Finding Answers When Your Doctor Says Everything Is Normal

What if better health begins with 2 things you can influence today? Your food and your thoughts. Welcome to Beyond Diagnosis. I'm Rita De Michele. This podcast is for people looking beyond symptoms and searching for deeper answers. Through expert conversations and real-life stories, we explore the connections between health, lifestyle, and whole-person support. Brought to you by the Beyond Diagnosis Collective, your guide to connection to trusted holistic practitioners. Recurring skin problems are not always only skin deep. Acne, eczema, psoriasis can be influenced by processes elsewhere in the body, while nutrition, movement, and sleep and mindset all help shape our long-term health. Today I'm joined by Jonathan Karp, board-certified dermatologist, lifestyle medicine expert, and founder and CEO of Miracle Noodle. He combines science, practical nutrition, and mental imagery to help people take greater control of their health. Welcome, Jonathan. So good to have you on.

Thank you for having me.

I love the take control of your health because that's what we want, isn't it? We all want to, like in your situation, help influence people that taking authority and ownership of their health is the best way to go, especially if they want longevity, if they want better control over whatever they're experiencing. And so many things biochemically have an influence. The one that I thought of straight away when thinking of your work was how high insulin can be soaring long before someone has. a diabetes diagnosis, and that definitely has an impact on someone's longevity. So what's it doing to the body, and how can our skin reveal it first?

Okay, well, high insulin, as you, as you correctly said, you know, sometimes insulin rises and we don't— it's not something that's checked by your doctor. And high insulin in the body actually causes very specific issues, especially with the skin, because insulin is essentially a growth factor. We think of it as something that allows us to absorb, you know, to open the gates of the cells to blood sugar, but it's essentially a growth hormone. And so people will often, as insulin goes up, they can get skin tags around their neck. That's one thing that it can cause. It can also cause increased acne formation. It can cause issues with chronic fungal infections. So, so many things that are happening inside the body, and you just picked one, which is insulin, can reveal a whole host of other signals and sort of, they're almost like indicators that something is going on inside the body. There is the thought that insulin being a growth factor could potentially lead to increases in things like cancer because it's a growth factor as well. And so one of the reasons why I was so drawn to dermatology, and a lot of people don't realize this, is that through the skin you can often see, see it as a window to what is going on inside the body.

They do say that the skin, the eyes, you know, they're the first, the first things that you can notice that will actually be an indicator to your what's happening. How can we help for on a So on a longevity basis, what can we do to help control insulin? Everyone says, I'll get your insulin down, or just eat properly. For a lot of people, what does that mean? You know, does fiber play a role in controlling insulin? Do certain foods are better for it?

Well, the first thing is that I always instruct people is that they should know what their fasting insulin number is. A lot of doctors do not get that blood test. And in fact, when you sometimes request that, they will put up a little bit of a fight because it's just not something That is linked to a diagnosis code. And then anyway, people should know what that is. I don't know what numbers— it's less than 10 in the US, but I don't know what the units are in Australia, so I can't say. Some countries have different units.

I think it's similar.

As an example, in the United States, most labs, they'll say that if it's 18 or under, that that's normal. Most of you, most probably a lot of your audience realizes just because something is normal doesn't necessarily mean that it's optimal. The first thing that people need to do is get acquainted with a certain number of blood tests. Of course, one of them is fasting insulin, and you want it under under ten. Of course, a low glycemic diet is going to be helpful. If you had to ask me what's the number one thing that I recommend for for insulin for fasting insulin is something called a fasting mimicking diet, which is basically a five-day reduced calorie diet that mimics the effects of a of a of a five-day fast, but it allows you to actually eat food, and that is very very good at lowering. Quickly lowering insulin level. It was popularized or created by a doctor by the name of Dr. Valter Longo. In the United States, he has a partnership with a company that makes a 5-day kit. But if you were to say look into his work, you can quickly, very on your own, sort of design this particular thing, which is basically 5 days. It's 1,100 calories the first day and then 800 to 900. And it's— there are details We don't need to go in here, but that's sort of my favorite thing, along with, of course, increasing vegetables, getting rid of highly processed carbohydrates, and really just making sure that you are not eating any foods that are gonna spike your blood sugar. That's sort of the first thing that you need to do. And that includes sometimes things like fruit juice, any sort of grains and flours that have been milled very finely are going to spike your blood sugar as well. When your sugar spikes, your insulin spikes, essentially. So ultimately, what happens over time—

Mm-hmm.

is that your, your blood sugar is spiking all the time, your insulin is spiking. And over time, you know, when you're young, your body is capable of bringing that, that down. But over time, you know, insulin— you need to, to release more and more insulin to keep your blood sugar steady. And so that's why it's important to understand what that number is way before, because even as your insulin goes high, your blood sugar could still stay normal. That's the most important thing.

Oh.

And so what happens is, is your blood sugar Stays normal, but over time, your body needs to release more insulin to keep it, to keep it normal. And then at some point in time, your body essentially tires out of that, and then your blood sugar starts to rise. So if someone has, for example, a family history of diabetes, in this scenario, you may be able to detect this inching up of the insulin even up to 10 years prior to the diabetes or the prediabetes. manifesting. And so that's why it's one of the— I have sort of 8 tests that I recommend that people become familiar with the numbers so they understand what those numbers are. And fasting insulin is sort of one of the 8 blood tests.

Well, that was a bit of a wake-up call. I mean, a lot of people, including people I know, rely on just that sugar level. Like they might have the home kit where they prick their finger and they go, well, I'm fine. You know, 6 isn't that bad, or 6.5 isn't that bad. You know, ideally it should be under 5, shouldn't it?

Well, I don't know what units you use. I, you know, in, you know, I think it's a different— we have— I never remember the, the units. But yeah, in the US, you know, you want it— you want your hemoglobin A1C, you know, as close to 5. You want your blood sugar, at least in the US, it's, you know, under 100, preferably even a little bit lower than that.

Okay. Yeah. But then you can get overconfident if you think, oh, my blood sugar— my blood sugar is low, I'm doing really well. But they have no idea that the insulin could be rising that's causing all the problems.

You know, it's definitely some of the problems, and over time can potentially be, you know, a significant part of the problem. So it's one of those things that, again, in dermatology, sometimes someone will come in, all of a sudden they're growing all these skin tags under their arms and around their neck, and I ask them, you know, do you have any history of diabetes? And at that point in time, they might not have any, and then I'll check fasting insulin, and, you know, they might be pre-diabetic, but with a very, very high, very, very high insulin. And so this is why it's, you know, it is an important has to have some understanding of. And I always tell people that you need to become your own authority in health. And part of that is realizing that this is not rocket science. This is something that you can understand. It's not complicated. You have to learn a few numbers, but really I've never had anyone not become comfortable with that. The problem that a lot of people have, you have to, you know, in the US we can now order our own labs. I don't know what the laws are like in Australia.

We can too here.

You can. So I would recommend, you know—

Through certain companies.

I recommend, I mean, you know, in the US it costs, you know, $15 to get, say, a fasting insulin. You can order it on your own, learn a little bit about it, take a little bit more control. And I will say one of the most impactful things I've seen with patients is just ordering that one test, you know, walking in and saying, I'm going to get, you know, whatever it is, in this case, fasting insulin. And then they get the result and they make a decision based on that number. That's a huge hurdle. It doesn't sound like a big hurdle, but it really is because you have to walk in. You're kind of not— you're doing it without your doctor telling you to do it. You're on your own. You're walking in, you're ordering a lab. It feels, you know, to a lot of people like they're doing something wrong because we've been conditioned to, you know, expect someone else to be taking care of that. But in the modern world, the way things are, we really need to become a lot more empowered and in control. And I can tell you, Dozens and dozens of times, the change of before ordering just one lab and after, it's significant. It may not sound that significant, but there is something really empowering about going about that on your own.

It's usually the first step that people feel paralyzed to take. I think it's also because taking interest in your health has always been left in the doctor's hands. You know, like you don't really take an interest in your health until something appears or, you know, you've got something even more dramatic and then you hand that all over to the doctor and it's only the doctor who knows, or the alternative practitioner, whatever, whoever you see. But it's not so. We have so much control over what we can do. It's just the confidence to believe that we do understand our bodies. You know, that we do.

It's true.

We've— no one understands how we feel like we do. Is there a connection? Because when you look at a lot of skin conditions and even problems with longevity, we go back down to inflammation. Is there a connection between rising insulin and inflammation and then that how that inflammation is expressed through the skin?

Yeah, I mean, they all sort of feed into each other in many, many different ways. Generally speaking, if someone is eating a diet that is going to cause insulin, very, very high insulin and eventually high blood sugar, it's almost always an inflammatory diet, meaning there's probably processed foods, you know, there's poor gut health as a result. With poor gut health, there could be a tremendous amount of inflammation because things are, you know, leaking out into, into the bloodstream. So all of these things are going to lead to a general sense of inflammation. And that is another one of sort of the 8 tests that I talk about, which is a test called hs-CRP, which stands for high sensitivity C-reactive protein. And that is really the most sensitive test To detect inflammation in your body. And that's another one of these tests that I feel everyone should really know about so that they can get a clear understanding of that. Sometimes you could be completely, you know, doing everything right, and sometimes it could just be periodontitis. You know, you haven't gone to the dentist. That can cause, believe it or not, systematic, you know, through the whole body inflammation. And so, you know, learning about all these different things about how important dental health is and All these things, it's not complicated. It just requires a little bit of time on your part. And I just believe that having a handful of numbers, understanding of certain labs, not, you don't have to understand all the different labs, just a few that can give you an indicator, like, like as an example, inflammation.

If someone came to you with psoriasis or eczema or burning rashes, like I used to get burning rashes. And I never understood why for years and years and years. And then, you know, a holistic chiropractor who did kinesiology, etc., she sort of did a few tests, etc., and she goes, I would get off dairy. And so I got off dairy, all those rashes went. So that dairy was creating so much inflammation that, you know, I was— it was burning my— like a layer of skin would come off. Can you explain to people how they need to think about inflammation? What, you know, what it is, how they think about it, and what contributes?

Yeah, sure. I like to describe inflammation based on how it's actually described in a medical textbook. And that is that acute inflammation is what happens after you sprain your ankle or you burn yourself. And it's basically the immune system calling over to the site of injury, certain types of things like white blood cells. At that time, those— your body needs that at the time because those, you know, it's cleaning out debris. It's bringing in immune cells to fight what might have penetrated into the skin. All of these things are very, very important. So that's acute inflammation, and we need that. The problem is, is with chronic inflammation, you get this same elevation of immune cells, immune reactivity. In other words, the immune system is like on hyper alert, essentially. And so in your case, for example, there could have been issues where the dairy was triggering this sort of immune reaction that caused you to have sort of inflammation in your body. It's essentially your immune system trying to fight something going on in your body, but on a chronic basis, which is— it's never meant to be. If you have a sprained ankle, okay, you have swelling, warmth, redness. All of these are the signs of acute inflammation. But as the body takes care of that, the warmth, the redness, and the swelling go down. But if you have something inside that is triggering a reaction that is, you know, internal—

Mm-hmm.

It's like a smoldering fire of redness, but it's essentially going on inside your body. That's probably the, the, the clearest way I can sort of explain it. In fact, if you look at— if you look in the blood, you can see the immune system being react— being activated by certain, uh, you know, it could be a whole host of different things, but it's the immune system that's sort of coming in and causing that inflammation.

And how can people, apart from— is there anything else apart from elimination of certain foods For them to know whether it is actually food or something else that is creating, you know, like there'll be a lot of people listening to this who have eczema or psoriasis and burning and all over their body, desperate for an answer. They're given creams or a medication, but it's topical. What can they do?

Well, it's different for each one. So we can take, we can briefly talk about each one. So for psoriasis, we know that psoriasis is is a— it's an immune reactivity that's happening sometimes with, with some genetic susceptibilities. But it's, it's a certain wing of the immune system that is essentially chronically activated. And what happens is, is that the activation is of a particular type of cell, you could call it, that gets into the skin and causes the skin to divide really, really rapidly. This is a form of when it— when the cells start going crazy, that in and of itself causes redness and inflammation in the skin. That's essentially what's happening. Now, there are lots of things that can contribute to that. So people who are, you know, high blood sugar, high triglycerides, increased weight, all of these things that we call sort of metabolic syndrome, all of these things are going to make psoriasis worse. In fact, we know that when you eliminate those risk factors, you know, the psoriasis tends to improve. And that in populations where they don't have these, there's much less psoriasis. With psoriasis as an example, if you have all of those things that I talked about, high triglycerides, which is related to, you know, too many, generally too many carbs, you know, insulin, we spoke a little bit about increased weight, all of these things are going to contribute. Visceral fat, you know, which is a fat that surrounds the organs. And this type of fat in and of itself releases like a— it's like a smoldering fire. Just having the visceral fat there, a lot of people don't realize that when you have the fat around the organs, that is not just sitting there, it's not just inert, it's actually releasing chemicals and immune-type chemicals that cause inflammation. So just by having too much of that is like having a, a smoldering fire inside your body, which is going to lead to a whole host of, of other problems. So that's sort of on the, on the psoriasis angle. Now, from the eczema angle, it's like a different wing of the immune system that instead of causing the cells to rapidly multiply, it actually causes the barrier of your skin to malfunction. And your skin is basically protecting you against what's outside. And if the barrier is not functioning, anything can cause the skin to break out red and irritated because it's being left without the natural oil barrier. The gut plays a role in both of these, and the gut, of course, plays a role in overall health in general. So a lot of people also tend to have gut issues. Now, for those people, it can take a while to figure out what that might be. In your case, you know, you had dairy as— and so sometimes, especially with eczema, we may do a type of elimination diet where we would eliminate the most common causes like dairy, dairy and wheat, as an example. Sometimes will check for gluten sensitivity because gluten intolerance is increasing and is really incredibly, you know, it's associated with psoriasis and eczema and a whole host of skin problems. So I tend to check celiac for celiac disease a lot sooner than a lot of my colleagues because I've seen it so much as a contributing factor. And the reason it's a contributing factor is because when the gut is damaged by celiac, it essentially allows a lot of cells that, you know, a lot of things that should have remained in the gut get into the bloodstream, and then that causes the immune system to overreact. And that downstream leads to a whole host of problems.

I want to talk about the gut-brain axis and how that influences our longevity overall, because that has a complete overall influence on our body, not just our skin or anything like that? Because if the gut is out, then the brain chemistry goes out. And if the brain chemistry goes out, I'm assuming, I'm not a professional here, obviously, then our— doesn't that then influence sometimes our food choices?

100%.

Can you talk a little bit about how that can be a bit of a vicious cycle? You want to be well, you want to live long, but the gut keeps influencing your brain to make not so great choices.

Well, everyone's probably heard of serotonin, and, you know, it's a neurotransmitter. And in a normal functioning gut, a large percentage of the serotonin actually is produced by the gut when you have a healthy microbiome. There's a whole host of other chemicals that are released from the gut, but it all relates back to the diversity of your gut microbiome. And if your microbiome has a poor diversity and it's like out of ratio, The bad bacteria that you might have can 100% influence how you make your decisions. They may cause you to reach for starchy foods and sugars and things like that because they're overrepresented in your gut and sending signals that they want to have more of this food. So it's happening directly from the gut influencing your food choices. So ultimately, The best way to improve the gut diversity, the microbiome diversity, is to eat the most amount of diverse plant fibers from different types of— it's like fertilizer. You want to have a, you know, it's essentially like a garden, but you want to be able to give it many kinds of different types of fibers to cultivate a lot of diversity in the gut.

So that actually goes well beyond people saying you don't have any discipline.

Yeah.

I mean, that can be so shaming in a way, can't it? When you've got this chemistry influencing your choices.

It's true. And not only that, but I, you know, some of the hunger hormones that we have, you know, when we've been eating poorly and maybe we went through a period of time when maybe we gained a little extra weight, sometimes like the thermostat of hunger gets pushed in a way that is almost impossible to fight. You know, in other words, it's like, Our hunger is set at a different trigger point. And so in those circumstances, just because you can't fight that, it's almost impossible to fight some of those signals. And so the key really is to focus on what you can control, which is paying attention to some of the numbers, making sure that you're eating a diverse gut, that you're not introducing foods that are going to make things worse. Like we were talking about in terms of starchy foods, you know, artificial sweeteners and such that can damage the gut, and that you're eating, you know, a decent number of vegetables and more of a natural diet.

In terms of the longevity part, how much does sleep and movement like exercise play into how well we feel overall, and then how well we actually can make better food choices or Or maybe push those thoughts away that gut bacteria are hounding on us?

I think the human body is designed to restore itself. That's the first thing. So before we, you know, so if you put your body in the right circumstances, meaning you're eating well, you're waking up with the sun, you're, you know, I always say that there's several pillars to your health. There's the mental state pillar, which is, you know, we're trying to maintain a positive attitude. There's, of course, the nutritional pillar. There's the movement pillar. You know, so there are many. So if we look at each one of these sorts of pillars, mental state, what are we doing to make sure that we are maintaining a positive outlook? The nutrition, we've spoken a little bit, a little bit about movement and mechanics. Are we taking the time to make sure that we have a, you know, movement exercise type, type of plan? Are we paying attention to our circadian rhythms? You know, in other words, are we getting outside in the morning, exposing ourselves to nature? All of these things are aspects of putting yourself in a position for your body to restore itself.

Do we underplay or don't give enough notice to our negative thoughts and how that then produces a cascade of chemistry that can send our health into like inflammation, disease? You know, you're a dermatologist, you must see it as skin problems. And what can we do about it? Like just some simple steps, because I think one of the hardest things is people to recognize that they do sometimes have a very negative outlook.

Some, for some people it's a significant factor. Um, for others it isn't. It, I always look at it as sort of the, that you've heard of the 80/20 rule where, yeah. And so for some people, the mental state is, is there 20% that's impacting them 80% of the, of the time? So in my practice, you know, I, I studied under a teacher by the name of Dr. Gerald Epstein, who was a master of, of what's called mental imagery. And mental imagery is a technique that, that teaches you to give images to various emotions to be able to help control them. It can give you an example of a patient who came in with neurodermatitis, which is a condition where, where someone is just basically picking the skin off their body from stress. And a lot of times they actually don't have a clear understanding even of the emotional aspect of that, even though they're doing it to themselves and they, they have some awareness of that. It also comes with itching. The internal emotional issues are actually causing a physical sensation in the body that's then causing them to, to basically pick their skin off, and they have sores all over their arms and wherever they can reach. And in this particular case I'll just, as just to give an example, I asked the patient, breathe out 3 times slowly, close your eyes. And blowing out slowly activates the parasympathetic nervous system, which calms you down. And then I asked her, what does your condition look like in your imagination? And she responded very quickly and said, it's like barbed wire being pulled across my skin. And then immediately she said, my God, I feel like I'm in prison. And then I said, what's the opposite of that image? And she came up with smooth glass tubes healing and being pulled across my skin. And that was enough to— and I told her to do that 3 times a day for the next 21 days. And that was enough to sort of interrupt the whatever the signals were to prevent her from picking the skin. That's just sort of one example. There's so many techniques of of self-awareness out there that can be helpful. But it is important to be able to recognize if you have repeated negative thoughts. We all do, of course. It's part of being— it's part of being human. The key is to realize that they don't necessarily represent who we are, those thoughts. They are just early evolutionary parts of our brain that are basically looking at everything as a threat or not. And in some way, we've made that connection. And so my teacher would say that almost all Negative emotions are based on worries, worries about the future or pain from our past. He would always say, whenever someone would say, well, what if this happens? It's all a story. First of all, everything's a probability and we don't know what the future is going to hold. So don't— we're very good at telescoping ourselves into the future or looking back in the past and seeing pain. And ultimately, My teacher would say, you know, the past is dead, gone, kaput, gone forever. And the future is not here. So just the concept of that is important. And then secondly is this idea that he would describe it as what we go through every day, which is called the false emergency state, which is where we react to things as if we're being chased by a lion when we are not. And ultimately, we don't ever really encounter true emergencies. The only true emergency is if someone has a gun to your head.

Honestly.

Everything else is not an emergency. Someone cuts us off in traffic, most of us react as if we're— our body's reacting as if we were being chased by a lion. And what happens when we're being chased by a lion? Well, in that scenario, we would run and use all of our energy to get away, and that would discharge all of this sort of emotional energy. But what do we do in our modern life when we drop a glass, when someone cuts us off, And we don't have what we expect. Well, we get that same reaction, but we stew in it. And that energy is not that— you know, when you have that reaction, there are hormones that get released, all the stress hormones and such, and they don't have anywhere to go. And that is going to cause your body to decay. I mean, that's ultimately what, what it does, because our bodies were not meant to stew in that sort of emotion. And so my teacher would always say that you get into the practice of asking yourself repeatedly throughout the day, is this a true emergency? And ideally you would say it to yourself. Like I would say, is Jonathan, is this a true emergency? Because there's something about, something about seeing yourself in the third person that gives you a little bit more awareness. And of course, the first time you do it, you'll think, oh, it's sort of sound, you know, it, it won't have the impact initially. But as you get into the practice, of asking yourself, okay, someone cuts you off in traffic, you'll remember to ask yourself, is that— is this a true emergency? And of course, it's always no. And over time, the things that you reacted— you became so reactive to in the past, they slowly disappear over time, and you're not as reactive. And when you're not as reactive, you're not releasing that gush of hormones that is going to shift your body into a stressed, you know, fight-or-flight state. And when that is, when your body is in that state all the time, you're going to decay. I mean, that's essentially your body needs to have a balance between, between the sympathetic and the parasympathetic. And if you're chronically in your sympathetic mode, sleep's bad. You know, your, your nervous system is imbalanced. That's going to cause you to feel emotionally completely different than you would if you had a balanced system. As an example, For example, you know, when you come back, sometimes you go away for a vacation and then you come back and for like a couple days or maybe even a week, the things that didn't bother you before, you know, they don't bother you as much for like a week or, you know, a couple days. Why is that? It's not because, oh, I just had a vacation. Let's look at it from a biological basis. What happened is, is that you went away and you activated your parasympathetic, the rest and recharge, which wasn't being properly activated before your vacation. And so you can think of yourself as more neurologically balanced. And so when you come back, you get a stressor, you have the cushion, so to speak, because it's balanced. And then a week later, you know, you're back into it and you don't have that reserve anymore. Well, the most important thing you can do is to make sure that you, in your daily everyday life, create that cushion. And how do you do that? You do that through active relaxation. That doesn't mean sitting in front of a TV or even reading a book. It's internally directed relaxation. Now, that could be, that could be reading Psalms, prayer, breathing, counting your breaths, meditation, sometimes reading some, something inspirational. Taking a bath is probably, you know, one of the greatest things you can do. It's just readily available by almost everybody and is so incredibly good. at activating the parasympathetic nervous system. All of these, there's so many things that you can, you can do, but you need to be aware of the problem. You are now, everyone who's listening, and recognize that you need 20 to 40 minutes per day of active inwardly directed relaxation to have some sort of cushion in your, in your nervous system.

To what we were talking about before about our thoughts. Now, if you want to hang on to a thought of I don't have time, I'm too stressed, I don't— to do this, well then what changes? So we have to get over that thought first, don't we?

We do. Yeah, it's true. I mean, it's, it's not, it's not an easy one, but even those thoughts are often based on some sort of, you know, irrational fear that leads us into a false emergency state. And so one way, you know, like if we're worried about even a deadline that's causing us stress, we're reacting as if our body's reacting As if it's an emergency. And that's going to trigger these. If you can get in there and say, okay, look, okay, I have a deadline, but right now it's not an emergency. You know, again, it's a practice. It's a practice.

And then I think it comes down to, like we said in the very beginning, to have agency over your health, to take that first step. It's making a choice. Do I want to do this? You know, is It's choosing nothing's more important than this 40 minutes or 20 minutes of rest that I need each day to reset. We want to lose, you know, so many people want to lose weight, they want to be more energetic, whatever their goal is, especially we talked about the visceral fat, which is so dangerous. But is it not true that the body will not release that? Doesn't matter how many diets we pay for or seek out, it won't do that if inflammation is high and our stress is high.

It's definitely, it definitely makes it much more difficult. For sure. And, you know, part of the— in the US, there's a lot of talk about, you know, the European paradox where people go to Italy and they end up in France and they eat all this, all they eat bread, and then they come back and, you know, they lost 20 pounds. You know, part of it, of course, is the ingredients, but part of it is also the fact that you're on vacation and, you know, and you rest and such. So there's— it's multidimensional. Yes, if you have stress hormones, your body is in a place, and you can think of it evolutionarily, like if you were in a stressed scenario evolutionarily, that probably meant that maybe resources were poor, you know, there was a threat for survival, and your body wants to hold on to as much as it possibly can. So you need to be in a relaxed state for— and there's no question inflammation rises when your cortisol is high. You know, we have it and everything is balanced. You know, we, all of us have a normal cortisol release in the morning. That is part of waking up. You know, it's, it gets our blood sugar up a little bit. It wakes us up, gives us natural energy in the morning. You're not supposed to have that the entire day. And everything can be looked at as sort of a balance in that way. The best thing you can do is to, is to inject that 20 to 48 minutes. daily into, and then ideally, you know, one day a week, not to, you know, take care of yourself in a longer, a longer way, you know, take a Sabbath of your own, you know, to recharge.

How, if I know everyone's different and they come in, it's all personalized, but if someone's come to see you, where do you usually start? Because you take a very different approach to dermatology. I've never been to a dermatologist that talks about lifestyle. So you're kind of like a bit of a unicorn there. So where do you actually start with somebody? Is it their gut? Is it food? What is it?

I should say that I have a very conventional dermatology practice. And so the way I approach it is every patient that I see, I float the idea out to them that diet and lifestyle can play a role in their condition. Very few people are interested in that. It's just No. The way, the way it goes. I've counted, it's 1 in 200 people on average that are interested in making— because I'm asking them, if, if I tell someone that their diet and lifestyle can potentially either reverse or significantly improve their, their condition, it's a lifestyle change. You know, they have to change an enormous amount of things. You know, they aren't necessarily coming to me for that. Now, well, now that I've, you know, podcasts like this, you know, people tend to find me, but it's a very small number. Now, when they are interested in that, it depends on the condition that I'm seeing them for. I certainly will be ordering some of those tests that I spoke about.

Yes.

And then I, I, I come up with a plan, but it, it varies according to, to the disease that, that, that I'm seeing.

1 in 200. That is incredible. For the person, that 1 in 200, who wants to take charge of their health today, what's one change that you would suggest they make first? Like, they've listened to this podcast and straight away, what's one change that they could make?

How to pick one? That's a hard one.

Well, let's go with 3 then.

Yeah, I would say, I would say correct your sleep. We didn't talk about that. Get rid of all processed, any kind of processed foods from, from your diet. And then I would say start learning How to start with a few blood tests and start becoming more involved in some of the some of the blood these blood tests that really they really do when you one of the most impactful things I see with patients is going over some of these numbers and seeing them improve not because of anything that I've done but because of what they've done after I've showed them the number that is again another one of those hurdles that when someone comes in just as an example with Oh, no. With, say, a patient with a condition called hidradenitis suppurativa, which is really an awful condition where people get draining cysts under their arms, in their groin. It's really a really awful condition. As you can imagine, from a social perspective, it's completely alienating and painful. And it's oftentimes when you lower— getting back to insulin again— when you get their insulin level quite low, The condition often just goes away completely. And so I had a patient, very— I'll make it very quick. His— he had a very elevated— I didn't even— I told him, look, next time I see you, I'm going— we're going to go over a little bit more detail about getting your insulin level down. And he went on to ChatGPT on his own after the visit. And he was so motivated because he was single and he, you know, he within like 2 and a half, 3 months, he got his insulin level down and His condition went away. But the point is, is that he did it. That's the most important thing. It was empowering him. I could have told him, look, I could have done it without even talking about insulin. I could have just said, look, I got a value and I want you to change this diet into— I would just— I want you to get rid of these foods. Instead, you know, he went home, he became empowered on his own, doing his own research, and basically cured himself. And that's probably the biggest lesson that I can give, which is— We are fully capable of remarkable things. It's almost like our birthright to be able to restore ourselves if we just sort of start learning a little bit more about some of these things.

Absolutely. And I love the whole empowerment angle because it's so— it is definitely important. And that's why I think, did you start your business around Miracle Noodle? Because people could then— because you've seen the impact. That high carbohydrate diet has on people. And then you develop Miracle Noodle so they could still enjoy what feels like, you know, like a noodle or rice without carbs.

Yeah, it happened exactly like that. In fact, it was— I had a patient by the name of Karen. She was my first patient that really— she had lupus. I couldn't control it. And she cured herself. And she brought in all the articles and the books and gave them to me. I only knew very little at that time. And it was shortly after that she made a significant change in my life because my whole practice changed after, after seeing what she was capable of doing for herself. And there's a lesson in that, that it took a patient, you know, to, to really get me to see sort of the power of diet and lifestyle. And then shortly thereafter, I was on a trip to Japan and I saw this particular product, and I was thinking about the patients that were trying to shift to eating a healthier diet, and this looked perfect. And, um, and so that's what generally interested me from the beginning.

I eat them. I think they're fabulous because I try to have a low carb. They do give you an alternative so you can still participate and think you're having, you know, your pasta or your rice or whatever. Thank you so much, Dr. Jonathan Carr, for coming on and telling us all about longevity, the impact of our food, our choices on our skin. And for everybody who's Thank you so much for listening to this episode. If you'd like to find out more about Dr. Jonathan Karp, his details, his website, his socials will be in the show notes. So do connect with him. Thank you so much for coming on.

Thank you for having me. It was a pleasure.