6 Things CAUSING INFLAMMATION In Your Body & How To FIX IT! | Mark Hyman & Shawn Stevenson

There's so many things that drive inflammation. And if you're overweight, you're inflamed. Most of our chronic illnesses start in the gut.

Need to address the inflammation in your brain in order for you to lose weight.

The thing that I really wanted to usher in and bring to the forefront, because it sounds the most like ghostly, it sounds like Casper the Ghost, like it's not even a real thing, is inflammation and how inflammation has an impact on your body composition. And the data exists. It's just that a lot of folks don't know about it. And the way that it really manifests when we're talking about inflammation is that it has this very detrimental impact on our organs that are related to our body's production and utilization of our kind of fat loss related hormones. So namely, let's take our liver for example. You, your liver is incredibly important in regulating your metabolism. We're talking about a relationship with how it manages insulin. Even the production of fat takes place in your liver too. The storing of glycogen can take place in your liver. If your body's overburdened by glucose, your liver can literally convert that into fat right there on the spot.

If something is damaging your liver, it's going to inherently damage your, your endocrine system and your process of metabolism. So inflammation. And I've just kind of shared some of the data in the book damaging your liver. And this is one of the most fast growing issues in our country is non alcoholic fatty liver disease. Yeah, this is really a kind of chronically inflammatory, inflamed situation taking place in our liver.

And also how do we get fatty livers? Because I think people should know, we go to fancy restaurants and they give you foie gras, which is French for fatty liver.

And how do they get the ducks to be like that? And how do they get us humans to have 90 million Americans with fatty liver?

Everybody should know by now. Very simple. The fastest way to damage your liver and to create that fatty liver. By the way, it's called non alcoholic fatty liver disease because we associate it with alcohol.

But sugar, Sugar, absolutely. Sugar, starch, flour, it's so bad. It's so bad. Particularly hypercorns.

Your liver has to take on the brunt of it because your liver is really, even the name live.

It'S responsible for so like every minute it's filtering your entire blood supply. You know, it's so important.

That's right.

But to take this one step further, and I'll just drop this little nugget so we can move on to the other topics. But also the master regulator, often referred to, of course, you know, I've even taught this in my conventional university setting. But your hypothalamus, all right, your hypothalamus is one of the major regulators and communicators with your thyroid, with your liver, with your adrenals, all the organs related to fat loss and fat storage. The governing kind of master gland is called. The master gland is your hypothalamus.

That's in your brain.

Right. And now we've got data that this new term neuroinflammation inflammation, specifically regarding the function of your hypothalamus, can damage what's happening with your metabolism. But nobody's talking about that in these cookie cutter diets that you need to address the inflammation in your brain in order for you to lose weight. Right. So these are all. And the beautiful part is it's possible. It's not just possible, it's probable when you have the right information. And we avoid the things that create the inflammation, and namely, you just mentioned sugar, but we go through a whole subset of the different things.

Yeah. In functional medicine, we also look at food sensitivities and environmental toxins and the microbiome and all. There's so many things that drive inflammation. And if you're overweight, you're inflamed. For those listening think, oh, I'm a few pounds overweight, a little extra belly fat. Maybe I need to lose 10, 20 pounds. Or maybe you're over more overweight or obese. You should really pay attention to what Sean's saying, because right now, during this COVID pandemic, what we're finding is those people who are overweight or obese or have even a little bit of extra fat are much more likely to get sick, more likely to end up in the hospital, the ICU, and to die from COVID 19 because of poor metabolic health. And what's so beautiful about the body is that you think, oh, my God, I've taken years and years to get here. Within a couple of weeks, you can change all of that. You might not lose all the weight in a couple of weeks, but you can change your inflammation markers, your hormones, your brain chemistry, literally in a couple of weeks of changing your diet and following the principles that are in Eat Smarter, which is Sean's new book, which you should all get a copy of.

Thank you, Mark. And just to reiterate what you just said, it's so important. You know, the CDC's recent report found that about 90 folks, 94% of the folks who lost their lives had an average of 2.6 chronic diseases or comorbidities. You know, and we've got to get our citizens healthier. And the big thing in the beginning of this was, well, we can't get people healthier overnight. When, when are we going to start? And truly it's up to us in conversations like this. So I just want to share that. But also leaning into this topic and just you mentioned environmental toxins, but I'm going to share something that's a little bit controversial and this has to do with supplements because there's been a big shift taking place that it went from about 7% to 20% of hospitalizations related to liver damage are related to supplements. Because this is because like Mark, when I was trying to turn my health around, I became a natural pill popper first. I didn't get it with the food. And so I'm taking, I've got like my grandma's like pill full of like 20, 30 different things that I'm trying to take to get these nutrients in. So not to say that the right supplements aren't helpful, but it's a largely unregulated field on top of that. Also we need to target and understand that your liver is responsible for metabolism of all these supplements and it's also responsible for drug metabolism. And now we've got about 70% of the United States population on pharmaceutical drugs right now and your liver is responsible for that drug metabolism. So just want to throw those things out there. But to shift gears to go from inflammation, that's one of the major causative factors behind an inability to lose weight. And the other one is hormone dysfunction.

Yeah.

And your hormone response. This is where the real magic happens. This is where the show is going on. Your hormones are like the little chemical messengers that are communicating with all the cells in your body and really communicating the message on what they need to do. And so there are hormones that are specifically related to fat storage and there are hormones specifically related to fat utilization. And just to give a super overarching look at this, insulin. Insulin is our body's major kind of energy storing hormone. It's a beautiful thing. Insulin is not a bad guy. That is storing energy, fat. It's helpful. We need it, it's part of our evolution to have it. Now it's getting, it's being hyper utilized and put to work chronically and it can get overworked and it can just be like, I quit. You know, so we've Got insulin. But on the other side, insulin has a brother, glucagon. Glucagon really does the opposite. And they're both produced at, you know, from their loving mother, Ms. Pancreas. And so they each have opposing roles. But glucagon can't do its job unless insulin sits down. You know, these two things is a binary process. But insulin literally triggers the cell to open up to use that energy. And there are specific nutrients involved in these communications, in these pathways, and nutrients that make these pathways kind of suppressed and create hormonal clogs. So a big mission with the book is taking folks through and teaching them about all of these fat loss and fat storage related hormones to give them really good education. But in a way that's fun and it makes sense. You know, we get a conversation about thyroid hormone, your adrenals, all those things. So hormone dysfunction, regardless of what diet you're on, we have to find ways to optimize what's happening with your hormones.

And it may play a huge role in regulating your metabolism, as you said. And they're driven in large part by what you eat. People don't understand their testosterone levels. And your sex drive is controlled by what you eat. If you're a guy, if you're a woman, your level of estrogen and fat is determined by what you're eating. Certain foods increase estrogen, like sugar and alcohol. That's why they give estrogen to male steers to fatten them up and marble their fat before they take them to market. Right. There's no lack of science about this. We just don't understand it. And then of course, there's the appetite issue, which is such a big thing for people.

Yeah. Oh, Mark. And this is so important. This goes back to when I mentioned Dr. Lulu Hunt Peters impressing upon society that hunger is related to weight loss. And unfortunately.

Millions of people still believe this. And hunger is a.

Biofeedback is biological feedback that something is awry here. All right? And this could be a nutrient deficiency. This could be related to some form of like habitual addictions, things like that. But our hunger isn't the issue. We want to make sure that we're not hungry because that hunger is associated with overeating, of course, and we could try to battle our biology, but eventually it's going to win out against our willpower, which is finite. And so with that said, let's get folks educated on how our appetite works. And now these terms that we've been talking about, you and I, probably for over a decade at least. But now a lot of folks know about the power of leptin and the power of ghrelin. These are kind of the major players, but we go deeper than that. And now we know that leptin, for example, leptin is your body's major satiety hormone, and it's actually produced by your fat cells. Now, here's the catch, folks. And this is one of the studies that I put into Eat Smart as well, and this was published in the New England Journal of Medicine, found that folks who are overweight and obese actually have plenty of leptin. That should make them satisfied.

Well, they have leptin resistance.

Exactly.

And inflammation causes leptin resistance.

Exactly. It all starts to go together. They're still getting the dm, the leptin DM is being sent, but it's going to spam. You know, it's just like, been spam.

I like that.

And so that's what creates that leptin resistance. And that's just one aspect. And then ghrelin is this glorified hunger hormone. There's specific things we can do with our nutrition. Obviously, that encourages leptin sensitivity and really helps to get ghrelin in check. But there's so many other players. Adiponectin is one that you're going to be hearing a lot more about related to satiety. And adiponectin has been found to help to move more of the kind of troublesome body fat in the visceral fat area and actually transfer that to the subcutaneous fat area, which makes it a little bit more protective. We still want to address both of these kind of white adipose tissues, but the visceral belly fat is what's really dangerous. The most dangerous from the.

What's fascinating about adiponectin is that when you have high levels of adiponectin, you can't actually mobilize fat. And what causes high levels of adiponectin is insulin resistance, which is prediabetes, which is eating too much sugar. So it all comes down to the starch and sugar. So your book is just filled with wisdom and information about these key mechanisms about how different foods and nutrients affect your brain function, about the microbiome, how it affects relationships, how it impacts our communities and stress levels. I mean, it's so full of beautiful things that are far beyond just what to eat. You talk about love languages in the book. It's such a fantastic book. And I just want to sort of close by talking about the research around sitting down for A meal with people you love and what that does to your health, your food choices, to your body composition, because we've kind of lost that. I think the idea of a family dinner, the idea of cooking together, eating together, being together. It's like I think the average family has dinner together a couple of nights a week, usually all while eating different foods made from different factories, heated up in a microwave that are eaten while watching, watching TV or being on their phone. Not exactly conducive to health. So tell us about this research about eating together.

Yeah. And this is incredibly powerful because it's not just what we're eating, but it's also how we're eating and who we're eating with has a major impact on our overall health. And I share this story in Eat Smarter that I grew up, it might sound a little far fetched for some folks. Just like people aren't sitting down to eat together. I can count on my hands how many times I sat down and ate a meal with my family growing up.

Wow.

All right.

Wow.

This was an incredibly rare occasion. This is usually, if it wasn't a holiday, by the way, holidays a little bit different, but it's usually just a free for all. We might eat at the same time, but we're not eating together and. Or we're not. We're eating in front of the television or playing a video game or something like that. And so this is not abnormal, by the way. This is really shifting to be the norm. And here's some of the healing factors of this. Researchers at Harvard University uncovered that folks who consistently eat dinner with their families frequently consume more fruits and vegetables and less processed foods and sodas. And one of the most. I think this can get overlooked. In the study, they found that folks who consistently eat dinner with their families also had higher intakes of, of some of the most important nutrients that regulate our fat storing hormones and your fat burning hormones as well. So things like calcium, folate, B vitamins. Also they found they had a generally higher, lower intake of dangerous compounds like trans fats and toxicants in our food. So this is really powerful. But one other study, and this is the most important for myself personally in this mission, and this was published in the Journal of Nutrition Education and Behavior and they found very similar results. And now it gets into numbers. They found that folks who eat with their family, and this could be any meal of the day, breakfast, lunch or dinner, just four times a week, dramatically increased consumption of fruits and vegetables and reduced consumption of soda and chips. And what was so beautiful about this study is that this was done on folks who would be considered higher risk, which was minority children, minority families. So this isn't just about fixing the environment around the thing. It's the personal responsibility as well, knowing you have leverage, because the simple act of eating together as a family helps to increase, improve the health outcomes for the children and the adults as well.

It's so true. My friend Lori David, who was involved with the movie Fed up that I was in years ago, wrote a book called the Family Dinner, and she talks about the research on if you have family dinners where you're eating food together and you're making it together and you're enjoying real food that the kids have less likely to have obesity, eating disorders, violence, do better in school, have less drug use. I mean, just so many benefits that you wouldn't even think, I mean, better grades, I mean, just by eating dinner together. So I think that's really important, and I think it's beautiful how you combine the understanding of the deep science around food and how to optimize your metabolism with the science around relationships and love and connection. And that's really what food's about. It's about joy and pleasure and connection, but it's also about having us live our best lives, because the, the tagline in the, in the, in the book title, transform your life actually is true. And food has the power to do that. And eating smarter will teach you how to do that.

What is the microbiome? Why is it important? What does it do? I mean, we thought it was just poop, and now it's like basically the holy grail for figuring everything out.

Yeah, so it's. It's gold is gold, and actually, you know, brown gold is brown gold.

Right.

So. So. So down in Boston, you know, so the microbiome is the sum total of all the organisms that we have and carry around inside of us. And that also can include viruses, it can also include fungi, and it's not necessarily, we call it good and bad, but it depends really upon the situation because, like, for example, all of us carry around C. Difficile bacteria. C. Difficile bacteria. When you take an antibiotic, it'll wipe out some of the good bacteria, and then the bad guys, if you will, they'll sort of start to overgrow, and then they can produce toxins.

So we all happened to me, and I almost died from it.

Exactly. It's very. Yeah, exactly. And the treatment of choice for that is, you know, if you have a really bad case, the treatment choice is A stool transplant, which is like an organ transplant. And the interesting thing is that one of the companies that does this is OpenBiome in Boston, which I think you're aware of, and they use freeze dried stool. And that is one of the cures literally for a really messed up gut microbiome.

Because if you can even get poop pills now.

Poop pills? Yeah, Crapsules. Craps.

Right.

I've never heard that.

That's a good one.

How many crapsules did you take?

Right.

And what it is, and I always make analogies because that's how patients understand things. It's sort of like, you know, the ecosystem of the microbiome inside the body is like a rainforest. And at some point some people's ecosystems are so disturbed and so messed up that it's like napalm has hit your rainforest.

It's like a corn monocrop.

Yeah. And so you, what you need to do is you need to repopulate the microbiome. Yeah, right, we're getting a little puns here. Yeah, you need to repopulate the microbiome and you can't do that just with probiotics. Although we use probiotics and we use prebiotics and we use those together, we call them synbiotics and those are oftentimes very helpful. But for the really sick people who have things like refractory C diff, stool transplant is the number one treatment.

Yeah, interesting. So you've got this whole ecosystem bacteria, it's been disturbed by all these reasons you talked about, C sections, antibiotic use, lack of breastfeeding and so on. And our diet also plays a huge role in the growth of good or bad bacteria. So you can feed it certain things and it makes it worse and other things and it makes it better. So talk about that.

Yeah, so. So I always tell patients that when you're eating food, you want to be choosing your food not just for you, what you like, your, your, you know, the things that are pleasurable for you, but you also want to be feeding the good bacteria. And we talked earlier about the, this Akkermansia mucinophilia, that's a specific bacteria that is in the body and that you want to have on high levels. And when we do the testing, we, we can actually determine do you have high levels of it or do you have low levels or do you have no levels or very low levels. And there are certain foods which you can incorporate into your diet. Things like pomegranate and maca and acacia, acacia viva cranberries and Things like that. These are foods which are basically pre. Pre prebiotics. And when you incorporate them into your diet, it's like putting miracle gro on that garden. They start to flourish, they start to take over, and. And they help balance out the whole ecosystem.

Yeah, I think it's one of the biggest advances in our thinking about gut. Who's gonna give probiotics and that'll fix it. But, you know, you're giving like 50 billion is a lot. Right. But you have 100 trillion bacteria, so it's like a drop in the ocean. Exactly. And one of the big insights I had was actually from an experience I had last year where I developed colitis. It's a long story, but I had been sick from mold, and I've told that story. And I had a recurrence of my gut because I had the C. Diff. And that was kind of really messed me up. And I checked my stool and had really low levels of this Akkermansia, which has been linked to autoimmune disease billing to poor response to immunotherapy for cancer. It's been linked to cardiometabolic disease and diabetes. And I'm like, whoa, this is not good. So I started to research it and created this cocktail of cranberry, pomegranate, green tea, acacia fiber, some probiotics, other prebiotics. And I took it, and it literally, within three weeks, I went from full blown colitis to completely normal. Perfect.

Yeah.

And it was sort of a wake up call for me, which was you can't just give probiotics. You've got to feed the whole inner garden. And what it likes is certain foods. And it likes all the polyphenols.

Yes.

And the polyphenol colorful, dark, rainbow color of chemicals that are in plant foods that are. Certain plant foods have more of like the berries and so forth.

Absolutely. Yeah. The polyphenols are gold. And that, to me, I think that's actually probably one of the things that plays a role with the French paradox is the polyphenols that are found in red wine. Yeah, I think that's definitely what you're doing, is you're actually feeding. The patients love me. Because the two things that I always prescribe to my patients is chocolate and red wine.

I say people like wine drinking, but I wouldn't give it as an extra thing.

No.

Right, right.

But I'm just razzing. But the polyphenols are the. The miracle food prebiotics for the gut. Absolutely.

So tell us a story about a Patient who had a screwed up microbiome and what you did and how they got better?

Oh, I've had, I mean multiple patients. I mean like for example, I just had a patient this followed up today, 18 year old with fatty liver disease and sort of pre diabetes picture. And lo and behold, I did the testing for him and his akkermansia mucinophilia was almost undetectable.

Yeah.

And now fatty liver typically, like you said, we used to see this in patients who were drinking alcohol. What we're now finding out is that fatty liver is the thing that is being driven by disruption of the gut microbiome. So what's happening is when you destroy the mucus, the protective mucus lining of the gut, some of those bad bacteria get into the, into the, into the body, get into the circulation, they go into the liver and causes systemic inflammation which in turn causes fatty liver. And there was just, I don't know if you saw the recent paper about this, about what is termed non alcoholic fatty liver is actually from alcohol produced by gut bacteria.

Yeah.

So some bacterial actually produce alcohol which in turn poisons the ferments. Right, Ferments.

It's just like, you know, you get this bloating food baby, that's actually your bacteria fermenting the food you're eating. And certain foods are more fermentable. Like starches and sugars. Exactly. Yeah. We, we actually have seen cases of patients who literally had elevated blood alcohol levels. Yeah. Auto brewery syndrome from the bacteria in their gut. And they literally got pulled over and found, you know, they had like for drunk driving.

Exactly. And it actually, the auto brewery syndrome is. I've had a couple of patients with that and they typically, that's usually been attributed to yeast overgrowth, but there also are cases specifically with bacteria that can also produce alcohol. I mean you're basically. It's like a, it's a brewery in your body. In your body.

Yeah. You don't need a Budweiser.

No.

This bud's for you.

So the, so what happened when you have this patient and you, you.

Yeah, so. So I mean you basically, you work on doing dietary.

Do you get better when you fix this or you just.

Well, this was just. I just, I, I was just offhand because I just had this patient this morning and I, it's, it was a very interesting case because the thing that really stood out is that his protective anchorman's anaphilia was quite low. He was also a vegan, which you know, we could discuss, you know, what is the best diet I Don't believe that veganism is actually the best thing. I think we're omnivores and you know, I come from a family of dentists, so I always talk to my patients. See that thing right there? That's a, that's a canine tooth. And a canine tooth is designed to chew meat and to chew fish. And we have specific enzymes in the body which are pancreatic elastase and proteases which are designed to digest protein.

Yeah.

So we are, you know, like Michael Pollan said it best eat plants. Eat food, real food, mostly plants, not too much.

Right.

So a plant based diet with healthy amounts of fish and lean meat on occasion is really probably the best type of diet. And I think some of my most difficult patients are the ones who are sort of strict vegans, for whatever reason, ethical or spiritual or whatever religious, can oftentimes get into really bad, difficult situations because it's like a cat chasing the tail. They don't have the specific nutrients to patch up and, and heal the body.

Doesn't all that plant stuff help the microbiome?

It does, absolutely. It's going to help the microbiome. But he was, he was, he had almost no omega 3s.

It was really nutritionally deficient.

Right.

See, unless people are supplementing, they get super nutritional.

Well, exactly. You can have a person like. It was just in the, it was just in the news recently. It was a 22 year old, I think it was over in England, who was living on potato chips, white bread and french fries. And when goes on french fries and went blind.

There's no vitamin A. Yeah, went blind.

So you can be walking and talking, but, and you know, you can be severely malnourished.

Yeah.

Because there's a, you know, there's about 40 nutrients that your body needs on a regular basis. And I like to also make the analogy to my patients is like your, your body is like a house that's being built and broken down 24 7. You need all those building materials to make that house. You need carpeting, you need wood, you need glass, you need all these materials. And if those materials aren't there, then the structure may still be standing. But if you don't have glass, the wind comes in, the rain comes in, the snow comes in. And then you're going to have problems with.

Your problem with traditional medicine is they don't look for those building blocks, they don't test for them. And that's what's different here at the Ultra Wellness center, we actually look for these things. We find them In. When was the last time a doctor looked for Akkermansia in someone with fatty liver? Probably never. Right. Other than us here. Or some functional medicine.

Or check their Omega 3s or check their vitamin D. Exactly. Yeah. Right.

And so those kinds of diagnostics are available and help us really think differently about treating disease. I mean, most doctors understand hepatic encephalopathy, but most doctors who are treating fatty liver don't actually think about what's going on in the gut microbiome or how to treat it. They don't even know how to fix it.

Well, you know, the thing that. One of my pet peeves, Mark, and I'm sure you've heard this, too, is that patients will go see the expert endocrinologist for their diabetes and the expert gastroenterologist, and they tell the patients to eat anything they want.

That is absolutely.

Well, you mean food has something to do with our health?

It does. Oh, my God.

What a radical idea. My favorite. My favorite was once I was at Canyon Ranch. I was playing basketball at lunch because they had these basketball pickup games. And there was one of this people there was playing, and he was a gastroenterologist. And I said to him, you know, have you ever thought of, like, how, you know, food might impact what's happening in the gut? Because you're putting literally pounds of this stuff through that tube every day. You think it might have something to do with why people have digestive symptoms. He's like, gee, you know, I never thought of that. That seems so interesting. Yeah, that makes a lot of sense. And I'm like, holy crap. You know? But, yeah, I mean, your microbiome is dependent on what you feed it. How you grow your inner garden depends on what you're eating. And you can create a nasty garden with weeds and toxins and bad stuff and poisonous plants, or you can create a really flourishing, rich garden that actually takes care of you.

Yeah, absolutely. And then also, the other acid thing that a lot of even physicians are not even aware of is that most of your immune system is in your gut.

Yeah.

So when you disrupt that. That ecosystem, that. That rainfall force inside of you, you are disrupting the immune system. And we're talking about fecal transplants. There's a recent study that showed that children with autism who got stool transplants had a marked improvement up to two years out from just replacing the gut microbiome. I mean, that's pretty powerful. So there is no pharmacological.

Because autism is like an encephalopathy. It's A metabolic to some degree. It's a hepatic encephalopathy.

Yeah. I mean, to me, that's. That's sort of the canary in the. In the coal mine in our environment today. You know that with. We have 1 in 68 kids having autism now, depending on where you are living in America and around the world, that is a big, big issue. And what we're finding out is there's more and more connection to the. The microbiome.

Yeah. I mean, so 60% of our immune system is in the gut.

Yeah.

And essentially there's a sewers. That's on the other side of the lining of your gut, which is only one cell thick. And on the other side is your immune system. And there's a breakdown which can come from having C sections, antibiotics, acid blocking drugs, stress, poor diet.

Yep.

All that stuff damages the gut, creates a sleeky gut. Gluten, dairy, all those things. Then you get this inflammation. So we treat a lot of people with autoimmune disease here at the ultra awareness center, and often the place we start is the gut. Yeah. So tell us, like, how. How that works and, and about some patients you might have had with autoimmune disease and how working on their gut help them.

Yeah. So, I mean, I had one patient in particular who I saw, who came in. It was a great story. She came in and she was having Ms. As her diagnosis. She also had autoimmune disease, autoimmune disease, multiple sclerosis, and she also had infertility. And I did a complete workup on her. She had dysbiosis, had bacterial and yeast overgrowth, also had sensitivity to gluten, and had also some. Not a heavy, not a big level, but some level of mercury in the body. So I worked on diet, worked on, you know, both prebiotics and probiotics to clean up the gut. Got her completely off of gluten. And lo and behold, guess what? Her multiple sclerosis went away.

Amazing.

Disappeared. All right, not. Not to say that.

And you got her metals out too.

Yeah. Not to say that all cases of multiple sclerosis are due to that. But there are many pathways to multiple sclerosis. Just that. There are many pathways to Alzheimer's disease or any disease. Or any disease. Exactly. Because the body will manifest it in only certain inflammatory pathways. But. And then. So ultimately she got off of her medications. Her Ms. To this day is in complete remission. She has no symptoms on no meds, and as a side effect, she got pregnant.

Wow, that's a good Side effect.

Yeah. And she was happy. So that's.

That's an amazing story. And I think, you know, for people who are listening, functional medicine is a new way of thinking about disease. It's not based on the label, Ms. It's based on the cause. And you can have one disease that has many causes, like ms, which can be caused by heavy metals, by Lyme disease, by Epstein Barr, by the gut microbiome, by gluten, you know, like B12 deficiency. Right. You can have so many things that are driving this same syndrome. Right. And the personalization of medicine is what functional medicine is all about. And that's really what's different here about how we practice medicine at the Ultra Wellness center, because we're looking at each person as an individual. We're creating personalized medicine and personalized health, which is a radically new way of thinking. And we just lump everybody with the same symptoms in the same categories. But it doesn't tell you anything about the cause. And I always say, just because, you know, the name of your disease doesn't mean, you know, what's wrong with you. Right. And that's what we do through very detailed histories here, through very advanced diagnostic testing, to look at some of these things.

Absolutely. And I think the enjoyable thing that I'm sure that you experience yourself is that every patient is unique.

Yeah.

You know, I've never treated two patients the same way from a functional approach.

No.

Completely different. Even in the same family. It's. Everyone is. And that's actually the fun part about it, is the. I call it, you know, the person comes in with their own genetic uniqueness, their own, you know, personality makeup, their own story. All of these, you know, things that you can paint the picture of, you know, where were they when they got sick? Where are they now? And what are the things that, you know, that we can remove? You know, like the four R. What.

It'S like being Dr. House. Right. It's like medical detectives.

Yeah, like medical detective. Exactly. And. And, you know, I think, you know, one of the most important things that. That I always tell people who are training in medicine is to listen to the patient.

Yeah. They'll tell you what's wrong.

Absolutely.

And when. And what.

Exactly. And. And. And sometimes I just have to sort of bite my. My mouth because you want to always interrupt patients, say, oh, what about this? And what about that? I just sort of let patients talk more, and I just sort of listen, and then I'll ask the questions later. And when you really do that and let the patients tell their Story in their own way, in their own terms and get that out. You really find out all the little details, and you can play house and play detect and try to, you know, piece the piece of the puzzle together.

Yeah. You know, we. We. In regular medicine, we are trained to create an exclusive history. In other words, someone comes in with a symptom. Let's say they have heartburn or reflux or chest pain. We don't want to know anything else about them except about that.

Right.

We want all the details about that. We don't know. Do they have a rash? Are their fingernails cracked? Do they have eczema? Does their butt itch? Like, don't talk to me about any of that, because that's not relevant. And in functional medicine, all of it's relevant because it's a clue that could give you a clue to what's actually happening for that patient. And that's what's so beautiful about this process. You know, I think I used to work in the emergency room. I think you did, too. It's boring. It's boring because someone comes in and he's like, okay, it's the heart attack treatment. It's the asthma treatment. It's a kidney stone.

It's a protocol.

It's like. It's like you just look at the nurse, you go, heart attack. Okay? They don't. They know what the orders are. They know what to do. You just barely write it down, and it's like. It's like rote and boring. It's. It's a. It's a formula, like a recipe.

Right.

In functional medicine, there is no recipe. There's actually having to think every time you see a patient.

Right, right. And, you know, and, you know, being trained in traditional medicine and also in a functional medicine approach, there's definitely, you know, if you're having a heart attack, you know, I want a thrombolytic. Absolutely. I want.

Blow out your knee. You need a knee surgery.

Right. I want you to follow the protocol that has been shown to work. But for chronic conditions, you know, acute care medicine, which is basically the scalpel or the prescription pad are probably some of the more toxic things that you can have. A lot of what I see in my patients here is iatrogenica imperfecta.

All right?

Which basically.

Translate that, doctor.

Translate that. Which basically means the doctor did it. Right. So the patient comes in, and they're on a whole, whole laundry list of medications. And these are interacting. You know, they run proton pump inhibitors are causing calcium. Yeah. The acid blockers, they're they're causing calcium deficiency, mineral deficiency, B12 deficiency. So there's, you know, there's these, these drugs have their, their, their risk benefit. And the, the less drugs you use in medicine, the better off the patient is.

Yeah, it's hard because that's what we know how to do. It's what we're trained to do.

Yeah.

It's like we don't know how to treat people with food is medicine. We don't know how to restore a gut from a messed up gut to a healthy gut. And that's really what we do in functional medicine.

Yeah. And I also. The other important thing that it's important for physicians out there who are new to functional medicine, also for patients, is to realize these things don't happen overnight. It can take time, but usually, sometimes you can see a difference in, you know, days to weeks. Sometimes it could take months, and sometimes it takes years. It depends. Depends on what's going on.

So true. I mean, sometimes it's like, it's almost miraculous and you go like, it's hard to believe. I remember when I first started practicing, I would like, go, okay, do these things. Take this, eat this. And then they'd call back a few weeks later or a month later. I'm like, how you doing? I'm all better. I'm like, what? You're better from that? Because it was such a contradiction to everything I learned. But then I started to trust it and I started to expect it. And I just remember this one patient, she had psoriatic arthritis, which is a horrible condition where you've got psoriasis but your joints are being deformed and destroyed. You're in pain all the time. But she had a bunch of other stuff which, quote, was unrelated. She had depression, she had insomnia, she was overweight. She had terrible reflux and heartburn. And she was having bloating and sibo and irritable bowel. And I'm like, okay, well, let's see. She's inflamed. Everything that she's got is inflamed. The weight is inflamed. Depression's an inflammation in the brain. Her gut. Symptoms are about inflammation. The gut, you know, everything's related to inflammation. So why don't we sort of just start simple and clear out things that are causing potential inflammation. So we got rid of gluten and dairy in your diet and sugar and starch and all processed food. We got her gut cleaned up. I gave her an antibiotic and any fungal and a little gut program a couple of nutrients to help her fight some, some inflammation that she was suffering from. And six weeks later she came back, her psoriasis was gone, her arthritis was gone, her reflux and irritable valve was gone, her depression was gone. She lost 20 pounds. I'm like. And she got off all her medications, even the one that was costing 50 grand a year to suppress her immune system from this rises. And it seems like a, you know, it seems like a miracle, but it really isn't when you follow this methodology. And that's what we've been doing here for decades, practicing functional medicine up in Berkshire in the middle of nowhere. But yeah, it's pretty amazing.

Well, it's really interesting because most of the patients who have psoriasis are going to see dermatologists and most dermatologists do not have a clue about the gut microbiome, nor are they testing or thinking about it.

Right.

And then, then if they get psoriasis and they develop psoriatic arthritis, which is arthritis in addition to the skin condition. Because I always tell patients is the skin is contiguous with the gut. So if I draw a line on the skin and I keep drawing a line and go down my tongue and I go into my esophagus down to my stomach and my intestine, I'm still on the same surface.

Yeah.

So oftentimes, you know, this mark is.

That's true. I thought of that.

Yeah. It's. Yeah.

Kind of a cool thought that.

That's how I explain to patients. So the skin is contiguous with the gut. It's an ectodermal tissue. And when there's skin issues, think gut.

It's really a tube too. It's outside your body, is your gut. Yeah, it's true. I mean, when I'm a patient with psoriasis, eczema, acne, rosacea.

I treat their gut.

Yeah.

And I don't put stuff all over their face or on their body. Exactly. To suppress the inflammation. I get rid of that and it's like a, it's really a miracle.

I mean, it is.

I mean, dermatology is not something that I'm an expert in, although I was trained as a family doctor in dermatology. But I feel like it's. We get the most amazing results just for something as simple as fixing the gut and changing the diet.

Absolutely. Yeah, exactly. Yeah. I mean, the body is this interconnected, complex self healing organism. I mean, that's the big thing is I often ask patients, I mean, do you think you're going to get better? And if I Have a patient who thinks they're going to get better, then together we're going to get better. But if I have a patient who doesn't think they're going to get better, then I try to get them to change their mindset because somebody, even though somebody comes to me, they, they really almost believe I'm not going to get better.

Well, that's what they've been taught. Exactly. To live with this.

Exactly.

You have to manage your disease.

Right.

And I want to manage it. I want to get rid of it.

And, and, and the, and the body's ability to self heal is amazing. As you, as, you know, it's really amazing. There's an intelligence in the body that we, you know, as much as we know about the body, there's a lot more that we don't know. And I, you know, the more I practice medicine, I think the more humble I become because I realize how little I know. It's, how complex it is. It's, it's really, really complex. But, but there's so much that we can do for patients that, you know, they've gone to, you know, the Mayo Clinic, they've gone to Mass General, they've gone to, you know, X, Y and Z everywhere else. And they, you know, as you say, the resort medicine, we come here for last resort.

I mean, yeah, I literally just walked from my office to here after seeing a patient who went to the Mayo Clinic who had chronic dizziness, chronic constipation, fatigue, insomnia, all these different symptoms that they couldn't find, quote, anything wrong with him. And I'm like, well, I know what's wrong with you. You've got this, this and this and this based on looking at it through the functional medicine lens.

Yeah. Well, and the other thing is, is, you know, I think, I think it was a Sid Baker, I think, who made the analogy it was in, or maybe it was Jeff Bland, is that, you know, if you have a dime and you, it's a, it's. You're on a dark street and you lose your dime over there and the street lights over here and you're looking under the street light, which is where you're testing. So most of the testing is basically looking where the dime isn't.

Yeah.

All right. So the type of testing that we do here, which is nutritional, metabolic, toxic genomic testing, is, is spreading out the searchlight to find that doctor.

Absolutely. That's such a key point because, you know, you go to the doctor and they say, well, we've tested everything and all Your results are normal, and the implication is it's all in your head. But I would say I don't agree with that, because, you know, either two things are true. One, the patient's crazy or the doctor's missing something. And I'm going to bet on the doctor's missing something, because when we start to look, we find all sorts of stuff in places that nobody's looked before because they're looking onto the street lamp instead of actually where the problem really is.

Exactly. That's exactly right. Yeah.

And I think, you know, what you alluded to before was really important, which is that functional medicine is about getting rid of the things that impair health and putting in the things that help the body thrive. And then the body can take over and with this amazing intelligence, can repair and heal from all sorts of things.

Oh, totally.

Tell us first, what is leaky gut?

Yeah. So so many people are like saying the word leaky gut. Leaky gut, but officially. Right. The official medical term is increased intestinal permeability. And I love to draw a picture for all my patients when they come in to really show them what we mean by increased intestinal permeability.

Yeah. I failed art in the eighth grade, so I just show them Google images. I don't know. Oh, that's good. That's good.

I don't know.

I'm still drawing it each time I.

Go to Google images.

That's very smart. So we know there's this one cell layer, right? There's that one cell layer of the endothelium that divides the inside of the intestine. Right. So where the food is and all sorts of other things that you.

Inside your GI tract is a tube. It's literally outside of your body.

Right.

I mean, it's a protected tube that you put food in, and all this stuff goes in, it comes out the other side. And it's literally like not really part of your body in the sense that it's. Right.

The stuff inside isn't yet in your body.

Right.

But there's that cell layer that has to determine what should come into my body. Right. And what shouldn't. What's been properly digested food, you know, has this protein been broken down enough yet? Should this come in? Should I absorb this, or should this stay out?

So that barrier, like a filter, it's like a coffee filter. You don't want the grounds getting into your coffee, but you want the good stuff getting in. That's sort of how your gut is supposed to work.

That's great. Yeah.

And when it does, it's like you have holes in your coffee filter and stuff leaks through.

Right.

And why is that a problem? Right.

Because that. That stuff leaking through that might be a food particle that's not digested enough yet, or it could be a bacteria or a bug, a fungus or some. Something that shouldn't be getting into the body. Some of the not so good bacteria. And when those things that get into the body when they're not supposed to, then they can trigger all sorts of other symptoms in the body, and that might be symptoms of inflammation. So somebody might feel like joint pain or asthma, congestion. It may trigger. And there's been a lot of studies to show this. It can trigger autoimmunity. Yeah, right.

Allergies, autoimmunity, asthma, all kinds of fibromyalgia.

Yeah.

But you know what's interesting is that most diseases that are chronic diseases are inflammatory diseases.

Yes.

Right. Heart disease, cancer, diabetes, Alzheimer's, stroke. I mean, these are all inflammatory diseases. Even depression is an inflammatory disease of the brain. ADD is inflammation of the brain. Autism is inflammation of the brain. Brain. And so, you know, what's really interesting about this gut issue is that when the barrier breaks down and you're basically like an area the size of a tennis court. If you laid your intestines out flat, and it's like, you know, one cell thick, so you're basically one cell away from a sewer, you know, on the other side.

Important cell.

Right. Yeah. It's like. And. And that can get damaged. And when that does, things leak in, like you said, and you've got 60% of your immune system right under that layer, which then reacts to whatever's coming through that's not supposed to come through. So your body's actually doing its job, creating the inflammation. Yep. It's just that your gut's leaky and the stuff getting in, you shouldn't be getting in.

Right. And then. And then you start to not feel so good.

Yeah.

Right. Like you mentioned fatigue or brain fog or joint pain or swelling in the body. We see a lot of people holding onto water or swelling or congestion or asthma and then that whole cycle of autoimmunity also.

Yeah. So it's really, you know, one of the most prevalent problems. And so why are we having all this leaky gut?

Oh, right. That's a great question. Right. And it's so much because of our crummy food supply.

What do we know about that? Yeah, Listening to me, that's all I talk about.

So our crummy food supply that we've been putting a bunch of, you know, pesticides and antibiotics into, which is just shifting our microbiota.

And I mean, like glyphosate from the roundup, the weed killer that's on almost all our GMO foods and even wheat products, is one of the biggest damagers of your microbiome. Forget that it causes cancer, whether you can argue that or not, but it does disrupt your microbiome.

Right, right. And, you know, we, of course, are trying as physicians not to prescribe as much antibiotics for our patients, but so many of us have taken, unfortunately, too many antibiotics, and then our food supply. Right. You know, we're using so much antibiotics in our food supply to grow bigger cows, for example, and that's just shifting our whole. That whole microbiota in our gut.

It's true. And I read a paper recently about emulsifiers in food, which is using all processed food to make it thick or, you know, solidify it, hold it together. And. And these emulsifiers, like carrageenan and xanthan gum, and they even have this thing called microbial transglutaminase, which is basically bacteria made gluten, if you can believe that. And the reason it's called gluten is because it's like glue. So it makes things stick together, makes the food stick together. Right. But it's highly damaging to the gut. And so you've got all these processed food ingredients in food that are linked to autoimmunity.

Yep.

Right. So it's not even. And then, of course, the starch and the sugar, the processed oils, all damage your gut. And then, of course, the lack of fiber, the lack of phytochemicals in our diet, the lack of good foods, prebiotic foods, probiotic foods, like, I had sauerkraut for lunch yesterday. I mean, we don't eat that stuff. And it's so important, and we've seen so much damage to our gut because of all of these various factors in our diet. And then, of course, there's the acid blockers that we take for everything. Antibiotics, as you mentioned, hormones can mess up your gut bacteria. You know, steroids can do it. And so you end up with antibiotics, obviously end up with this horrible cascade of people with gut issues. It's the number one reason people go to the doctor.

There's so much of it now. It's crazy, isn't it? I mean, so many people are coming in with digestive issues.

And symptoms of inflammation in their body, but it's really common. Even if people are coming to us for Other reasons we're seeing, okay, it's the gut, and we've got to start with the gut and pay attention to what's going on there.

Functional medicine has been thinking about this for decades, and now there's a microbiome revolution. Everybody's talking about it. There's huge industry development around it, and we're talking about probiotics and this and that. And we've been focusing for decades on the simple fact that most of our copies. Chronic illnesses start in the gut.

Yes.

And whatever the name of the problem you have, whether it's migraines or whether it's depression or whether it's diabetes or obesity, I mean, I had a guy, rheumatoid arthritis or autism or whatever, you got to start with the gut.

And.

And traditional medicine, like, leaky gut is not a thing. Like, you go to the doctor if you have arthritis, and they're like, how's your gut? Right. Go to the cardiologist, how's your gut?

Even though there's so much research showing the connection, we don't get trained.

And so it's this huge gap right now where the science has advanced so far, but the practice hasn't.

Right.

And in functional medicine, we've been really great at actually getting the memo that the gut is at the center of our health.

Right. So for years. Right. We've Learned about that 5R program with functional medicine and how helpful that can. Can be to heal the digestive system.

And then heal all these symptoms or diseases that somebody has.

Yeah, I mean, it's amazing. I was talking to the CEO of Cleveland Clinic recently, and he was telling me about studies that he'd heard about that had used fecal transplants in autistic kids, and taking the poop out of a healthy kid and putting them in an autistic kid, and the kid's autism goes away.

It's phenomenal.

I mean, that's not true for all kids with autism, but it's phenomenal. Yes. It's amazing. Or they're doing transplants from people who are thin to people who are diabetic, and their blood sugar gets better.

Right.

I mean, I had a guy once who was a really great patient, and he was very poorly controlled diabetic on lots of medications, and we worked on his diet. It helped a lot. Took it down from like 200 to like the 120s or so, but I would never could get all the way down. It was a really good diet and exercise. And he was telling me he had a bunch of digestive issues. And so I said, you know, why don't you take some charcoal and do this and do that. And he called me back, he says, I don't know what happened, but my blood sugar went to 90. So we absorbed all the toxic crap in his gut that was causing inflammation that was causing his blood sugar imbalance. These are the kinds of things that we do every day in functional medicine, but that are not part of traditional care and people are missing out on.

Right, right. When we're saying, why is that? Why is this going on? How do we get to that underlying root cause for that individual person?

So, so you've got some amazing cases. And I think I like to sort of get into it because, you know, people don't understand how so many of our issues come from the gut and how easy it is to diagnose it and treat it. And we use tests that traditional doctors just don't do. Like, we have a different set of lenses, a different set of filters that we can sort through information and data and ask questions that traditional doctors can't. Like, how do you measure a leaky gut? How do you look at the microbiome in the gut? How do you look at the digestive function in the gut? How do you actually start to treat it in a different way? And I think your first case is just so rich with a story that is so common that I just love you to share this because I think everybody's going to resonate with this story. And by the way, I've never seen this patient as your patient, but I've literally seen the same story a hundred times or maybe 500 times, a thousand times in my practice. Same freaking story, Right? So tell us about this.

So it was a 24 year old gentleman who came in to see me and was really struggling over the last year with his digestive system. He was having a lot of bloating and gas pain in his stomach. Every time he ate. He was having diarrhea and sometimes he was getting constipated. And he went to his traditional GI doctor and they told him, you have irritable bowel. And. But he, he wasn't getting any better. Right. And he was just really. He was, because he was having so much stomach pain. He had lost some weight, so he wasn't, you know, he was on the thin side to begin with, but because he was having stomach pain when he ate, he wasn't able to eat as much and he was even losing more weight. He was feeling really weak and tired and sad, depressed. Right. And so for him, the time. Well, for everyone, the timeline is so important. Right. That's what we are. We learn. We learn in functional medicine is the gathering that information, learning about that individual patient's story, seeing.

So we start, we start, we start with a history with the mother and her pregnancy and the birth and whether they breastfed and when they took antibiotics, whether they were sick as a kid, what happened when they were introduced to food, when they got gluten, when they got dairy. We ask all these questions. So when someone comes in with irritable bowel, the average GI guy is not asking all these questions.

Right.

So why do we ask all those questions?

So, you know, because, because for this gentleman, for example, you know, he really didn't have stomach pain before a year ago. But what we found out is that when he was a kid, he had ear infections. So probably because he was eating dairy. Probably. Right. So it's such a common connection.

Oh, my God. I remember once being in the ER list and I. This patient came in and this little boy keeps coming back and like the toddler was coming back over and over to the ER with ear infections and. Yeah. Just so inflamed. And I said, how was he like? Like, did you breastfeed? Yeah. So when did he start getting the ear infections? When we started formula and dairy and milk. And I'm like, oh, okay. And this is even before I knew about functional medicine.

I know.

And I was like, well, maybe you shouldn't eat dairy. Yeah, yeah, the kid was fine, you know.

Right. That's such a, such a common connection. I mean, even my son with. When he started dairy, he got asthma and eczema. It was, it's, it's unfortunately such a common connection. So for this child, he had a lot of ear infections and.

Eczema, and so he was on antibiotics about once or twice a year in his childhood. And he really didn't think that was very much. Yeah, he's like, that's not, you know, that wasn't too much. But, you know, it makes a huge impact on the microbiome, as we're learning. And then he started to have acne as a teenager, maybe because of dairy more. Right. Or some of the imbalances in the microbiome. Right.

When you screw up the gut with antibiotics or a C section or lack of breastfeeding.

Then you get often more acne. Yes, we treat acne from the top in as opposed to the inside out, which is actually where it works much better.

And this, this gentleman was given low dose antibiotics for two years so then he took even more antibiotics. And so this history of antibiotics sort of set him up. And about a year ago, he had some sort of stomach bug, so some probably viral stomach infection. And then since that time, he started to have all these digestive issues and was losing weight.

And so this is a common story. People are so common, this sort of smoldering, a bunch of insults over the course of their life. You know, maybe they're a C section, they had antibiotics as a kid, they took acne antibiotics, they had, you know, they were eating a crappy diet, whatever. And then all of a sudden something happens and then boom, the body can't take it anymore and it creates some kind of disease.

Yeah.

But if you look at the story, you can often map out exactly how this happened.

That connection with his acne, with. With his asthma, with his digestive issues, with those antibiotics. That's that story we often see.

And we're not making this up. There's so much science that shows that your gut microbiome plays a role in acne and eczema and asthma, that it plays. I mean, we're actually doing this at Cleveland Clinic now. We're studying asthma and looking at how the microbiome plays a role and how it affects inflammation. All these various factors that most doctors just don't pay attention to.

Right. So with him, as we do with most of our patients, we do food first. Right. So we said, okay, we've got to really focus on this person's diet and help him start feeling better right away so he can start to eat more and regain some of his strength. So we pulled away inflammatory foods, we took them off of gluten and dairy while we were waiting for tests to come back. You know, sometimes we will do some tests that look at. Of course, we'll test for celiac disease or.

Which is a big cause of leaky gut.

Yep. That's for sure.

Probably the number one.

And he didn't have that, by the way.

You don't have to have celiac disease to actually have a problem. Right. You can have. They call it non celiac gluten sensitivity. I would estimate it probably affects 20% of the population. And I think if you look at the antibody levels, you can get a clue, which most doctors don't look at. And I read a study that autistic kids and schizophrenic patients often have. 20% of them have antibodies to gluten. And it may not be full blown celiac.

Absolutely. And. And even, regardless of, even if people are negative, Totally. For celiac, if they have increased intestinal permeability, they start reacting to a lot of different foods. So then you start to see with that leaky gut, as we talked about before. Right. The coffee filter and things are coming through, then the body's reacting to lots of foods that it maybe never reacted to before.

So they're not true allergies. They're more like sensitivities.

Sensitivities and be. Because of. And the real thing is it's because of this increased intestinal permeability. So our job is we have to heal that increased intestinal permeability so that they don't have to be so restrictive with their foods. I mean, we still always want them to be on a healthy diet, but we want to relax those restrictions over time. Most of the time we can.

Yeah. And so it's part of the approach of functional medicine. We start them on the elimination diet. So eliminating all the inflammatory foods, gluten, dairy, processed foods, all that stuff. And then you remove.

Right, that's the remove.

The 5R is we remove, replace, reinoculate, repair, rebalance.

Yep.

And we'll go into each of those because they're really important. But the.

Next step is also there's other things we may need to remove. There's tests we need to do. So what kind of tests would you look at as a functional medicine doctor that you wouldn't see at a traditional doctor's office that give us a roadmap of how to treat these patients?

Right. So we did a stool test that looked at his microbiome, and what we noticed is that there was an overgrowth of unhealthy bacteria and unhealthy yeast. So he had this, you know, probably because of years of antibiotics, he developed this dysbiosis, this imbalance in the bacteria and yeast. And so there was an overgrowth of the unhealthy things.

It's like weeds. Having a lot of weeds in your garden.

Right, right. It's not always like one of those. You think of a stomach infection, and you're getting really, really sick. You're throwing up or having diarrhea. This is this. It's an imbalance, and it's called dysbiosis. But that imbalance causes a lot of symptoms in people. When you have the wrong bacteria and the wrong yeast levels. You know, you can get a lot of bloating after you eat. You can get a lot of fat fatigue after you eat. You can get those symptoms of constipation and diarrhea. And that causes this inflammation in the digestive system. So all of your digestive enzymes don't work well. So you're not breaking down your food well, you're not absorbing your nutrients well. And it becomes this vicious cycle that people are dealing with and we see all the time.

Yeah, it's so powerful. So, you know, when I see this patient, I'm like, okay, you don't have to do all the tests, but sometimes if you get stuck, you. You look at various tests that look at antibodies against things that are in the gut that determine a leaky gut. We call it Cyrex 2 testing, which is a test you can get through functional methodology.

Right.

You can test to see if there's leaky gut. I love that test, too, because it's a great way for us to follow up and see how much we're seeing improvement. Are we doing enough? Are we seeing improvement in their leaky gut or increased intestinal.

And then we look at poop testing, like, you know, where we do thousands and thousands of these tests. And it's so helpful. And it doesn't just look at the microbiome. It actually looks at the function of the gut.

Yes.

Like, whether there's malabsorption, whether you had no digestive enzymes, whether there's inflammation, whether there's overactive antibodies in there, whether you have imbalances. And we call the short chain fats, which are the food for the colon, that are produced by bacteria eating the right kinds of fiber. And if they're low, it means there's an imbalance. Then we look at the microbiome and we look at what grows. We look at parasites, and then we target and micro target the things that are out of balance for that person, and it's different for everybody. And we might look at food sensitivity testing. We might look at. And even things like heavy metals or other things which can also cause it. I had a patient with ulcerative colitis once, and I did everything right. I did the whole 5R. It wasn't working, but I forgot the first part of the R, which is remove. And I thought, well, maybe, you know, heavy metals can cause autoimmunity. Maybe it's a problem. And so I tested him, and he was like, wasted away. And he was like, it was terrible. He actually had high levels of mercury. We treated mercury, and his colitis went away. So phenomenal. Yeah. Yeah. So I think it's so powerful. This case is so important because it really describes how a patient, you know, goes to traditional doctor, is diagnosed with a disease, irritable, bowel syndrome. By the way, anytime you hear syndrome, it means doctors know what the heck's going on. It's just a collection of symptoms that we agree we're gonna put in this bucket. And if you have those symptoms, you have this disease, but it's not really a disease.

Right.

And so that's what functional medicine is. It sort of looks upstream to figure out what the root causes are and personalize the treatment for everybody. And there's common things that we do, like the 5R, but it may be different Rs for each patient.

Right, right, right. So for him, we removed the inflammatory foods and we removed the bacteria and yeast. I actually treated him with an antibiotic, a non absorbed antibiotic and an antifungal. So I treated him with prescription medication. Yeah, weed killer. So that was the remove and then the replace. Because he was underweight and because of that inflammation in his digestive system, I gave him some digestive enzymes for a short period of time just to help him help it. So the food wasn't as inflammatory for him and to help him absorb more nutrients. And then we worked on reinoculating.

Right.

So after we gave him some good.

Probiotics, Put in the healthy bacteria.

Put in the healthy bacteria, some good prebiotics. Right. So we know that what are prebiotics? Prebiotics are the, are the things that help feed the good bacteria. So they're the food for the probiotics.

Which is usually what, like fibers?

Fibers are amazing prebiotics. We know a lot of phytonutrients are prebiotics. So this, I think is really exciting research. When we're looking at our phytonutrients, you know, we know that what are phytonutrients, Right. So I know it's amazing, right? So our food has minerals in it, it has vitamins, but it also has these things called phytonutrients, which are these component in, in our plant foods that have this amazing health benefits for us. So that can include things like ellagic acid that we see in pomegranate that can feed some of the good bacteria, that Akkermansia that we know can lower inflammation.

We know that just to back up on that Akkermansia thing. So when we look at the poop, we can tell that there's like good levels of different bugs. And one of them we look at is Akkermansia. And it turns out that that is so important for protecting your gut. It helps you keep your biofilm or that little coating over the gut so you don't have a leaky gut. And it's involved in so many autoimmune diseases in response to cancer therapy and metabolic issues and weight, and it's such an overlooked thing. And you can't take a probiotic of it, at least not yet.

Right.

But you can feed it the good guys.

We can feed it. We can feed it with all these amazing phytonutrients, like what's in pomegranate, the ellagic acid. And also we know that sulforaphane from our cruciferous vegetables feeds the good bacteria.

You know, so broccoli, collards, kale, but not juicing it, right?

Brussels sprouts, all those good ones. We know that green tea that has good phytonutrients in it, that's good for the digestive system. So we always say to people, you know, get something from every color of the rainbow every day. You know, you get some plant foods from every color of the rainbow every day. Get some good red foods like the pomegranate or cranberry. Get something orange and yellow and green, blue, purple, white, tan. You know, those. All those good, healthy plant foods that we, you know, like our vegetables, our fruits, our spices, our teas, our coffees really actually are impacting our microbiome, which is fascinating.

It's so great. And, you know, just. Just a great anecdote from a colleague of mine, Dr. Lee, who was on our podcast talking about Eat to beat disease. His mother had stage four uterine cancer, and being the smart doc he is, he understood from the research that if you have low Akkermansia, patients don't respond to the immunotherapy, what they call the checkpoint inhibitors, which is this new form of cancer therapy that helps activate your immune system. So if your gut isn't healthy, you can't actually get the cancer cells to die with immunotherapy.

Right.

So basically, you die unless you have good bacteria in your gut. And so his mother was. Had stage 4 uterine cancer and was gonna die and wasn't responding, and he gave her pomegranate, cranberry, green tea. All these phytochemicals got her akkermansia levels up, and she was cured of her stage four cancer within a month.

That's a phenomenal story.

It's an incredible story. And I think that just shows the power of these plant foods, of the plant foods, and of getting focused on the gut.

Yes.

And this can be a devastating clinical scenario where all of a sudden this young boy or girl starts getting These strange neurological type behaviors, these tics, these OCD type behaviors and etc. And these things are driven by neuroinflammation. The original description was that it was due to a strep infection. Mothers and fathers know about that because when their kid gets a sore throat, they take them to the doctor, make sure they don't get a strep infection. And typically we focused on strep being important because a strep infection can cause rheumatic heart disease, a strep infection can cause glomerulonephritis. That's why we're so on top of strep infections. But what doctors are missing and even a lot of mainstream pediatricians are missing, is that those strep infections, not only can they cause molecular mimicry where the molecules, when they're attacking the strep bacteria, what they'll do is those antibodies will actually start attacking the brain. And that's where we end up with these conditions like pandas.

Yeah, it's just such a remarkable, the research on the brain the last decade and how it's revealed that all the conditions that we thought were maybe psychiatric or maybe more biological in the sense that they're disorders of brain immune function. And you mentioned the glial cells, which is the brain's immune system, that cleans things up. But there's so many things that screw it up and including lack of sleep, which is a big one. That's when it's really active. But I know I've seen in my practice that focusing on brain inflammation has led to the most miraculous cures for all sorts of, quote, incurable conditions. And it's not often easy to find what the cause is. And I had a patient the other day who had tics since he was a little boy. And it turned out he was really. They come on after he had really bad series of strep infections. And I think to my mind, he hasn't even thought of having pandas. But he might have this low grade inflammatory response from the strep that's been going on for 30 or 40 years, but nobody picked it up. So we see all this kind of stuff, whether it's depression and depression. Depression, you think, oh, that's a mood disorder? Well, yeah, it is a mood disorder and sometimes it's because, you know, you have a loss or some tragedy in your life and usually that's. That are temporary. But these sort of chronic mood disorders are often related to brain inflammation. And they've even talked about using drugs for rheumatoid arthritis, for depression to kind of shut off the inflammation of the brain. I think it's a bad idea. But you know, what's, what's causing all this brain inflammation that's leading to this sort of rampant epidemic of brain diseases? I wrote a lot about this in the UltraMind solution over a decade ago. And it's only, you know, increased in terms of the prevalence of these problems and the data linking inflammation and, and actually uncovering some of the causes of inflammation that are driving this. Can you talk about like what, you know, from a traditional perspective? What we do is we give you medications, we give you antidepressants, and we're not actually giving anti inflammatories for Alzheimer's, although they tried giving people like Advil and see what happens, but it didn't work. So what is like the approach we take to finding out what the causes are?

Well, that's where you really have to take time. And as you well know, we do a deep dive in listening to the history. And I think that's one of the things that probably distinguishes us when we do functional medicine is we have the time, we take the time to actually listen and listen to the patient's story. And there's a, there's a saying in medicine, if you listen long enough, the patient will tell you what the problem is. But you have to allow the patient to talk and you have to be able to listen and piece together the puzzle. So it's really about mapping out the timeline of when did their patient, when did the patient symptoms start, how old were they, what was happening around that time, did they get a vaccination, did they take an antibiotic, Were they bitten by a tick, were they exposed to some kind of a toxin? Did they have dental work? I mean, there's all different kinds of things that, that can trigger inflammation. And that's where you really have to play medical detective. And you know, sometimes you're going to find it on the first time, sometimes you're not. It might take you a lot of uncovering, you know, lifting up stones, leaving no stone unturned. And that's where a functional medicine approach where, you know, we do a lot of advanced testing to look for, you know, not necessarily an infection per se. It's not like you have a fever and you're, you're sick, but what we would call a stealth infection where you have a bacteria or a virus or an atypical bacteria present in the body that is causing this immune activation. And in the process of the immune activation the brain gets inflamed and then can manifest as having a whole bunch of different types of neuropsychiatric conditions or potentially even memory issues or motor conditions or other neurological conditions like multiple sclerosis. So it's a real. It's. You know, you have to play detective is what is it is.

I mean, and the key things, you know, really drive the problems are the usual things we see that drive inflammation in general, whether it's autoimmune disease or anything else. You know, it's toxins. So it could be all the environmental toxins. We see this in Parkinson's with pesticides and chemicals. We see evidence of, you know, heavy metals playing a role in many of these brain disorders that drives inflammation as well as toxicity. We see the microbiome playing a huge role. I just recorded a podcast with Emerin Mayer for the Doctor's Pharmacy, and he's all about the gut immune connection and how it affects the brain and the gut brain connection. And he's written a lot about the biology of this. This is not some abstract idea. It's something that's really becoming fleshed out in literature and that people are coming to grips with as a force to be reckoned with in terms of the brain. And so we have to understand the microbiome's role. Toxins, foods, for example. Gluten can be very inflammatory for the brain for many, many people, because it produces.

Both inflammatory antibodies that affect the immune system and autoimmune disease. But also it can be a direct irritant in terms of the proteins that get digested and inflame the brain. And then, of course, there's infections that you were talking about, like viruses or tick infections and so forth. These all can be driving brain inflammation. So in functional medicine, what we do is we go, wait a minute. Well, what is the story behind this person's particular illness? As you said, we go into a deep history, and if we don't do that, we will miss often the real keys to figuring out the root cause of their problems. And that's really what's so beautiful about functional medicine, is we have a set of tools and a set of therapies that allow us to, one, identify the causes and two, to actually treat them directly. And it's pretty exciting because we do see a lot of changes from people's health.

Absolutely. And you were talking about, you know, the connection with the gut, and there's really some fascinating stuff. You know, when I was in training, you know, we talked about Parkinson's and Parkinson's is the old, old person's disease. As you get. As you get older, you slow down. And part of that slowing down is Parkinson like features. But what we're finding out is that Parkinson's is a spectrum illness. And there is a big connection between patients who have Parkinson's and gut disruptions, leaky gut, gut dysbiosis without actually both bacteria and yeast. And there's a fascinating.

Literature on the microbiome and the metabolites of the microbiome. And there's a woman whose husband has Parkinson's, and believe it or not, she actually diagnosed his Parkinson's by how he smelled, which is to say that when you eat certain food, the bacteria in the yeast actually do a metabolism of those foods and will produce these chemicals which are called the metabolome or the gut micro metabolome. And those metabolites in some people can affect the brain. And so in essence, you can sort of sniff out Parkinson's. And she actually did that. She actually could. She sensed that there was something going on with him and then had him examined. And he was then diagnosed with Parkinson's. And in fact, they're actually training dogs to sniff out Parkinson's.

Dogs can tell you if you're going to have a seizure or if you have a low blood sugar or if you have Parkinson's or cancer. It's pretty fascinating.

I prescribe dogs all the time. It's one of my prescription. Absolutely. Yeah.

It's interesting. The body knows, and I think.

Maybe we could just sort of share as a way of illustrating the power of addressing inflammation on the brain. With some cases, I have a bunch of cases from autism and Alzheimer's, but we're good to get sort of a sense from your experience, what are the. What are the things that show up and how did you treat it and what happened?

Well, you know, I. I've had a whole. A whole variety of cases. In fact, a couple of cases that we've had at the clinic where we had some patients who presented to psychiatric hospitals. And when it came out, you know, you know, when somebody has psychosis or a breakdown, if you will, they call that, you know, a psychotic break or a manic break or whatever you want to call that. And we've had a couple of recent cases where the patient's underlying trigger was.

Lyme disease, which is a spirochetal condition. And always remember, this is something that I really like to emphasize to my patients is that way back when doctors used to treat syphilis, we don't have a lot of syphilis in a private practice today. It's just a condition which was readily treated and it's pretty much gone, although there's still some occurrences of it. But syphilis was caused by a spiral or is caused by a spirochetal bacteria. And that's the same thing as Lyme disease. And Lyme disease is the great mimicker. And it also can cause dementia and psychosis. So that's one of the conditions that trigger neuroinflammation. And then also there was a recent case of Bartonella, also causing neuropsychiatric conditions and a diagnosis of schizophrenia. So it's really a fascinating, fascinating field. And the problem is, is that psychiatrists are not trained to think this way, and neurologists are not trained to step over into psychiatry. So they're like they're two different fields, but they're really the same field. So it's neuropsychiatry. This is an area that is actually really quite fascinating to me. And I, you know, people always ask me, you know, what kind of doctor are you? And I have my own.

Description.

I do answer that question.

Yeah, I'm a psychoneuroimmuno endogist and basically looking at the whole connection between the brain, the gut, the immune system, and all of the body when it's all sort of interconnected. And it's really, really fascinating. And you can really help these people who are having significant conditions.

So what happened? You said this patient with schizophrenia, right. And you found the tick infections. What happened then?

Were able to get their symptoms down by treating the underlying cause, which is the underlying.

Spirochetal infection. I also had another patient who had mycoplasma infection, and it's actually known in the literature. Mycoplasma is an atypical bacteria, and it's another infection which can cause the brain to be on fire. So it's a really fascinating thing. And one of the tests that you can do that can check for this, it's not a common test. I don't know if you've done this, Mark, is the NMDA receptor antibody testing. This is looking at the parts of the brain that are stimulatory. And this is something that any doctor who has a patient who has gone, quote, unquote crazy or had a psychotic break, they should have an NMDA receptor antibody test. Because if you have this, it tells you that there is some type of neuroinflammation that's driving their symptoms.

Yeah, it's quite incredible. So I've had patients who are schizophrenia before or bipolar disease. And you think these problems are just so intractable and so difficult to treat. And they can be. But in fact, the whole field of functional medicine came out of the field of psychiatry with Abraham Hoffer's discovery that you could treat schizophrenia, you know, using nutrients and helping to improve the biochemistry of the brain. And then Linus Pauling wrote his seminal paper, Orthomolecular Psychiatry and Science magazine in 1969, which talked about the perspective of how do you straighten molecules, in other words, how do you correct the imbalances or dysfunctions in your biochemistry? That's called orthomolecular, which means to straighten. And that has really led to the whole field of functional medicine. And we then sort of expand on that with our understanding of the role of inflammation in the brain. And I, and I, you know, many schizophrenic patients have high levels of, for example, gluten antibodies. About 20% of schizophrenics have anti gliding antibodies in their bloodstream. When you take the gluten away, they do better. That causes brain inflammation. And when you do autopsy studies on people with Alzheimer's or autism or schizophrenia or depression, you find that their brains are inflamed. So, you know, when you start to think about that, it's like, wait a minute, we are treating this completely incorrectly. And this is what was classical traditional medicine. You treat the symptoms, not the cause. And functional medicine is really about the cause. And why not just what disease you have, but why do you have it? And in the case of these brain disorders, it's often not obvious. And the problem may be far away from the brain. It might be in the gut, or it might be in your diet, or it might be a toxin, or it might be an infection and, and, or it might be mold, and it might be all sorts of things that we are kind of missing the boat on. And so we have this potential to sort of rethink our whole approach to brain science. That's what's so exciting when we see the work of guys like Dale Bredesen or others, and nutritional psychiatrists like those at Harvard and metabolic psychiatrists at Stanford, they're doing work in this field, Understanding the connection between the brain and some of these systemic processes.

Yeah, absolutely. And when you, when you take a schizophrenic and you look at them with a PET scan, the positive emission tomography, what you'll see is their brain lights up. And that's because their microglia, which is their immune cells in the brain, are on Literally on fire. And unless you actually treat that, the schizophrenic is at high risk for developing dementia down the road because their fire is not being put out. And this mark is, I'm going to mention this because when I was, I actually done some lectures for American Academy of Anti Aging Medicine on neuroinflammation. And in the process of preparing for that, I came up against some really fascinating things. One is that when you look at the genetics of schizophrenia.

They did this whole genome wide association studies of saying what gene or what genes are associated with schizophrenia? And they did what's called a Manhattan plot. And on chromosome 6, it sort of stood out like the Empire State Building. And what they found out is that on chromosome 6, chromosome 6 is highly involved with the immune system. So that tells us that a lot of patients who have schizophrenia have an issue on chromosome 6 related to the immune system. And what I'm going to tell you next is absolutely, positively fascinating. And this sort of blew me away. There are two case reports. And remember, case reports are just like a doctor observing. Okay, this is interesting. Look what happened. You know, why did this happen? And the two case reports were this. And this tells you, you know, how the immune system is intimately involved in schizophrenia. One is a patient had refractory schizophrenia and developed some type of cancer and needed a bone marrow transplant. Transplant. The refractory patient with schizophrenia got a bone marrow transplant. Bone marrow transplant is basically giving you a new immune system. After he got the bone marrow transplant, guess what happened to his refractory schizophrenia? It was gone.

What happened?

Gone. It completely cleared up because it changed his immune response to whatever it was responding to. I don't know. But his refractory schizophrenia went away. On the flip side, there was another gentleman who also needed a bone marrow transplant. He got his bone marrow from his brother who had schizophrenia. Guess what happened to him?

He caught, he got schizophrenia.

Schizophrenia.

Wow.

It goes both ways.

Pretty amazing. That's pretty amazing. Yeah, it is amazing.

I, I was, I was blown away by that. And I think that, you know, in, you know, people who are doing, I'm, you know, I'm a clinician, I'm seeing patients. But those, those case reports are really, really seminal to change how we think about how we see these conditions. I also found it fasting that, you know, we talk about the gut microbiome and how that's so important related to the immune system is that when you do stool transplants, you can literally transplant or infect a person and make them skinny or you can transplant stool and make them fat.

You go autism. We don't Parkinson's. Right. They're actually doing fecal transplants with autism and with Parkinson's and seeing real changes in the brain function. That blows my mind when you think about that.

It does blow my mind. And the thing about this is we are still in the nascent period of really understanding this, because it's not like you take this one chemical or you take this one probiotic, and everything's fixed. It's a very, very complex array, and we have hundreds of different microbes and bacteria and viruses in the gut. So it's going to take us a while to figure this all out. But, you know, I think we're also in a very good stage where, you know, we have, you know, massive computing power and we have artificial intelligence. And I think that we're going to probably approach these areas of understanding neuroinflammation and really difficult to treat conditions like als, like schizophrenia, like Parkinson's and such, and we're going to be able to biohack them. And Alzheimer's. You're right. Alzheimer's. That's another thing. Now, this is. You're bringing up one of my favorite things. So, for years, Mark, what did neurology focus on with Alzheimer's? It was what it was.

Right. All you got to do is get rid of the amyloid and you get rid of part of Alzheimer's. That's right. Get rid of cholesterol and get rid of heart disease. Right. So guess what?

The plaque, the beta amyloid plaque that was found in the brain, guess what that actually is. That's an antimicrobial peptide. The brain is producing beta amyloid in response to some type of organism, be it a virus, a bacteria, or a fungus. So when we see that those are the footprints of a organism that the body is trying to attack.

Yeah, absolutely. And I think, you know, we actually probably should have Rudy Tanzi on the podcast. He's a scientist at Harvard who specializes in Alzheimer's, and he has discovered the microbiome of the brain. So, literally, there are viruses, yeast, bacteria in the brain, which we thought was sterile, that may be triggering this cascade of inflammation. And then the question is, where does this come from? And it seems like a lot of it may come from the gut, which is crazy. How does it get from your gut to your brain? But it does, and it triggers this neuroinflammation that's driving things like Alzheimer's. I think we often get stuck on one thing, though, right? In Medicine we stuck on, it's this or it's that. And I think the important thing people remember is whatever your diagnosis is, it doesn't immediately tell you what the cause is. So you could have 10 people with Alzheimer's, they could have 10 different causes and in one person you could have three or four or five different causes. Right. And I just remember one patient I had who was seven years old. Really pretty significant, you know, Alzheimer's. Not bedridden at this point, but pretty non functional. Also depression and was struggling really badly. He was former CEO of his company, a family run business, couldn't function anymore, behavior was changing. His kids, grandkids, family didn't want to hang out with him anymore because it was acting inappropriate. And turned out he had so many things going on. I mean the biggest thing he had was high mercury, which he lived in Pittsburgh and had exposed to all the steel plants and they use coal ash for fertilizing land and they put it on the streets in the winter instead of sort of salt for the icy roads. And he also had a mouthful of fillings and he also had a terrible history of irritable bowel for 30 years and was on stelazine, which is just like an antipsychotic. So it's like a relaxant for your gut, which is terrible. But he had terrible gut issues and bacterial overgrowth and leaky gut and gluten sensitivity. And he also had insulin resistance, he had pre diabetes. So essentially, essentially he had all these problems, heavy metals, microbiome issues and he had insulin resistance or pre diabetes, which we know drives inflammation in the brain. They're calling Alzheimer's, you know, often type 3 diabetes. And he had all these other biochemical issues, genetically like methylation problems and, and which is the B vitamins. We're also driving inflammation in his brain because he wasn't able to produce antioxidants and glutathione. And when we started to address all these things, we got the mercury out, we fixed his gut, we cleaned up his diet, we got rid of the sugar and starch, we optimized his B vitamins. He literally came back from the deadlight rip and winkle and was able to function, go back to work, be a functioning member of his family again. This is someone who would have just been said, okay, you have Alzheimer's and you are going to be a nursing home. And that's the end of that. And it was pretty miraculous to see that. It sort of woke me up to how by really being diligent with these Patients, you can. You can really help them either completely recover or dramatically recover. And I've seen, you know, the spectrum from, you know, in the tough cases of autism, Alzheimer's, you know, depends how much they're they've got going on, how far down the road they are. But you see amazing stuff with things like depression, bipolar disease, you know, mood disorders. It's often remarkable how quickly the brain responds. Add and it's something that we just unfortunately are not thinking about that well in traditional medicine. That's really why we do what we do at the Ultra Wellness center. And we've treated nearly thousands and thousands of patients in this way. And we now do stuff virtually, too, which is kind of fun. So we can see people from all over, and we have a great team of physicians and nutritionists and practitioners who really help guide people through this space. Because what kills me, Todd, and I'm sure it kills you, is you hear story after story, and I'm sure you get this all the time, hey, could you help this one? Could you help that one? With my mom or my dad or my sister, my friend. And people are just struggling to find answers. And when you hear the story, you go, oh, God, I know what's wrong with this person. But it's because we have a certain set of filters or lenses that we look at, and it's so gratifying.

So let's break down the 5R program for everybody. So we got the remove. So what are we looking at? We're removing.

Removing unhealthy foods or inflammatory foods for that person.

So they can be food sensitivities, things.

Like gluten, diabetes, food allergies, sensitivities.

And then we're removing processed food and junk food.

Oh, yeah, that's for sure. And sugars and, you know, excess sugar, which is feeding the wrong bacteria. And then we're removing the unhealthy bugs or yeasts or viruses or fungus.

Bacterial over growth. Yeast over growth. A parasite.

Yep.

You know, I was on the red table talk, and Jada and her son both had parasites, and they both had gut issues for a long, long time.

Right.

And they thought it was just how they were, but with, you know, short little course of treatment, they were both. I've never felt better.

Right.

And all these other symptoms, because now.

You'Re actually absorbing the nutrients you're eating, which just helps the body heal.

Yeah. So. So then. So you remove, then we replace. But you might also remove things like heavy metals or stress or toxic people in your life or whatever's Giving you a stomach problem.

Replace means just to replace some of those digestive enzymes, if needed, reinoculate.

So the replace also could be like prebiotics. Right. So putting in the fibers to feed the gut and to actually maybe use hydrochloric acid sometimes for people who aren't digesting their food as they get older. Yeah.

And to help get them off of the acid blockers, which, you know, we know are creating a lot of problems because we need that acid in our stomach to digest our food.

Ok, let's take a little detour. So you just mentioned acid blockers. These are among the most prevalent drugs prescribed today in America, other than statins. I think when I was in medical school in the 80s, we just had those drugs come on the market. The drug reps used to come to us and say these are very powerful drugs. Never use them for more than six, six weeks because they block stomach acid and they'll cause significant problems if you do that long term.

Right.

You can cure an ulcer with it. You can fix an acute problem, but never use this. Now, people are on this for decades.

Yes.

And it, and, and the, the side effect which is listed in the, you know, manuals that we get as doctors is that it causes irritable bowel syndrome.

Right.

So you end up fixing the heartburn, but you get irritable bowel and bloating and bacterial overgrowth and all these problems. Right.

Because you need the acid in your stomach. And when you block that acid, then there can be an overgrowth of bacteria where there's not supposed to be, and that can cause all those slew of problems.

You change the ph, you get more yeast issues and all this stuff.

And then you're not absorbing your minerals, so you can get osteoporosis, and you're not absorbing your B12, so you can get fatigue and dementia. Right. It just goes on and on and on.

It'll absorb zinc and magnesium, minerals, calcium. You cause osteoporosis, pneumonia. It causes, you know.

On and on.

Right.

It's.

It's. So it's. And it's, it takes some work. Sometimes when people have been on an acid blocker for a long time, it takes some work for us to help wean them off because their body has gotten pretty used to it. They, they start to get their bodies, Their body wants to make acid. So it's, it's working against the medicine. So when you wean them down, sometimes they get more acid production.

It's called rebound. So you actually.

Yeah, it's like.

And it's sort of a trick. Like, you get off it, but it makes you worse. So you feel like you have to get back on it. I get back on it, but it's actually not true. And you can actually get off it.

Absolutely.

So we do that all the time.

We do it all the time. So re. Inoculate giving all the good prebiotics and probiotics, the good bacteria and all the things that feed the good bacteria. And then the fourth R is repair.

How do you know what probiotics to take?

Oh, that's a great question.

I want to know what are you proof.

Oh, my goodness. That's such a. That that goes on and on. We could talk about that. That for the next hour.

It's true.

Right.

There's a lot. There's more and more probiotics on the market every day, and all have different roles and different functions. And we're just sort of. Honestly, I think, you know, we've been doing this forever, but feels to me like we're at the infancy of this understanding of how to use these in medicine.

Yep.

So what.

I mean, there's some great brands that I trust and I use all the time, but when. When somebody is, you know, doesn't maybe know what to do, I'll say, you know, get one. Get. Go to a reputable place, a reputable pharmacy or a good wellness store pharmacy and get a probiotic. Try it. If it makes you feel worse, then stop it. Because there's some good bacteria that make people feel worse.

Exactly.

If you have bad bugs growing in there and you put the good bugs in there, they have a fight and they cause all of them.

And so that means we just have to do more work before we can start it.

Yeah. So they got to re. Inoculate. And then you got the.

And then repair. And that's the fourth R. So that's things like. That's like giving good protein, good amino acids, which are the building blocks of protein sometimes repair. Yeah. To help repair that barrier, that coffee filter.

Right.

We have to repair it with good protein. And sometimes we'll use amino acids like glutamine that help repair it. We'll give more zinc, whether it's from food sources or as a supplement, maybe we'll give some vitamin A, which also helps with healing that barrier. It helps with healing the endothelium in the gut. So those are things we will do to repair and then rebalance. That's the fifth R, which is really focused on managing our stress and how we're reacting to the world. Because we know that when our parasympathetic nervous system is engaged, when that calming nervous system is engaged through meditation and yoga and breath work, that our body has, has the ability to heal. And it heals better when our body is, is, is at rest.

I mean, yeah, I think, you know, you just touched on something very powerful, which is that our, our gut and our brain are connected. There's a whole hard wiring of nervous system and our gut and the gut even has this independent nervous system that actually is like a second brain.

Yeah.

And, and so, you know, you know, we often say people are irritable bowel, are emotional or anxious, or have, you know, just maladaptive emotional coping mechanisms. But it turns out that, that the irritable bowel actually can cause an irritable brain and lead to anxiety and all these emotional issues. So it's a bi directional. And I think that's a great lever for helping people, People reset their gut.

Absolutely.

You know, I just want to share a story because I, you know, I've been doing this for a long time and of course my.

I don't know what it is, curse or blessing, depending on how you look at it, is actually getting really sick and having to figure out what to do to fix myself. And I've had a lot of gut issues over the years, which is why I really focused on this. The first is when I had mercury poisoning and I tried everything. I did every functional medicine trick in the book back then and it wasn't working right. And until I got the mercury out, which disrupts all your enzymes, it disrupts your gut, it causes leaky gut, it causes yeast overgrowth, it screws up the bacteria in your gut. Until I get rid of the mercury from my system, I couldn't get my gut straight.

Yeah. And then it's impacting your immune system too.

Right, right. And then, and then I fears, many years later, I, I, you know, kind of got an issue which was triggered by an antibiotic for a root canal that I had to take clindamycin, which is known to cause C. Diff, which is a terrible bacterial infection that kills like 30,000 people a year. Yeah. And I got that.

Yeah.

And I was so sick and I, and you know, Liz would come over to my house and I was like, it was pretty bad. I'm like, we're all struggling to figure it out. And I, Yeah. And I had mold in my house, all these other things, but I ended up having colitis and I had tremendous leaky gut and I did my Own stool test and my friend Patrick Hanaway, who it worked for the stool test company for many years, my colleague at Cleveland Clinic. He and I looked at my stool test and we probably between the two of the seen like 20,000 stool tests, we're like, this is the worst one we've ever seen. And everything was screwed up and I had no good bacteria. I had low butyrate, I was not digesting, I had tons of inflammation. It was terrible. And I couldn't really fix it using a lot of the traditional things. And then I started to sort of work on a gut shake, which included a lot of the sort of 5R concepts. Right. So I clean up my diet. Obviously I got rid of the bad bugs, but I used a combination of these polyphenols from the plants, a pomegranate, cranberry, green tea. Also added, you know, glutamine. I added prebiotics, probiotics. I even added colostrum.

Yeah.

You know, which is to help regulate the immune system. And it was like a miracle. I had went from full blown colitis to like normal in three weeks. And I've been great ever since. And you know, it's just like, wow, this is something that people can actually do. It's not that hard. It's not drugs. And the alternatives are like really bad drugs. Right. So, you know, we, we, we want to go into the next case, which was sort of not about people with a gut centric issue, because people often think, oh, well, if I have a leaky gut or if I have gut related problems, I'm going to know it. My stomach's not going to be right, I'm going to feel symptoms. But that's true, it's not always the case. So the first case was a guy who did have a typical history of, you know, antibiotics and acne and some infection and then, you know, diet and all this stuff. And that was pretty clear. But there are many cases where people come in and they have zero gut symptoms, but their guts a mess and it's causing all these issues. So tell us about your, your next case of this patient with autoimmune disease.

This was a 50 year old woman who came in and she didn't have any real digestive issues that she was paying attention to or that were bothering her. What was bothering her were her joints. So she was having a lot of joint pain, especially in her hands, and she was starting to get a lot of swelling and deformity. And she was diagnosed with rheumatoid arthritis.

Really common.

Yep. And her rheumatoid wanted to put her on a biologic medication. He wanted to start her on Enbrel.

And so by the way, these are drugs that suppress your immune system, that can cause life threatening infections and increase risk for cancer. That costs 50,000 a year. So it's not risk free and it's super costly.

Yeah.

And it can save lives and it can be a great rescue medicine if people need it. But most of the time using functional medicine, not all the time, but most of the time you can figure out the puzzle of why they're sick and fix that and then they get better and they don't need the medication.

Right. So she, and she wanted to try it a different way. So she came to see us and said, you know what, before I go on this medication, can we do it a different way? Can I, can I, can I, can my body heal and can I get to the point where I don't need this medication? And, and so we did a lot of testing on her and what we found.

And by the way, the testing can sometimes be expensive, but it's a lot cheaper than a lifelong course of these medicines and the suffering that goes along with it. Right. So if you have to spend a few thousand dollars up front to figure it out, you know, you can stop having to pay 50 grand a year for the medication for the rest of.

Your life and you feel so much better.

Yeah.

And so we found out that she had increased intestinal permeability. We did that test that you were mentioning earlier, that Cyrex 2, which looks at antibodies against different proteins in the digestive system, and if they're elevated, it gives us an indication that there's that increased intestinal permeability. And hers was really, really high.

Yeah. And she had no symptoms.

No. And she had no symptoms. Right. And one of the markers on there was high. That makes me also think, okay, is there really a gluten issue for this person? Because we know that that can damage, as you were mentioning earlier, that for people with celiac disease, that really can damage the, that end of that, that those villi in the intestines and is a major cause for leaky gut.

Yeah.

So.

Well, just that's an interesting point you brought. Bring up gluten. So even if you don't have celiac, you can still have issues. And you know, one of our functional medicine faculty, Dr. Alessia Fasano, is one of the world's experts on leaky gut and gluten.

Yep.

And. And he discovered this because he found that you know, in cholera, when there's a mechanism in the body that actually causes you to have a leaky gut and sort of get rid of the infection, and it can kill people if it's bad enough. But he realized that the same thing that gets activated, cholera, something called zonulin, is activated by gluten. So gluten causes this protein to be produced that creates a leaky gut. And you don't actually have to have celiac. And you could even have what we call non cell mediated immune response, which is the old ancient immune system that doesn't even use antibodies. So you can't even measure it or test it. Right.

Just inflammation.

Just inflammation. Sort of like it's like, you know, the difference between a smart bomb and like, you know, carpet bombing. You know, like, it's just a. It's like sort of an ancient part of the immune system just reacts and gets pissed off and inflamed, and that can cause a leaky gut. So when people have high zoning levels or create antibodies, as I. It's meaning there's some issue with gluten.

Yes, yes. And so, you know, we. We said. When we saw her intestinal permeability test, we said, okay, we've really got to focus on these five Rs with you. And we went on. We went on to find also a bacterial overgrowth. We found a bacterial overgrowth in her digestive system, and we found a bacterial overgrowth in her mouth. So we know that there's been really interesting studies showing that when there's certain bacteria in the oral cavity that have been associated with autoimmune disease. So gingivitis, or inflammation in the gums from a bacterial overgrowth has been associated with autoimmune disease in some people. People. And I think for her, there was. We saw that connection because we saw some elevated levels of unwanted bacteria in her mouth, and we saw some unwanted bacteria in her digestive system.

What does she need, like mouthwash?

Dental care?

Yeah. You know, I mean, you can. You can treat. You can treat the bacterial overgrowth in the mouth. You can treat it with certain types of dental care. Scaling and root planning. We also used a herbal. She wanted to go the whole herbal route. So we used an herbal rinse for her mouth, an herbal toothpaste, and an herbal rinse that helps get rid of the overgrowth of unwanted bacteria. We used some good probiotics that you actually chew and that they give bacteria. Mouth probiotics. Yeah.

Cool.

And we also used an herbal regimen that for the digestive system to get rid of that bacterial overgrowth. Because what they're learning. Right. Is that there's certain bacteria that when they cross into the body, when they're not supposed to, they trigger the immune system and they trigger this autoimmune process and they trigger that inflammation. And then the body gets confused and it starts fighting off its joint space when it's not supposed to.

Yeah. Maybe genetics, like the gene. I think it's doctor four or something, which. Which is associated with increased susceptibility. Rheumatoid arthritis in the face of certain gut infections.

Yes.

And we. We know this from medicine. We were trained in medical school that if you have certain bacteria like Yersinia, you can get arthritis. Or if you have Entamoeba histolytica, which is a parasite, you can get rheumatoid arthritis. So we learn this as traditional medicine doctors, but we sort of don't pay attention to the fact that it may be more broad than that.

Yep.

And I think, you know, you also mentioned the overgrowth of bacteria, so I think people might be wondering, well, isn't there a ton of bacteria in your gut? Anyway, what's the big deal?

Right? So. So, but there's some bacteria that. That are good. I mean, we can put them in the category of good. And some that we. That we don't think are as good and that have been associated with inflammation in the body and autoimmunity. So it's really. It's all about balance.

And sometimes bacteria can go where they're not supposed to go, right?

Absolutely.

So, like, the small intestine is where you get. Get most of the leaky gut. And what happens is sometimes those bacteria that are. Should. Should. Shouldn't be there, kind of migrate up into the small intestine, which is like 22ft, and then start to grow. And then when you eat them in. Sorry, when you eat certain foods, it causes. It causes that food to ferment because the bacteria is there. That's where you get the food, baby. And the bloating and the dislocation. Yep. And that's a big. That's a big clue for people if you have bloating after eating.

Yes, that is a big clue.

You know, it's not normal. You should not know you have a digestive system until like two minutes before you have to go to the bathroom. You go to the bathroom in five minutes or less and you're done. That's it. Like. But people don't realize it. You know, the constipation, the bloating. The weird bowel movements, the diarrhea, the irritable bowel. It's so common.

Yeah. So for this woman, we did, of course, the 5R program. We removed gluten, we removed those bacteria, we used an herbal protocol, and then we. Then we reinoculated. Right. We. We gave a lot of the good bacteria, the pre and probiotics, and we did a lot of nutrients just to help her body heal. Right. The vitamin A, the zinc, the colostrum you mentioned before, and really worked with her to help with managing her stress. And she was able to avoid the biologic medication. Her joints got better, her joints got better, her energy got better, the inflammation in her body went down. She actually lost a bunch of weight as a side effect. She was happy with that side effect.

Yeah, it's a good side effect.

Yeah, she was happy with that. So she really got much better. So it was. It was exciting to see.

And we see this all across the board when we start focusing on the gut and leaky gut, whether it's, you know, allergies or asthma or migraines or autoimmune diseases or colide. I mean, it's just. It's amazing how powerful it is. And. And this is the one thing that functional medicine has focused on, that the traditional medicine is almost uniquely ignored. I mean, I remember when I was at Canyon Ranch probably 25 years ago, and I was talking to a bunch of doctors who were. They were guests there, and we were having a dinner, and I started talking about Leap. He got. And it was an allergist there, and she's like, that is just such garbage and nonsense. It's not true. But now it's really different. And now there's enormous amounts of research going on about the gut microbiome and about leaky gut, and now they're looking at treating in the icu and.

Right.

It's like. It's like, wow, we've really taken a huge turn in the last 30 years.

Right, right, right.

It's really great. But I think, again, if you're suffering from any kind of inflammatory issue, if you're having any kind of cognitive, behavioral mood issue, if you're struggling with any kind of sinus or allergy stuff or any gut stuff, you gotta find a doctor who really understands how to work with the gut in a way. And the truth is, it's not that hard. It's like, once you figure it out and how to navigate. But we need to sort of just review what we talked about because it's so compelling and I think that most people don't really grapple with this idea, but that leaky gut is a thing that it causes a whole range of conditions. We just talked about. The traditional medicine ignores it. There's really great tests for it. Right. There's really great tests to look at food sensitivities at your microbiome and your gut and all the factors, overgrowth of bacteria, yeast, parasites, that'll tell you exactly what you need to do. And then you use functional medicine to fix the problem using this 5R approach, which we kind of went through with these patients. And even diabetes is caused by leaky gut.

Yes, right. Yes.

Because the, the metabolic toxins get in the system and anything that drives inflammation causes weight loss.

Right, Those lipopolysaccharides. Right.

And there's a whole like, yeah, a lot of science about this. So it's pretty exciting. And then, and then people can start to change what they're eating to include more prebiotic foods, include probiotic foods, to more fiber foods, more phytochemicals and phytonutrients. They can do things to help their gut repair using enzymes or prone prebiotics and using gut repair nutrients like we talked about, vitamin A, C, so all, sorry, vitamin A, D and gluten, I'm sorry, glutamine and zinc. And that really is an incredible roadmap for people to heal their gut and to heal all these chronic conditions. And this is what we do with the Ultra Wellness center day in and day out. We've been doing it for 25 years together, 15 years at the Ultra Wellness Center. And I, I think I just want people to understand that they don't have to just suffer. People just suffer needlessly when there are ways to heal these problems that are quite different from what you get in traditional medicine.

And there's some really good evidence of the particular bacterium, which is a bad actor. And it's called Porphyromonas gingivalis. And I have seen this in a number of patients who have had early Alzheimer type symptoms. You can also see this oral bacteria in patients with rheumatoid arthritis. So looking for this with DNA of the mouth organisms. And again, you know, this is to me is a really fascinating thing. You know, somebody says, well, Alzheimer's runs in our family. Well, Porphyromonas gingivalis may run in your family. You may be spreading the bacteria from person to person. And this, this bacteria, which is in, found in saliva, it stimulates the immune system and genetically susceptible individuals and can really lead to profound neuroinflammation. And in one patient in particular, who I saw, he had Lewy Body dementia, which is another form of, you know, inflammation. Lewy bodies, because they.

Anatomical examination of the brain, they find these little things, they call them Lewy bodies, right? It doesn't mean that they understand it. It's just Louis found it, and that's because he named Lewy Body after Louis.

And that's actually what is what Robin Williams had. Rob Williams had Lewy Body dementia with Parkinson's, you know, so we call it, we call it Parkinson's, we put it in this neat little category, and then we call it Alzheimer's, or we call it dementia. We put it in this little category and then we call it Lewy Body. And they're all sort of this interacting, overlapping kinds of things. And yeah, they can have different clinical presentations, but as you said, there can be many, many factors that go into, into the, the origin of this neuroinflammatory process. And diet plays a huge role. You know, if you don't have the right nutrients, you don't have the right fatty acids, you. You're more going to be more prone to. All of your cellular membranes have omega 3 fatty acids. If you're not able to make the compounds in the body, which are called pro resolving mediators, or SPMs, and actually have this as a supplement. Now, these are actually quite fascinating compounds. The SPMS are selective pro resolving mediator compounds. They're basically turbocharged fish oil. And certain people, some people can't take the, their omega 3 fatty acids and turn them into these compounds. And clinically, I have found them, they either work really well or they don't work. I don't know about you, Mark, but these are other things that you can use as a, as a nutraceutical to help turn off inflammation in someone who's got some chronic inflammation. Not to say if you take it, it's going to help with Alzheimer's per se, but it's one of the other tools that we can use to modulate the inflammatory response in the body.

Yeah, so true. You know, we often in traditional medicine don't know how to evaluate the brain properly because we're just looking at the brain, but we have to look systemically, and that's really what we do in functional medicine. And, you know, Dale Bredesen coined the term a cognoscopy, like a colonoscopy, but for your brain. And it's looking at all the things we've been talking about. Looking at diet, looking at nutrient levels, looking at hormones, looking at toxins, at the microbiome in the gut, looking at infections, looking at mold, looking at allergens, looking at the overall health of the person and seeing what of those things are driving adverse consequences for the brain and for brain function. And any individual, the same cause might cause different things. One person might cause schizophrenia, another person might cause Alzheimer's, and the person might cause depression. So we really have the tools to look at a true cognoscopy. And then the question is, how do we help the brain repair? How do we set up the conditions for the brain repair? So let's talk about how, from a traditional functional medicine point of view, we actually treat these people, because it's a pretty systematic approach that addresses diet and lifestyle and also some of these underlying causes.

Yeah, I mean, so we, as you mentioned, Mark, we do a lot of the testing. So we'll do organic acid testing, which is checking for the nutrient metabolites that are found in the body. Also do gut microbiome testing, looking at all of the different bacteria, viruses, yeast, parasites, potentially in the body. We'll look at markers for leaky gut. The other test that I do is a leaky brain. You know, just like you can have leaky gut, you can have a leaky brain. There's actually a test for that. Cyrex Laboratories does the blood brain barrier test. You can check also for neuro autoimmune markers with the Cyrex 7X test. Again, you can do gut microbiome testing. The one that I like to use is the GI map test, because I think it's, it's quantitative pcr. So I, I find it to be very helpful. The, I think the whole GI realm area is an area that we're just learning. And there's gonna, I think as time goes on, these tests are going to get better and better. But I find that to be very, very helpful to distinguish what's going on inside the. The person that I have. The other thing which I think is also really, really critical, Mark, is sleep. And this is something that I really emphasize to people, is that when our bodies sleep, our brains take out the garbage. Okay? And I'll guarantee you, when you have a patient who's got a neurodegenerative condition, one of the first things that you'll see is disruptions of their sleep. And what happens is during the day, you know, our brain only comprises 2% of our body weight, but it can, it uses 20% of our body's energy, which Means that there's a lot of metabolic activity. And what happens throughout the day is we get metabolic waste products that build up in the brain and our brain flushes them out during deep delta sleep. If we don't get that deep sleep, we can't flush the brain and take the garbage out in the brain. And those toxins build up those things that metabolic byproducts fold, misfolded proteins, inflammatory molecules, amyloid, etc. Build up in the brain and can affect how the person's cognition is, their memory, their mood, et cetera.

It's amazing. Yeah, I think, you know, the diet is such a huge role too in the brain. I mean, we see that the diet we're eating is a highly inflammatory diet in this country of processed foods, inflammation.

That are driven by sugar and starch, excess refined oils, all the lack of things that are anti inflammatory, the whole foods with all the phytochemicals in them and the nutrient dense foods. So we're eating a diet that's super inflammatory. So this is the first thing. And often dairy and gluten are among the worst.

And then we focus on how do we get the right nutrients. Because if you're low in certain nutrients, whether it's the antioxidant nutrients or the B vitamins, your body needs these nutrients to regulate your immune system to function. Whether it's zinc or vitamin A, or selenium or vitamin D, vitamin C, all these are really necessary for proper regulation of immune function. So getting adequate levels of these is key. Also, we really get people on an elimination diet if we suspect or we test that they have sensitivity to certain foods. We treat the underlying infections if we find them directly with antibiotics, if we need to. Antivirals, or sometimes we'll use herbal therapies or things like ozone and other approaches to deal with infections will fix the gut. Often that's a big issue. So we have a whole functional medicine approach to fixing the gut. We've talked about a lot on this podcast and, and then we'll address whatever toxins are there and help you eliminate the toxins through a really focused detoxification program. And so building on, on the framework of functional medicine, we can identify in each individual which of these things are the problem. And then we can start to map the right treatments for that person. And it's so gratifying when you see this in people's lifelong depression. Gets better. I mean, there was a woman who was.

Severely depressed, who was in and out of psychiatric hospitals on lots of medications, her marriage was falling apart she wasn't able to really work at work anymore. It's about to get fired from her job. Very overweight diet, obviously high in sugar, starch and processed foods. And she did the Daniel Plan, which is a faith based wellness program, but it's based on a whole foods anti inflammatory peganish diet essentially. And she said at the six week reunion, she's like, Dr. Hyman, after three days of changing my diet, my depression went away. And I've been on piles of medications, in and out of hospitals, admitted for severe depression to hospitals many times in my life, and it's just gone. And I'm like. She goes, is that possible? I'm like, yeah, it's possible. If whatever you're eating was triggering the inflammation in your brain, you stopped it. Yes. So it's really is sort of untapped reservoir of tools and tests and therapies that traditional medicine, psychiatry, neurology, you're just not using. And it's really where the money is.

And you bring up a really good point, Mark, because I, you know, I often ask my patients who are seeing a psychiatrist and I'm not going to bash psychiatrist, but I think the profession of psychiatry is in the dark ages. I can't remember the last time a psychiatrist that I've seen has done a blood test or examined the patient. And I think that a lot of psychiatrists would actually do a good job if they actually took a side course in neurology to really understand how the brain is working. So if you're a psychiatrist and you're seeing a patient and you are not utilizing a good nutritionist, preferably a functional medicine nutritionist, if you're not doing some blood testing and you're not actually examining your patient, you may be doing more harm than good. And it's not. And the other, the other, my other pet peeve about the psychiatric world is that we are now medicating young children in ways that are unexplored. We're doing polypharmacy in the young, polypharmacy in the old, with these neuropsych drugs, they're advertised on television and it is a complete, if you will show, excuse my French, it is awful. It's a, it's a terrible, it's a terrible thing in this country. And I'll stand up here and I'll shout from the rooftops, because this is a bad thing that we're doing to the brains of our people, the brains of our young kids. This is something that we should not be doing, period.

No, I mean it's true. We really are. You're relying on downstream treatment. So when the neurotransmitters go awry, whether it's depression or autism or Alzheimer's or add.

We go, well, how do we fix the neurotransmitters? And the question isn't how do we fix the neurotransmitters. The question is, why are the neurotransmitters so screwed up in the first place? And it's because of these phenomena. One of the great examples I'll see is that the basic.

Driver of inflammation is diet. But there are other factors, and anything that causes inflammation can interfere with our enzyme function and throughout our bodies. And there's a key step in converting serotonin, I mean, tryptophan into 5, hydroxytryptophan into serotonin, which is the happy mood chemical. And when you get a high level of inflammation in the body, that enzyme is sort of blocked and you end up with this byproduct called kinurate or kinurate, I don't know if I'm pronouncing it right. I was reading, I don't pronounce it.

Kynurenic acid. Right?

Yeah, kynurenic acid. And that level goes up and you can actually measure it in these patients. And you see when they have high levels of these quinolinate or kyarinic acid, it indicates inflammation. And you know that the serotonin pathway is being screwed up and it's bypassing and producing these toxic molecules that cause inflammation in the brain. And, and so one, by getting rid of the inflammation, two, by giving the helpers for these chemical reactions, you can often really help improve the cognitive function of the brain. But it's really about the inflammation. And that's what's so, so different striking about it.

You know, it's interesting you say that, Mark, because I used to lecture for Metametrics Laboratory who does the organic acid testing. I'll never forget when I first learned about the quinolinic acid and that quinolinic acid is measured on organic acid testing. And this compound was actually first isolated in patients who had AIDS dementia. And what they found is that, as you mentioned, how that pathway gets switched over, various things, like viruses, like the AIDS virus, can actually upregulate the production of quinolinic acid. And high levels of quinolinic acid cause the brain to become inflamed, they cause the brain to shrink, and they can potentially cause Alzheimer's or dementia type symptoms. And that's where AIDS Dementia was, is basically how we found the importance of quinolinic acid. I'll bet you there's not many psychiatrists who are measuring quinolinic acid in their, in their psych patients or even neurologists who are doing that.

Yeah, we do at the Ultra Wellness Center. We definitely do. And we see so much from that data that can help us figure out how to help these patients. And that's, that's really what's. To me so, so exciting.

Well, you know, I also, this is, this is, I'm going to go back to when I went through my training because I went, I trained at Dartmouth and I went, I had a great education at Dartmouth Medical School and one of my neurology professors was Dr. Alex Reeves. And he was a fantastic teacher and wonderful, open minded, energetic, enthusiastic guy. And he really helped me to understand how the brain works and also understand how it's connected to the mood and your whole being. And I also had, when I did my psychiatric training at Dartmouth, I had another.

Mentor who was board certified both in psychiatry and neurology. So that's where I really got. And he was someone who would actually order tests on patients and understand that, you know, let's, let's try to figure out what's going on. This was, you know, way before functional medicine was, was prominent. And it got my, my, my, my own brain thinking about, you know, neuropsychiatry and it's a fascinating field is there's, you can't split them. Neurology and psychiatry are one. And when you think that they're, that they're separate are, you know, you have this dichotomy, you're not gonna, you're not going to help neurological patients and you're not going to help the psych patients. You need to think in neuropsychiatrically.

Well, you know, I'm sure this happened to you like it happened to me. But, you know, I started practicing functional medicine. I wasn't focused on the brain. I wasn't focused on, you know, treating people by dealing with the, you know, the things that I, I thought were focused on the brain. I was really focused on fixing their health issues. People came in with irritable bowel or they came in with asthma or they came with an autoimmune disease or they came in with whatever they came in with. And I would literally work on that problem. So fix their gut or fix their, their, whatever was going on and, and incidentally, their psychiatric problems would get better or their, their ADD would get better and they report, Dr. Hyman, I'm not depressed anymore. My panic attacks are gone. My OCD is better. You know, my memory is better. I was like, what's going on here? And so I began to go, wait a minute. And I didn't really come at this from an academic point of view. I came at it from a clinical point of view. And I started noticing if you pay attention to your patients, you, like, listen to them, they'll actually tell you what's going on. I'm like, well, something's going on here. And that's really what led me to write the book the ultramind Solution, which is how to fix your broken brain by fixing your body first. And that book is a little dated now, but honestly, if I look back at it, I think it's still way ahead of its time, even now, because it's talking about the ideas that were, you know, then were in the literature, but just really beginning. And stuff that I saw clinically, like the role of, for example, tick infections, the role of the gut microbiome. I mean, who's talking about the microbiome in the brain 15 years ago? No way. But we were paying attention to this and we saw these patients get better. And I was like, like, wow, this is a whole new field. So that's really why I wrote that book. And I can't tell you how many people have said to me, I got that book and it changed my life. I followed the directions. It's basically a step by step guide on how to fix your own brain. And sometimes you need help with Dr. And there's even sections in there and what to do if you need to go see a doctor and what test you should ask for. But it really was striking to me. And I remember this one patient came in after a while, after I'd written the book about a year later, and I said, oh, why are you here? So, well, I'm pretty good. What's going on? Well, a while ago I had all these brain issues and depression and memory issues and blah, blah, blah, blah. And I'm like, why are you here then if you're better now? She said, well, I read your book and I followed all the directions and I got better. It took nine months to get an appointment. And I said, maybe you can help me get even better. I'm like, okay. So what was so beautiful about it was that I literally took the science of what we do in functional medicine and applied it into practical steps for people to do. And sometimes people need to dig deeper, but I think it's such a gratifying field that we're in, Todd, because we get to see how people really can transform by fixing the root causes, by looking at the underlying biology, by treating the system, not the symptoms. By helping deal with this brain on fire through looking at all the factors that can interfere with it.

Inflammation, which is what I had. Right. Widespread inflammation in my nerves. Inflammation in my gut. Inflammation in your brain.

In my thyroid.

Exactly. It doesn't qualify as a treatable disease.

Inflammation. Right. That's what I was joking. Say functional medicine doctors are inflamologists. Yes. I love that. I remember that.