Functional Medicine Secrets To HEAL DISEASE... | Dr. George Papanicolaou & Mark Hyman

You can't just ignore the fact that somebody's got a stone. You've got to look for root causes. You know, it's so common that it's invisible. You've got to look for other disease processes that may have predisposed them to form that stone. Everybody says, you know, a lot of people now, oh yeah, it's my gallbladder. Now I'm gonna have to get it taken out. Their thought is the only cure for the gallbladder is to take it out. There's no thought to their lifestyle, their nutrition, and the impact that bile is having on the gut microbiome, which might be causing some other symptoms in their GI tract. Absolutely.

I think that, you know, I've seen patients who really been able to turn things around by correcting them and correcting their diet and their lifestyle and taking the right supplements. And, you know, it's not an easy condition for sure, because if you already have big stones and it's blocking things, sometimes, you know, you need to have dealt with. And, after people have surgery, I mean, are they restricted in what they can eat? Often people say, I can't eat fat. Is that true? Can they use enzymes? What are the sort of consequences of actually having the surgery?

Well, you know, the consequence of surgery is that now the gallbladder can no longer store the bile. So, the bile can freely flow into the small intestine. And so, In regards to the ability for the bile to do its job, it's not going to be being triggered appropriately. It's really important that if you've had your gallbladder out, that you take something called ox bile with your meals so that you can appropriately break down your fats. It can have a significant role because you may not break your fats down completely. and you need as important fatty acids, your omega-3s, your DHA, your EPA that you get from your fat. And if you can't get them, then it's going to have a huge impact on you. In regards to foods you can eat, it's more what you should eat. I think there are restrictions, but they're not always necessary. It's really making sure that you're getting a higher fiber diet. You're getting foods that are going to be favorable to your gallbladder. celery, what are some of the other ones? Help me out here, Mark. Bitters, bitters, so bitters are great. Green leafy vegetables, things that they can be very helpful.

Absolutely.

The key thing becomes staying away from all the processed carbohydrates, staying away from meats that are not organic, that have lots of toxins in them. And if you do that, you take your ox bile, increase your fluid intake, add in some bile salts, which you can do through supplementation. You should be able to live pretty healthy. Even more healthy because we're going to change your diet because we're going to say, look, these are the things that got you to the stones and now you're going to have a really good leverage point on getting people to start to eat a healthier diet. That's fantastic.

Well, you know, the truth is that there's so much we can do and it's such a hopeful message for those who have gallbladder disease and can actually make a difference in the course. Maybe they'll need surgery, but maybe they won't if they try some of these other things that we use in functional medicine. We also deal with the whole gut issues. And what have you seen in your patients with us? You had a patient who was over 40, a woman, she was gaining weight, had gut issues. Tell us about her and your approach. What did you do diagnostically? How did you treat her? What was the outcome?

Sure. So, as we learned in medical school, it's the four or five Fs, depending on how you think about it. But unfortunately, it has a lot to do with women. And it has to do with the fact that they're pregnant, which is fertile. They're 40. Those are two things that, you know, are high. They're. They're associated with.

Not overweight. Right.

Yeah.

Fertile. I don't want to say fertile fat.

Fertile fat. That in medical school, we learned all this stuff, like fertile fat and 40. That was what we learned.

Yeah. Yeah.

George didn't want to say it, but I didn't. Yeah. So.

So, this woman came and her concerns were that she was really feeling fatigued. She had sudden weight gain. She had gone to her PCP. She was told that her thyroid looks fine. The numbers are okay. Not to worry. You still got kids. The same old, you're getting older. You have kids, you're running around, you're busy. She was just living with this fatigue and this weight gain. Then she started having gut issues. She started having bloating and distension. She just couldn't take it anymore and she came to visit us. She had, I think, one episode of pain that sounded like it was gallbladder disease. It had lasted for an evening. It was after having a really fatty meal. She hadn't gone to the doctor. She sort of suffered through the night. She never really dealt with it. After our first visit, I told her, I really want you to go get an ultrasound of your gallbladder. I said, you, have a lot of things going on, but one of the things I need to really find out is if you do have gallbladder. disease. It turned out that she did. She has some stones, and she probably did have an episode of a stone that passed and caused her some pain. The complete workup for her involved looking at her hormones, looking at her thyroid, and looking at her microbiome and food sensitivities. When I got her thyroid numbers back, Her TSH was 3.9. Okay, so now, you know, doctors, you know, will look at that and say that's within the normal range because traditionally they've been taught anything from, you know, 0.45 to 4.5, it can be considered normal. But we've learned more and more that that's not the case. When you see a 3.9, you see a 4.2, You start to think, I don't think that thyroid really is an optimal function. Well, I also, when I check the thyroid, I also check for antibodies. And when you know her antibodies against her thyroid were sky high, she had Hashimoto's thyroiditis. On her food sensitivity panel, she had gluten sensitivity. She did not have celiac disease. which she had gluten sensitivity, Hashimoto's, hypothyroidism, which then set her up for a couple of different things. But certainly it slowed her gallbladder down and set her up for having a stone by the mechanisms that I've already explained. And she was estrogen dominant, meaning that relative to progesterone, she had more estrogen than she needed. And she had a history of a cycle that had been irregular, a cycle that she had a lot of breast tenderness, she had a lot of water retention around her periods, she had PMS around her periods. And that just screams estrogen dominance. And she's had that most of her life. So, what did I do? Step by step, we just started to deal with the underlying issues. I started to treat her thyroid, treat her Hashimoto's thyroiditis. I treated her, she had SIBO, by the way. First thing we did, we stopped the gluten. She was off of gluten, and that's going to, you definitely want to do that because if you have sensitivity to it and you get one autoimmune disease like Hashimoto's, then you're going to set yourself up for more because it's more likely that you'll get another one once you have one. Gluten stopped. and then we addressed her SIBO, SIBO small intestine bacterial overgrowth. We put her on a low FODMAP diet, which helped address that. I used some antimicrobials that were botanicals that addressed that.

How did she do?

She did great, obviously. It took a while to get her hormones under control and balance those out. It took a little while to get her SIBO under control, but once we had CIBO under control. We got her thyroid function down from 4. What I said was 3.9. 3.9. Got it down to 1.2. Her energy was back. She felt great. And then, as we work with her diet and we clean up her CIBO, she was back to normal in a very short course of time within three months.

That's amazing. So, we really can affect people's course and she really didn't need surgery then.

She did not need surgery. As I said before, and I explained this to her, I said, the stones are just enigmatic of the bigger problem. They're the canary in the coal mine of your nutrition not being where it needs to be, and you may be having excess toxins in your system. And the estrogen dominance, estrogen needs to be metabolized and it is in the liver and it ends up in the gallbladder. But if it's in too higher concentrations, it can have a very negative impact on gallbladder function. So her dominance, her SIBO, her thyroid, she was just, it was just, she was, you know, it was a matter of time before she had SIBO. And if she had had that stone and gone to the emergency room and hadn't passed it, she would have had her gallbladder taken out and nobody would have ever addressed these other issues.

Of course. Gallbladder is such a common problem. It's one of the most common surgeries. It's such a common problem in America. Tell us about gallbladder disease and what is it, who gets it, how many people have it, and what are the symptoms and why is it such a big deal and what do we know about who's getting it and all that. Let's take us down the whole rabbit hole of gallstones. Then we're going to get into how conventional medicine treats it and what functional medicine approach might be that might be worth trying.

Yeah, sure. It's almost so common that it's invisible. What I mean by that is that people don't really think about it. They don't think about their gallbladder. Why would they think about their gallbladder until it hurts? Gallbladder disease affects 6% to 9% of adult age people between 20 and 70. And of all of those people, they've either had gallbladder disease or had their gallbladder taken out. So it's a pretty large problem. It's a huge healthcare expenditure. It's very, you know, it's a fairly expensive surgery. So it has a big drain on our system. [tkn] Gallbladder disease, people really don't know that there's anything going on with the gallbladder until they have the symptoms, which is going to be what we call biliary colic. That's when you've eaten a meal and then within half an hour to an hour, you begin to feel really bad pain in your right upper quadrant. Where's that? That's going to be below your ribs, to the right and it's going to be really, really painful. And you're not going to like it at all. You're thinking you're having a baby and it's not coming out. It's really painful. And you can end up in the emergency room and then you're going to be given some medications that will, you know, hopefully relieve your pain. And then if it is a gallstone, then hopefully it will pass. on its own. And hopefully there will be no complication and then you'll leave the emergency room, you'll see your primary care, the primary care will confirm that you're feeling better and then tell you to take it off and send you on your way. And then we're missing so much. I mean, we've just lost, like, okay, it's not just that you had a stone that didn't pass and you had pain, get to the root cause.

What is the root cause?

Why did the stone end up there in the first place? Where does it come down to? It comes down to what we always start almost every conversation you and I have. It starts with diet. It starts with the foods that you eat. Yes, there's genetic predisposition. Yes, you can be a female, you can be overweight, you can be pregnant, you can be 40, you can be a diabetic, you can have other chronic underlying diseases that predispose you to gallbladder disease, particularly gallstones. But when it comes down to it, a lot of it's going to have to do with your diet. Are you eating a high fiber diet? Are you eating a nutritious diet where you're getting all of the nutrients that actually keep your gallbladder healthy? Are you drinking enough water in your day because the bile that's in the gallbladder is 95% water and then it's made up of bile acids, bilirubin, fats, amino acids, proteins, enzymes, hormones like estrogen, toxins. Your bile plays a very important role in the the detoxification process in your body. If you're not getting what you need to make good bile, then you're going to put your gallbladder under pressure. If you're not drinking enough water, here's what happens. Where's the gallbladder in first place? It sits right under the liver on the right side. Your liver makes bile, and then that bile goes into the into the gallbladder where it's stored. And then when you're eating, when fat that you've eaten enters your small intestine, it triggers something called cholecystokinin, which then sends a message or is the messenger to the gallbladder to release the bile. The bile is released and it will then start breaking down your fat so you can get all the nutrients that you need out of your fat. And so that's what happens, that's what the gallbladder does. And you need healthy bile to then do its job to breaking down fats. And so where does the problem become? These stones are actually the compounds that are in the bile in the gallbladder that begin to precipitate out. So they start to connect to each other and form crystals. And then these crystals can get really big. So when those crystals get big enough, and they become stones, or they become hundreds of thousands of little crystals that sit in your gallbladder, and on an ultrasound that will be done, will just look like sludge. It will look like sand at the bottom of the hourglass sitting in your gallbladder. And so, That's how you get the gallstone. Interestingly, this is very interesting. What's the other thing we talk about all the time? The immune system. Yeah. The immune system. So, when you start creating these crystals, because you're not supporting a healthy gallbladder, or you have a disease process that slows the gallbladder so it doesn't empty, it gets filled up with bile. The bile can't get out. that's going to trigger again, the precipitation out of these compounds that are in your bile, and they'll form the crystals. But here's the interesting thing. There's been research that shows that you have an immune response to these crystals. Your immune system actually sees them as foreigners and sends eosinophils, which are white blood cells, to attack the crystals. the azinophils get broken down in the acidic environment and when they become damaged they begin to form this matrix around the crystal that exponentially increases the precipitation and the formation of the crystals. And then you can get these huge stones that won't pass or get stuck in the duct that leads from the gallbladder into the intestine. Pretty fascinating.

Amazing.

That's how we get there.

Well, you know, a lot of, a lot from a functional medicine perspective, you know, we see a lot of this in diabetics.

Yeah.

A lot of, this has to do with insulin resistance and poor metabolic health, which affects, you know, 88 of Americans. So that's why gallbladder disease is such a big deal. And the problems that people suffer from are miserable. You know, pain, vomiting, nausea, you know, just severe issues and they can't digest their food. And often the traditional treatment is just surgery. But from a functional medicine perspective, what do we think about, how do we begin addressing this? What are the ways that we support these patients and how do we sort of get them better? And sometimes they do need surgery, but talk about the approach we would take in terms of what diagnostics we would use and how you would help people.

Yeah, sure. Just for its sake of contrast, I would say that just doing my research for this podcast is really fascinating that the gallbladder and bile play a really important role in the body. I think this is one of the classic examples or the differences between functional medicine and conventional medicine. Because in conventional medicine, it's the stone, it's the pain, it's the complications of the stone. And so if you continue to have stones, we'll take your gallbladder out. If you have a complication to the stone, you have an infection, then we'll take your gallbladder out. And that's it. That's it. There's absolutely no thought as to the role, what got you there and what the role of bile is in the rest of the process because it just doesn't break down fat. Because of the contents of bile, which spills into your intestine, it can have a huge impact on your gut microbiome. So I just wanted to emphasize that, you know, that's why I said earlier, it's sort of like it's so common, it's invisible, and because, you know, we just take it out, there's even more reason to not think about it.

You wanna know my secret for living a long and happy and healthy life? Well, all I have to do is check out my weekly newsletter, Mark's Picks, where I share my favorite tips for health, longevity, wellbeing, and lots more. check it out and link below. Talk about that connection between the microbiome and the gallbladder.

Well, yeah, that's okay. So, all right, I can enter that highway from multiple routes.

So.

I will go at it from this perspective that when When the bile, if it's too acidic, if you have too many toxins in it, and it enters into the, and your nutrition is poor, so you don't have enough amino acids in it, you don't have enough proteins or enzymes that actually can be an aid to the bacteria in the gut microbiome to do their job, then it will start to alter the environment of the gut microbiome. And then you'll end up with what we call dysbiosis. The bile will cause damage to the gut microbiome. When that happens, then the organisms that are really healthy start to decline. They become destroyed. Then you start to develop some organisms like Candida. that will alter the gut microbiome even more. And some of those commensals that live there, they've been hanging on in the poop party where it's nice for bacteria to grow, they will start to grow. Now all these bad bacteria take over, you get inflammation, you have a breakdown of the mucosal lining that plays a very important role of protecting your immune system and allowing for the bacteria the healthy bacteria in your gut microbiome to communicate to the immune system in a very precise way, because that happens and it's very important. And when that communication system breaks down because the gut mucosa has been damaged, then the immune system begins to be overwhelmed and starts to have inappropriate responses leading to autoimmunity and leading to inflammation throughout the body. That then triggers this inflammation. Then it affects the gallbladder. The gallbladder then will be affected. I'll give you an example. Let's say you have a gluten sensitivity and you don't know it. You eat gluten. Gluten is a real strong potentiator for creating autoimmunity against your thyroid. It can create Hashimoto's thyroiditis. There have been studies that show a very strong connection between Hashimoto's and gallbladder disease.

Interesting.

What happens? Gluten has antigens on it very similar to the thyroid. In the immune system, it's antibodies against the gluten, it also can confuse and those antibodies can attack the thyroid. Okay, what happens? Well, now that's called Hashimoto's. Hashimoto's, in its end game, stops your thyroid from working. Your thyroid loses function. We call it hypothyroidism. Hypothyroidism slows down the gallbladder's ability to move the bile out. That becomes the first step in your stones developing. If you can't get the bile out and sluggish gallbladder, then the bile builds up. Now, you set up that environment for all those compounds to precipitate out. The threshold for that precipitation to occur lowers as you have more and more bile sitting there under pressure. you know, you can see there's a cycle there. That's why I said you can't just ignore the fact that somebody's got a stone. You've got to look for root causes. You've got to look for other disease processes that may have predisposed them to form that stone. The stones are just the beginning of the process.

And the disease process, things like insulin resistance and diabetes, there's a big one, which is such a big factor that we deal with. And often it's not really addressed as a way of treating stones. Hey, YouTube, if you like this video, you're going to love the next one. Let's talk about the gut in connection to some of these diseases. We treat something a lot that's called SIBO. Now, when I went to medical school, this wasn't even a thing. But essentially it means small intestinal bacterial overgrowth, which means bad bugs growing in the small intestine where there should be sterile that have an impact on our health. So what are the symptoms? How would people know they have it? And what kinds of problems are they connected to? And let's kind of get deep into what our approach to diagnosing and treating it's going to be.

Sure. So, you know, I just want to be a little cautious here because we're jumping right into talking about a disease.

Yeah, right. Well, it's not a disease, it's a phenomenon.

It's a phenomenon that actually causes all sorts of other problems. Right, we do have to give things labels, but it is a phenomena that's connected to many different parts of our body and getting somebody better involves the whole lifestyle spectrum and it involves us using something in the functional medicine realm that we call the matrix. And the matrix is looking at not diagnoses, but conditions. Yeah, let's talk about the matrix.

Tell us more about the- what is the matrix? How does it differ from traditional diagnosis? So, why do we use it?

For me to tell you about the matrix, you have to swallow the red pill. Which one do you want to swallow?

I think I'll take the red pill.

Okay, take the red pill. That's the right pill. Okay, so anyhow, now I can tell you about the matrix. So the matrix is basically a construct that we have in our minds where when you start telling me, I have headaches, I have fatigue, I have belching, I have bloating, I have a diagnosis of Hashimoto's thyroiditis.

Migraines.

Migraines. They don't become the endpoint. They become part of the narrative of your disease. and we put it together into a story we call the Matrix. And so we look at assimilation, which is the gut. We look at energy that takes us from, you know, an idea of fatigue, we rattle it down on our brain to what are the things in the body that control energy? Right? And so we think about mitochondria. When we think about energy, we think about toxins. How do toxins influence the rest of your well-being? We think about our transport our blood vessels, our lymph drainage, and the connection between lymph drainage in the brain and your gut, leaky gut, leaky brain, things that we'll talk about. And we think about the hormonal system, neurotransmitters to adrenals to thyroids, and we place this all in our mind in this matrix, this paradigm of thinking, and then we make the connections. We say, okay, what's SIBO? Okay, well, it's going to be symptoms: bloating, gas, distension. I feel like you've used the term food baby. There's something always in my gut. Yeah, when you have a food baby.

You'Re something and you feel your belly bloat up. That's called SIBO.

Right, that is SIBO. You don't feel like you fully evacuate when you have a bowel movement. You're fatigued, you get depressed, and you can actually feel your depression and it's related to how your gut feels. I had that food baby. I'm anxious. I feel depressed.

It impacts my mood.

And it can link to all sorts of other diseases, right? fatigue. And then when we think about fibromyalgia, you know, we need to think about the gut and what's been impacted there. And we think about Parkinson's. 50% of people with Parkinson's actually have SIBO.

Yeah. Now, asthma.

Right. And we don't know. We know there's an observational connection there. We don't know anything about causality, but it's something you have to consider when you're thinking about other diseases. So the fatigue, the brain fog, the potential inflammation and joint pain, all of the gut issues, that's SIBO. And a lot of SIBO, we don't know all the causes. There used to be some standard ideas what the causes were, but now we know that it's hard to determine. So the use of proton pump inhibitors.

And other- Acid blockers like Prilosec, Prevacid, all that stuff.

All that stuff. And then we have stress plays a major role. And so that's some of the cause that SIBO can look like. and now how do we address it? How do we get it down?

I'm just gonna back up for a second. You mentioned these acid blockers because they're giving out like candy, you can buy them in the drugstore, they're over the counter now, and people think they're safe and fine. I remember when I went to medical school, they just came out and we were told by the drug reps, these are very strong drugs, they completely shut down acid in the stomach. You never wanna give them more than six weeks, and now people are on them for six decades. And what they do is pretty frightening. literally they will help your heartburn, but the side effects, which are not really side effects, they're effects, we just don't like them, so we call them side effects, are bloating and diarrhea and distension, all the SIBO symptoms. And by the way, they cause osteoporosis and pneumonia and prevent B12 absorption and zinc absorption and mineral magnesium absorption.

So they're not exactly the same. I just have to say this, Mark, and you know, is that this is my, this is the concern we all have for medicine when we've been unplugged. And this is the issue, is that we have pharmaceutical companies that provide medications to our patients, support sick lifestyle that perpetuates disease.

Yeah, love those advertisements on TV where they're like, don't worry, eat your sausage and peppers and don't worry, just take this pre-medications, take the purple pill. It's ridiculous.

It is. But on the functional medicine side, here's where the hard work is, changing the lifestyle to make it a healthy lifestyle so people can be healthy, prevent disease, if they do get sick, then we help them change lifestyle because that can impact disease more than anything else. And then for people who are well or have gotten better, we can use lifestyle to optimize their aging and again, using a term I've heard you use, age young. And that's part of what we do here at the UltraWellness, the whole spectrum, prevent, treat, and then help people optimize and age young.

Yeah, my goal is to die young as late as possible.

So, back to the SIBO thing, right? It's that, so once we make that, now how do we make the diagnosis? So, I always tell people, tests are good but there's no perfect test. And, your cognition, your doctor's ability to think through problems is the most important thing that they do. That's what we do in functional medicine, right?

We are thinking differently. My mentor, Sid Baker, who is one of the leading, I think, medical minds of the last century, who's really pioneered a lot of the visionary concepts of functional medicine, he says we're in the name it, blame it, and tame it game. We name and blame, we name the disease, then we blame the name for the problem, and then we tame with the drugs. So we say, oh, you're sad and hopeless and helpless. you have depression, that's what's wrong with you. No, it's just the name of what's wrong with you. It's not the cause. Let me go, I know what you need. You need an antidepressant. And that's like, it just doesn't make sense. Instead of what we do in functional medicine, it's called thinking and linking. We actually think and link. Everybody, you know, thinks you treat the.

Same disease with the same treatment.

And in functional medicine, you can have 10 people with migraines or treat everyone differently. Everybody's different. Absolutely. 10 people with lupus and everybody's treated differently because you're looking at what the root cause for them is. And, I think that's really profound. And, I want to get back to the SIBO thing, but I just want to come back to the matrix because that's such a key concept. And, you described all these biological networks, assimilation which is the gut, defense and repair the immune system, energy, how we make energy, detoxification, our transport system, our circulation, our communication systems, hormones and our transmitters, our structural system. And all those are influenced by our lifestyle, by our thoughts, our feelings, our relationships, our diet, our exercise, our sleep, all those things.

Intrinsic relationship.

Yeah, and then they're also influenced by external factors like toxins, allergens, bad bugs, stress, poor diet, and those impact our genes to change the expression. And so we have basically our inputs that are problem and then our lifestyle and that causes a disturbance these systems. And no matter what disease you have, we use this model. And every single chronic disease, and even acute, many acute diseases are caused by disturbances in our biological systems. And that is what functional medicine is so unique at diagnosing and treating in a totally new way.

Absolutely. And so it's that constant work around the matrix. And one of the things that I said earlier is functional medicine is hard medicine. It's hard for the doctor, it's hard for the patient.

Yeah, because you think you have to think.

Right, and you're constantly thinking and as you treat the environment of the patient changes. So you treat, you begin the treatment plan and the patient comes back with a particular response. And that response will be based on what is their lifestyle, what part of the lifestyle have they been able to change? Because it's a real struggle. for people to change lifestyle. That's hard work. And then, you know, what are their genetics? You know, and, and how are their genetics? Because we, you know, use a lot of genetic testing here that help us identify that. And so once they come back and they've responded to our first step of treatment, then we go around the Matrix again. Yeah. And we rebalance and we look. Okay. Okay.

It's like pit tailoring. You adjust every time they come.

It's like, it's like a fine watch, and you're just. Constantly working the gears, asking questions, having them tell their story again, retell their story. I can't tell you how many times I have sat in an hour and a half initial visit, only to have the patient come back over Zoom or a physical visit to the office, and I ask them the same questions, and all of a sudden they're in a different place and I get a different answer that opens up a whole new realm of thinking about their disease, their health, and even their goals for their life. So every time I go around the matrix, I get that person better and better and better.

So we don't treat 155,000 diseases, we just work with optimizing our biological systems in the matrix. That is the key to functional medicine. So that in a way, it's very simple, but it's also very unique because each patient's different. And for the patient, some of the changes are hard because we're asking people to change their diet or take different supplements. but the truth is that it's actually, you know, ends so much suffering and helps them so much that people are so excited about it. Oh, they do it. And so, it's actually, in many times, very easy for patients to change because they see the results so quickly. So, let's talk about the CBO. Let's get back to CBO and talk about its cases. I think we should share some cases. Give an example of what we're talking about. Because it's sort of abstract.

I would say that very rarely do I see SIBO by itself. And why is that? Because, Mark, you've already talked about it. It's the microbiome. When the microbiome is disordered as it is in SIBO and you have these bacteria growing or they shouldn't grow. And so you're now changing how food is processed, you're changing where it's processed, and you're changing the body's ability to absorb it. And what we know about the microbiome is those bacteria actually train our immune system. They're very closely related to our immune system and our immune system identifies antigenic material from the bacteria and the bacteria is able to tell the immune system, here's what you need to be worried about, here's what you don't need to be worried about. And so when we alter that gut immunity, we can create inflammation and we create inflammation, we begin to break down that that membrane that's responsible for opening and closing and letting good compounds and good nutrients in and keeping the bad guys out. When that breaks down, we have leaky gut. And now all of a sudden, our immune system starts to see proteins that have not been completely processed down to the peptide level that they're accustomed to, and they start making antibodies against commonly eaten foods.

Foods.

So now this person with SIBO is sensitive to a plethora of foods that they eat every day, which they might not be allergic to those foods, but they're sensitive to them. So now they're not eating. So they're coming with all these symptoms. It gets exacerbated by almost everything they eat in their diet. And it, because now the disease is.

Eating and they don't know what to do not eat because everything bothers them.

Right, right. And so now they can come in that sick. Now that their immune system's triggered, they have muscle aches, they have joint pains, they have brain fog, because now they're having fatigue. They have fatigue, their mitochondria being affected, their brains are inflamed, they're being affected. So now this person comes in and they may say to me, I have brain fog. I have this, I have that. I get the whole story and I hear the gut always start in the gut.

Right.

So now what do we do? When they tell me there's symptoms, we order a test. It's called a small intestine bacterial overgrowth.

Before you end the test, I just want to recap because what you said was so profound. Yeah.

Which is that.

I like being profound, thank you. No, I mean, it's a total frame shift. So most doctors don't think much about the gut unless you have direct digestive symptoms. And even when you do, they treat it. kind of in a very linear way. But what you're saying is when those bugs that should be in our lard intestine migrate up to the small intestine for various reasons, it causes an imbalance in there. And that leads to a breakdown in the barrier which causes this leaky gut. And then all these foreign proteins and bacterial components leak into the system. Your immune system goes, ah, that's not me. And it starts creating a response. And then you get systemic inflammation, which is why you get brain fog and muscle aches and fatigue and joint pain, all these things, skin rashes, acne, whatever. And people think these are all not connected, but they're all connected.

That's why SIBO is such a great topic to start with, because it connects the entire matrix.

So, tell us how we test for it.

Now, let's get into a case. Okay. So, testing will be with a breath test. It's called a SIBO breath test. And we starve you for a day. basically we want to starve out those bacteria that are living in the small intestine so they become metabolically inactive. And then you wake up in the.

Morning and you take some laculose, which.

Is like a non-absorbed sugar. Not non-absorbed sugar. But before you do that, you breathe into a little balloon and then we put that aside as your baseline test. Then you drink the sugar drink and now the bacteria are like, we got some food, we're excited, we were starving out, thought we were doomed, and then they get very metabolically active. And then, within 30 minutes or 60 minutes, when they're metabolically active, they start producing the exhaust of their metabolism, hydrogen and sometimes methane and even sometimes sulfur gases.

So, it's not just the cows that are burping methane?

Nope.

Humans? Nope. Yep.

Uncle Art's been building... So, if you have SIBO, you're contributing.

To climate change, is that it? Yep. That was gonna be when we get to the magic wand question, I'll talk about my wife.

So there's also other tests like urine tests. You can look at metabolites, right?

Yep. You can look at. Yeah. So, yeah, we can look at or metabolites that will show us markers for dysbiosis in the gut using an Organics test. So an Organics test is when we look at all the organic acids that are products of your metabolism. And so we're able to tell, we know what should be, you know, in the metabolism appropriately, and we can look.

At organic acids, and we do that as part of our GI work. Which is a test that traditional doctors don't do. They'll do the traditional breath test, but.

They'Re not going to do an organic acid test. Organic acid test or something even more advanced called an ion profile that looks at all of your amino acids. And that's important when I do a SIBO workup because if I look at your amino acids and you're depleted, then I know you're really in trouble with your SIBO because you're not getting good nutrition. You're not absorbing. And then I can see markers of inflammation on the ion test. I can also see the organic acids are really critical because there are things that the bacteria produce that will end up in our urine that indicate to us that, wow, those things are in the urine because you have bacteria overgrowing or don't belong in your gut. And now we find out- I think you're right.

I'm gonna jump in with a case that just reminded me of a little girl I saw years ago who was nine years old. and she was a pretty little sweet looking girl who was a monster, like a terror. She would constantly get kicked out of class. She literally couldn't make it home on the bus without the bus driver having to stop 10 times to settle her down. She was violent. She would rip, you know, pictures of a part of her family at home. She would terrorize her sister. And I'm like, what's going on with this girl?

Right?

And we did. a whole workup, and we found her organic acid test, and we found she had massive levels of overgrowth of bacteria, and she had overgrowth of yeast, which is not called SIBO, but SIFO, or small intestinal fungal overgrowth. And what I did was I gave her an antibiotic and an antifungal, and literally the girl completely transformed. So you think you're treating a psychiatric disorder.

Absolutely.

With antibiotics and fungals. How does that make sense? Well, it makes sense when you understand the connections between the gut and the brain. I mean, this was over 10 years ago, and I remember writing about it in the Ultra Mind Solution. Girl, like, wow, you know, the gut is so connected. I had another one with OCD, the same thing. She had high levels of ammonia, and she had severe OCD. She wouldn't put up anything off the floor.

I gave her an antibiotic, and literally she became like meat freak. It was the weirdest thing. Oh, yeah. Now, I. So I would. So in, in those cases, In the cases I've seen, SIBO is very commonly related to neuropsychiatric disorders. So when I have people with memory loss, brain fog, ADHD, just as you've said, I've had multiple patients of mine, autism, the first thing we do is treat their SIBO, change their diet, and within the first six weeks, we're starting to see significant change in their behaviors with ADHD and in their verbal with autism kids.

We talk about this case.

So, I was going to talk about a fibromyalgia case, but I will talk about a ADHD. I had a, actually an anxiety depression case.

Talk about both of them.

Yeah, I'll talk about them. There's so many cases I could choose from. There is a recent case from a patient from a different part of the world actually, came in and they were having lots of difficulties with their child, very bright siblings, but this particular child was having lots of issues with impulsive behavior, attention in the classroom, moodiness, to the point where there was the child would speak of not wanting to live anymore. And so I went through all of their symptoms and the biggest thing that this child had difficulty with was the bloating and the distention. That was constant. Mom noticed it from almost day one of life. So, we did not only the SIBO breath test, but we did something called a GI map test, which we'll look at. It will using DNA and PCR technology, look at all of the bacteria in your gut, the major colonies, the major species, look for Candida, and then also look for markers of inflammation. Those two test on this patient indicated severe disruption of the balance of the microbiome. The patient was put on a brief elemental diet, which is a diet that takes out most foods.

All the foreign proteins.

All the foreign proteins and then was put on an autoimmune paleo diet. And very difficult to put a kid on a diet like that.

Starches a lot of the bad bacteria. Absolutely. Instead of feeding them with all the starch and sugar and carbs, which they.

Love, you're giving them less of that. And we combined it with a low.

FODMAP diet to make sure that the.

Child got all the nutrition they need. FODMAP is like what? It's like- so those are long chain sugars that get fermented very quickly by.

Bacteria and when you eat them and.

You have small intestinal bacterial overgrowth. You get a very big food baby. You start nine months pregnant. Right. And the food baby is this basically. fermenting food where you shouldn't be. Food's meant to be fermented in the large intestine and that's like Florida, right? But what's happening with small intestinal bacteria over here, the bacteria are up in Maine and the food's coming into Maine, Maine's not ready for gas. So now all of a sudden you've got this gas where it doesn't belong geographically, you feel very uncomfortable and it starts to impact everything we talked about. Your nutrition, your inflammation, and that translates to that gut-brain connection. The brain gets affected. That's why we see so much benefit when we treat diseases like SIBO and dysbiosis in our patients with neuropsychiatric disorders from ADHD to OCD to anxiety and depression. And you've noticed it. I know we've talked about even like Parkinson's and other disease processes that will stabilize once we start addressing gut issues.

So what happened to this kid then?

So within the, when we had the six-week follow-up and we had started, it was actually not the six-week follow-up but the six-week follow-up we went over all the testing and we started the, the, the second part of nutrition plan. Once we started the nutrition plan, and I used some natural herbs to get rid of some of that overgrowth, sort of, sort of antibacterial antibacterial herbs that come different compounds that we use. At the eight weeks later, that child's behavior, the mood swings were completely gone. Yeah. Completely gone. Impulsivity was drastically reduced and the teachers were saying he was now paying attention in class. And that was just with food. No stimulants.

That's remarkable.

No stimulants.

Just herbs like oregano and- Oregano, and thyme and things like that.

Absolutely.

Yeah, powerful stuff.

Yeah, and so that's the SIBO story. It's that gut-brain connection is so powerful.

I brought back some bad memories because when you talk about the food baby, when I got sick from mercury poisoning almost 30 years ago, one of the things mercury does is it interrupts all your enzymes and your functions. So my gut became very dysfunctional. And I remember literally having food babies all the time. I literally almost couldn't eat anything without my stomach blowing up and feeling like someone just pumped my intestines up like a bicycle tire. and at that point in time, we didn't really think about SIBO. We didn't really name it and we weren't really aggressively treating it. I was trying things that I thought would work, but it was really tough. Until I got rid of the mercury, I couldn't get rid of the SIBO. So often there's something underlying it, right? There's often a root cause. I've seen people with gut issues that maybe were caused by Babesia, for example.

There'S a tick infection. Oh, absolutely. So Lyme disease paralyze the gut. Right, so if I have a SIBO patient, it's not getting better, I think two things. One is I think about Lyme disease because if one of the symptoms of Lyme disease and is a trigger to test somebody for Lyme is when they get Bell's palsy. Lyme disease can affect the nervous system. And so Bell's palsy is when you have your facial nerve is paralyzed and it can be caused by Lyme. The same thing can happen in the gut. You can get a paralysis and a dysfunction of the migrating motor complexes and now that the peristalsis of the intestine is declining, the intestine won't move. Now these bacteria can stay there and populate. So again, it's all these things that are happening.

And that's the thing, you know, when you go to a traditional gastroenterologist, you might say, okay, we do the breath test, you have SIBO, take these antibiotics, forget about the yeast stuff, and like I'll see and help cross things. And there's so many times it fails because they're not getting the root cause.

So the root cause may not be SIBO, it might be something that's causing the SIBO, like lime or like mercury or something else. And there's something else too, going back to lifestyle. When I can't get a person better with SIBO and I start going around the matrix again, are you sleeping? Are you exercising? How's your marriage? How's your relationship? Do you have a toxic relationship? Because the people that I've done everything for, I've given them bone broth and colostrum and elemental diets, they're not getting better. It's the fifth R. We use the five Rs, right? We use remove, repair, restore, and I can't remember four.

It's remove, replace, reinoculate, repair, rebalance. Rebalance.

And the rebalance piece, the fifth R, I call it fifth R. It's the fifth R. It's getting people to rebalance their lives. And that is basically, are you dealing with your stress? the people that aren't dealing with their stress, aren't getting their sleep, aren't exercising.

And what does stress have to do with your intestines?

That's another podcast.

Come on, give us a nugget here.

Okay, so stress. So stress is probably the start of all disease. It impacts everything from your hormones in your own body, But stress actually creates some neurochemical changes in your brain and there's a communication between your brain and your gut microbiome. And your gut, it's called the second brain.

It's the second brain.

Well, some people think the gut was the first brain. Maybe. Right. You know, and that our brain only developed once mitochondria, we're starting to make energy for us and then we're able to convert, use that energy to make a second brain that allowed us to reason. and so forth. However, once you have that gut-brain connection, stress can actually, you know, we have this Vegas nerve. It's a superhighway from the gut to the brain. And more, there's actually- It's the relaxation nerve. It's the relaxation nerve. And your brain can communicate anxiety and stress to your gut microbiome and actually change the makeup of your gut microbiome. Yeah, and your nervous system.

Right, and your nervous system. And it literally paralyzes stress hormones literally paralyze your gut, your sympathetic nervous system and your fight or flight. You don't want to be digesting your food when you're running from a tiger. You want your gut to shut down so you don't have to poop or do anything else.

Your gut shuts down and that's what happens. We live in a state of chronic.

Stress and our gut's not working. It's not working and then you end up with, now you create that environment for SIBO to develop. Yeah, I just, you know, I was talking about SIBO, I just remember this patient I had a few weeks ago was what a striking case. She came in with what we called vestibular migraines, which is essentially a migraine from hell, where your room is spinning around, you're in bed, you're nauseous, you can't get up, and she had it like 25 days a month. And she was a really smart young woman who wanted to go to graduate school and was basically in bed. And so I started not just asking about her headaches, and she'd seen like 45 doctors and seen neurologist and everybody, and she was on this medication, nothing was working. So I'm like, what else is going on? Well, I bloated all the time, and my belly's extended, and I could see she was puffy and swollen, she gained a bunch of weight, she was severely depressed, she was anxious, and I'm like, this is not a messed up person, this is a person whose biology is messed up. And I said, well, let's just try to put you on a clean diet, eliminated all the allergic foods. I gave her a non-absorbed antibiotic and a fungal, basic nutrients, very simple. And I waited for a test to come back, and she came back in. On the first time she came in, she had to leave the door open. She was so anxious, her system was so in fight or flight, she couldn't even be in the room. She stood up, she's pacing around. I'd never had a patient like that. She came back six weeks later. She looked like a different person. I mean, not only was all the inflammation gone out of her body, all the fluid, not only did she lose 20 pounds, but her gut was normal and she hadn't had a migraine. She was completely better. She maybe had one or two very mild headaches. And, when I got her test back, yes, she had SIBO and I sort of could anticipate based on her history what was going on. But, that's a case where she had been seen doctor after doctor after doctor. And, these are the kinds of patients we see here where I often joke because because we've been here for about 15 years. Before that, I worked at Canyon Ranch, was the medical director, and I always joke, I was a resort doctor, the doctor of last resort. And that's the kind of patients we see here, or I joke, I'm a holistic doctor, 'cause they take care of people with a holistic approach, a holistic problems.

Right.

So, and the treatment for this is.

All the things you mentioned, it's diet. Right, we start with diet, you know, it's really diet and lifestyle. And by the time patients get to me, as I said before, SIBO is just part of the whole complex because once you've affected diet, then you're affecting how your hormones are working, your autoimmunity and so forth. So we always start with diet because we can impact all the systems with a good diet. So diet, we can include a FODMAP diet, it can include Elemental diet, it can include autoimmune paleo. And our nutritionist here at the UltraWellness Center, we work very closely with. And when a patient is here, after I see them, I will consult with our nutritionist and we will customize the diet plan for each particular patient that has SIBO. It's not always going to be the same diet.

So that's really important you said. So we here at the Ultra Wellness Center work as a team.

Absolutely.

And tell us a little bit about that.

Yeah. So we have a team from the first phone call to your first visit and beyond. Each team is made up of a navigator, a nurse, a nutritionist, and a doc. And we meet every week, multiple times a week, and we discuss cases and we discuss cases that are coming to our center, cases that we're working on, and we're constantly collaborating and we're always trying to answer that question. We're always asking why and how. And so our team, from the first visit, the navigator will identify you know what your needs are, and then you'll get a phone call from a nurse practitioner who will do a collaborative pre-visit. A whole hour you'll spend before you even get here going over your case. And we'll get all your documentation, we'll get a summary from the nurse practitioner. I review all of that before the patient even gets here, and I will review that case with my nutritionist even before I go in the room to see the patient for the first time. So before I even come in the room with the patient, I've actually gone over all the data they sent in. It's been reviewed by a nurse practitioner who's actually interviewed the patient. I get that summary. I talk about the case with my nutritionist. I actually begin to create the patient's matrix before they come in for their visit. So when I'm sitting there, I am now getting them to fill in all the blanks, any questions, any pieces of the puzzle that I haven't been able to figure out yet. An illustration I will use with my patients is I'll say, look, you know, we get patients from all over the world and they're usually very complex and usually been to many other doctors. And they bring me this big sack and they empty it and it's puzzle pieces. It's the pieces they've collected from all.

Their other medical workups.

And we connect the dots. And we put those puzzle pieces down and we try to piece them together and by the end of that first visit, I can see where the gaps are. I can't tell if it's a lion or a tiger or a bear or an elephant. but I can start to get a picture. And at that point, we make the decision, here's some more testing we need to do, here's more information I need to get, and here's some things we're going to try based on what you've tried before and what might be a good starting point for you. It's always nutrition and it's always lifestyle change.

Food first.

Yeah, food first. I mean, when I started this practice 15 years ago at the UltraWellness Center, I think we probably were the first practice where it was mandatory to see a nutritionist if you wanted to get an appointment. Because if food is medicine, then how do we practice without nutrition? Just imagine taking a prescription pad away from your doctor. I don't even know where my prescription pad is anymore half the time. Because I barely use drugs, 'cause I don't need to.

I'll use them if I need to, but I don't usually need to. That's absolutely correct. And I'm in the same situation.

I went from using them a lot barely using now. And you also mentioned testing. Now, people think, oh, all tests are the same. My doctor worked me up, he did all the tests, everything was normal, and everything's fine. What do you have to say to that?

Conventional testing is wanting. It's very one-dimensional. Again, it looks at the root cause of disease. So, one thing that we do a lot of is we do genetic testing. Knowing, and we don't do a 23andMe. You get 5,000 genes, we don't know what 4900 of them do, right? And we don't know how to make clinical connections. But we use a company that looks at eight very important biologic systems and the most important potential variants.

Yeah, things that are common that you can do something about. That you can make a clinical decision.

You're actionable.

They're actionable genes, what we call single nucleotide polymorphisms. Just basically, when one gene is altered in a way that the gene will still be a blueprint to make an enzyme or a protein, it just the protein or enzyme that's made might not be as effective.

Or has a different functionality.

Different functionality. It might do what it's supposed to do really fast. It might do what it's supposed to do really slow, and that will impact how you will function. So doing that genetic testing allows us to see what your blueprints are. And you have baseline variants that if we alter your lifestyle and alter your nutrition can support those variances so they optimize and now your body is functioning better, your immune system is functioning better, your ability to stop oxidation improves, your ability to turn good inflammation on and turn it off when it's done, that can be improved because they can be affected by those blueprints. So genetic testing is a critical part of what I do for all my workups. And then another test that we do is we check for toxins.

Yeah. So what you're saying is we're starting to look down through the matrix. We're looking at these biological systems and dysfunction or imbalances that aren't, quote, diseases through testing that isn't available really in most places or for sure through conventional medicine.

Right.

And that's where we find the answers, right? You know, I once was doing a study, I mean, a lecture on vitamins, and I had to figure out how many chemical reactions there were, 'cause all chemical reactions depend on vitamins and minerals. And there's 37 billion billion chemical reactions every second in the human body. That's 21 zeros. Okay, how many blood tests do you get from your doctor? 30? Yep. You got your chem screen, your CBC, your cholesterol, and we think, oh, well that's fine, so you're healthy. But the truth is, those only look for diseases.

Yeah, if we want to talk about testing, we can just go down that cholesterol route and we can just talk about the double that is for our patients. With the testing that's done, it's very one-dimensional, one layer that doesn't really look at cardiovascular risk at all. So testing that we do, it starts to get into those deeper levels that really impacts the function of the looking at toxins. We live in a toxic world, right? It's not a matter of, you know, do you have toxins? It's how many do you have? You know, persistent pollutant toxins that will just camp out in your fat and just leach into your system on alter how your mitochondria work, alter how your immune system works. Great case that I had. It's a gentleman who has Alzheimer's. He was seen at a very large institution in Boston and he was diagnosed at the at the age of 56 with, you know, moderately Advanced Alzheimer's. He was, he had a basic evaluation with a spec scan, and he was told he had Alzheimer's. He was given a pill that we know doesn't work for more than 18 months to stabilize it. Right. Yeah. We, he was given a. Doesn't work even for. Yeah, he doesn't even. I was just trying to be generous.

And then that's not our opinion. This is basically in the major medical journals.

The pills for Alzheimer's don't work. These don't work. so then he was given start behavioral therapy and cognitive therapy. Again, hasn't been proven to do anything to slow the progression or improve cognition at all. So, at a major institution given those two things to do, he is a very, very active gentleman with a great deal of huge responsibilities in his life, very dear man. And he comes here for the first visit and he's, you know, he's, you see these issues and so we start talking and I start testing. So we do the tests. Let's look at the gut. Let's see if there's toxins. Let's find out about your hormones, right? Let's see if you have any autoimmunity. Let's do some, we do some, you know, we do specific autoimmune testing to see if your body is making auto antibodies against brain tissue.

So why would you do that? Because Alzheimer's is what?

Alzheimer's is a multifaceted, multi-causality disease. It's inflammation in the brain. It's inflammation of the brain. That's what's driving it. Right. And there's lots of things that can cause an inflammation.

Right.

So we're going to look for everything that can cause inflammation. And there's also disruption of normal function.

Yeah.

Right. That, that, that might be distant. So what effect does having a low testosterone have on the brain. Testosterone has a big impact on the brain. It can have an impact on inflammation. It can have an impact on how the pituitary and the hypothalamus are secreting other hormones, how those hormones will work, how your neurotransmitters may work. So here are some of the things we found with this gentleman.

He had a mercury of 120. Oh, wow. Now, put it in perspective. Zero is normal. Zero to four. And anything over 10, I worry about. 20 is bad and like 120 is, you know, a handful of people.

Yeah.

That you see over the course of decades have 120.

Yeah, yeah. Very, very few people. Mercury level, testosterone level.

From where?

Fish, water, air. But, you know, he's a fish eater. He was a fish eater in his lifetime. And again, you know, he wasn't like an extraordinary fish eater. But if you look at his detox genes.

Yeah.

He had a lot of on his genes, he had a lot of variants that made him susceptible to not being able to detoxify as well as he should. So, you and I could go eat sushi the whole week. Not me, I got those same genes.

Okay, you got the same genes.

That's why I got mercury poisoning. So, I could eat it, I don't have an issue with mercury. My mercury wasn't high at all. And, I love fish, I eat a lot of fish. So jealous. Okay, well, so mercury, his testosterone level was 150. So, at his age, his testosterone level should be, you know, 600 on average.

800. 800.

600 to 800. Yeah, right.

So 150 is like nothing about what a woman has.

Exactly. So. So he had his testosterone as though his mercury was bad. And of course, there was SIBO and he had dysbiosis. So not only did he have his.

Gut was all messed up, his gut.

Was all messed up. And then finally on top of it, he tested positive for Lyme disease. So that's another thing that we do here at the Ultra Wellness Center. is, you know, you can't practice functional medicine without coming across Lyme disease almost every day. You know, it's stealth infections, Lyme disease and the co-infections that can be found with it along with other viruses are a big part of what impacts people. He had Lyme disease.

So we had four strikes against him.

And so, so here's what's really interesting. We arranged for him to get some really intensive Lyme disease treatment at another clinic in Germany, where they do hypothermia. Hypothermia, and they give IV antibiotics when you're by making somebody really warm, you are able to, that's when the bacteria are most susceptible to antibiotics. And so at that really high temperature, about 107 degrees, they're going to put an IV infusion of an antibiotic in and fight the infection. I did that.

I went to San Diego and I had hyperthermia and I had Lyme disease and Babesia and I had night sweats all the time and I did the treatment and it kind of went away. And I've seen this case after case. Now, it's not something that's available in the United States, but it can be very powerful treatment.

Yeah. So, in his particular case, we chose that direction because of the degree of the severity of what he was facing. so we wanted to, let's just, let's just hit this hard, hit it fast. It was something we really believed in. So we arranged for him, and I worked with his doctors in St. George Clinic. And then we treated his Mercury. We, we started treating his testosterone using first, getting him to sleep better, working on his nutrition. I always like to work on lifestyle before I start treating directly with hormones. Then we added in some hormones that would benefit his testosterone levels. And at six months, he had stabilized. So he had not worsened. At six months, actually about the eighth month mark, when we saw where he was at, he was still working and he noticed that his memory had not gotten any worse than it had been. And so we're continuing to work. It's a story that's ongoing, but really, really exciting because- I think that's important.

To say that this is a progressive disease. because usually a year later, people are a lot worse, right?

I was thrilled that at eight months he wasn't worse.

And where his numbers better?

Right.

Oh, absolutely. Testosterone levels were up to like 500 at that point. Mercury level was coming down. Mercury can be hard to come, you know, bring down. It can take a period of time. But I do like to remind people he was very excited to know there are things I can work on. See, he left a large institution with things to do that weren't going to work, it's sort of hopeless.

So, this is a really important point with functional medicine. Alzheimer's is a diagnosis, it's not the cause.

No.

And, functional medicine helps you figure out what that is. It doesn't mean everybody with Alzheimer's has those things, although they're common, but tick infections, heavy metals, hormonal issues, gut issues, things you can actually treat. And, I think this is such an big difference between functional medicine, what we do here at the Ultra Wellness Center in Lenox, Massachusetts, and what people get when they go to a traditional physician. They're not having somebody pull back the hood and look underneath and see what's going on. They go, oh, I know what's wrong with you. You have Alzheimer's.

No, that's just the name of the problem. Now let's start to figure out what's going on. And that's beautiful. We see everything here. We see autoimmune diseases from Hashimoto's thyroiditis, to ulcerative colitis, to rheumatoid arthritis, we see Alzheimer's disease, ADHD, autism. We see people with- It doesn't matter.

What diagnosis you have because we treat the system, not the symptoms of diseases.

Exactly.

And when we do that, whatever they have has a chance of success.

And that's the point I want to make. You know, we see everybody with everything from every age and we end end up being able to help them more than the specialists did because we're looking at everything and we're getting to the root cause. And so in a course of a week, I can see a two-year-old or a three-year-old with autism. And I can see a 62-year-old with ALS. I can see a woman with depression, no libido, fibromyalgia, and it's all in my purview.

Yeah.

And it's all really, really important point.

You know, people say, well, do you treat this? You treat that. I'm like, I treat things I've never seen. I never had a patient with vestibular migraines before. I mean, I don't know that much about it other than, you know, the basics, what I learned in medical school. But I know how to treat the body. I know how to treat the system. I know how to treat a human being and look for the root causes. When we go to the doctor, they go, well, your tests are fine. Your exam is fine. you know, I don't know what's wrong with you. And there's not one or two answers to that problem. Either you're crazy or your doctor is missing something. And what's really extraordinary in this moment in time is that medicine is going.