseed can both help to lower Lp(a) 5-10%.  L-carnitine might drop Lipoprotein (a) 20-25%. (