#65 - Immune Reboot with Dr. Robert Silverman, Part 2

Hi guys. Welcome to another episode of The Factor Podcast. I'm your host, Jessica Riddle. If this is your first time tuning in, welcome and thank you for listening. In today's episode, we wrap up our 2-part training Titled Immune Reboot: A Guide to Maximizing Immunity and Optimizing Vitality, featuring guest speaker Dr. Robert Silverman. Today, Dr. Silverman will discuss the long-term impacts of COVID-19 infection on the lung-gut-brain axis and gut microbiome. We will also talk more about the role of systemic inflammation in what is now considered long-hauler COVID. We will also chat about strategies for reducing inflammation, such as diet, supplements, and lifestyle improvements. And we'll learn about some effective nutritional protocols for the Omicron variant and immune support. Dr. Robert Silverman is a chiropractor and clinical nutritionist, bestselling author, renowned presenter, and the founder and CEO of West Chester Integrative Health Center. He serves on the advisory board for the Functional Medicine University, is a Chief Clinical Consultant for KBMO Diagnostics and Erconia Laser Ltd., and holds a science board position with NutraDyne. With over 23 years of clinical experience, Dr. Robert Silverman is considered a thought leader in his field and has contributed to several studies in peer-reviewed journals and other mainstream publications. As you listen to today's training, I'd like to challenge you. Pick out one or two things that you can start implementing in your practice with your patients right away. Let's cue the intro music and get started.

So post-COVID-19, bottom line is fatigue, brain fog, headache, physical exertion. These are some of the common persistent symptoms. But the real takeaway here is the median time was almost 1 year. So Long COVID is truly long. It's arduous. And unfortunately, it hasn't truly abated over the last 2-year period. So digging in on the cognitive symptoms, patients with Long COVID, once again in another study, difficulty concentrating, brain fog, forgetfulness, trouble Recalling a desired word, maybe losing your proverbial filter, saying an unintended word. Huge takeaway. Many health outcomes of people who develop long COVID after mild acute SARS-CoV-2 infection resolved 1 year later. So people say, oh, a year later. I mean, that's a long period of time. I can never remember anything like a flu, a bad flu. Everlasting, or the symptomology, or the adverse effect of it lasting for a year. Now, full disclosure, I did have COVID. 4 days I was better, very happy, very fortunate. I do try and take care of myself. So fingers crossed. Hopefully I don't have any more crosses to bear, if you will. That said, let's look at some of the biological changes of people post-COVID. Disturbances in the circulatory system. There's a destruction of the enzyme that is a cellular receptor for the virus. So essentially we've got this triple spike protein. The reason they call it a coronavirus is it's a crown. You have what we call ACE2 receptors that these spike proteins like to attach to. On top of the ACE2 receptors, you have an ACE2 enzyme. That enzyme is a protective mechanism in that it makes it slippery So that spike protein can attach or attach tightly. Once that spike protein attaches and attaches tightly to the ACE2 receptor, we lose in many instances that enzyme. So we lose the protection at the proverbial non-Velcro level. Ongoing state of inflammation in the body, immune systems typically not returned to the pre-COVID state. See that all the time in blood labs. Abnormalities in T-cell function, and once again, a high rate of autoantibody function. Mitochondria distress and dysfunction. We will talk about that in the next 5 minutes. And for me, again, the gut is the epicenter of your health. 80% of immune cells are in your gut. It's where your macro and micronutrients are absorbed. I had a conversation with my wife today, and I said, we have to, have to make sure before they buy any kind of vitamins, That we test their gut health. Because if their gut's too permeable, the vitamin won't be absorbed, passed through, and many of our patients will think our vitamins don't work. And we know of the quality that they have, and we know of the clinical outcome they can share with our patient base by utilizing these vitamins. So the gut microbiome actually may be damaged first. You could have a loss of diversity in your ecosystem. A loss of anti-inflammatory organisms, increased leaky gut occurrence, of course. Cellular danger response. Mitochondria regulates cellular danger response that controls the innate immunity and healing. Chemical pollutants in the environment lower the threshold, believe it or not, for cellular danger activation, and persistent activation of cellular danger response inhibits healing and leads to chronic illness. So Let me back the truck up just a little bit. What are we saying? Our mitochondria actually originates from bacteria. So it's a cousin or a sister to our gut. So it communicates with our gut. And in so, it actually allows for protection to the innate immune system. So when you get sick, like with the flu, you can use up to about 55% of your mitochondrial energy production. And you shut that off to allow the immune system to function well. And you take a chill pill, if you will, and you rest, or you get quite fatigued. I'm sure everybody's nodding their head now, remembering when we had a flu, we got fatigued. Now, unfortunately, if we have this drop in energy, the mitochondria will actually sense that as a threat. It results in a mitochondria changing its primary function from energy to cell defense. It's called the cellular danger switch or response. We shut off all our energy-producing properties. With the shutoff of those energy-producing properties, we are out like a light. We feel like ultimate crap, no energy. Now the question is, that's a switch, like a light switch. To turn it back on is the cycle of a cellular danger response to get out of it. So the healing process is a dynamic circle that starts with injury and ends with recovery. This process becomes less efficient as we age. And the reason is because most people as they age, we have mitochondrial dysfunction. Mitochondrial dysfunction is, or mitochondria that is dysfunctional will stay around longer than mitochondria that is functional. So therefore, a healthy healing cycle starts with a wakeful activity.

Right.

But inevitably, some of stressor will eventually trigger mitochondria to move into the cellular danger response. You have to go through three different pit stops to get a healthy energy mode after going through each three. Each stage of these responses is energetically and metabolically distinct, and each has a checkpoint that must be met before the next stage is reached. So therefore, the The takeaway here is tell your patients it's a switch off, but it's a cycle on. And what have they done to train their mitochondria to go through this cycle efficiently and turn back on? Most people don't, hence the idea of fatigue. Picking up the pace now, Long COVID, Epstein-Barr. We talked about Long COVID, Epstein-Barr being interrelated, COVID actually activating many viruses. On blood labs, the one of note, Epstein-Barr. So the impacts of Long COVID on numerous organs with a wide variety of pathologies actually shown. So you see chest pain in the heart, you see lungs, you see the immune system, the pancreas, the gastrointestinal. You're also seeing neurological symptoms, kidneys, spleen, liver, blood vessels, reproductive systems. So what are the hypothesized mechanisms of Long COVID pathogenesis? Number 1, immune dysregulation. We've talked about that. Microbial dysbiosis, the unleveling of good and bad bacteria in your gut. Autoimmunity and immune imprinting. Blood clots and endothelial abnormalities. And dysfunctional neurological signaling. Or any or all of these checklists could lead us down a path towards long COVID. So the real question is, do we have a better answer And I say yes, we have a resounding yes in that we have a better answer. So here's my long COVID protocol. What you want to do is you want to deal with the gut health, mitochondria support, immune activation, manage and modulate inflammation, obesity, blood sugar, and anti-inflammatory status are things that we want to deal with. Long COVID protocol. If you want to improve your mitochondrial function and decrease fatigue, You want to make NAD+, you want to make B vitamins, you want to utilize coenzyme Q10, acetyl-L-carnitine, alpha-lipoic acid. All your dosages are there. Glutathione, magnesium, zinc, selenium, vitamin C. You also, if you want to have immune activation, you want to utilize mushrooms: reishi, maitake, lion's mane, chaga, and shiitake. So long COVID, change your lifestyle, change your diet, utilize low glycemic index carbs. As a macronutrient, there's no essential carbohydrates. I'm not trying to make them the bad guys, but you really want to utilize carbohydrates, or I should say minimize carbohydrates, especially those that are high in the glycemic index. Don't have any processed carbs, As a chiropractor once said, Dr. Jack O'Lane, if man makes it, I won't eat it. You wanna ingest good fats and amino acids. So fats and proteins are without question key macronutrients. Protein is the number one thing that I would recommend. I think that people are under-consuming protein and over-consuming carbohydrates. And for a lifestyle everyday hack, intermittent fasting is a great choice. Intermittent fasting, I'm a big believer in fasting and feasting in the same day. So it's really referred to as time-restrictive eating. After about the 13th hour, you can stimulate something called autophagy, which won a 2016 Nobel Prize in that it's the idea of breaking down old cells, using the debris to make new and rich cells. So if you break down all immune cells, you can get immune rejuvenative cells. It's kind of like breaking down a raisin and giving yourself a grape. And also mitophagy, the breakdown of old mitochondria to new mitochondria. I'm a proponent of low-level laser therapy. It is without question a great choice of electromagnetic transfer of energy. Sleep and exercise will also really support your immune system and clearly detox in the spring and the fall twice a year would be a great choice. A lot of people want to go back to exercise and have a little trouble. They've got the malaise. L-arginine and vitamin C are 2 great supplements to help exercise post-Long COVID. Nutrition can play a role or a key role in the management of post-COVID-19 syndrome. That was in February of 2022. I think it's a great statement. It's just a little late to the game. A third of long COVID patients suffer from persistent loss of sense of smell. This was huge in my area. This is huge in when I speak to our colleagues in front of the stage. Many of their patients have lost their sense of smell. So here's a great protocol that I found to be extraordinarily effective. Use an essential oil or a food that has a very strong smell. Put it under their nose. Chart it. My nutritional protocol is very simple. Alpha lipoic acid, 600 milligrams daily. Zinc, 60 milligrams daily. Do it for a 30-day treatment protocol. We've seen between 80 and 90% of the people gather their smell back. Remember, The bulk of the reason that their smell is gone is the olfactory bulbs are swollen and you lose the ability to function those cranial nerves. Loss of taste: ingest glutamine 2.5 grams, NAC 500 milligrams, astragalus 1 gram, glutathione 500 milligrams, omega-3 fatty acids which decrease interleukin-6 4 grams, curcumin decreases interleukin-6 1 gram. The famed JFK once said, the time to repair the roof is when the sun is shining. If I could extrapolate, he was basically saying that take care of your body now as opposed to wait till you get sick. So is it immune support or is it immune rejuvenation? Well, you don't want to support a dysfunctional immune system. You want to allow for immunorejuvenation. You want to balance your immune system. You want to make your immune system more resilient, more flexible, the ability to bob and weave, lateral movement, if you would. Great study, great article on immune response. It really showed that you don't need to take 20 bottles if you want to balance your immune system. There are vitamins and minerals that are pleiotrophic. They are the following: vitamin A works for both the innate and the adaptive immune system. Vitamin C also. Vitamin D. Vitamin D is a virtuoso of sorts. It's used for a swath, or I should say it possesses a swath of different health-promoting properties. Zinc. Zinc works with both the innate and the adaptive immune system. You could probably write in magnesium in there also. Omega-3 fatty acids are a great choice to stimulate the innate immune system, and the adaptive immune system can be boosted by utilizing pro-resolving mediators, a fractionated fish oil, which allow for the resolution of inflammation and the balance of the initiation and the resolution of inflammation. Here's some immune support supplements: vitamin C, zinc, Mixed mushroom complex, vitamin D3 with the critical vitamin K2. K1 and K2 also are quite synergistic with vitamin D3 because they allow calcium floating around, or they allow vitamin D to take calcium to the bone as opposed to leave it floating around and damage the soft tissue and plaque. Probiotics, all about the gut. Probiotics are for life in the gut. NAC and liposomal glutathione, selenium, omega-3 fatty acids, elderberry, and vitamin A. If someone has to take a vaccine and the usage of the vaccine has dropped precipitously, here are some of the supplements that I would do to get a balanced immune response. Number 1, multivitamin, multimineral, vitamin D3 with K2, quercetin, omega-3 fatty acids, Work the lining of the gut. Branched-chain amino acids are glutamine, NAC and glutathione, and probiotics. Post-vaccine, if they've just had a vaccine. Now the pre and the post, you want to do for 30 days before the vaccine and then the post obviously 30 days after. Turmeric, resveratrol, ginger, Boswellia, white willow bark extract, detox formula, sulforaphane comes from cruciferous vegetables, omega-3 fatty acids, D3 with K2 and a multivitamin, multimineral. Omicron and all of its variants, Omicron number 98, whatever we're at. Vitamin D3 with K2. Melatonin, and we're gonna have a slide on melatonin. I am a big fan of melatonin. Astaxanthin, probably the number one antioxidant once with its ability to pierce the cell easily. Curcumin, quercetin, zinc, NAC, pro-resolving mediators, L-raminosis and L-planterum, resveratrol, and NAD+. So I have a friend of mine that just loves to argue the data. Very medically oriented. Lots of respect for it. Here's the takeaway. There were 7 clinical studies found with vitamin D. If your vitamin D level was over 50, which I don't consider high, I consider a good level 60 to 80. It was a statistic of zero, vaccinated or not, of people dying. So vitamin D is something that all your patients should be taking for a multitude of reasons. Vitamin D also really can vanquish the cytokine storm. Vitamin D is able to stimulate interleukin-10, which is one of the anti-inflammatory interleukins, which conversely can decrease pro-inflammatory TNF-alpha, INF-gamma, Interleukin-6 and interleukin beta. So it balances the inflammatory process. Possible applications of melatonin in long COVID. Essentially, melatonin is great for sleep. Sleep is a critical element to help you get over long COVID. It's fabulous because it decreases oxidative stress, it decreases inflammation, and it supports autophagy. So melatonin is a medicinal nutrient. COVID and hair shedding. I can tell you that the interesting thing is people pay a lot of money not to lose their hair. I'm as vain as the next guy and I get it. But a lot of people are losing their hair post-COVID. Here's your COVID protocol. So you have vitamin A, vitamin C, vitamin E, vitamin D, biotin, pantothenic acid, zinc, hydrolyzed Big collagen fan. Take collagen every day. Take it for my joints, take it for my gut, great for the hair, and a strong amino acid blend. So let's talk about the gut and how COVID-19 causes GI symptoms. Well, the virus enters intestinal cells using ACE2 as a receptor. The spike protein binds to ACE2, triggers cells to release cytokines, increasing inflammation and GI symptomology. Unfortunately, COVID-19 can change the gut microbiota. The virus actually can travel through the portal vein, and the virus can impact vagus nerve. Wish we had more time. Maybe we can come back and have a whole hour just on vagus nerve. And all of this can occur because of viral shedding. A factoid on the gut: 100 times more ACE2 receptors in the gut than there are in respiratory organs. GI symptoms increase the likelihood of developing a severe incidence Of COVID-19. SARS-CoV-2 has been shown in data to actually cause more dysbiosis. And here's a study: Post-Acute COVID-19 Syndrome and Gut Dysbiosis Linger 1 Year After SARS-CoV-2 Clearance. So once again, for me as a functional medicine chiropractor, I integrate functional medicine in my chiropractic armamentarium. Every patient I ask, have you had COVID? And if you have, I do want to test the gut barrier panel. So when you take a look at this slide, there's a lot going on. I mean, here's a slide that I could spend 15 minutes on, but the takeaway here is very simple. Biological barrier alterations leading to mechanical barrier alterations, ultimately leading to immune barrier alterations, leading to bacteria translocation. So essentially, the breakdown from COVID is allowing bacteria to float through your body. What does that mean to you? As a chiropractic aside, 52% of people who had disc surgery were found to have a bacterial infection. That bacterial infection could be traced back to their leaky gut. So B-cell expansion. B-cells are your antibodies. So B-cells are critical to proper functioning of immune system because the B-cells actually protect and they also remember. The number of B-cells are greatly increased after any kind of bowel damage. So the takeaway here is B-cell expansion doesn't allow guts to heal. So your gut heals on a 5 to 7 day plan. Stromal and epithelial cells come together. They are slowed down, or your stem cells, which release these cells, are stopped because of expansion of a lot of antibodies. So when you have a condition that requires you to produce a lot of antibodies, You're never really going to heal your gut, and that's the reason you're susceptible to increased intestinal permeability and/or leaky gut. So let's look at these possible entries of SARS-CoV-2 into the brain. When you look in letter A, it describes an entry of SARS-CoV-2 from the nasal epithelium to the olfactory bulb entering the central nervous system. B, this actually explains the entry of SARS-CoV-2 from the nasopharyngeal region to the cerebral spinal fluid, thus gaining access to the central nervous system. Letter C describes a binding of SARS-CoV-2 to ACE2 receptors on the endothelial cells of the blood-brain barrier, thus invading the central nervous system and stimulating the cytokine storm by binding to ACE2 receptors on glial cells and neurons. So as you can see, it's very easy for SARS-CoV-2 to pierce the blood-brain barrier and adversely affect the brain. COVID's tied to an increased risk of Alzheimer's disease and Parkinson's disease, 3.4 times higher incidence of Alzheimer's and 2.2 times higher incidence of Parkinson's disease. This study, an MRI in the brain, actually highlights the damage in that lingering brain abnormalities in patients up to 6 months after they recover from COVID-19 There was a high susceptibility of value in the regions of the frontal lobe and in the brainstem. Here's my Super 7R action plan. This is what I kind of house what I do in my office. I'm going to do this in a very quick fashion because we're getting towards the hour mark, and I do want to open it up for a few questions. So my Super 7R action plan, very simple. R number 1 is reset. Reset what? Reset your diet. Reset your lifestyle. Reset your mindset. Get those sugars out. Get those high carbohydrates out. Eat a more whole meal. Make better choices when you're in a restaurant. Remove. Remove what? Unwanted pathogens. Remove unwanted pathogens. The first thing to do is take out is food sensitivities, food allergies. Remove bacteria, viruses, and fungi that shouldn't be there. You can do so by utilizing oregano oil. Berberine, garlic, serum bovine immunoglobulin, which is the gold medal winner. SBI, or serum bovine immunoglobulin, actually is the mop of the gut. It binds with all different kind of pathogens and antigens and takes them out of the gut. The 3rd R, and each R is done singularly, R number 3 is replace. You would replace digestive enzymes and stomach acids and pancreatic enzymes and increase bile flow. If you take any functional medicine courses with me, you'll see that bile acid is a critical element to avoiding leaky gut, avoiding small intestinal bacteria overgrowth, and you'll have a better cholesterol number on your serum tests. 4, regenerate. Regenerate what? The damaged intestinal mucosa. Heal and seal the gut lining by also creating an anti-inflammatory environment in your gut. Reinoculate. Reinoculate with good pre and probiotics. The 6th R is you can reintroduce certain foods removed in step 2. Remember, taking a food sensitivity out is not removing the food for life. Food allergies may be the case. And lastly, retain your health and your GI integrity and do so by a good diet, lifestyle, mindset, and some standard supplementation like multivitamin, multimineral, omega-3 fatty acids, Vitamin D, probiotic, and good quality greens and fruit drink. I said earlier, you can't control the virus, but you can control the host. So let me give you some lifestyle hacks before we close. Please avoid certain foods. Use my acronyms of GPS and DNA. GPS: no gluten, no processed foods, no sugar. DNA: no dairy, no nicotine, No artificial sweeteners. Try not to use any vegetable oils and avoid anything that's deep fried. Follow an anti-inflammatory diet, a low sugar diet. Control your glycemic index and your glycemic load. Avoid those sugars. Detect and avoid food sensitivities. They are the hidden cause of inflammation. Decrease your environmental overload. Make clean eating a priority. Choose organic farm-to-fork food. If you're going to go for protein, have wild smash fish. Wild smash: salmon, mackerel, anchovies, sardines, and herring. Eat a plant-based or plant-forward diet. Consume fruits and vegetables. Watch the sugary fruits. Grass-fed meats are a great choice. High fiber is also— nuts and seeds, raw nuts, sprouted even better, makes the enzymatic reactions more available. And kills all anti-nutrients. Chicken soup and bone broth is every ethnic soup's penicillin, if you will. Herbs like ginger and turmeric are great choices. Make sure you consume an appropriate fluid intake. If you're gonna drink coffee and tea, and I am a coffee aficionado, organic coffee is the choice. The oils you wanna cook with at a low flame over a duration of time, extra virgin olive oil, avocado, macadamia nut, and coconut oil. Consume mushrooms. Lifestyle hacks, we talked a little bit before of intermittent fasting, time-restrictive eating. Make sure you get good quality sleep. Have a home exercise and on the road and an exercise program every day if possible. Let's not forget how robust chiropractic care can make your immune system. Again, I'm a low-level laser guy. I believe in modifying stress as much as you can. Support, balance, make your immune system more resilient, because instead of reacting to disease, a proactive, healthy lifestyle can help reduce the risk and prevent it.

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So again, we're at the end. Shameless plug, here it is, Immune Reboot. It was a bestseller in December, came out in December. I really appreciate all the support. You can order it now on immunereboot.com, or you can just go to Amazon If you wanna reach out to me, follow me on social media. I'm on Facebook. I'm posting twice a day. We're doing videos. We're doing health videos. They're shareable with your patients. drrobertsilverman.com. And I left a couple of quick, short minutes for Jessica to come on. And if there's any questions, I'd love to answer them.

Thank you so much, Dr. Silverman. And I have to second what he was just saying about his social media presence. Dr. Silverman does an incredible job featuring different guest speakers from time to time. He comes on and does videos and trainings, tons of great content going out, research articles posted all the time. So definitely check him out on those channels. We did have a few questions that came in through our chat feature. One of the things that you mentioned earlier on was that in terms of the T-cell production in children and teens versus adults, in your practice and in your research, have you seen that there's been a difference between the type of long COVID symptoms that children and teens are experiencing versus adults?

I see similar symptoms, but the children are not, fortunately, getting as much as adults, which is a little surprising because they don't have a fully developed immune system yet. So it just goes to show that the health issue in America is real unfortunate in that the adults are just getting sicker and sicker and sicker because we're eating these crappy foods. So again, I don't want to get into political genre, but I would really love the TV to give an alternative doc— I'll say myself or anybody— a chance and say, hey guys, there's all these options no matter what you want to do to your body. If your body's more resilient and healthier, you're going to respond better.

Absolutely. And I know there's been a lot of news lately about this underlying kind of ADHD pandemic that's coming out of the COVID pandemic. New research is showing that adult ADHD cases have increased 4 times what they were in terms of the diagnoses versus pre-COVID. And a lot of that they're saying may have to do with what they call this MCA or masked So, neurodegenerative cell disease that happens as part of that cytokine storm and as part of what happens with long COVID. Are you seeing a lot of that in your patients? How are you addressing some of the neurological symptoms that are existing and becoming chronic conditions after COVID?

There's a lot of neurological conditions. There's a lot of damage to the brain. My mom, I mean, my mom's old, she's in her 90s, or 90, I think it was 91 when she got COVID. was acting as if she had a stroke. So there are a lot of neurological conditions because if you adversely affect the gut, you're gonna also affect the brain because they're bidirectionally communicating. Whatever you do to your gut, you do to your brain. Whatever you do to your brain, you do to your gut. This particular virus is so small, it's able to pierce the blood-brain barrier and damage certain areas. And we can see that in a lot of the symptomology, like the loss of sense of smell. That's a cranial nerve issue. So I am doing a lot of chiropractic care. I'm using a lot of low-level laser therapy, and I'm applying a lot of lifestyle changes to help people get through this onslaught to their nervous system.

Absolutely. And I know that coupled with that, there's also been this worldwide shortage of medications that can treat some of the neurological symptoms, medications that can treat— again, ADHD is the one that's making news lately because there's been a shortage worldwide and People are looking for alternatives to stimulant medications. I think people are looking for alternatives now to prescription medication because of the rising cost of prescription meds. And then now that in this new post-COVID world, there isn't a supply chain that's really reliable. So I know you had mentioned that you have this protocol that you implement with a lot of your patients when it comes to their immunity and next steps. Are you finding more and more patients are coming to you looking for alternatives to a lot of the prescription medications that they've been prescribed?

Oh yeah, I mean, without question they are, because I think there's a— I want to be politically correct— I think there's a loss of trust. And I think people weren't, let's say, anti-medicine, but they were looking for other options within that and realizing there's a whole toolbox. So all that being said, People are coming for alternatives. People are coming for ways to keep their body healthy. Listen, we've been fighting this as an example for 3 years with no— nobody won. There's no real outcome other than we're living with it. So the sooner we all get healthier, the sooner we can deal with any kind of health issue.

Absolutely. Another question that came in was regarding your typical new patient intake. The first part of the question was, Are you asking about things like past COVID on your intake forms? And then the second part of that question is, can you give us kind of a 30,000 overview of the type of testing that you do with new patients, whether it be blood panels, panels for food allergies? Can you give just a quick rundown of the type of testing that you usually do in your intake?

Sure. So first thing is I just say, did you have COVID? I mean, it's a fair question. Now remember, I live in New York, so we have different laws than almost anybody else in the U.S. But I ask them, have you had COVID? Yes, is the typical answer. Did these symptomologies start after COVID, before? Have they gotten worse from COVID And we had the conversation. If there's a relationship, which in many instances there is, we have a conversation because no one's asking that. And if there's not, Well, so be it. Tend to what the problem is. My goal, and I'm not at 100%, is my goal, every patient walking in and out of this office gets a full comprehensive blood serum test. I think that the number one thing where I've grown is in my analyzation of blood serums. And I do anywhere from 22 to 26 vials. So people think I am a vampire without question. So full comprehensive blood exam. Food sensitivity test, gut barrier panel test. Those are standard bearers without question. Vitamin D, omega-3 tests. Once in a while, a poop test to see what's going on in your microbiome. So I can see what the body's doing from the inside out. I mean, most chiropractors take x-rays, but they're afraid to take blood labs. The blood labs are quite revealing.

Wonderful. And just for our docs that might be on the call or our other healthcare providers, Do you provide any services via telemed? If they had a patient that they were kind of scratching their head with and just struggling with from a nutrition perspective or to help with some of these immunity challenges, is there a way that they could contact you for consulting? Do you offer any of those type of services?

Yes, I do a lot of telehealth. I've already dedicated a day and a half a week just to telemed. For me, I— that is kind of where I'd like to see my nutrition practice go because I'm able to touch people that don't have to drive 2 hours or take 2 days to get here.

Absolutely. And I know a lot of providers are beginning to offer more telemed services again in this, this new, new world that we find ourselves in. You had mentioned also that you utilize laser as part of your treatment protocols and low-level laser therapy. Could you expand a little bit on specifically how you're utilizing your laser in practice and What types of conditions you're seeing the best results from?

The conditions that I'm seeing the best results from are musculoskeletal. And then I apply to the gut barrier axis. So I am also doing it for the gut, the brain, concussions, TBI, and of course the vagus nerve. So I'm using multiple wavelengths. Maybe some wavelengths are 405. Another one's 532, which is green. I actually just completed with another doc. We were co-lead investigators and we got an FDA clearance for a particular laser that's green and violet. I also happen to use red, but I use real lasers. I'm not big on the infrared. And I use lasers that come out of laser diodes. And I found that laser has been, for me, a breakthrough modality. And you can use it on its own or synergistically with any other type of soft tissue release, like a factor. Hint, hint.

Wonderful. No, I always love to hear that in great and creative ways that docs are using different modalities and, and being on the cutting edge. One final question and one thing I'd like to ask before we leave. So what's next for you, Dr. Silverman? I know you recently released this book. I know that you're involved with a lot of teaching at conferences. You obviously offer your own education both online and in person, and then you are participating in a lot of research. Tell us a little bit about what's ahead in 2023 for you.

That's a great question because we just had that conversation last night. We had it last year going into last night, if you will. My goal, what's next for me, is the expansion of the message. My dad taught me one thing when I was young. I always tease him. I said, Dad, you didn't spend a lot of time with me because I threw a ball and caught it. You didn't like that. You wanted me to fix doorways. But you did say one thing, that you're never gonna have a job as long as you love what you do. So I love what I do. I love getting the message out and trying to get the message on what chiropractors can do and the indelible mark they can make on our healthcare system. And I think that we are the forgotten physician in America today.

Wonderful. Thank you so much, and I appreciate you coming on today and sharing this great information. I certainly would love to have a follow-up second part to this at some point in the future on that vagal nerve training that you mentioned. Again, thank you so much, Dr. Silverman. We appreciate you being on today, and I hope everyone has a great rest of their day.

That's all for today's episode. Be sure to tune in for episode 66, Where we kick off a new training with Dr. Tyler Kemp titled Bone Stress Injuries: The Good, the Bad, and the Ugly. You won't wanna miss it. Episode 66 drops in 2 weeks. For those of you that have been listening to The Factor Podcast for some time now, you know that we like to cover topics that range from clinical skills to business, marketing, personal development, and a little bit of everything in between. And as we plan ahead for the new year, we have some exciting new projects in the works that speak to the business aspects of being successful in practice. I am personally calling upon my network of incredible business minds to put together trainings and resources to help you make 2024 your best year yet. So if you can do me a favor, I would really appreciate it. Click the link in our show notes and answer a quick one-question survey for me. It's completely anonymous and literally is just one question. We want to know what keeps you up at night when it comes to your business. No answer is a bad answer here, and all responses are welcome, whether you're a seasoned practice owner starting to plan for retirement, or if maybe you're a student and still uncertain of what you'll do when you graduate. Simply click on the one-question survey link in our show notes. Or visit our website at factorpodcast.com. As always, be sure to also check out in our show notes the special offers from our sponsors, view our upcoming live course dates, and view the recorded replay link to this full webinar training. We'll see you next time.

Hey guys, if you like what you heard today, I encourage you to visit our website at factor-store.com. That's spelled F-A-K-T-R hyphen store dot com to find out more information about all that we have to offer. We have a variety of online offerings as well as our hands-on Factor Rehab System course scheduled in cities around the globe. Be sure to also check out our event calendar and bookmark any of these upcoming live webinar dates coming up in the near future so you can join us live. And of course, the biggest compliment. we can receive is for you to help us spread the word to your friends, colleagues, and classmates. You'll find all the important links as well as info about our sponsors in the show notes, so be sure to check those out.