In Conversation with Dr Tom O'Bryne

Theory.

You know, these things we have still— I use it nearly every day in my talks, and I remember you.

Yes, it would be very nice to start with the same sort of story.

That's what I wanted.

Okay, well, uh, okay, thank you. Um, yeah, um, my friend and mentor and the founder of functional medicine, Dr. Jeff Bland, refers to functional medicine as a disruptive technology. It disrupts the way that we think and what we thought was the way to practice our healthcare discipline. It's completely disruptive. And as you read more and more science, it starts to make more and more sense. To look at the big picture. For example, and I did not think I'd be talking about this today, so I don't have the slides prepared for you, but the National Institute of Health in the United States identifies that 8 of the top 10 causes of death, of morbidity and mortality, are chronic inflammatory diseases. It doesn't matter if it's diabetes, or cancer or cardiovascular disease or autoimmune diseases, they are chronic inflammatory diseases. The only 2 of the top 10 causes of death that are not chronic inflammatory diseases according to the National Institutes of Health is unintentional injuries and suicide. However, we know that suicide comes from depression, and depression is a chronic inflammatory disease. So arguably, 9 out of the top 10 causes of death in the industrialized world are chronic inflammatory diseases. If we understand that basic principle, Unless a patient is coming in with an acute injury from trauma, anything else they present with is likely a manifestation of a chronic inflammatory condition. Everything that patients present with, and it— during the Q&A, I will invite our audience, if there is any condition that you know of that is not a chronic inflammatory condition, please let me know. I only know of one, and that is a sodium deficiency that will cause shrinkage in the brains of children without inflammation. Aside from that, as far as I know, every condition is a chronic inflammatory condition. And if we think about that, then the obvious question— two things happen. There are two lines of thought when we're working with our patients, our clients. The first line of thought, how do I help them feel better? The second line of thought, where is the inflammation coming from? Because if we help our patients feel better for the symptoms that they come in with, but we do not address the trigger that over time produced those symptoms, then the patient's going to come back next year with something else. Or not. They won't come back because I went to that doctor, he really didn't help very much. So we have to think from two different lines of thinking. The first is how do I help the patient feel better with their complaint? The second is, where is the inflammation coming from? From that perspective comes the waterfall analogy. When patients come into you with diabetes or prediabetes, it's like they have fallen over a waterfall into the pond below. And they swim up to the surface of the water and they spit the water out and they're trying to stay afloat in the pond of prediabetes. But the waterfall keeps falling into the pond. The lifestyle habits contributing to the blood sugar imbalances continue for that patient. The water is falling into the pond. So the pond is very turbulent. It's difficult to stay afloat. And we all have been trained to give our patients life jackets to stay afloat in the pond of prediabetes, or in the pond of chronic fatigue, or in the pond of cardiovascular disease, What kind of a life jacket can we give them with the least possible side effects to help them stay afloat so they're not suffering so much in the pond of their metabolism? But what we have to teach the patient to do— of course you give them a life jacket, of course, but then you teach them to swim over to the side of the pond, get out of the water. Walk up the hill and walk back upriver to see what fell in the river that eventually carried you downstream into the pond of diabetes. What lifestyle habits, what environmental triggers set you up, Mrs. Patient, for the symptoms that you currently have? That's the basis of functional medicine. Functional medicine is not a more comprehensive treatment approach. We all have our own unique tools that we use for treatments, whether it's, uh, nutritional protocols, pharmaceutical protocols, emotional protocols, tapping, whatever our therapeutic protocols are that we have found of value. Wonderful, but functional medicine is about teaching patients, get out of the water, walk up the hill, walk upstream, and find out what lifestyle habits threw you into the river that carried you downstream into a metabolism that has produced these current symptoms. That's the waterfall analogy, more or less. So I'm going to share my screen now because of the presentation I wanna give you today. Is a very thought-provoking presentation on the brain. Could everyone please mute your phones? Someone— I can hear a conversation. Someone is not on mute. Thank you so much. Okay, let's move along. Now, everything that I'm about to tell you is part of the training that we give to our practitioners. I will show you this information later. I just— someone's microphone is on with children in the background. Please mute. Thank you so much. I will show you that slide later and about our training programs. But everything I'm going to give you today is to just touch the surface. And we go into much, much more depth in our trainings. But this is to say, "Oh, I never thought of it that way before." So first, what is the most prevalent pathology at the root of practically all disease? And we understand if you look at the title of this paper, Chronic Inflammation and the Etiology of Disease. Across the lifespan. And we know that it's inflammation that dominates morbidity and mortality worldwide. It's inflammation. Chronic inflammatory diseases are the most significant cause of death in the world today. But most of us are so busy with giving patients life jackets, we don't think about going upstream as to How do we reduce the inflammation? Inflammation— I, I see that I do have these slides here for you today. 8 of the top 10 leading causes of death, and you can see the only 2 that are not inflammatory according to National Institute of Health is unintentional injuries and suicide. Now I recommend that you get this study and that you get— print this drawing out from the study and put it in clear plastic in your examination rooms so that you can show it to patients, because this tells the story. You see that on the right side of the screen whether it's metabolic syndrome and diabetes, nonalcoholic fatty liver disease, cardiovascular disease, cancer, depression, autoimmune diseases, neurodegenerative diseases, it doesn't matter what the presentation is. The mechanism in the development of those presentations are systemic chronic inflammation. That wheel in the center, when it turns, it turns the larger wheel on the right depending on your genetic vulnerability and the antecedents, how you've lived your life so far. That's the combination that determines where is the weak link in that patient's chain. If you pull at a chain, it always breaks at the weakest link. It's at one end, the middle, the other end. It's your heart, your brain, your liver, your kidneys. And wherever that weak link is, is determined by your genetics and the accumulated damage of how you lived your life called antecedents. And what pulls on the chain? The pull on the chain is inflammation. And here in this drawing, you see that when that center wheel turns, the wheel on the right turns and you will develop whatever weak link in your chain you have, that is where you will eventually begin showing symptoms. Now, as we look to the left, what moves the wheel of inflammation? It's chronic infections, physical inactivity, obesity, an alteration in the microbiome to where there's too many bad guys, not enough good guys. We call that dysbiosis. Food, the most common source of inflammation is what's on the end of the fork, what we are eating. Chronic stress and stress hormones, non-nourishing sleep, and a very huge problem, more so than ever before, is xenobiotics, chemicals that are accumulating in our body. Perhaps we'll have another session in the future on chemical toxicity and how bad is it and what do we do about it. But for today, this vision, when you show this to the patient, they understand about the wheel turning, the bigger wheel that eventually manifests as whatever the genetic vulnerability is. Today we're talking about neurodegenerative diseases. And it doesn't matter what neurodegenerative disease you talk about. This is from the same paper. And you see seizures, schizophrenia, depression, multiple sclerosis, Alzheimer's, Parkinson's, ALS, autism, anxiety, bipolar disorder, They are all chronic inflammatory diseases. So if someone presents with severe depression, of course you need to give them a life jacket or more than one to help them function. Of course we need to address their symptoms, but that's just the prerequisite to the treatment. If you want to correct the condition, arrest the development of that chronic inflammatory disease, we have to look at where the inflammation is coming from. And for neuroinflammatory diseases, the neuroinflammatory state does not originate in the central nervous system. It comes from chronic systemic inflammation. These are powerful concepts. On Alzheimer's and Parkinson's and depression and anxiety and schizophrenia. So when I'm with you in person, we would take a couple of minutes and just in small groups of 2 or 3 people, just talk about what neurological presenting complaints in your practice are not inflammatory. And the answers are always the same, and that is Almost all of them are inflammatory. So why are we talking about the brain? Because the brain is the canary in the coal mine. That concept is an advanced warning of danger. It originates from the times when miners would take canaries in a cage down into the coal mines, and they listened to the birds singing. All day while they were working. And if the bird was not singing, someone would walk over, and if the bird had fallen over dead in the cage, they blow a whistle, everyone gets out of that mine immediately. Because canaries are very sensitive to methane and carbon monoxide that will kill them. And it kills humans, but we have a little more of a window of opportunity before when we inhale it before it becomes fatal. So the canary stops singing, they blow a whistle, and everyone gets out of the coal mine. That concept is so true for our brains. Your brain is the canary in the coal mine of what's happening in your body because many, many people talk about that they're getting old because they're not remembering the way they used to. And we joke about it, but it's no joke. And the brain is often where you first see symptoms of systemic chronic inflammation. So we know that there's about 400 miles of blood vessels, capillaries in the brain. And the blood-brain barrier maintains the gradient between what's in the bloodstream. Your bloodstream is just a highway. You know, everything's going in the same direction, but it's just a highway and there's no lanes of traffic. We were just talking last night of how dangerous it is to drive in New Delhi. And I was saying, you know, that's one city I will never drive in is New Delhi. Because it's like the bloodstream. Everything's bouncing around into each other. And you know you got a problem when the car next to you has pulled their mirrors in. And so I said, "Uh-oh, watch out for that guy." Everything's going in the same direction in the bloodstream, everything. And the blood-brain barrier maintains the gradient so only certain molecules can get through into the brain. What are the current numbers of frequency of brain dysfunction at both ends of life? Well, we all know about the increase in autism and autism spectrum disorder. When I came into practice in 1980, it was 1 in 10,000. Now it's less than 1 in 40. Um, our children's brains are at great risk and Today is not the topic to talk about, perhaps we'll do it in the future, but it's the toxicity in mom that she's accumulated over a lifetime that these toxins impact on baby's brain development in utero. And on another session, we can talk all about that. Today, the point is more and more children worldwide are developing autism. At earlier ages. At the other end of life, the Alzheimer's Association tells us that 1 in 3 seniors will die with Alzheimer's or another dementia, 1 out of 3. This drawing comes from an advisory council meeting at Health and Human Services. From the government, U.S. government. They brought in experts to look at this thing with Alzheimer's because 3 pharmaceutical companies at that time, a couple of years ago, had already closed their Alzheimer's research departments and they laid off the researchers and the scientists. They said, we're not spending any more money on a cure for Alzheimer's. We don't think you're going to find a cure. For Alzheimer's. And so they closed the department and they fired the scientists. And so the government put together an advisory council to say, what's going on with Alzheimer's? Because it's expanding so quickly, what is the problem here? And they drew this drawing. Now, we have a normal level of antibodies to brain tissue. Why? Why would you ever have antibodies to your pituitary or to your hypothalamus or, or to your cerebral cortex? Why do you have antibodies to brain tissue? Because, Mrs. Patient, you have an entire new body every 7 years. Every cell in your body regenerates, every single cell. And the way that happens is that your immune system has to get rid of the old and damaged cells to make room for new cells. Antibodies are an important component of that process. That's why if you do a blood test for thyroid function and you look at thyroid antibodies as part of that test, there's a normal reference range with most laboratories is between 0 and 42, a normal reference range for antibodies to the thyroid. Why? Because if you're in that reference range, you're getting rid of as many thyroid cells as you're making. That's normal. But when you have elevated antibodies, when the blood test comes back and says they're elevated, you're killing off more thyroid cells than you're making by definition. And we're going to talk about blood tests of antibodies to the brain. When you wanna measure inflammation in the brain. So we have a normal level, antibodies attack all of our human tissue, all of it, your muscles, your joints, your heart, your collagen, your hair follicles, your skin. We have antibodies to all of it, that's normal. But when you have elevated antibodies, you're killing off more cells than you're making. Now, what contributes to the elevation of antibodies? We know that food sensitivities, infections, bacteria, viruses, environmental exposures, when you lose tolerance to an emotional, too many stress hormones, structural problems, that when you have so much exposure creating inflammation in your body, eventually your immune system trying to protect you is going to try to get rid of that insult, whether it's dairy or gluten or DDT or PCBs. When there's too much accumulation of this insulting chemical, Your immune system makes antibodies to get rid of the DDT, to get rid of bisphenol A, to get rid of mercury, to get rid of lead, to get rid of gluten, to get rid of dairy, doesn't matter. Your immune system trying to protect you when the volume of the compound is too high stimulates an immune response to get rid of this toxic material. And when that happens, when you lose tolerance, now you start making elevated antibodies. And the elevate— and when these toxic substances like organophosphates in your hand washing soaps that you use, and when your organophosphate levels get too high, Organophosphates can cause a breach of the blood-brain barrier. You've heard of leaky gut, this is leaky brain. Just Google organophosphates and brain, and here come the studies that show you when you have too high a level of organophosphates or too high a level of gluten, it doesn't matter what the compound is, you start making antibodies to that substance. And the organophosphates get into the bloodstream, then they get— they cause a breach of the blood-brain barrier, they get into the brain, and your glial cells, the most potent immune cells you have, are the glial cells in just inside the blood-brain barrier. The glial cells get activated to attack this substance. It doesn't matter what it is. If it's not supposed to be there, your glial cells get activated to destroy that invader, whether it's a bacteria, a virus, a chemical, a food peptide, it doesn't matter. When the glial cells get activated and fire their chemical—

I think we lost Dr. Tom. I— he will rejoin again. Please stay muted.

The neurologist may refer them to a tertiary research center. This is a tertiary research center, neurological research center in England. And what they discovered is when the cause of a neurological disease diseases, when they can identify what the problem is, the percentage of people with antibodies to gluten is 5%. But when they can't figure out what the problem is, the percentage of people with elevated antibodies to gluten is 57%. And when they put them on a gluten-free diet, they get better. This is a tertiary neurology research center that tells us this. Why? Because IgA antibodies to gliadin, the peptide of wheat, cross-react with brain blood vessel tissue. So the antibodies to wheat attack the blood vessels of the brain and you get leaky brain. And when you get leaky brain, molecules get through that leaky brain into brain tissue that they should not get in there, but they do. That activates the glial cells, the most powerful immune cells in your body, to attack this thing, creates this inflammation to kill it, but there's collateral damage. And because you're eating wheat every day, or you've got this dormant strep infection, or you've got mercury toxicity, or you've got lead toxicity, or it's BPA because bisphenol A is in the water in plastic water bottles, whatever the environmental trigger is, it keeps coming again and again and again and again. And you continue to have leaky brain, leaky brain, leaky brain, and the glial cells are activated again and again and again and again, and the collateral damage occurs. And with the collateral damage, now you make antibodies to the brain tissue. And that is a very common mechanism in the development of neurological disease. Now, if you trust for now that these studies are accurate and accurate representations of basic physiology, which patients with systemic inflammation would you not test for a loss of tolerance to gluten if every time they're exposed they create transient intestinal permeability? Every time. Who would you not test? Meaning you test everyone just to see. Here's a case example. A 44-year-old— is someone drawing on my screen? I don't know how that's happening. We'll let it go. A 44-year-old goes to a neurologist with a 6-month history of right leg weakness, wasting, and intermittent painful spasms of his quadricep. He's having a hard time walking. In the preceding month, he also had difficulty with his right arm. He could not button the buttons on his shirt. He couldn't write very well. And when they did the examination on him, they diagnosed him with ALS, amyotrophic lateral sclerosis. Now, a family history, had a maternal aunt with celiac, a sister with Crohn's, a maternal grandmother with MS. This is a pearl for you. That's why the pearls are in the background on the slide. This is a pearl. Anytime there's a family history of autoimmune disease, always check for gluten. You, you just have to check. Are there elevated antibodies to wheat? And it's so very common to see. Here was his MRI, um, when he first came in. 2 months later, he goes back because he can't walk now. He's using a walker. And you see that his MRI, the lesions have grown in 2 months. Now he's in a walker. In the blood work, they found out that he was anemic. And they said, wait a minute, you're not supposed to have anemia with ALS. Why do you have anemia? And they discovered that he was a celiac. So they put him on a gluten-free diet. No other drugs or therapies were instituted, just the gluten-free diet. 7 months after the symptoms began. So now you know how many years did this guy have a problem going on where he felt fine until he crossed the line of tolerance, killed off enough brain tissue. Now he starts getting symptoms, right? Those lesions are developing in his brain. And you saw the speed that the lesions are progressing— 2 months. So they put him on a gluten-free diet for 9 months. Now after 9 months, his right arm is working better. He's walking. He's out of the wheelchair again. He's using a walker— a little— a cane. He's using a cane, not a walker. And, um, he can— his right hand is back to normal. He can write. He can fasten his buttons again and look at the difference in the MRIs. Look at the difference, 9 months on a gluten-free diet, no other treatment. If you tell a neurologist that sometimes you can reverse lesions in the brain on a gluten-free diet, they don't believe you. They say that's impossible. In my all-day course, I've got 5 studies and I show you the MRIs. Before and after, that sometimes gluten is the primary trigger creating the inflammation. And when you get the inflammatory trigger out of there and the inflammation comes down, the brain regenerates healthier tissue. So once again, what's under the surface? It is of critical clinical value to have valid tests identifying if the brain is suffering from chronic inflammatory conditions that eventually accumulate damage into becoming a disease. And the rule is test, don't guess, test. Now, we know that the identification of antibodies to the brain may give you not only identifying the risk of developing autoimmune diseases, but they provide therapeutic targets. And I'm going to elaborate on that for you here now. There is technology that has come out called silicone chip technology in laboratory medicine that has changed the face of medicine. And you have 97% to 99% sensitivity and 98% to 100% specificity with silicone chip technology, meaning these tests are accurate every single time. If you want to know how accurate your tests are, you have to do what I did. And let me— stop sharing screen for a minute so that I can tell you this. I can look you in the eye. I did this myself where I— when I drew a patient's blood, I took 2 tubes of blood in the one draw. And for the patient, I ordered whatever the test was I was going to order. And with the second tube, I put a fake person's name and ordered the same test and sent it to the laboratory. When the results came back, I was startled to see how different they were. They were completely different. Well, wait a minute, wait a minute. It was the same blood in the same blood draw from the same arm, but the test results were completely different. That means that the sensitivity and specificity of the tests that I was using were not very good. And I was using the primary labs. And this caused a conundrum for me for many years because I then understood— and I did that 5 or 6 times, and I had to pay for the second test myself. You don't tell the lab you're doing this. You don't tell them. And then when you see the results, It's a reality check on the tools that you have available when you're trying to figure out what's wrong with the patient. It's a reality check. You can't argue with those results. And it costs you a few hundred dollars to do this when you order a second test for a patient. Well, with this technology, what they're telling us here is that with this technology, and I've done the same with, with this lab is called Vibrant Wellness. And with Vibrant Wellness, the tests come back accurate every single time. And I've done this 3 times with Vibrant. Now there are, I have 6 studies from Mayo Clinic on this technology and how accurate it is. So I don't, after the 6th time that, I'm sorry, after the 3rd time that I did the double blood draws, I didn't spend the money anymore. I knew that I was getting accurate information. So what I'm about to show you is contingent on having accurate laboratory procedures available. And this test is called the Neural Zoomer Plus. And the Neural Zoomer Plus checks for antibodies to brain tissue, antibodies identifying a breach of the blood-brain barrier, the leaky brain, antibodies to the autonomic nervous system disorders, antibodies to systemic brain autoimmunity, antibodies to bacteria in the brain causing inflammation, antibodies to viruses in the brain causing inflammation, antibodies creating demyelination, antibodies creating peripheral neuropathies. And this is what the test result looks like. So, and I'm just going to go through the pages. You— there's no way you can absorb all of this, this quickly. This is just to give you an appreciation for what's available out there. There were 6 antibodies to demyelination, antibodies to— 4 to the blood-brain barrier. Antibodies to the autonomic nervous system, antibodies for peripheral neuropathies, antibodies for neuromuscular disorders, antibodies to brain autoimmunity, whether it's cerebellum or Purkinje cells or amyloid beta and, and, or other brain autoimmunity, all brain autoimmunity antibodies for brain inflammation. Antibodies for infections, whether it's— there are over 200, just Google herpes and Alzheimer's. There are over 250 studies on herpes simplex virus 1, the cold sores that so many people get, and Alzheimer's, 250 studies on that. And other viruses, herpes 2, Epstein-Barr, cytomegalovirus, herpes 6, herpes 7, streptococcus, that we look for all of these antibodies, but how are you ever going to interpret a test like that that has 53 different antibodies on it? How are you supposed to understand a test like that? Well, you don't do this. You don't do this. Rather, we just start to study, and it may take you 6 months. Perhaps you look at one antibody a week, and you spend a half hour once a week to learn a little more. I've got all the training courses on this, then it's all in my book. This is my book that came out a couple of years ago. It's all about brain inflammation. Everything I'm telling you today is in this book and so many protocols on what to do about it. And we talk about the environmental triggers, most of the environmental triggers that one may be susceptible to. I highly recommend the book. I did the audio of the book if you prefer audio, and confidentially, that was the most difficult thing I've ever done in my life. Was the audio because it's 8 hours a day for 4 days of every sentence. I must be focused on every sentence. I can't be thinking about dinner. You know, I have to keep my brain focused. It was really difficult but rewarding to do. So you may enjoy the audiobook. But— and this is what we say for our patients. The subtitle of the book It's the secret to success. Whether you're a patient feeling overwhelmed by all this information, or you're a doctor and you've just been exposed to a test with 53 antibodies, most of them you've never heard of before in your life, and what do I do with this? You take 1 hour a week, just 1 hour a week, and you just study one at a time. And in 6 months, you've got this. You've got this down. Now, this is the test result of one of my patients. This was a 38-year-old president of a bank, a very young president of the bank whose brain wasn't working very well anymore. He had been to Mayo Clinic twice. He had been to Columbia. He had been to some famous clinic in France, and no one could help him. He was losing his memory and no one could tell him why. Well, this is his test result on the Neural Zoomer Plus. You look and see there are 6 different antibodies that are elevated. And I'm gonna show you how you begin to think about each of the 6 that were positive for him. And these are the types of things you learn in our courses. Of how to interpret this kind of thing. So anything that's positive is a problem, anything. And the first one is ganglioside antibodies, anti-ganglioside-1 antibodies. Well, what do we know about ganglioside antibodies? Well, we know that the most common neurological symptom in celiac disease is peripheral neuropathies. And that 22% of celiac patients have peripheral neuropathies, and that every single one of them have elevated antibodies to gangliosides. So if you have elevated antibodies to gangliosides, at least the first thing you're going to do is check for a problem with wheat. Do they have a problem with wheat? Because that could be fueling the ganglioside antibodies There are 6 different mechanisms that we teach you about, but the most common mechanism is called molecular mimicry. But there are 6, but that's the first thing you would do with ganglioside antibodies is confirm, is the immune system fighting wheat? The next one is Purkinje cells. And what do you do if a patient has elevated Purkinje cells? Well, we know that there's a cross-reactivity, it's very common to see between Purkinje cells and gluten. So antibodies to gluten. Now, we found in our practice that 26% of patients that had elevated antibodies to wheat had elevated antibodies to cerebellum. 22% of patients that had elevated antibodies to wheat had elevated antibodies to Purkinje cells, meaning there's different tissues in the brain that can cross-react. I showed you earlier IgA gliadin antibodies attack the blood vessels, uh, in the brain, and then where the collateral damage occurs is where you might find the antibodies. Once again, there's a lot to learn here. But you take one of these antibodies a week and you begin learning. The next one is S100B, a marker of leaky brain, blood-brain barrier disruption. And what do we know about S100B? We know that it goes into the bloodstream when there is a blood-brain barrier disruption, and they develop— antibodies develop because of persistent or repeated blood-brain barrier disruption. So when you've got elevated antibodies to S100B, it's because you've got a leaky brain. Now, what about aquaporin-4 antibodies? Aquaporin-4, a significant percentage of people with multiple sclerosis show elevation in antibodies to aquaporin-4 but they also show elevated antibodies to the aquaporins of soy, corn, tomato, and spinach. Aquaporin-4 is tissue, neurological tissue in the brain and central nervous system, but the family of aquaporins are also in soy, corn, tomato, and spinach. And if you look at this drawing, if you look on the bottom left, where it says soy, corn, spinach, and tomato, these are IgM antibodies. If they are elevated, then you're very likely— the more red the color, the more often it happens— you're very likely to have IgM antibodies elevated to S100B, myelin basic protein, human aquaporin-4, and myelin oligogangliosides. Then the same is true for the IgGs, they go up into the center. Then the same is true for the IgAs, they go up to the top on the right. The more often you have antibodies to those foods, the more likely it is you may suffer from elevated antibodies to that brain and central nervous system tissue. It's molecular mimicry. Now, what about rage antibodies? Well, what are rage antibodies? We know that when you cook food, you produce advanced glycation end products. We've all known about this for many, many years. Uh, the difference between bread dough and baked bread is that the sugars and the proteins have glycated to form the tougher bread. We know that's true. And when you cook Steak or meats, if you like that nice blackened edge to it, that's glycation end products. And we know they're not so good for you. Foods rich in both protein and fat, mostly of animal origin, cooked at high and dry heat produce advanced glycation end products. Now, it's known that the blood-brain barrier is very important for balance on amyloid beta. And that the blood-brain barrier regulates the transport of amyloid beta, the problem with Alzheimer's. And there are two receptors that do that: low-density receptor-related protein 1 and RAGE. Remember, we're talking about anti-RAGE antibodies here. The RAGE protein mediates the influx of amyloid protein from the blood into the brain, whereas the LRP proteins take amyloid beta out of the brain. So RAGE escorts amyloid beta into the brain. RAGE is the receptor for advanced glycation end products. The more advanced glycation end products you produce, the more you stimulate the RAGE receptor, the more active that RAGE receptor gets, the more amyloid beta you escort into the brain. So what does that tell you? Generally, efflux, meaning taking amyloid out of the brain, is greater than influx. But in Alzheimer's disease, that ratio is reversed. And one of the contributors to that is increase in expression of RAGE, the receptor for advanced glycation end products. So if RAGE expression creates an increase in the influx of amyloid beta through the blood-brain barrier, how do we reduce the expression of RAGE? Well, once again, this patient had RAGE antibodies. So how am I going to calm down RAGE? Well, you reduce the expression of RAGE by reducing the production of advanced glycation end products. You reduce the expression of advanced glycation end products by giving the patient more colors of the rainbow in their diet, more fresh fruits and vegetables, reduce the amount of cooked protein and cooked fats, high temperature cooked proteins, high temperature cooked fats. You reduce the production of advanced glycation end products which will then reduce the expression of the receptor for advanced glycation end products, RAGE. When you reduce the expression of the receptor for advanced glycation end products, RAGE, you reduce the antibodies to RAGE. When you reduce the antibodies to RAGE, you reduce the breach of the blood-brain barrier, the leaky brain. So here's an example. This causes this, causes this, causes this, causes that. And when you give them more fruits and vegetables to eat, the colors of the rainbow, you get that efflux of amyloid coming out again more than the influx going in. Okay, what about streptococcus? This patient had elevated antibodies to streptococcus. Well, the result of that is you have to give them, whether it's antibiotics or natural antibiotics, you have to deal with a strep infection. But this is an example how every single one of the antibodies that you test for on this test, there's something you can do about it. The patient is not helpless. You have to educate them on how to go upstream and start working with every one of these antibodies. And we never redo this test for at least 6 months to a year, depending on how compliant the patient is, 'cause the lifespan of the antibodies is 2 to 4 months. So save your money, Mrs. Patient, live this lifestyle, and it better, this test better be better when we do it again. It better be, it may not be perfect yet, but it better be better. And patients understand that. So it's time for a paradigm shift. We have to study more. We have to learn more so that we can take our patients and walk with them upstream in the world of functional medicine and investigate where is the inflammation coming from? Where is it coming from? And this is, our training course for healthcare practitioners. You can review this, you can go to certifiedglutenpractitioner.com and it's an 8-hour online course that you do at your own speed. You've got 3 months to complete it once you begin. It gives you the basic education, the facts about celiac, non-celiac gluten sensitivity, and the inflammatory cascade that creates the autoimmune spectrum. Everything I've talked about here today is in this course in much greater detail. Lifetime access to the resource center. I send all of my certified gluten-free practitioners articles about once a month, sometimes twice a month, that I think are relevant articles. And I send 2 copies. I send a clean copy, but then I send a highlighted copy. These are the bullet points. No one has time to read all the research. So just read the bullet points and you will have the understanding of what that article has to say. So that is our Gluten-Free Practitioner course. And these are testimonials, and there's lots and lots of testimonials. I'm honored that when I go to a seminar, Next week I'm back on the road again. I have 7 seminars in the US in 5 days that I'll be doing. But I'm honored that people come up to me now all the time and say, "Your course changed my life. Thank you. I've helped so many patients. I really understand this now so much better." And I say, "Thank you very much for that." Please remember that— and I don't know who's doing the drawings on here, but please discontinue with the drawings. Or if that's your child playing on the screen, please stop. The brain is the canary in the coal mine.

Giri MS, please stop this drawing. Thank you.

So take care of yourselves, everyone. Take care of yourselves. Make sure to tell those important to you how much you love them. And with that, I would say thank you for your kind attention. And I will stop sharing my screen so we can go to questions now. Thank you so very much.

Thank you, Dr. Tom. I think you've made us think more now. Uh, and, um, I would really love to go through the papers you have spoken in this presentation and enhance my knowledge so that I can help more patients. And I'm sure everybody here would be be thinking about same. So I will allow all of you to unmute yourself. You can unmute yourself and ask your questions. Yes.

Can I ask one?

Yes, please.

Uh, so sir, I just meant to ask whether colostrum can be taken if someone has a milk IgG sensitivity.

That's a very good question, very good question. And we recommend colostrum as a primary component of reducing the inflammation in the gut. And when people have a sensitivity to dairy, colostrum is Mother Nature's way of healing a leaky gut. Every— some— somebody's microphone is on, please turn it off. Every newborn is severely permeable at birth. It's normal because in utero the baby is in this soup and the soup is— the nutrients are swimming around baby through the eyes and the mouth and the nose into the brain and everywhere. Those borders are not yet closed. When baby is born The first 3 days of breast milk is not milk, it's colostrum, 3 to 5 days. Colostrum carries the messages down to the genes in the gut, close the tight junctions. It's time now to reduce the intestinal permeability to normal functional, the rest of your life levels. So colostrum plays the entire symphony of healthy gut. It is Mother Nature's way of doing this. But some people have a sensitivity to some component of dairy. Very good question. What we tell our patients, Mrs. Patient, we just found out you've got a sensitivity to dairy. Okay, get the milk out and the cheese and the ice cream and everything, just get it all out of there. but I'm going to recommend you try the colostrum for 2 months. As long as you don't have any symptoms, as long as you don't have any bloating or gas or abdominal cramps or diarrhea, as long as you don't have any symptoms, I'm gonna recommend you try the colostrum for 2 months because nothing is as powerful at turning around the inflammation in the gut as colostrum. It's worth a try. It's a clinical decision to give it a try. But if you have any problems, just stop, and we'll do all of the other things to achieve the same result. But colostrum just gives us more bang for your buck. You get the results faster.

In other words, Tom, uh, colostrum, you know, on its own is, is, is the top of the list, would you say?

It is the top of the list. If there's only one supplement you're going to use, it should be colostrum, as long as they don't have a dairy sensitivity. If they do, clinically, I will use it for a couple of months, as long as they have no symptoms, and say, we'll, we'll deal with the antibodies to dairy after we're done with this first phase.

And age is no bar?

Correct.

What about green tea? If you combine that with the cholesterol?

There are many nutrients that have been shown to be effective in addressing inflammation in the gut and helping to address a leaky gut, pathogenic intestinal permeability. There are many, many. Green tea is one of them. We have— if you go on my website, there We have the pack, I put together these packs called Gluten Sensitivity Packs, GS Support Packs. One pack has 6 pills in it. The 6 pills are 22 nutrients, 22 nutrients that have extensive science on healing a leaky gut and reducing inflammation in the gut. 'Cause no one's gonna open 22 different nutrients, no one will. 22 different jars. But this is the way I said, Mrs. Patient, can you take one pack a day? One pack a day? Yeah, doc. I said, there's 6 pills, but it's one pack a day. Yeah, I can take one pack a day. I said, good. Now, while you're doing that, if you like it, also include green tea. That's something that I will do as a lifestyle habit that's easy for many people to include. I've not used green tea as the primary emphasis on inflammation in the gut, but we often use it as an addendum. Uh, uh, uh, Ritu.

Yes, thank you. It was a very informative session. First of all, thanks for that. I have a very different question. When you were speaking about the, you know, uh, the odors, the senses which our brain can recognize, and if the person is not able to smell anything— on that, I have a different question. What if the odor senses are really super active, kind of superpowers? Uh, maybe if the person is able to smell even from a very distant thing, or maybe if a picture is there in front of you like of any food item, and just it is a picture and you can smell that. And it has not happened once, it has happened multiple times. So it's not just a, you know, just a one-time thing or two-time things, or maybe, or coincidence. No, if it is happening from multiple things and multiple times, so is that a disorder? Is that a superpower?

Yeah, that's a very good question. And if you think about that, If you think about that, my wife and my baby are saying, come on, come on, they're waiting to go to the beach. So I said 5 minutes, 5 minutes. Yes, I have not seen a paper on this before, but the way I've addressed that situation, I've had that a few times come up in our practice, and we look for for accumulation of toxic chemicals in the body. And every time we look, we find them. We find there's either heavy metal toxicity or petrochemical toxicity, organophosphates, that something is making the nervous system hypervigilant, hypervigilant. Just, if you consider someone with anxiety, That is a manifestation of hypervigilant emotions. Yes, they're anxious, they overreact. The nervous system, when it overreacts, may be being triggered by extensive chemical toxicity. I've found that in every case and I've only had maybe 5, 6, 8 cases like that over the years, but we've been able to help every one of them after we identify what it is with an extensive detoxification protocol.

Thank you, Doctor.

Thank you. So, Dr. Tom, there are—

One more.

Just a minute. There are some questions in the chat box, Dr. Tom, so I will just quickly ask you those. Does long Does intermittent fasting, dry fasting help in lowering down autoimmune issues of brain? Ritu Khurana.

Yes, the, the concept of fasting and fasting mimicking diets is an advanced level of study for functional medicine practitioners. But when you take the time to learn about this, you realize And when you read the science, and I give you a lot of the science, when you read the science, you understand you increase stem cell production throughout the body with fasting-mimicking diets. And when you increase stem cell production, you increase the production. Every cell in your body regenerates, every single cell. But if your thyroid is functioning, I'm going to make up a number, 6.1 on a scale of 1 to 10. Your thyroid's functioning at 6.1, not very good. When that thyroid cell reproduces, it reproduces as a 6.1. But the lifestyle that's causing the inflammation wearing down the thyroid, now you start functioning as a 6.2. 6.0. Well, that 6.0 cell reproduces as a 6.0, and then a 5.9 and a 5.8. And when you change the lifestyle, when you reduce the inflammatory triggers, so there's less inflammation, your body always wants to be healthier, and you reproduce a healthier cell, a 6.2. And you continue this lifestyle, and then it's a 6.3 and a 6.4. And in 6 months, your friends who haven't seen you said, wow, you look marvelous.

What have you—

well, I changed my diet and I've been exercising and I'm taking a few supplements and I feel so much younger. That is the concept of going from a catabolic state to an anabolic state. I have not seen anything accelerate that process as much as fasting-mimicking diets. 6.0, 6.1, 6.2, 6.5, 7.3, 7.4, 7.5. They're safe, they're effective when you learn how to do it properly. You just have to study to learn how to do it properly.

So do you think a fasting-mimicking diet could be better than pure fasting?

I think for most people, their lives are too hectic and too demanding to do pure fasting. If you are going to do pure fasting, you stop your life and you rest, you meditate, you're on vacation, you're not going to work, you're not— you don't have high demands because you're demanding from your body when you're fasting. I think fasting is probably the most powerful powerful, but the way we do it creates so many stress hormones in our body for most of us. So if you want to fast completely, great. Take a vacation and do it on vacation so you truly can relax and allow your body to heal. Fasting mimicking diets allow you to live your everyday life while you're activating the production of more stem cells and detoxing. And enhancing all the benefits of that.

Right. Dr. Tom, next question is, is Parkinson's disease also due to inflammation? What is the approach to reverse it using functional medicine?

Yes, that's a very good question. I'm going to change it and say, is ALS also a brain disease of inflammation? Is Alzheimer's also a brain disease of inflammation? Is seizures also a brain disease of inflammation? They're all brain diseases of inflammation, every single one of them. It does not matter what they present with, that this is a primary concept for every patient that has a chronic inflammatory disease. This is not the entire approach. This is the basic 101 of a functional medicine practitioner is to identify the triggers of inflammation. Then depending on the condition that they present with determines which protocols, which life jackets you give to help accelerate the healing and regeneration of healthier tissue for that person.

Right. The next question is, Dr. Tom, Is 100% whey protein isolate advisable for such patients?

I'm sorry, could you say that again?

Is 100% whey protein isolate advisable for these patients?

As long as they don't have a sensitivity to dairy, using whey protein is an excellent source of protein. As long as they don't have a sensitivity to dairy. Well, my patient doesn't get sick when they eat dairy. That doesn't cut it. You're a functional medicine practitioner. You don't guess anymore because people will go for 25 to 30 years with brain deterioration eating gluten, eating dairy, because they don't feel bad when they eat it. The ratio with celiac disease is 8 to 1. For every 1 patient that has gut symptoms, with celiac disease when they eat wheat, there are 8 patients that do not have any gut symptoms. They've got skin symptoms, brain symptoms, joint symptoms, but no gut symptoms. So they eat bread and they think, well, I feel fine when I eat bread, it's not a problem. You cannot use patient symptomatology to diagnose whether or not they have a problem with a food. You must— the rule is test, don't guess.

Thank you, Dr. Tom, for this, because when I came into functional medicine 6 years back, I used to do the same, depend on symptoms, and a lot of my patients then were not recovering. And I learned it, you know, test, not guess. So thank you for sharing that again. Friends, if you have any Any questions? I've just taken the old questions. Please unmute yourself and ask.

Yeah, one more question from my side, please.

Yes, uh, Parlik.

Yeah, right.

Yeah, please.

So, uh, you know, there are these FODMAP foods— fermentable oligopoly and such— saccharides, FODMAPs.

Yes.

So can those be taken in the case of dysbiosis in the large intestine? Because I know they, they shouldn't be taken for the SIBO.

It depends. It depends. Sometimes they can, sometimes not. FODMAPs are the more common cause of gut symptoms, not gluten, not the proteins of wheat. It's usually the FODMAPs. The proteins of wheat stimulate the immune response The FODMAPs in wheat stimulate the bloating and the gas and the gut symptoms. And if someone has a sensitivity to wheat, that's any component of wheat because FODMAPs will contain some of the proteins of wheat also.

Tom, can I ask you a question? I have a problem with a lot of patients who are presenting with the lichen planus and Morphea. They don't have active scleroderma, but they have Morphea, and there's a breakup between is it Morphea, is it Lichen Planus?

What—

I mean, would these same supplements or same food products be the same thing, or what about adaptogens for that? So I'm struggling with a few patients who have both Lichen Planus and Morphea.

Yeah, so what you're asking me is what life jacket do I use with these patients? And you have to stop the inflammation. As a functional medicine practitioner, the attention has to be where is the inflammation coming from that's manifesting as lichen planus? Where is the inflammation coming from? That is the primary concern.

—But are there any specific things that you could recommend for that?

Yeah, yeah, yeah. I would do the Gut Zoomer test to identify what kind of an environment do we have in the gut right now. 36% of all of the small molecules in healthy blood, 36% of everything, is the metabolites of the microbiome in the gut. I call it the exhaust of the microbiome in the gut because the metabolites are the messengers that get into the bloodstream and they tell the brain what the ratio is of neurotransmitters to produce. They tell the heart what the heart rate should be and how strong the contractility of the myocardium should be. They tell the liver what detox enzymes to produce. That 36% of everything All of the directional molecules in your bloodstream come from the gut. Now think about that. So any condition you have, any chronic condition, you always want to look to the gut. Where is this gut out of balance? And my experience with Lichen planus is often there's mold, mold and fungal infections, and you have to check the environment for mold. That's very common. I'll do one more question and then my wife will kill me.

Doctor, I wanted to ask one query regarding soy protein and cholesterol, how it would benefit.

Okay, I'm gonna do two questions. I'll do, uh, first, the first one will be, uh, Baiju, uh, and the second will be Sudhir.

Okay, thank you, thank you, doctor. Thank you very much, Doctor.

Doctor, in this context, soy protein powder along with colostrum supplement, how it would be benefiting?

I avoid soy, um, uh, at every turn. Soy has too many familiarities with estrogenic chemicals that too, too many receptors in our body get activated by soy. If there is absolutely nothing else available and you need to get some protein into a person, okay, okay, but for a short period of time. But I do not ever recommend soy because of the potential downstream impact that it can have.

So always whey protein will be better that you are suggesting, right?

No, no, I'm not saying always, no. There are vegetable proteins, combinations of pea and lentil and other types of vegetable proteins that can be used also, but soy is one that I avoid completely.

Thank you. Yeah, Doctor, uh, yeah, I had a question that, uh, when you are seeing a case where some, uh, they have some digestion and, uh constipation problems, but coupled with very poor absorption of fat. So is that— is it something related, uh, to this gut and the, uh, to the, uh, inflammation, or is it something else? Or does poor inflammation also cause very poor absorption of fat, uh, by the person? Really good question.

Really, really good question. And we have to understand that the study of functional medicine, you know, we're always learning new things, right? So when there's poor fat digestion, the first thing you think about, of course, are digestive enzymes. Is the pancreas functioning adequately? What about the gallbladder? Is it functioning adequately? For example, cholecystokinin is the messenger hormone produced on the lining of the gut that goes to the pancreas and goes to the gallbladder that says, this much protein is here now, I need some proteolytic enzymes. This much fat is here, I need some bile to break down the fats. And that— those messengers that tell the gallbladder how much to secrete and the pancreas how much to produce, those messengers produced on the inside lining of the gut are reduced by two-thirds when you have a sensitivity to wheat. If you have elevated antibodies to wheat, you reduce the production of cholecystokinin by two-thirds, which means your pancreas is not getting enough of a message, so it's not going to make enough pancreatic enzymes to digest your protein. Your gallbladder is not getting enough of a message, so it's not going to contract to squeeze the bile down into the gut to digest your fats. So it's the same concept. Where is the inflammation coming from? So in a case like this, I would do a stool analysis. The one we use is called Biome FX, Frank X-ray, Biome FX. And you'll see it on my website. And that test is available in India, I believe. But you, you evaluate what's not functioning properly and then you go from there.

Okay. Thank you.

Thank you. I think, Dr. I just interrupt once again. I have been struggling with one thing. Root vegetables, you know, are very highly glycemic, but also because they also contain inulin, how do we balance that factor out? How much root vegetables, uh, which cause high glycemic index versus inulin, which is very helpful for us?

Very good question. Um, 78 to 81% of the prebiotics in the Western diet come from wheat. Put people on a gluten-free diet and you eliminate 78 to 81% of their prebiotics. That their probiotics have been dependent on for a lifetime. Yeah, so people feel better initially on a gluten-free diet, but 8 months, a year later, you increase their risk of morbidity and mortality dramatically on a gluten-free diet if it's not done correctly. One of the components— this is all in the course, of course— uh, one of the components of a proper gluten-free diet is that the patient is instructed to eat one root vegetable a day, every day, one, which not a big plate of potatoes, but a potato or a half a potato or one radish or one turnip. And we, every patient is told one root vegetable a day and go on Google and type prebiotics, the list of prebiotic foods, and print the list out and put it on your refrigerator. An onion is a prebiotic. A banana is a prebiotic. Garlic is a prebiotic. There are many easy-to-implement prebiotics, 'cause when you take gluten out of the diet, you must replace the prebiotics. One root vegetable a day and two from the list every day. That way— and sometimes a supplement for a couple of months of prebiotics. But for a lifetime, Mrs. Patient, just a little bit of root vegetable every day, not a large serving, especially if they have, uh, metabolic syndrome or insulin resistance. But a little. Some people will shave a radish raw and put it on a salad. That's a prebiotic. And every root vegetable feeds different families of probiotics. So you do not eat just sweet potatoes. You have some sweet potato and some carrot and some rutabaga and some turnip and some parsnip. And some radish. So you alternate, and that, that's all in the course.

That's, that's very good. Thank you for that.

Yeah, you're on mute. Sorry. Thank you, Dr. Tom, for joining, for being here with us today. We really enjoyed the session and learned a lot.

Please share the email ID and the website. Thank you.

Yes, one, one more thing I'm going to say And that is, our website is thedr.com, thedoctor.com, just don't spell the word doctor out. And for everyone who has stayed for the entire event, my gift to you, if you like, I will give you all of the citations that I talked about today, all of the articles, you're welcome to them. You just have to email us at info@thedoctor.com info@thedoctor.com, and we will send you all of the studies that I'm talking about today. I give to you info@thedoctor.com, I-N-F-O. Now my staff does not know this yet. I haven't told them. So give us 5 to 7 days to do this. Because they'll have to go through the entire presentation. But give us a few days and I'm going to give you one more gift, honey. I'm going to give you one more gift before I say goodbye and share with you. This is my joy. Yes, he's ready to go to the beach. So we are off to the beach today. Thank you all so very much for your invitation, and I'd look forward to working with you again.

Thank you, Dr. Tom, and sorry for holding you. Please have fun.

Thank you so much. Okay, bye-bye.

Thank you, Tommy. Bye. Thank you so much. Thank you everyone for joining us.

Thank you. Bye-bye. Thank you. Thank you, guys.