Episode 94: Improve Your Overall Health by Testing Your Oral Microbiome, with Danny Grannick

Hi, I'm Dr. Tabitha, the functional gynecologist. I'm a board certified OB, GYN and functional medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey. And I'm super excited to share my wisdom and unique perspective as it pertains to women's health. So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, then you've come to the right place. I want to be your functional gynecologist. So welcome. All right, ladies, I'm really excited about this episode because we're talking about something a little bit different today. We are talking about oral health.

And.

And why am I talking about oral health? Because our oral microbiome and oral health directly impact what's going on in the rest of your body. And this is, you know, easily seen during pregnancy. You know, as an obstetrician, I would see it often that women would develop cavities for the first time when they got pregnant. I know that happened with me. Or get gingivitis. So swollen gums, different diseases of the mouth, and a lot of times that's connected with nausea and vomiting in the first trimester of pregnancy and things like that. And we've always been so reactionary in the past with just trying to manage the symptoms and treat the symptoms, but not really understanding why is this happening. And it turns out that it has a lot more to do with the bacteria living in your mouth and the westernized diet that we call the SAD diet, Standard American Diet, which is very, you know, high in processed sugars and things like that. So my guest today started a moral oral microbiome company, and they will test your oral microbiome and tell you, do you have the wrong bacteria living in your mouth? I'm really excited about this because every day I see patients, you know, for hormonal issues, thyroid issues, chronic fatigue issues, and they inevitably have gut issues. You might not have outright gut symptoms. You might have pretty regular bowel movements, things like that. But oftentimes, what's living in our gut and in our intestines, in our stomach is impacting our health systemically. And what impacts the bacteria in our gut, the bacteria in our mouth. So it all is connected. I just, I'm so excited about the future of medicine because people are figuring it out. We're finally getting to the root cause of issues. And it's microscopic. Microscopic. It's tiny little microbes that you cannot see. But they are running the show, I promise. And So I love that they are finally figuring out all of these connections. And when you can get your microbiomes in balance, then you can live in harmony with the people. Not the people, the bacteria, the viruses, the fungi. Everything that's living in you that should be living in you because they actually keep you in harmony and balance. So this is like Forefront pioneer. I love it. It's so cool. So let me just sing Danny's praises really quick and let's get on with this really awesome conversation. So, okay. So Danny Granick is the CEO and co founder of Bristol. He received his BA in biochemistry from the University of San Diego. After receiving his degree, Danny moved into a variety of commercial roles at Illumina, focused on bring genomic technologies and applications to existing and emerging markets. Danny was then recruited by Oxford Nanopore to lead sales and business development for Northern California in strategic accounts. His passion is in bridging the gap between innovation and implementation. So he is, you know, at the heart of it, a scientist, a researcher, he's in the lab, but he found that he's just so much more interested in the clinical results and outcomes that that research has. And so he has really pivoted and is going in a new direction. And I'm just really excited that there's young, super smart people like Danny out there doing this amazing work in the labs because this is the future of our health. They are figuring out what is contributing and causing disease and we can finally start fixing the root cause of these issues as opposed to just putting more band aids on. So this is a really good conversation today. I hope you stick with it all the way through. If you're finding this stuff interesting and I would love it if you'd hit the subscribe button, throw me a review. Five stars would be amazing. You know, when you take 30 seconds to hit the subscribe and leave a review that tells itunes that this kind of information is important to you, you want to hear more of it. So it, you know, not only boost my podcast up in the list, but any health related, you know, podcast that really is bringing new information to the forefront. So it's really important for us to support efforts like this so that you guys can get this information. This is how we disseminate this information. So I would love it if you'd support me because honestly, I'm doing this for you. I don' get paid nothing. Like this is all for you ladies. So let's talk to Dani. Well, welcome, Dani, to the Functional Gynecologist podcast.

Thank you. It's great to be here.

Yeah, I'm really excited about this conversation because oral health affects women's systemic health so much and they really don't know the impact and so many doctors don't realize the impact. And I love that you guys are bringing this to the masses so that we can start to understand this a little more. Tell me, like, how did you even get into this?

Yeah. So our whole team's background is in the genomics industry. My own background was originally in biochemistry and I was doing a lot of research in the lab and found myself a lot more fascinated around the applications of my research than the experiments themselves. So that was, that was a bit of a wake up call that my future may not have been in the research and kind of PhD route and something a bit more broad spectrum focused on the business side. So that evolved into a five year career in genomics and sequencing, starting off in San Diego and then moving up to San Francisco. And I think it was a really exciting time in the industry. Sequencing was starting to be applied in some really incredible clinical areas. Oncology, non invasive prenatal testing was another huge market and there were some really exciting advancements there for us. I think it was really serendipitous that the technology had advanced to the point where it was becoming cheaper to access. And coincidentally, Brian, one of our co founders, has had some issues with cavities his entire life. It was the combination of those two experiences that highlighted oral health as this relatively unmet area in health care. We knew, based on our work in the genomics industry, that we could take the same technology and apply it in this new space.

Awesome. So you are studying DNA and like, how people, you know, manifest disease, how we interact with our microbiomes, all of this stuff. And tell my listeners, like, with your new test that you're doing the Bristol oral microbiome testing, what are you testing? You know, explain that to them in layman's terms.

Yeah, we can back up. There's something called the microbiome. And a microbiome is a really general term, but basically what it means is a makeup of bacteria, fungi and viruses that are related to a specific environment. There's a lot of familiarity around the gut microbiome and the bacteria that live inside of our gut and help with the digestive process. We have skin microbiomes, bacteria that help protect and clean our skin. We have vaginal microbiomes related to vaginal health. Just like all of those areas, we have an ecosystem and a microbiome that lives in our mouth and our saliva. Just like every other microbiome, there are some microbes that live in there that are really beneficial to our health and help us fight off disease and break down foods. There are some microbes that are harmful or disease causing or pathogenic, and they can produce harmful byproducts that lead to infection and diseases that we know today or conditions that we know today like cavities, gum disease, and bad breath. Cavities is an easy example where there is a subset of bacteria that, that can reside in the oral cavity and those bacteria consume carbohydrates or sugars and they produce acid. So if we have a lot of these bacteria present or if we eat a high amount of sugar, then those bacteria end up producing a lot of acid. The acid erodes the enamel in our teeth, eventually leading to tooth decay. And then that decay is exactly what your dentist is picking up in the X ray when you go in for your appointment and you find out that you have cavity.

Okay, so I think that's going to be surprising to some listeners that there's bacteria causing cavities. I don't think that when you go to the dentist, that's really talked about because we haven't really understood what bacteria should be living in there necessarily and what to do about the bad bacteria. So I love all of this work that you're doing. I think it's so important, so for people listening. Oh, my goodness. Okay, so bacteria can cause cavities. There's been this huge push the last 20 years to like sterilize your mouth, you know, to the point where you're mouthwashing with stuff that burns and feels like it's killing everything. Is that the right answer?

No. I mean, I think, Yeah, it's. It's not the right answer. You know, just like every other part of our body, we want to maintain homeostasis. We want a balance of. Well, we don't even want to balance. We really want to maximize what's good and we want to eliminate what's bad. And there's a lot of different ways to do this. And I think that, you know, the idea around mouthwashes, it's an example of what has become a pattern in the way that we address disease and the way that we go about health care. It's a reactive kind of prescriptive approach where instead of addressing the root cause of disease and the causal factors that caused those things to manifest, we want to eradicate the symptoms that result from those things. So mouthwash, most forms of mouthwash are a really good example of like an antimicrobial. And while it may be effective in eradicating the disease causing bacteria, it's also wiping out everything that is beneficial to your health. And in a lot of cases, good and bad bacteria compete for space in your mouth. So when you wipe out everything, it's great because you're getting rid of the bad bacteria, but you're also giving those harmful microbes a chance to potentially expand into new places because you don't have those protective bacteria anymore. And I think the oral care industry is particularly behind in developing new ways to really promote the growth of beneficial bacteria and selectively eradicate the harmful ones. We've been relying on these kinds of broad spectrum products for decades now.

Yeah, well, I mean, it's the exact same mentality in the healthcare system where we just give antibiotics for everything and we wipe out your microbiome and we hope that the right stuff will grow back, but inevitably it really doesn't because we're not eating the right stuff, we're not making the right choices, we're not supporting that beneficial bacteria. So have there been strong research linking what's going on in your mouth with what's going on in your gut?

Yeah, so there are actually two studies that came out in the last month that produced some really exciting things. I think again, it's a remnant of our healthcare system to think of our bodies as these completely distinct and independent components when everything is really interconnected and dependent on each other. Right. So if you have issues in one part of your body, it's not just isolated to that single part, it's probably manifesting as other symptoms or other conditions in other places. So two studies came out. The first study connected distinct shifts in the oral microbiome with patients that were diagnosed with IBS and IBD and periodontal disease. We know that there's a connection between, again, looking at the single digestive tract, there's obviously a connection between what's going on in your mouth and what's going on in your gut. There was another study that came out, I think it was a few days ago, and one of our team members just sent this to me. But they were connecting the bacteria in your oral microbiome to some pathogenic microbes in the small intestine. Again, that linkage between oral disease or oral shifts in the oral microbiome and systemic diseases in other parts of the body.

Yeah, I would say I see that all the time. Like on GI map stool testing, you got bacteria showing up in your stool which should never ever get there. It's starting in the mouth and the stomach and it's someh not getting killed off and it's making its way all the way out. Right?

Yeah. And I think, you know, one of the most exciting discoveries, I think, in the past couple of years was the presence of P. Gingivalis, or one of the bacteria that causes gum disease being present in the brains of Alzheimer's patients. And they were able to find connections between proteins that those bacteria produce in the onset of Alzheimer's. And we've actually had, I think, three companies now formed around creating therapeutics targeting that protein. There's this incredible connection, and I think it's true for the gut as well, between our microbiome, our systemic or digestive health, and obviously our brains as well.

Wow, that is so crazy. You think of having elevated blood sugar as increasing your risk of Alzheimer's and dementia, but just that there's bacteria connected. It all makes so much sense. I just feel like they're running the show. You know, we're just inhabiting the body, but really they own it and they're in control is how I see it. And so it's so important to make sure you have the right stuff living in there.

Exactly. I want millions of years of co evolution.

Yeah, exactly. And, you know, I heard the statistic there's more bacterial DNA in our bodies than human DNA. So really they are running the show. What are the most common patterns you're seeing in these oral microbiome testing associated with health or with disease? Like, are there good bacteria that we're striving for and certain ones that we know we need to kill off?

Yeah, I mean, I think it's a mixture of both. We've identified a series of really beneficial bacteria that are present in the mouths of. Of individuals that were really diagnosed by a dentist as having a healthy mouth. And we're continuing to investigate behavioral changes and specific products that people can use to increase the abundance of those bacteria. And then on the flip side, we've identified distinct bacteria that are associated with the onset of periodontal disease in cavities. And again, there's some very simple behavioral changes, dietary changes, hygiene changes that people can make to reduce the onset of those bacteria, as well as specific oral care products that can target them. We're also starting to see. I mean, I think one of the most interesting things that I've seen is just being able to show a very direct correlation down to the reduction of the abundance of those bacteria between good oral hygiene and poor oral hygiene. So you Know, we've kind of heard this mantra from our dentist of brush and floss more, but there hasn't been a ton of evidence behind why. And it's hard to really see the results of those efforts. But that's something that we're starting to uncover in the test. And it sounds obvious, but it's really exciting to see.

Yeah, I mean, obviously, if brushing more and using more killers in the mouth was all that was needed, we'd have made some headway by now. Right. And we haven't. I mean, I just. It's getting worse and worse. So are there any particular products that you would just recommend in general that women or women avoid or use.

Well without giving any medical advice? You know, I think it really depends on the specific makeup of bacteria. There are certain products that are going to be more effective against certain oral microbiome programs, profiles than others. I think it's a combination. I think part of it is, especially with pregnant women, just keeping in mind that the dietary changes that you make during pregnancy and some other factors can increase your risk for oral disease. And it doesn't mean that you have to cut out sugar completely from the entirety of your pregnancy, but it does mean that maybe you should be a bit more mindful about the symptoms that are popping up and maybe be a bit more mindful about the cadence of hygiene that you're using in terms of specific oral care products. I mean, I think one of the most effective oral care products and one that we're really excited to continue investigating is xylitol. So it's a form of a sugar, but it is unable to be digested by the pathogenic bacteria that cause infection and cause and produce acid as a byproduct. So in using xylitol instead of traditional sugar, you're tricking the bacteria into thinking that they're getting food, so they start becoming more active and burning a lot of energy, but because they can't process the xylitol, they end up essentially starving and dying off. So it's been. It's been a very effective ingredient in a lot of chewing gums and toothpastes and mouthwashes. I would say definitely recommend looking for products with that ingredient in there.

Oh, that's so interesting. Okay, that's really cool. So should everybody get their oral microbiome checked or is it just people that are having oral issues?

Yeah, I mean, I think there's been this. We're really trying to progress a distinction between dental care and oral health. And dental care is necessary, but it's kind of the traditional way that we've experienced dentistry today. You get told to brush and floss, but you probably don't do it. You get told to go in every six months, but you probably don't. And eventually something pops up or worry, some symptoms, some toothache, or your dentist has finally convinced you to come in. And we use observational screenings and X rays that look for the symptoms of cavities and gum disease. And if they find those symptoms, then you have to go back in for a reactive procedure. And it's this endless cycle. What we're trying to do with oral health is progress. This idea that, one, cavities and gum disease are largely preventable. And it's. It's wild to think about that fact and then also realize that they've been the most prevalent diseases on the planet since 1990, but they're entirely preventable. There are a multitude of behavioral changes and product changes that people can make to greatly reduce their risk for disease. And I think the last piece is, you know, there's been this missing connection, like what we've talked about, between oral and overall health. So getting people those insights and highlighting some risk factors outside of how much sugar do you eat as contributing to your risk for oral disease. I think one, obviously reduces your risk for oral disease, but two, improves your overall health. So to kind of get back to your last question, Yes, I think everybody should get their oral microbiome tested, and I also think that everybody should be a lot more mindful of their oral health status because it means a lot more than just having a cavity.

Yeah, I think you hit the nail on the head. It's very reactionary. It's like, let's just keep waiting until you have the problem and then drill a big hole in your tooth to fix it and fill it with something probably toxic that's going to get you sick in the future. That's a whole nother podcast. But, you know, you think of indigenous people in, like, Africa and places like that, they never brush their teeth. They never get cavities. They have white, strong teeth their entire lives. And it's, you know, our lack of oral health is really, you know, a civilized problem that we've created with our food industry and our, you know, poor health and poor eating and all of it. So I just think it's awesome that we can even get a picture into what's going on with this test and really, you know, start making changes now. So you don't wait until you have periodontal disease. Like, why wait until your gums are swollen and bleeding and you're miserable.

Right, exactly. And it's. Yeah. I mean, there has been a huge shift. I was actually talking to another founder the other day in oral care, and they had mentioned that there was a huge change in the Industrial Revolution in terms of the kinds of foods that we were eating, both from an ingredient standpoint. So a lot more sugars and carbohydrates and also from the way. The way that we created food, so they became a lot softer. And basically there was this huge divergence in what we were using, how we were using our mouths and teeth before the Industrial Revolution and how we were using them after. And there was a huge influx of oral disease coming out of it. So I think that we need to keep those kinds of things in mind and be very aware of not only our personal kind of lifestyle changes, but also societally, what we're exposed to on a daily basis and how that's impacting our health.

I know. I mean, it breaks my heart. I have friends whose children have gone to the operating room and been put to sleep to take care of all of their cavities and their oral issues. And so much of it is diet, but so much of it we can have an impact on if we know how to support the good bacteria. So I love this. This is so good. So tell my listeners how can they check their mouth microbiome?

Yeah, we make it pretty easy. You just have to go to our website. We have three different versions of the test available. It's all the same information, but there's an a la carte option, so you can just order one test. If you want a snapshot of your oral health status, we have subscription models. You can get one every six months or every three months. And we basically provide you direct insight into your oral health status, highlight different risk factors for having these gum disease and bad breath, and then give you very personalized recommendations on what you can do to improve. And in the future, we're going to really try to create a pretty comprehensive experience, so enable telehealth and connections to dentists, to oral care specialists, to nutritionists. And then we are also working to be able to provide the very products that we're recommending directly to our users as well.

Okay, cool. So how do you collect the test?

What's involved? So we send you a kit, the.

Little tube on it.

And there's a tube in there. There's a funnel you just put in. You basically spit in the tube. We recommend doing it first thing when you Wake up before you brush your teeth or drink anything. So I usually put mine, like, right next to my nightstand. You spit in the tube, you'll shake it up a little bit. We include a little bit of a clear solution called a buffer. So that just helps keep your sample intact. And then you mail it back and we'll process it in the lab. And results are generally ready within five to ten days of receipt.

Okay.

You'll just log on and. Yeah, get everything you need.

That is awesome. Very cool. Okay, so we are going to test our microbiome. You're going to give us recommendations to kind of switch things up, make some interventional recommendations. And, you know, I would say if you're already at the point where your gut's impacted, you might want to do stool testing and oral microbiome testing. Have you noticed anything that interferes with this test other than, like, eating and drinking? I mean, do you have to not eat certain foods or have any restrictions?

Um, no. I mean, I think that the best, you know, the best snapshot of your oral health is just doing your normal daily habits and then getting. Getting that sample first thing in the morning. We don't want anybody to necessarily make any major dietary changes because depending on how long you've implemented it, there could be some impacts on. On your oral microbiome results. So I would say just do your normal routine. Avoid eating or drinking at least 30 minutes before you take the test. Best case scenario, you do it right first thing in the morning.

Okay, cool. So another area of concern is pregnancy, right?

Yeah. So we see significantly higher rates of periodontal disease in pregnant women. And then we have also noticed some associations with the future outcomes of children in terms of their risk for oral disease. And we think that there's a big connection between the oral microbiome of the mother being seeded into the newborn infant.

Yeah, I have no doubt that's the case because moms kiss on their babies. We're loving all on those little babies when they're brand new and we're kissing them on the mouth. We're cleaning off their pacifiers and their bottles with our mouth. I mean, we're putting our fingers in their mouths. It's a lot of close connection. So that makes total sense to me. So I've also seen this with pregnancy. You know, we know that poor oral hygiene and bad dental health really can impact the pregnancy. It can cause preterm contractions. There's even research of pre labor, but not necessarily going to the dentist and getting those things, quote, unquote. Fixed stops that or helps that. So the key is what you're doing, right?

Yeah. And I think, you know, just like some other patient populations, I'm sure, as a. Well, I can imagine as a pregnant woman, it's pretty hard to get to the dentist consistently. You know, there's a lot of conflicting priorities. Things physically become a lot harder to do. So, you know, getting access to that kind of consistent and preventive oral care can be really difficult. And that's something that we're hoping to solve with the test, really getting in front of the progression of oral disease. And, you know, unfortunately, I think a lot of mothers aren't aware of the changes that are going on in their mouths until those symptoms begin to arise. But. But we know that certain hormones increase blood flow to the gums, causing inflammation that makes you more susceptible to pathogenic bacteria after the birth. With the newborn child. To your point, there's a lot of saliva swapping going on between mother and child. I think the last statistic that I read showed that children with parents who had a high risk or had a history of cavities themselves are at three times higher risk for oral disease in the future. It's a bummer for everybody.

Yeah, well, it makes so much sense, but I would love to see us get to a point where we can figure out how to maximize our beneficial bacteria in our oral microbiome so that we're breaking that cycle and we're not passing the bad bugs on to our kids. Because if we can make a dent that way, how amazing would that be?

Yeah, exactly. I mean, I think, again, taking some early preventive steps during pregnancy, if that can impact future incidents of disease, then that would be incredible. It's a huge impact without having to do too much extra. And I think this reminds me of another statistic that I came across or another research study I was reading. But back to our point about the oral and gut microbiome connection, there's also a placental microbiome, which I didn't think of mentioning in the beginning of our conversation, but is obviously incredibly relevant. There are a couple research studies that showed that the oral microbiome is more similar to the placental microbiome in a mother than it is to the gut microbiome. So there's a very clear connection there as well.

Yeah, I guess that makes a lot of sense because of the direct blood flow. I mean, the oral microbiome can very easily get into the bloodstream just by any little nick or whatever from your toothbrush and biting your tongue. Things like that. And that will definitely go straight to the uterus and placenta. So I'm really excited about all this work. This is really amazing. The future is going to change. Things are going to be really different now that we understand what's running the show and how we can pack and influence that. Thinking about the moms and their bacteria when they're pregnant, I'm just thinking, I remember being so sick that all I could keep down was saltine crackers, which are just basically sugar that your body's waiting to digest and absorb. And so I'm feeding the wrong bacteria in my mouth and increasing my risk of cavities and disease because I'm just trying not to throw up and feel sick.

Right.

So if women could really focus on getting. Getting some fiber in, would that be beneficial and eating more, like, raw stuff that you have to chew on and things like that? Like what feeds our good microbiome in our mouth?

Yeah, I mean, we're still trying to figure out a lot of that information just because, again, oral health has been such an overlooked area. We've been so focused on these 10 or 12 bacteria that cause periodontal disease or cause cavities. There hasn't been a ton of attention given to the beneficial microbes. But you hit the nail on the head. I mean, I think staying away from carbohydrates and sugars, making sure you're getting a lot of fiber, these are things that we know improve digestive and oral health in general. And as a company, we're working to investigate exactly what those connections are with specific microbes. And I hate to be that person, but, you know, another. Another kind of complication during pregnancy is sickness. And obviously, you know, during vomiting, you're introducing a lot of acids back into your mouth, and that contributes to not only tooth decay, but it can lower the pH in your saliva. And that's very selective to pathogenic bacteria as well. So it's. There's. There's a big battle to fight. Right.

And I have no doubt that those bad bacteria are making their way to your stom stomach and wreaking havoc in your stomach and making your nausea worse. So then you're stuck in that vicious cycle again. So I love the idea of, like, doing probiotics for your mouth, doing probiotics for your gut, like, really supporting those good bacteria eating whole, real foods that, you know, we didn't manufacture in the factory. Right. Quit eating out of boxes and bags, everybody. Oh, my gosh. Okay. Well, this has been so good. Okay, so where can my listeners get your test, Danny?

So if you go to bristlehealth.com there's a button I think in the right hand corner and you can click it and it'll take you right to the product page. I would also highly recommend going through our blog. There's tons of really good information on there. A lot of it really hasn't been disseminated to the public. So we're making a huge push to go out and find the best research to educate our users. Once you get the test, we'll continually update it with new information. Even if you just get the snapshot, you'll get an email every now and again letting you know what new features we've added or what new discoveries we've made. I would say just on top of that, every new user that takes our test contributes to the creation of this really exciting data set and helps accelerate a lot of the discoveries that making. So you know, the more, the more pregnant women that we can get on, the more discoveries that we can make, you know, connecting the oral microbiome and oral health to pregnancy.

Awesome. Well, thank you for being such a pioneer. Like, this is amazing. It's the future and I hope everybody does the test because like you said, the more data you can get, the more that we can understand and really make some headway in the this issue. So thank you so much.

Yeah, thanks for having me.

Awesome. I hope you thought that was really cool interview. I love just hearing all of the amazing new things that are coming out in science and unfortunately most doctors aren't aware of this. You know, I will just say, like, when I was stuck in that broken medical system working as an OB gyn, I was in survival mode. You know, I was focused on trying to get a couple hours of sleep and just taking care of my patients like that was priority number one. There was no time to be reading new research and studies and articles. You know, we had one or two journals that we would read and those are very much directed by the broken medical system that's, you know, driven by big pharma. And so unfortunately, the information that we're even given as physicians is biased. It's one sided, it's very much tunnel vision. And I, what I want you to understand is don't be mad at your doctor. They don't know any better. They're trying to, to do their best. They're trying to help you, just like I was. So it's important to keep doing your own research and keep listening to new podcasts, watching new summits Watching docu series, reading blogs and articles. And don't give up searching for answers because we need to figure out the whys. Why don't you feel well? Why are your hormones imbalanced? Why isn't your thyroid working? Why are you getting cavities? Why are you so tired during the day that you don't even want to participate in life? Like, if you can keep asking why, you'll find the answers. And the answers are coming from the amazing research that these people are doing in the lab, labs and understanding our microbiomes. So I would really love it if you would support Danny and his company bristle in this effort to, you know, help us understand how the oral microbiome affects the rest of our body. And the more that we can support them, the more that they're going to understand and be able to help and support us and our children in the future. So this stuff's really cool. It gets me excited. So thank you, guys, guys. And if you want to work with me, if you want to get your gut microbiome tested or any of that other stuff, or, you know, go over your oral microbiome test with me, just schedule with me. I am here for you. I will see you. I work from home, so I can see you in your home, wherever you're at. You can call my office. You can, you know, 616-227-0445 or you can go online to drtabitha.com it's D R T A B A T H A. All the links are in the show notes. You know where to find us. I am here for you ladies. So go out, have amazing kick ass week. Maybe back here next week.