The Dr. Hedberg Show

In this episode of Functional Medicine Research, I interview Ashok Gupta about his limbic system retraining program. Trauma of any kind can change the brain and nervous system in a way that prevents one from getting well. Many people never get well because they don't address the underlying trauma that has triggered or contributed to their health challenges.

If you've tried eating right, exercising, sleeping well, taken the best supplements, and managed your stress, but you still aren't feeling well, your brain and nervous system may be out of balance. The Gupta Program is designed to change the neuroplasticity of your brain and nervous system so you can heal and feel well again.

We discuss a new and exciting published paper that validates this method of limbic system retraining.

Full Transcript on Limbic System Retraining Interview

Dr. Hedberg: Well, welcome everyone to "Functional Medicine Research." I'm Dr. Hedberg, and I'm very excited today to talk to Ashok Gupta about limbic system retraining. And Ashok is an internationally renowned speaker, filmmaker, and health practitioner who has dedicated his life to supporting people through chronic illness and achieving their potential. Ashok suffered from myalgic encephalomyelitis or chronic fatigue syndrome about 25 years ago when he was studying at Cambridge University, and through neurological research that he conducted, he managed to get himself 100% better. He then set up a clinic to treat others and then published the well-known recovery program known as "The Gupta Program" in 2007. He's published several medical papers and he's continually researching these conditions. You can find out more information at guptaprogram.com. Ashok, thanks for coming on the program.Ashok: Thank you so much for inviting me. Very excited to be here.

Dr. Hedberg: Yeah. So, the limbic system is something that I've been interested in since I started practicing 17 years ago, and you know, I have a variety of recommendations that I give to patients for that. You know, things like meditation, mindfulness training, therapy, or just a number of things, but your particular limbic system-intensive program, I heard about it recently and became very interested in it. And why don't we begin by talking about just the limbic system itself? Can you give people kind of an overview of what the limbic system does and why it's important?

Ashok: Yes. So, there are many different ways of describing the limbic system. I think primarily if we start with this idea of it being a defensive system to ensure survival, right? So, most people would associate the limbic system with our emotional responses and medicine often separates the kind of psychology and the emotional responses from defense responses as if they're something different, you know, physiological defense responses versus emotional defense responses. But I see the limbic system as the automatic survival systems that we've inherited over generations of different animals and whatever that actually create responses that ensure survival. And so, a fight or flight response, a fear response, an anger response, a memory of a previous experience, all of these things are designed to ensure survival. So, that is for me the primary motive or motivation of that limbic system. And within that limbic system, there are different structures that play specific roles. And a lot of our research focuses on the amygdala, which are two almond-shaped structures that sit behind our eyes that essentially are taking all the incoming information from the outer world and the inner world, process it according to the previous experiences we've had in life, our memories, and then creates a coordinated response across the brain to ensure survival, yeah? And one way to look at this Dr. Hedberg, which I find fascinating is to ask the biggest question of all, you know, why are we here? And we can answer that question from a philosophical perspective, but from a scientific perspective, we're here because over so many generations over millions of years, this nervous system that we've inherited, this immune system has adapted to the environment to ensure survival, which is ultimately culminated in this nervous system, this brain, and this limbic system that knows how to identify threats and ensure survival so we pass on our genes to the next generation.

Dr. Hedberg: Right. And let's talk a little bit about how that gets out of balance. I've done a few podcasts talking to guests about adverse childhood experiences and how to overcome trauma and things like that. So, it just seems like, I mean, pretty much any kind of trauma input into the system, whether you're young or an adult could potentially cause imbalances in the limbic system. So, can you talk about all the potential things that can happen to someone that can cause an imbalance in their limbic system?

Ashok: Yes. It's fascinating. And it's great that you're incorporating that as part of your integrative approach because it's so important. The way we look at it is the combination of nurture and nature. So, we know that there can be, and it's a fascinating area, inherited trauma that can actually be passed on through our genes, and then even experiences within the womb can impact on how reactive our amygdalas are, right? So, research has shown that if a mother is having a particularly stressful pregnancy, that can impact on the stress of the child moving forward. The actual experience of childbirth can impact on the limbic system, and then obviously, adverse childhood experiences. So, that might be bullying, abuse, physical or emotional abuse, even sexual abuse, all of these things impact on what we call the factory setting of the amygdala. So, we have the factory setting when we're born and then it keeps adapting and changing according to those adverse childhood experiences. And then even during teenage years, that can be impacted. Then during our adult lives, we have that genetic and nurture inheritance that then impacts on our reactivity to the world around us. And that is why those adverse childhood experiences can impact on our mental, physical, and emotional health. Now, I think it's well-documented that our emotional health can be impacted, but the processes on how our physical health is impacted is what we focus here on in terms of our research. And as I said earlier, if we go back to this idea that our brains don't differentiate between emotional, physical, chemical, or biological threats, the brain simply asks the question, "How do I survive?" So, if we've had adverse childhood experiences, which make our brains more defensive, then when we then are exposed to physical dangers, the brain becomes hyper-reactive and hyper-responsive, which then can lead on to so many different chronic illnesses that we experience, you know, in the surgery.

Dr. Hedberg: Right. Right. And one of the things that we'll see, and I'm sure you see as well is the people who they seem to be doing everything right. You know, they're sleeping well, exercise, eating well. They're just doing a lot of the things that one would expect to achieve good health, but they're just still not feeling well. And so, I think this is one of the areas that is just really the sticking point for a lot of people with chronic illness, the limbic system is out of balance and it's just not able to recover. So, what are some of the symptoms or conditions that would make someone think they potentially have an imbalanced limbic system?

Ashok: Yes. We collectively call these conditions neuroimmune condition syndromes or NICs. And generally, as you say, someone's resting, they're having a good lifestyle, but still, there seems to be, you know, a low level of functioning or continuing background illness or severe illness. And we believe, yes, it's an imbalance not only in the limbic system, but also, especially in the insular. Now, the insular cortex kind of sits between the kind of limbic system and the cortex. So, it's more a part of the cortex than the limbic system. And the insular is where we also believe a lot of the imbalances lie. So, it's not purely in the limbic system in our research. And if I can just describe to you an overview of the hypothesis and that will help then your listeners to kind of understand how it impacts on chronic illness. So, let's take the example of flu virus or, in fact, even COVID-19, which are obviously in the news right now. If somebody has, let's say a lot of ACEs or a lot of adverse childhood experiences or is going through a lot of stress, we know that stress reduces the effectiveness of the immune system. And then let's say they have the flu virus, the brain is prioritizing survival. So, it thinks, okay, we've got to now overcome this flu virus. This is potentially life-threatening or COVID-19. And the brain and the nervous system and the immune system coordinate to facilitate that, to overcome this virus and rid it from the body. But if there is a compromised immune system, then that whole system takes a lot longer to fight off that virus. And there comes a point at which the brain becomes traumatized. The amygdala, the insular, the anterior cingulate become traumatized in this response, like a physiological traumatic response where the body says, actually, we don't seem to be fully and effectively fighting off this virus. We must now go into an overdrive as it were and keep stimulating the nervous system and the immune system to anything that reminds us of the original sensitizing event.

So, the brain keeps overstimulating immune responses and nervous system responses, and it learns that. So, that's a neurological conditioning in the brain. And even once someone recovers from flu or COVID-19, it's left a legacy in the brain. The brain has now learned that anything that reminds it of the original infection indicates danger and potentially death. So, even once the virus is gone,...

In this episode of Functional Medicine Research, I interview Dr. Deb Matthew about her new book on male sexual health "Why Can't I Keep Up Anymore?: A Guide to Regaining Energy, Focus, and Peak Physical & Sexual Performance for Men Over 40". We discussed the causes of male sexual dysfunction, lab testing, causes of low testosterone, stress and cortisol levels, sex hormone binding globulin, testosterone replacement methods, how sleep affects hormones and much more.

This book isn't just for men. If your male partner is showing signs of low testosterone then this book is a must-read with resources on how to find the right kind of doctor to get well.

Male Sexual Performance with Dr. Deb Matthew Interview Transcript

Dr. Hedberg: Well, welcome, everyone, to "Functional Medicine Research." I'm Dr. Hedberg, and I'm really excited today to have Dr. Deb Matthew on the show. Dr. Matthew is a medical doctor, and she's also known as the happy hormones doctor. She's a best-selling author, international speaker, educator, wife, and mother of four. And after suffering for years with fatigue and irritability, her quest to resolve her personal health led her to change everything about her practice of medicine. She has been featured on national podcasts, radio, and broadcast shows, including NBC, ABC, CBS, and Fox. Dr. Matthew, welcome to the show.

Dr. Matthew: Thank you so much. It's great to be here.

Dr. Hedberg: So, we're going to be talking about your new book, "Why Can't I Keep Up Anymore?: A Guide to Regaining Energy, Focus, and Peak Physical & Sexual Performance for Men Over 40," which I read recently. It's an excellent book. Wanted to have you on and talk about something that is...well, I would say most male issues are overlooked, but testosterone is really a big one and so is sexual performance and male hormones. So, why don't we begin by talking about why testosterone is so important for men?

Dr. Matthew: Yeah. You know, hormones, in general, play a big role in how we feel on the inside, how we relate to the world around us, how we react to other people. And so, testosterone drives a lot of how men feel and even behavior, and it really plays a role in men feeling like a man. So, it's important for drive and for motivation so that when you wake up in the morning and your boots hit the floor, you're ready to take on the world. And when testosterone levels are not quite right, men just don't quite feel right. And for women, when we go through our hormonal changes, it's pretty obvious. We either get menstrual problems or, you know, we get hot flashes. And so, there's some pretty obvious things that happen at some pretty obvious times in our life in order to notify us that our hormones may be changing. But for men, it's much more subtle.

So, it is something that often happens gradually over time. And so, what I hear men say a lot is, you know, "I just don't quite feel like myself anymore. I'm just not quite keeping up the same way that I used to. But you know, maybe it's just my age." I hear that all the time, "It must just be my age. I'm not 18 anymore." And so, you know, maybe it's not fair to compare to an 18-year-old, but if you're 40 or 50, like let's not blame it on age. If you're 95, okay, fine. We'll blame it on your age. But when you're younger, even though things change, they don't have to feel that way. And so, one of the things that could be contributing to not quite feeling like yourself anymore is low testosterone.

Dr. Hedberg: One of the things I see in practice is men who, you know, they're diagnosed with low testosterone or they have the symptoms and they see their conventional medical physician and they try a testosterone, but it doesn't work at all. Sometimes they get a little bit worse. Sometimes there's really no change. What do you think the conventional medical approach is missing when something like that happens to a man?

Dr. Matthew: Oh, am I ever glad that you asked this question because this is what we deal with all day every day. So, if all we do is replace testosterone with topical gels or whatever it is, some men do feel better, like you said, some don't really feel better because there's a whole lot of factors that affect why the testosterone was low in the first place and how that new testosterone is going to react in your body. So, it's, first of all, important for us to have some basic understanding of why the testosterone was low in the first place. So, again, like if you're 95, we're going to blame it on your age. But we see low testosterone in younger and younger men. We have men in their 20s in the practice that have low testosterone.

And so, you know, if a man is in his 40s or in his 50s and testosterone is low, we still want to think about the why behind it. And there's a whole bunch of reasons you know, that I'd be happy to talk about because I think that's important. But there is lab testing that we can do to get a better understanding of the why's behind it. And then what we'd love to be able to do is address some of those factors, because if we can correct the factors causing the testosterone to be low, then there's an opportunity for the testosterone to get better even maybe without the testosterone replacement. So, that's one thing is we want to know the why behind it.

And then the next is when we're giving a man testosterone replacement, we need to make sure that it's going to work properly in their body. So, one of the things that I see, not that uncommonly is testosterone naturally, it gets converted into estrogen to some degree in all men and that's normal, but for some men, the problem is that the testosterone gets converted too much into estrogen. And there's a list of reasons why that may be, diabetes, obesity, especially like that belly fat, or inflammation in the body.

So, if a man is making testosterone into estrogen at a greater rate than they should, then the testosterone will be low and the estrogen will be higher than it should. So, now, if their doctor measures their testosterone level, finds it low, gives them more testosterone in the form of a gel or shot or whatever, then as the testosterone level goes higher, the estrogen level just goes higher too. And so, the relationship or the ratio between testosterone and estrogen is important because too much estrogen doesn't feel good for a man. So, the testosterone level might look better on their test, but they don't feel better because estrogen is getting in the way. So, that's another reason why they may not feel better even if they're on testosterone and even if their lab value goes up.

Another thing that I see that's a problem is that it's actually difficult to get an accurate testosterone blood level for men who are on topical testosterone gel, which is the most common way of giving testosterone. So, it matters how many hours it's been from when you applied the gel to when you get your lab done. So, if you get up in the morning and if a man puts the gel on, say at, you know, 8:00 a.m. and then goes to the lab and gets the lab tests done at 10:00 a.m. their level's expected to be quite a bit higher than if they went on the way home from work at 4:00 p.m. Or if they put the testosterone on their arm and then somebody sticks a needle in their arm right through the spot where they rubbed the gel, then the level could be quite high.

So, it makes it difficult to really accurately dose it based on a blood test, and you know, a lot of doctors have recognized it's not quite so perfect and it's not quite so accurate. So, they let men sit with relatively lowish levels of testosterone so that even though they're taking the testosterone, as long as their lab test isn't ridiculously low, they're told that it's fine, even if it's not that great. So, there's a bunch of reasons why just because you've been handed a prescription for testosterone and just because you've been applying it properly that it's not really doing all the things that it's supposed to be doing.

Dr. Hedberg: Right. And that's kind of the issue sometimes with conventional medicine is just looking at a single hormone and then taking a single approach when obviously everything is connected. So, one of the other things that I'll see sometimes is I might actually see elevated testosterone. It could be elevated total and elevated free testosterone, but they're not on testosterone and they have all the symptoms of low testosterone. And I might also see the sex hormone binding globulin is actually elevated. Can you talk a little bit about what might be some of the issues with that particular picture?

Dr. Matthew: So, sex hormone binding globulin that you mentioned is a protein in the bloodstream that attaches to testosterone and kind of carries it through the bloodstream. So, sometimes I describe it it's like a bus and that loads up all the testosterone molecules onto the bus so that it can't be used, and the only testosterone that your cells can use and feel is the testosterone that's free or you know, the stuff that's walking, no room for it on the bus. So, when men have a high amount of sex hormone binding globulin, a whole fleet of buses, then they can bind up most of the testosterone and there's not much left for their cells to use. So, the vast majority of the testosterone gets loaded up on the buses there's hardly any left for when they're walking.

And with age, sometimes SHBG or sex hormone binding globulin levels go high. So, for whatever given amount of testosterone a man has, like the total amount, like you said, it could even be, you know, nice and generous, but if it's all bound, if it's all on the bus, then they can't use it. So, they don't feel better. They have all the symptoms of low testosterone, but they're told that everything is normal, and that can be really frustrating. And one of the things actually that makes that sex hormone binding level go high is when men have a higher estr

In this episode of Functional Medicine Research, I interview my friend and colleague Cass Nelson-Dooley, M.S. in a discussion on how to heal your oral microbiome. Cass recently published the book "Heal Your Oral Microbiome" and we discussed many important topics about this often overlooked health issue. We discussed what conditions may be connected to a dysbiotic oral microbiome, how oral microbiome dysbiosis affects your health, health sweeteners, strategies to heal the oral microbiome, testing, dental products and more. If you're struggling with healing your gut or have a health issue that won't resolve, your oral microbiome may be the missing link.

Full Transcript on How to Heal Your Oral Microbiome

Dr. Hedberg: Well, welcome, everyone, to "Functional Medicine Research." I'm Dr. Hedberg. And I'm very excited today to have my friend and colleague, Cass Nelson-Dooley, on the show. And Cass studied medicinal plants in the rainforests of Panama in 2003 as a Fulbright Scholar and then launched a career in science and natural medicine. She researched the pharmacology of medicinal plants at the University of Georgia and AptoTec, and then joined the innovators at MetaMetrics clinical laboratory and Genova. She enjoys teaching, presenting, writing, and researching how to address the underlying causes of disease, not just the symptoms.

She has over a decade of experience teaching doctors about integrative and functional laboratory results. In 2013, she started Health First Consulting, a medical communications company with a mission to improve human health using the written word. She created innovative videos and patient education handouts to improve practice efficiency and motivate patients. Miss Nelson-Dooley is the author of the book "Heal Your Oral Microbiome," which we'll be focusing on today. And has published case studies, book chapters, journal articles about natural medicine, nutrition, and laboratory testing. Her website is healthfirstconsulting.com. Cass, welcome to the show.

Cass: Thank you, Nick. So happy to be here.

Dr. Hedberg: Yes. It's been a while. We were just kind of reminiscing about the days at MetaMetrics and I read your new book, "Heal Your Oral Microbiome." So, I was excited to have you on about that because no one's really talking about it. So, why don't we talk about, kind of, the foundation of what we're talking about here, which is periodontal disease? And so can you just talk a little bit about what that is?

Cass: Sure. Sure. So, yeah, it's great talking with you after all these years and in the starting out, getting to know you in the functional lab industry. But, yeah. So, this book was a really fun book to write, especially from the jumping-off point of gut health, right, which is kind of a central tenet in functional medicine. And that's some of the testing that we used to talk about years ago. So, so much of what we know about the gut really just perfectly translates to the mouth. And periodontal disease, you know, I kind of like to just simply say that it is a dysbiosis. It's an oral dysbiosis that...and an aberrant or an over-reactive immune response to that dysbiosis.

So, one of the fascinating things, when I was writing this book, was realizing that so many of the things that plague our mouths are really just dysbiosis, you know, which we talk about all the time in regards to the gut. So, periodontal disease is an imbalance of oral bacteria that triggers an immune response that attacks and destroys bone and teeth. Cavities are a bacterial dysbiosis in the mouth. Root canal infections are bacterial imbalance in the pulp of the tooth. And then you can get cavities on the root of a tooth, which is, again, dysbiosis. So, it was pretty fun to realize, wow, all of these problems just go back to the oral microbiome and we just need to try to rein in that oral microbiome and make it healthier in order to prevent these diseases.

Dr. Hedberg: Yeah. And when you think of the microbiome, most people think of the gut, beginning with the stomach, but there's a microbiome almost everywhere. Like you point out in your book, the sinuses, the mouth, you know, everywhere and...

Cass: The skin.

Dr. Hedberg: ...the skin. Yeah. So many places. Anywhere there's a cavity. So, it's not just the gut. And, you know, really, people are not talking about the oral microbiome. They'll look at, you know, stool analysis results and just think about the intestine or the stomach, or they talk to the patient, and they're just thinking about their symptoms in relation to the gut. But the oral microbiome, I mean, it has just a significant impact on everything downstream going into the stomach, small intestine, and the colon. So, why do you think this isn't a bigger issue? Why aren't more people talking about it?

Cass: Well, I think it's coming. I think we're just at the front edge of it. I mean, the gut has been in the spotlight. The gut microbiome has really gotten a lot of attention over the last decade or two, at least, if not more. So, I really just think it's a matter of time. I mean, this book, "Heal Your Oral Microbiome," is the first one on the topic. So, I mean, people certainly know about the oral microbiome and talk about it. And I would argue that this is what dentists are working with on a daily basis is the oral microbiome. But no one had written a book about it before. And that was kind of neat that the publisher saw that opportunity, you know, that the time was right for this topic.

The oral microbiome is second in biodiversity only to the gut. So, I mean, it really is time to talk about it. It's time to talk about the oral microbiome. And I think for anyone who has been interested in functional medicine or practicing functional medicine, it's just kind of a natural next step. It just kind of needs to be folded in, like, instead of thinking of the gut as, you know, the stomach and downward, we need to think of it as starting at the mouth.

Dr. Hedberg: Right. Right. Many years ago, I was reading an interview with the gastroenterologist who wrote the book "The Second Brain." I'm blanking on his name now, but they asked him what he thought of the idea of leaky gut and he said leaky gut is garbage. That's just quackery. And now we have, you know, so many published papers on leaky gut. And so it's a real thing now. And you talk about leaky mouth, which I thought, you know, is really interesting. So, can you expand on that?

Cass: Sure. And this is something that, you know, I have written about and mentioned and other dentists, I know Dr. Mary Ellen Chalmers had mentioned it, kind of, in passing years ago. This is just, kind of, an idea and I think it's something that various of us have come to on our own because it's just an extension of the leaky gut idea. But the lining of the mouth is very similar to the lining of the gut. And we know that, actually, it's a little bit more porous, a little bit more porous than the gut lining. And we do know that just even in a healthy person when they chew or brush their teeth or get a dental cleaning, of course, anything like that, when they eat a meal, they develop some bacteremia from that, you know, kind of, action, that disruption in the oral microbiome. So, the bacteria from the mouth go through the oral lining and the mucosal lining and get right into the bloodstream, so, even in a healthy person. So, you know, it's like, okay, we've got that barrier there.

So, what about someone with gingivitis? What about someone with cavities or a root canal infection that hasn't been addressed or periodontal disease? What happens when they brush their teeth or eat or get a dental cleaning? That's dysbiotic flora going right into their bloodstream. So, I think the concept of a leaky mouth, you know, when there is oral disease, I think this is a really big thing we need to consider. I mean, we know that oral bacteria flood into the bloodstream. We know that we can find oral bacteria in the joints or in the heart or in arteries or, you know, in various distant sites from the mouth. So, I mean, we really want to have a healthy microbiome in the mouth because that barrier is not...even in a healthy person, it's not a watertight barrier. Things pass through it.

Dr. Hedberg: And, you know, cavities and gum disease and things like that is basically what you're talking about in the book is dysbiosis in the mouth. So, if someone has one of those or it's happening all the time, why don't we get into what they can do to begin to shift their microbiome in the right direction?

Cass: Sure.

Dr. Hedberg: What would you say is the biggest way to begin that shift?

Cass: Yeah. So, I mean, for me, it's diet every time, you know, kind of we are what we eat, right? And our microbiome is what we eat. And this is, again, such an easy jump to make from integrative and functional medicine because we already know how critical the diet is to the whole body health. So, it's, you know, going into a healthy diet, meaning, you know, no sugar, no refined carbs, no packaged foods like breads and cookies and, you know, pasta and things like that and, really, working toward a whole foods, plant-based diet with plenty of fiber if a person can tolerate that if there isn't a gut dysbiosis they're managing. But, yeah. So, a healthy diet, I think, is one of the best ways to shift the oral microbiome and even things like, you know, in greens, you know, leafy greens and beets. I mean, it's so interesting the foods that our oral microbiome really likes, you know, and thrives off of. So, lots of veggies and fiber. That's really, you know, how the microbiome evolved with us, we would be on that type of a diet.

But that's not all. There's a lot of other things to do to improve the oral microbiome. I mean, since writing the book, I'm a big fan of oral probiotics, especially...Hold on one sec. Oh, yeah. Excuse me. Oral probiotics are really great....

In this episode of Functional Medicine Research, I interview dietician Tracey Long in a deep discussion about how to overcome mold and biotoxin illness. Tracey has firsthand experience with mold and biotoxin illness so she brings a unique and valuable perspective to this topic. We discussed Tracey's personal journey with mold and biotoxin illness, how to test your home for mold, lab testing, associated conditions, symptoms, and management strategies to get well.

Full transcript on How to Overcome Mold and Biotoxin Illness

Dr. Hedberg: Well, welcome, everyone, to "Functional Medicine Research." I'm Dr. Hedberg. Really excited today to have my good friend and colleague, Tracey Long, on the show. Tracey is a registered dietician, with specialty certification training in Integrative and Functional Medical Nutrition Therapy and The Bredesen Protocol to End Alzheimer's. She owns a private practice, Big Picture Health in Hendersonville, North Carolina, where she sees clients via video consultations. She specializes in working with clients with neurodegenerative conditions, biotoxin illnesses, gastrointestinal conditions, and nutrigenomics. She is a published author and teaches health coaches for Chris Kresser's Health Coach Training Program. Tracey's education includes a master of public health, an emphasis on nutrition and exercise physiology from the Colorado School of Public Health, where she studied under Dr. Loren Cordain who many of you may know as the author of "The Paleo Diet." And she's also a registered yoga teacher and certified exercise physiologist. Her personal interest include hiking with her husband and dog, urban farming, teaching yoga, foraging for mushrooms in the mountains of Western North Carolina, growing medicinal herbs and produce, paddleboarding, and visiting her three grown daughters in Colorado. Tracey, welcome to the show.

 

Tracey: Thank you so much, Nik. I'm so happy to be here with you today. Really appreciate the opportunity.

Dr. Hedberg: Yes. Yeah. It's gonna be fun. So why don't we begin by talking about your personal journey with mold? And that's gonna be the topic of today, mold and biotoxin illness. So why don't you share your personal journey?

Tracey: You bet I'd love to. And really, my personal journey, Nik, really started with a professional journey in that I became very interested in neurodegenerative conditions and I completed Dr. Bredesen's training, as you mentioned, The Bredesen Protocol to End Alzheimer's. And Dr. Bredesen has sub-categorized underlying causes of Alzheimer's, and one of those underlying causes he refers to as type three Alzheimer's that's really related to toxins. And he's identified three categories of primary toxins. The first one is heavy metals and the second one is biotoxins. And in that category, biotoxins, certainly, mold is included and also tick-borne illnesses. And now even recently we've added COVID-19, especially from the standpoint of, you know, people who have had COVID-19 and they haven't recovered. You know, we're referring to them as long haulers. And I bring that up. I'll tie that all in in just a minute. The third type of toxin Dr. Bredesen addresses are organic compounds. So there are things like herbicides and pesticides, things that we can be highly exposed to in the environment. It was interesting in that journey that I had that training and I started working with clients with all the subtypes of Alzheimer's, little did I know that I would end up having my own personal experience. So I was assisting clients who had been exposed to mold, certainly, and then we ended up moving to North Carolina. It's in the South. It's very moist here, as you know, I know you live here too. So, you know, we've had a year of record rainfall here.

So I moved from Colorado, which was very hot and dry to the Southeast, which is living like in the tropics, really. We're living in a rental house. And when we found the house, we were really excited because, for a rental, it looked really great on the surface. We just thought, "Wow. We found such a treasure in this house." And I was able to set up my office in the basement, which happens to have...it's kind of a partial basement, so it's got some really nice natural light and big windows and I thought, "Oh, even for a basement office this is just great." And got set up and started working. And after living in this house for about five months I just gradually started to get sicker and sicker. And it's interesting that even though I was assisting clients who had biotoxin illness, and especially mold illness, certainly some people with tick-borne illness as well, it's almost like I couldn't see it in myself. And that rings true with people with biotoxin illness, the impact that it has on us neurologically can really impair our ability to think and process information. And so I certainly was becoming more cognitively imperative myself. I ended up gaining about 20 pounds almost overnight, which really bothered me as a dietician because I practice what I preach. I eat a whole foods, paleo-based diet and, you know, a big exercise fiend, and I hadn't changed anything. So I'm just like, "Where the heck did this 20 pounds come from?" And then as I continued to get more sick, I suddenly was like not sleeping, like, I mean literally not sleeping. The insomnia was horrible, then exacerbated by hot flashes. And so I just continued down this decline.

I had to cut my work back by at least half. I really was becoming dysfunctional. And then this profound fatigue set in where I almost...I would be sitting at my desk working and I would get hit with this fatigue where I almost just had to, like, lie down in the floor. I didn't have enough strength left in me to up the stairs and, you know, lie on the couch or even get in my bed. And I would curl up on the floor in my office and just fall asleep for two hours, you know, and it was really at about that point that I just thought, "My gosh, what is wrong with me?" And so I ran the tests on myself and discovered that I had really high mold levels. And we started... We had our home inspected. Our landlord happened to be very much on board with that and very supportive, and we found some pretty significant high levels of very toxic mold growing in this house kind of underneath the surface.

So I ended up leaving the home for about three weeks, my husband, who was not feeling, you know, the drastic health issues. And I would love to talk about that too, Nik, in that you can have people in the same household who, you know, one person can be very sick or a few family members, very sick, and then other people not sick at all. And we have theories around why that's happening. But luckily, my husband maybe was experiencing some hormonal dysregulation and some issues, but I was able to go back to Colorado and stay at a friend's house for three weeks. And our landlord's very fortunate because my husband's very handy and he was able to do a bulk of the remediation to making the house at least safe for me. And I didn't mention too that I'd also kind of spontaneously developed asthma, which I never had in my life.

So it was interesting, you know, just getting out of the house and, you know, being in that safer place in Colorado, my asthma just went away immediately and I'd had to go... I went to see a doctor and I was using an inhaler here in North Carolina. And so I instantly started feeling better when I got out of this environment. But I ended up coming back and I was able to help my husband with some of the remediation. It really took us about three months total. And it's been a journey. I mean, this has been really going on about a year and a half. And I would say that I'm about 80% improved, but I still have a little ways to go. So mold really did a number on me. Yeah. That's an overview for you.

Dr. Hedberg: The immune system remembers, that's one of the difficult parts about it. And you mentioned testing. So what does that look like for people if they suspect that they have a mold issue? Why don't we start with home testing? Are there regional labs that will do this? Or is there, you know, a standard test people can get?

Tracey: You know, that it's a tricky area to work in because it's relatively new. And, you know, I don't mind sharing with you that I've done a deep dive. I love learning. And then when something like this happens, I think, you know, "I wanna advocate for myself and my clients." So I've recently attended three big deal mold conferences. I mean, it was really bringing the best in the world to these conferences and they were presenting on this very issue. And I mean, I do wanna come back to something you said, you know, how does someone, if they suspect they have mold, how do they start testing? And I wanna answer that question, but I would like to circle back around to how does someone know or how would they suspect they might have a mold issue? So I I'd like to come back and speak to that in a minute.

Right now, we could really look at this two different ways. You could start by testing your home or if you suspect that you have mold illness, you could test yourself. And our best tests right now are urine mycotoxin tests. So think about it this way. Mold is an organism. I think we're all familiar with it. We can picture mold growing on yogurt or bread, and it's white, or green, or blue, and it's fuzzy. So when mold grows, it needs substrate, like in the case of bread, that works. And then it also needs moisture. So if you have those two things combined, you can grow mold, but mold makes spores. Spores are very tiny and they can float around in the environment. I mean, just walking through a room or having your HVAC system running and circulating air, these spores will filter all throughout, you know, the area and then they can land on surfaces. And if those surfaces have dirt or substrate like wood and then also moisture,...

The Paleo Diet is a popular diet that can work well for many chronic diseases, especially autoimmune diseases like Hashimoto’s disease. However, the Paleo Diet can be somewhat restrictive which can result in deficiencies if the dieter doesn’t carefully review their food and micronutrient intake. Iodine is one important micronutrient that may become depleted on a Paleo Diet. The Autoimmune Paleo Diet is an even more restrictive diet so the same deficiency may happen.

Let’s review what the research shows about the Paleo Diet and iodine deficiency.

A paper published in the European Journal of Clinical Nutrition entitled, “A Paleolithic-type diet results in iodine deficiency: a 2-year randomized trial in postmenopausal obese women” sheds some light on this question.

Introduction to this study on the Paleo Diet and iodine deficiency

This study was done in Sweden and the authors begin by stating >50% of iodine intake comes from iodized table salt followed by dairy and seafood. The Paleo Diet is void of dairy, grains, legumes, refined sugar, processed oils, and salt thus removing two important sources of iodine. 150 micrograms of iodine per day is recommended by the Nordic Nutrition Recommendations (NNR) but the thyroid can function at 70 micrograms of iodine per day.

Urinary iodine concentration (UIC) by spot urine is recommended for determining iodine status. Adequate iodine intake is a UIC of 100-199 ug/l. Mild iodine deficiency is a UIC of 50-99 ug/l. Moderate iodine deficiency is 20-49 ug/l. Severe iodine deficiency is <20 ug/l.

However, the authors do state that the best way to measure iodine status is a 24-hour urinary iodine excretion over multiple days.

The authors point out that those at greatest risk for iodine deficiency include pregnant or lactating women and vegans.

How was this study done on the Paleo Diet and iodine deficiency?

This was a randomized controlled trial consisting of one group following the Paleo Diet and the other following an NNR-based diet for two years. Urine and blood samples were collected at baseline, 6-months, and 24-months. Testing included 24-hour urinary iodine concentration and excretion as well as thyroid hormones.

24-hour urine was collected on three separate days. TSH, Free T4, and Free T3 were the thyroid hormones tested.

70 post-menopausal women were included of which 74% were obese and the rest overweight. 49 subjects completed the study of which 22 followed the NNR diet and 27 followed the Paleo Diet.

What were the study results?

Women following the Paleo Diet totaled a weight loss of 10.7% compared to 7.7% in the NNR group.

The Paleo Diet group developed iodine deficiency but the NNR group maintained normal iodine status.

TSH, Free T4, and Free T3 levels did not differ between the groups at any time except for Free T3 levels declined after 6 months in the Paleo Diet group.

The author’s conclude that pregnant women should avoid the Paleo Diet because iodine deficiency can cause impaired brain development of the fetus.

The weakness of this study is the 30% drop out rate but the authors state that they don’t believe this affected the results because those most likely to adhere to the diets remained.

Dr. Hedberg’s Comments

This study was done well but a larger group would have provided stronger results. 24 months is an adequate time to assess micronutrient deficiencies from dietary interventions.

The Paleo Diet group did lose more weight but when you look at the NNR recommendations you’ll see a much higher carbohydrate intake of 60% compared to the Paleo Diet group who only consumed 30% carbohydrates. These women were obese or overweight, so they were insulin resistant which means that they won’t do well on higher carbohydrate intake. The Paleo Diet group also consumed 30% protein compared to just 15% in the NNR group.

The decline in Free T3 on the Paleo Diet is due to the lower carbohydrate intake which isn’t necessarily a bad thing as long as each individual doesn’t develop symptoms of hypothyroidism. T3 is going to change based on caloric intake and carbohydrate intake so if you lower either one of those variables you’re T3 levels will decline. TSH and Free T4 levels remained stable indicating the hypothalamus was comfortable with the changes in calories and carbohydrates.

How should you get iodine on a Paleo Diet?

If you have Hashimoto’s disease, you may have been falsely scared about iodine. You must have some iodine to maintain healthy thyroid function. You just don’t want excessive amounts of iodine. 150 micrograms a day of iodine from food or a multivitamin is fine for most people.

I recommend an unrefined Celtic sea salt product from Selina Naturally called Gourmet Seaweed Seasoning which is basically unrefined sea salt with some seaweed added. A ¼ teaspoon contains 375 mcg of iodine so just use a little here and there throughout the week to get enough iodine if you’re following a Paleo Diet or Autoimmune Paleo Diet. Although iodized table salt will prevent iodine deficiency, this is strictly sodium chloride which isn’t real salt which may result in many long-term health consequences. You could also increase your consumption of seaweed products but be careful of where they are sourced because our oceans are becoming more and more polluted.

Always remember to work with a healthcare professional if you’re going to follow a specific diet, so he or she can help you identify deficiencies that may arise. I have seen many patients who come in to the practice with multiple micronutrient deficiencies due to restrictive dieting.

I would like to report on the new product GI Meal Select from Moss Nutrition. With the increasing prevalence of gut disorders, we need more strategies to help patients get well quickly and effectively. GI Meal Select has been carefully formulated to address many aspects of gut healing in an affordable and effective product.

GI Meal Select is designed to provide optimal nutrient sustenance so it can act as a stand-alone meal replacement. It is easy to digest, pleasant tasting, and reasonably priced. One of the issues with many meal replacement products is the carbohydrate and fat content which can cause gut issues like gas and bloating so this product has almost completely eliminated both.

It also contains no protein powder such as whey and pea which most people with gut issues can no longer tolerate. Instead, it uses the Reginator amino acid blend to maintain muscle mass and promote tissue repair.

Resting the digestive organs can be paramount in helping to enable proper gut healing and repair, provided there is an ongoing presence of protein building blocks (essential amino acids) to prevent tissue breakdown, and sufficient micronutrient cofactors to enable enzyme function and structural support. GI Meal Select provides these requisites along with two targeted gut health nutrients: a potent 2 grams of immunoglobulin rich IgY Max plus 1.75 grams of pure L-Glutamine, the primary fuel of enterocytes (cells lining the digestive tract).

All the nutrient components in GI Meal Select are provided in their basic, predigested or “elemental” forms, taking a great burden off the digestive organs. In this sense, GI Meal Select offers restorative and reparative benefits similar to those of elemental formulas. However, GI Meal Select is very low in calories and free from added carbohydrates and fats, macronutrients which may trigger symptoms in GI patients. Individuals who do tolerate fats may be advised to add one teaspoon of a liquid omega-3 supplement such as EPA/DHA HP Select (high potency fish oil), Icelandic Cod Liver Oil (also a good source of vitamins A & D3) or flaxseed oil to their GI Meal Select shake.

While not appropriate for extended use as the sole source of daily nutrition, GI Meal Select can be taken one or more times per day, as directed, in place of a regular meal or between meals. By allowing the digestive organs to temporarily rest, removing dietary components that feed gut microbes, supplying the body with elemental nutrition and directly nourishing the gastrointestinal tract with immunoglobulins and amino acids, GI Meal Select may help to promote repair of the intestinal lining, decrease the severity of inflammatory GI conditions, diminish the incidence of small intestine bacterial overgrowth (SIBO) and help to reset overall gut health, structure and function.

A COMPREHENSIVE MULTIPLE VITAMIN/MINERAL Each serving of GI Meal Select contains a complete array of vitamins and minerals. Fat soluble vitamins A, D3, E and K2 help to heal mucous membranes and support healthy immune function, bone and vascular health. B-complex vitamins in bioactive forms, featuring methylated folate and B12, and vitamin B6 as P-5-P, promote healthy energy production, detoxification and nerve cell transmission. Buffered vitamin C is gentle on the stomach. Full spectrum minerals,

In this episode of Functional Medicine Research, I interview Dr. Sam Yanuck in a discussion about his latest paper on COVID-19, written with co-authors Drs. Joseph Pizzorno, ND, Helen Messier, MD, PhD, and Kara Fitzgerald, ND.  Their excellent paper outlines a phased approach to COVID-19 with specific strategies on prevention, management throughout the infection, and into the recovery period.  Dr. Yanuck has an erudite understanding of the immune system which you'll find to be extremely useful in navigating this virus.

Disclaimer

None of the information contained in this podcast and transcript should be construed as medical advice. This information is for educational purposes only. Please consult your licensed medical professional about everything related to this topic.

Below is a transcript of the interview with Dr. Yanuck on a phased approach to COVID-19

Dr. Hedberg: Well, welcome, everyone, to Functional Medicine Research. I'm Dr. Hedberg. And I'm really looking forward to my conversation today with Dr. Sam Yanuck. And Dr. Yanuck is the CEO and Director of Education for cogenceimmunology.com. It's an online functional immunology course whose growing community includes nearly 5,000 clinician participants from more than 60 countries around the world. He's an adjunct assistant professor in the program on integrative medicine in the Department of Physical Medicine and Rehabilitation at the University of North Carolina School of Medicine where he teaches topics in functional immunology. Dr. Yanuck is clinical director of the Yanuck Center for Life and Health, a functional medicine clinic in Chapel Hill, North Carolina where he sees patients with complex autoimmune disorders and other immunologically challenging cases. Dr. Yanuck has been seeing patients from everywhere since 1992. He also provides online consultations to clinicians around the world. And you can connect with the Yanuck Center at yanuckcenter.com. And today, we're gonna be talking about Dr. Yanuck's paper and his colleagues. They recently published a functional medicine perspective on COVID-19. And that paper is entitled "Evidence Supporting a Phased Immuno-Physiological Approach to COVID-19 From Prevention Through Recovery." Dr. Yanuck, welcome to the show.

Dr. Yanuck: Thanks, Dr. Hedberg. It's a pleasure to be here.

Dr. Hedberg: Great. So, this is an excellent paper outlining four phases of approach to COVID-19. Before we jump into those phases, why don't we just talk a little bit about who is at the greatest risk of developing COVID-19? And what would make someone at a greater risk for contracting the virus and having a difficult time with this particular virus?

Dr. Yanuck: Sure. Well, this is really a moving multifactorial equation. There are ways that a person can be surprisingly predisposed to having a severe case of the illness that may not be obvious. Those are kind of wild cards that relate to things like antibodies against interferon, and so on. And so the challenge here is that we can come up with a sensible sort of view of who is and is not at higher risk, and yet, it's important to understand that those views, those descriptions are going to be inherently imperfect because of this wildcard effect where there are cases that have been characterized where the idiosyncrasies of a person's own diminished capacity to kill this kind of virus may only become apparent when the person is in the ICU, when the person gets the virus. And despite the fact that there are,

“Adrenal Fatigue” is a term used for many years by alternative medicine practitioners but does it exist? This is certainly a term that I have used for some time but not in the way that most practitioners use it. I will use terms at times that are widely searched for on the internet so that I can spread the science behind these terms but it doesn’t necessarily mean that I endorse the term or subscribe to the existence of a condition.

There are a few published papers that tackle this very issue that I’ll cover in this article on “adrenal fatigue”.

What does the research show about "adrenal fatigue"?

The first paper I’d like to mention is entitled, “We are tired of ‘adrenal fatigue’” by Ross et al. The title of this paper quickly gives you the underlying frustration of the authors about this term. This paper is a position statement and not a clinical trial, review, or analysis of any kind. The authors begin by outlining the adrenal fatigue theory and that is doesn’t exist as a defined medical condition.

The authors do point out a valid adrenal disorder called adrenal insufficiency which is characterized by insufficient cortisol production after an adrenocorticotropic (ACTH) hormone stimulation test. They also mention Addison’s disease which is true adrenal failure.

Interestingly, those who suffer from fatigue actually showed a greater rise in cortisol with an ACTH stimulation test which indicates excessive cortisol production not insufficient cortisol production in those with adrenal insufficiency.

And another study actually found no difference in salivary cortisol levels taken throughout the day in two-thirds of healthy subjects compared to those who suffered from fatigue.

Dehydroepiandrosterone sulphate (DHEA-S) has also been used as a marker for adrenal fatigue but research has shown this to be unreliable.

The most recent systematic review of adrenal fatigue is entitled, “Adrenal fatigue does not exist: a systematic review” by Cadegiani and Kater. The authors searched 3,470 published papers but only 58 of them fulfilled proper criteria for evaluation. Of the 58 studies, only 10 actually used the term “adrenal fatigue” but none of them did any kind of testing to validate this false condition. Some studies tried to use the term “burnout” instead of “adrenal fatigue” but no scientific evidence was presented in these papers.

None of the studies in the above review were able to validate any of the functional tests used to assess adrenal hormone production including cortisol and DHEA. Additionally, no valid information was found in these tests to assess HPA axis dysfunction which is one of the hallmarks of “adrenal fatigue”.

The authors rightly point out that anytime there is a suspected issue of HPA axis dysfunction, the following must be ruled out as a cause of this dysfunction:

1. Sleep apnea

2. Adrenal insufficiency

3. Mental illness

4. Overwork

5. Night-shift workers

6. Other hormonal imbalances

7. Liver and kidney dysfunction

8. Heart conditions

9. Lung disease

10. Autoimmune disease

Some alternative practitioners are not adequately assessing each patient for the above list of potential issues and jumping into treatment of “adrenal fatigue”.

The authors conclude that there is no demonstrated evidence that “adrenal fatigue” is a real condition. Their two final statements are:

1. “The results of previous studies were contradictory using all the methods for assessing fatigue and the HPA axis.”

2. “The most appropriate methods to assess the HPA axis were not used to evaluate fatigue.”

It is clear from reviewing the above paper that the methodology in all the studies reviewed was very poor and did not provide any valid scientific support of “adrenal fatigue”.

What about corticosteroids?

Many integrative practitioners are prescribing oral corticosteroids to treat adrenal fatigue which can have many negative consequences. Corticosteroids will immediately improve one’s sense of well-being no matter what condition they have thereby giving the false impression that this treatment was necessary for the patient.

Corticosteroids can lead to osteoporosis, glaucoma, myopathy, insomnia, psychiatric disorders, cardiovascular disease, and metabolic disorders. It can be difficult to come off of corticosteroids the longer someone has been taking them which can be a long and arduous process. This overuse of corticosteroids is a major problem in integrative medicine today.

Dr. Hedberg’s Comments on "adrenal fatigue"

Unfortunately, I see many patients who believe they have “adrenal fatigue” either because another practitioner told them they have it or they read something on the internet that lead them to believe they have it.

There is no doubt that HPA axis dysfunction exists but the majority of the time this doesn’t lead to adrenal glands that aren’t producing enough hormones as claimed in "adrenal fatigue". Adrenal insufficiency or Addison’s disease as noted above are two real conditions that lead to very low levels of adrenal hormone production. These require specific testing to diagnose and must be treated through conventional medical therapies.

Adrenal hormone testing through combined urine and saliva such as the DUTCH test by Precision Analytical can be useful to determine if the patient has adrenal insufficiency or to investigate further for Addison’s disease. The interpretation of the DUTCH test can also help to determine inflammation and insulin resistance depending on the patterns found on this test.

If you do have HPA axis dysfunction then it can be useful to take adrenal adaptogens as outlined in my article on the best adrenal adaptogens.

I rarely do testing for adrenal hormones because this is rarely the primary issue with each patient as most of the issues that cause adrenal hormone imbalances are addressed through my treatment plans. These include things like trauma history, gut health, insulin resistance, thyroid health, metabolic acidosis, dietary factors such as protein and carbohydrate ratios, insomnia, too much or too little exercise etc. which can all stress the body and the HPA axis.

It is unhealthy to cling to a label of any condition but it is even worse when that condition doesn’t exist. If you have been told you have “adrenal fatigue” or believe that you have it, the best thing you could do for health is to let go of this label and move on to figuring out why you aren’t feeling well.

This is why it’s important to work with a functional medicine practitioner who takes a science-based approach to health so you’re not paying for unnecessary tests or supplements. You can now enjoy a new lease on life by letting go of this label and continue to focus on what is really going to help you get well.

In this episode of Functional Medicine Research, I interview naturopathic physician Dr. Ilana Gurevich on overcoming inflammatory bowel disease.  We had a deep discussion about testing and treatment options for inflammatory bowel diseases including Crohn's disease and ulcerative colitis.  We covered diagnostic testing, the pros and cons of stool test markers, probiotics, fiber, digestive enzymes and hydrochloric acid, gut healing nutrients, diets like the Specific Carbohydrate Diet, helminths, and much more.  It was a pleasure to have Dr. Gurevich's expertise on inflammatory bowel disease.

Below is a transcript on How to Overcome Inflammatory Bowel Disease with Dr. Ilana Gurevich

Dr. Hedberg: Well, welcome everyone to "Functional Medicine Research" I'm Dr. Hedberg, really looking forward to my conversation today with Dr. Ilana Gurevich. She is a naturopathic physician and acupuncturist. She graduated from the National University of Natural Medicine in 2007, with her doctorate in naturopathic medicine, and in 2008, with her masters of Oriental medicine. She is currently co-owner of two large integrated medical clinics, one in Northwest Portland and one in Northeast Portland.

She runs a very busy practice specializing in treating inflammatory bowel disease, which we'll be talking about today, as well as IBS, SIBO and other functional GI disorders. She lectures extensively and teaches about both conventional and natural treatments for gastrointestinal conditions, including inflammatory bowel disease, SIBO, and IBS. She's one of the foremost experts on the intersection of IBD and IBS and how treating one resolves the other. Dr. Gurevich also acts as a mentor in the naturopathic community, educating and consulting with physicians about GI disorders. She supervises residents and consults with doctors about their most difficult GI cases. She was nominated as one of Portland's top docs by the Portland Monthly in 2014, 2016 and 2020. So Dr. Gurevich, thanks for coming on the show.

Dr. Gurevich: Thank you so much for having me.

Dr. Hedberg: Yeah. So this is gonna be really interesting. I've heard you talk before and I wanted to have you on because you're extremely a research-based, you know, scientifically sound. And of course, you have tremendous experience in inflammatory bowel and SIBO and IBS. So why don't we just lay some groundwork? And if you could just talk a little bit about what have you found to be the real causes, the triggers of inflammatory bowel in your patients?

Dr. Gurevich: You know, it is such a multifactorial disease. So with inflammatory bowel disease, there are these two peaks of when people generally get diagnosed. The first is, you know, adolescence, right around puberty to like the mid-30s or 40s. And then the second is menopause, andropause in your 60s, 70s, 80s. And those patients tend to get found a lot just on their basic screening colonoscopy.

And so, you know, because there are these bi-modal peaks of diagnosis, it really makes me think that one of the issues is hormonal changes that happen. And, you know, we're learning more and more recently about how hormones affect the GI, mainly using the estrobolome as an example, and then how the estrobolome affects how you conjugate or process your hormones. And so there's definitely a hormonal component.

Research is also exceptionally clear that diet is a huge component. You know, in parts of the world where they don't really see inflammatory bowel disease like Africa, like Asia, when people from those countries move to a Western civilization, they start getting diagnosed with inflammatory bowel disease equal to people of the West, which means that the way that we're eating is definitively changing our microbiome, which is then causing onset of inflammatory bowel disease.

What's interesting is the opposite now is also happening as we introduce the Western diet into more diverse countries that in the past were, you know, utilizing their own natural forms of eating as opposed to processed food. Now, those countries are seeing an upsurge in inflammatory bowel disease. And so the microbiome and us killing the microbiome or shunting it is definitely causing lots of changes that then upregulate the immune response in the intestine that's causing the onset of inflammatory bowel disease.

And then there's always the mental, emotional component. You know, the majority of your neuro-transmitters from your GI, from your brain are made in your GI and so the higher stress, the higher depression, the higher changes that happen. Then there's also an upregulation, not so much with diagnosis, but definitely with flares of disease. So I have a fair amount of patients, you know, I've been at this a while, and so patients are with me for a long time and we'll have them super, super well-controlled, and then they'll go through like one of the most stressful events of their lives and then all of a sudden, they'll go into yet another flare. So that's another thing.

And then my big thing is I will...it's pretty well-documented that antibiotics and certain antibiotics in particular will cause onset of an inflammatory bowel disease flare. And so antibiotics is the fourth big pillar that I'm always educating patients about. You know, my rule of thumb is you get an antibiotic if you go into the hospital. And if not, we have ways to treat you. And generally, using all of the natural tools that we have, I can get you out of whatever you need the antibiotic for so that you don't need an antibiotic so you won't go into a flare because I have just seen it so many times when they have an abscess or they need dental work or something like that and they end up getting a flare because of the antibiotics.

Dr. Hedberg: Yeah. I see that as well, emotional traumas triggering autoimmunity. And you mentioned moving from certain countries into the West. Do you think that, you know, things like intestinal parasites or just hygiene in general has any connection with that?

Dr. Gurevich: I really do. And I really, really do, especially because I'm looking at some of the research that we've done, that we've seen recently with helminths there's that one study that was done, I wanna feel like 10 years ago that was done in Argentina. Do you know the study I'm talking about?

Dr. Hedberg: I do.

Dr. Gurevich: Okay. So he was an MS doctor. And so when their entire economic system collapsed, so did a lot of their sewage system and stuff like that. And people used to come in with helminths that they were finding and all of a sudden, their MS was going into remission. And so, yeah, I definitely, you know, there's this whole theory called this old friend theory, which is we evolved with these parasites, protozoa and worms. And because of that, when our immune system is targeted at those parasites, protozoa and worms, it's not likely to target us. And I also wanna say, I have also seen the opposite be true, which is parasites, protozoa and worms could also be causing dysfunction because they are pathogenic species. And so I've definitely seen both happen.

Dr. Hedberg: And have you seen viruses as a player? This is a, you know, one of the real areas that I focus on and I'm interested in things like Epstein-Barr and other viruses like that. Have you seen that as well?

Dr. Gurevich: You know, I think just because of how hyper specialized my practice is, I don't focus on it as much. I'm also in a relatively large integrative clinic. So if people are coming in with that chronic-infection-like picture, then generally, I'll refer them over to one of my more infectious-disease-specialized colleagues. And so, you know, I feel like when we're talking about when patients are having both going on, and their GI is, you know, they're not in a flare, I usually take a back seat and let one of my colleagues really manage the infectious disease aspect of it.

Dr. Hedberg: Excellent. It sounds like you have a really great team where you work, so...

Dr. Gurevich: I'm exceptionally fortunate.

Dr. Hedberg: Yeah. So once you've established that someone has inflammatory bowel, let's talk a little bit about lab testing. I know you've done tremendous research on this, and I'm going to assume that you're gonna be doing stool testing on a lot of these patients and some of these markers are somewhat questionable. So why don't we just talk about some of these starting with pancreatic elastase? Have you found that that is a good marker, a good test?

Dr. Gurevich: So when you were talking about working up in inflammatory bowel disease patient, you are, you know, where I usually start with is, I usually start with actually not specialty labs, but just the regular standard Quest lab labs. And if it's an ulcerative colitis patient, I'm always, before I start any treatment, I'm always gonna get a baseline.

And the baseline for UC that's been most validated is a fecal calprotectin or a stool calprotectin. This is a stool test that I will say, I don't trust specialty labs. I've seen their values go up and down. And I have a theory about it. I don't know if my theory is correct. And so I'll always run a calprotectin through one of the standard labs. It's looking for white blood cells within the intestine.

When you have white blood cells in the intestine that means there's an inflammatory response. The number, depending on how high that calprotectin is, that tells us how much of a flare they're in. And it's something like 96% predictive for equal to a colonoscopy. So that's a really good test for the large intestine. It's less so a good test for the small intestine. Efficacy of calprotectin for the small bowel is somewhere between 30% and 90% effective, depending on what study you look at.

And so what I've done recently is I've pivoted away from stool testing for small bowel Crohn's patients to a blood test that's put out by Prometheus Labs....

In this episode of Functional Medicine Research, I interview a very distinguished guest, Ethan Taylor, PhD about his published research on selenium, glutathione, and COVID-19.  Dr. Taylor has a wealth of knowledge and research experience on pandemics, selenium, glutathione, vitamin D, viruses, antimicrobial drug resistance, and how human relationships with animals causes so many of our health problems and climate change.  I was extremely grateful to have someone like Dr. Taylor on the show to share his expertise.

Disclaimer

None of the information contained in this podcast and transcript should be construed as medical advice. This information is for educational purposes only. Please consult your licensed medical professional about everything related to this topic.

 

Dr. Hedberg: Well, greetings everyone and welcome to Functional Medicine Research. I'm Dr. Hedberg and I'm really looking forward to my conversation today with Dr. Ethan Will Taylor. And Dr. Taylor is a pharmacologist, computational chemist, and virologist. He has a Bachelor of Science in chemistry from the University of Winnipeg and a PhD in pharmacology and toxicology from the University of Arizona. He began his career as Assistant Professor of Medicinal Chemistry, and later, Professor of Pharmaceutical and Biomedical Sciences at the University of Georgia College of Pharmacy. He's currently Professor of Chemistry and Biochemistry at the University of North Carolina, at Greensboro, where he has also served as a founding member of the Department of Neuroscience and as Director of the Biosafety Level 3 Laboratory. Dr. Taylor has been engaged in research on HIV, Ebola, and other emerging infectious diseases for over 25 years and is best known for his work on the role and mechanisms of the dietary trace element selenium in reducing the pathophysiological effects of various RNA viruses. He's also an amateur musician. And with his wife Maria he operates the Dharma Farm Animal Refuge and Vegan Event Center in Archdale, North Carolina. Dr, Taylor, welcome to the show.

Dr. Taylor: I'm happy to be here.

Dr. Hedberg: Excellent. Great, so I wanna have someone on the show who has some excellent expertise in some of our biggest issues today in the world. Some of this will revolve around the current pandemic as well as we'll talk about how the consumption of animals is leading to pandemics and how it's affecting our environment. Before we jump into those details, can you give us just a general overview of your research interests and the work that you've done?

Dr. Taylor: Sure. As you stated in the bio, my background was in pharmaceutical sciences. Which means you're looking at drugs and how drugs work and designing better drugs. And so, I had that kind of background and I was a pharmacy professor for 18 years. But the more I studied drugs and how they work, you come to realize that most of the drugs we have, a lot of them treat symptoms. We have some phenomenal drugs, they're really great to have when you're doing surgery on people and things like that. And many of the drugs work well but a lot of them really just treat symptoms. And I became kind of more interested in, what's really the underlying cause of this pathogenic effect. And that led me inevitably to nutrition and being interested in nutrition. And part of it was a serendipitous, almost accidental discovery that I made when I was studying HIV, that led me to this trace element of selenium that you mentioned.

And so, that has kind of been my background but I essentially evolved into this area of looking at...became very interested in antioxidants, selenium in particular and its role in viral diseases, particularly RNA-virus diseases. And along the way,