Inflammation Is Repair Deficit: Dr. Russell Jaffe on Ending Autoimmunity

Welcome to Integrative Medicine with Dr. Leland Stillman. This show is for men and women who are exhausted, inflamed, living with brain fog, gut or skin issues, and who won't settle for answers like, your labs are normal, or, just take this pill. Here, we focus on the root causes of disease and on what I call repair deficit, the gap between what your body needs for optimal health and performance and what it's actually getting. This podcast is not personal medical advice. It is education to help you ask better questions so you can make better decisions about your health. Thank you for joining us and welcome to today's episode. Hello everyone. Dr. Stillman. Today I'm excited to welcome my dear friend and mentor, Dr. Russell Jaffe, to the show. We are going to be talking about autoimmunity. We are going to talk about what's really causing it, what it is. I think it's very misunderstood. I find a lot of patients have an autoimmune condition and have never been told that. And many who have an autoimmune condition have been told things about it that are not really true. And so we're going to unpack all that because he's got a wealth of information and knowledge and a deep experience in integrative and conventional medicine. I will let him summarize his experiences so people kind of know where he's coming from. And then we're going to talk about why this is such an important issue, because truthfully, and I just said this before we started recording, if we do not solve this problem, which is why the book I'm releasing is called The End of Autoimmunity. If we don't solve this problem, then what will happen is civilization will collapse, run out of money, and run out of able-bodied people who can solve our problems and help keep moving society forward. So, Dr. Jaffe, thank you for joining me.

Thank you for inviting me. And I'm looking forward to your book, The End of Autoimmunity.

Thank you. Would you tell people a little bit about your background and what got you interested in autoimmunity?

Sure. I was trained in internal medicine at Boston University where I got 3 degrees on one day. Then I came to the National Institutes of Health known as NIH first As a resident in laboratory medicine, clinical pathology. Then I got double board certification in laboratory medicine, and I have been practicing what I do for half a century, including the fact that I've been meditating, that is mindfulness practice, for almost all that time. I've been mentored by some of the best and brightest, and some of that should have rubbed off on me over all this time. And I am more than grateful to have avoided autoimmunity. And inflammation, because inflammation underlies autoimmunity. Now, inflammation and autoimmunity apply to almost all chronic illnesses, from cardiovascular disease to arthritis, from pericarditis, and anything that ends in -itis. And anything that ends in -itis is most likely an inflammatory chronic condition. I'm delighted to talk today about what are the causes, and more importantly, what are the natural remedies for this pervasive problem in our society today.

Absolutely. You coined the phrase repair deficit, which I think you mentioned it offhandedly to me in a conversation or a podcast that we did together. And you then continued to reference it in your work that I was reading and watching. And I thought, you know, this is a really elegant way of reframing and explaining what's really going on and what's really going on behind a lot of the modern illnesses that I see patients suffering from, whether we're talking about Alzheimer's or heart disease or diabetes and obesity or allergies or autoimmune diseases or cancer, what that gets framed as in the literature and in a lot of medical education and marketing, to be honest with people, is this is inflammation and chronic inflammation. And if you don't know what inflammation is, it's basically the body's response to try to solve problems at a cell and tissue level. So you get a cold, you get a flu, you have an injury of some kind, crush injury, maybe something falls on you. Maybe you have penetrating trauma. Your body mobilizes resources in order to respond to the problem. And solve the problem. And that gets labeled as inflammation, which then has been turned into this concept of inflammaging. Because if you look at how people age and how quickly they age, it has to do with how much inflammation they have. A lot of the markers we rely on to help patients get well in terms of laboratory data are all based on markers, direct or indirect, of inflammation. But I find that the concept of inflammation is actually, it's not misleading. A little bit like saying you have a fire, which doesn't actually tell us the solution. Right. And what I like about your framing of inflammation as repair deficit is that it gives us the solution and the way out. You know, this isn't a fire that we need to control. We need to ask better questions like, why is there inflammation in the first place? Why are the cells and tissues on fire requiring medical intervention, creating symptoms, causing signs of disease in the first place? So how did you come up with this idea of repair deficit and what does it really mean to you?

Well, I have a PhD in biochemistry and a lot of that work had to do with collagen, a connective tissue. There are several connective tissues in your body. Collagen is the ropes. Then there is elastin, which is the rubber bands. So my earliest work was on the cross-links in collagen and elastin and what inhibits them, what prevents them from repairing. Then I worked with Dr. Dan Dakin at Beth Israel Hospital in Boston, and we worked out An application of that which has to do with how collagen activates platelets. Platelets deliver cholesterol to the membranes. Platelets are really essential if your body is going to repair itself. So in 1973, we produced what has become a rather seminal article on the architecture of platelets and collagen in Journal of Clinical Investigation, known as JCI. And I was very fortunate to have mentors Like Karl Franz Blau and Dan Dakin and others who set me on the path to a deeper understanding of what's going on. Inflammation really is a fire that chronically disturbs and destroys the quality of your life, but it's really a repair deficit. Something is preventing the platelets and the other immune defense and repair components from repairing what has become chronically unwell, chronically unrepaired, chronically not working the way it should. So whether we're talking about, as you correctly said, whether you're talking about arthritis in the joints or cardiorespiratory diseases or anything that has -itis at the end of it, you're talking about inflammation, which is really and truly a repair deficit. So if you want to resolve these issues, you need to stimulate the repair mechanisms in the body, which none of the conventional therapies really work to do. So I decided to dig in more deeply. dig in with an application of what I had been mentored to do. And we have a company called Perque, P-E-R-Q-U-E, Perque, which has more bioavailable nutrients and really is the solution, the repair deficit that provides the essential biological natural nutrients that the body needs to stimulate it to repair. We have done a double-blind placebo-controlled trial of Lifeguard, our multivitamin. And we showed in that study done at the military medical school that Our Lifeguard is 100% bioavailable compared to 15 or maybe 20% for other supplements. So many supplements have a, a label, an amount that's in the product, but they don't tell you about bioavailability, how much gets into you in a helpful way. We have pioneered more bioavailable supplements, and we want people to know that it is possible to get more of the beneficial, essential required nutrients into your body.

Absolutely. Yeah. Source supplements from you. So if you're looking at supplements in our store, store.stillmanmd.com, a lot of them come from Dr. Jaffe and his team. And I came to that, I made that decision because you'll also notice that they are more expensive than competing brands and products. And I came to that decision after many years of practicing with various different brands. Let's just say there's a, there are a lot of people who come to us on a lot of supplements and we completely stop their supplements and we start different brands, products that we carefully source like Dr. Jaffe's, and they would get better results. on fewer supplements, sometimes for less money, but they didn't care as much about that as just about let's get high-quality supplements in that actually move the needle. And the example that I will cite from my own life is that, you know, I will do my own quality control with the vitamin C that we have, the way that we dose it, which, you know, Dr. Jaffe, I learned this from another mentor, but then I saw Dr. Jaffe using it the same way. And I thought, oh, that's really interesting. We'll use powdered vitamin C and we use very, very high doses orally. And it takes twice as much vitamin C from a competing brand to saturate my body compared to Dr. Jaffe's product. And that is not the only person we've had in the practice. I mean, not just providers, but patients, of course, who've noticed this massive difference in quality. You feel different. It will have different effects. And I just looked at the numbers and said, all the competing brands are half as potent as Dr. Jaffe's, and they're about half as expensive. So I'm paying the same amount. And we just listen to patients. You know, what, what moves the needle? What gets the credit for your improvement? And the vitamin C comes up very consistently. And the other thing that comes up is that people will say, it's everything. I don't know. I'm not sure. And that just means all of it together is, is making the difference. And, you know, we use, like I said, a fair number of the products from, from your company in the practice. So we know they work because the patients tell us.

Thank you. Now our potency is actually produced under a nitrogen blanket, which means That what you get is fully reduced, fully bioavailable, fully beneficial to the connective tissue of your body.

Yes.

Most vitamin C is produced under air. That means it is damaged before it gets to you. It is oxidized, which is a technical way of saying damaged. So when we started our company, as a biochemist, I wanted to produce products that really worked, that you feel the difference With Perk products. And thank you for acknowledging that we did a good job with this.

Quick pause. If you're listening to this and thinking, he's talking about me, I'm tired, foggy, inflamed, and it feels like no one can figure out why, then your next step is not another random protocol. It's a structured assessment with myself or a member of my team. Go to stillmanmd.com and click book a call. Pick a time that works for you and add it to your calendar. On that call, we'll look at your story in more detail. and see whether our framework is a good fit for your situation. If it is, we'll outline what a realistic path forward could look like for you. This is not emergency care and it's not a promise of cure. It's a calm, structured way to stop guessing and see whether our approach is right for you. We have a limited number of these appointments each month. If this conversation is hitting close to home, visit stillmanmd.com now and book a call with myself or a member of my team. Thank you for listening. Now back to the show. Absolutely. Yes. And we also mentioned that we, because we do a lot of various different types of testing, we'll notice that patients who are on poor quality supplements will sometimes have a higher burden of toxins in their body. And we know that this is because of a lack of quality control, both in sourcing. So they're getting raw materials that are not pure. And then in also production, they're going through a process that does not remove impurities or that introduces them. And, you know, there's just no way around it. I've done, I've looked at this problem every which way. The more you try to cut corners and buy cheaper products, the more you end up paying in the long run because you're buying more. Sometimes you're, you're not just buying more to get the same effect, you're actually actively hurting your progress. You know, struck by that, like I said, consistently in the practice with patients coming in and they've tried everything and they've been everywhere and they've seen everyone and they've listened to all the podcasts and read all the articles and so on and so forth. And then it's just, you know, it's like, oh, well, you didn't have the right balance in your protocol. You didn't, didn't have the right ingredients and the right doses and things like that. So we spend a lot of time figuring that out and as well as the lifestyle piece. So, Dr. Jaffe, let's jump To autoimmunity, I really want to make sure we stay focused on that. And I, because of the book coming out, right. But also because the reason I wrote the book was that it's what I saw coming into the practice that responded really well to what we did. And what we did was really built around, in large part, nourishing the body with the nutrients that it needed, as you mentioned earlier. What is your thinking behind how you pick and select nutrients to help modern people and what nutrients do they need in order to solve repair deficit, which then if unaddressed, And avoid it leads to this repair deficit that then, you know, is chronic inflammation and then autoimmunity.

Well, in a word or two, it means more of the good and less of the bad. This means less of the contaminants. All of our products, all of our nutrients are the highest available, and we do testing. That's my background, to make sure that toxins, adverse-affecting products are not built into the product we're delivering. So in a nutshell, it's more of the good, less of the bad. And that means less of the chronic PFAS, permanent bioavailable but harmful contaminants that are often unfortunately built into products that don't do the testing we do. This means more of the heavy metals. That means lead, mercury, arsenic, cadmium, and nickel, which we avoid by choice and by testing, and more of the good. This means bioavailable nutrients, as you have proven in your practice and many colleagues have, because less of the good is worth more of the bad. That's a short way of saying that if you have more bioavailable nutrients and they're not contaminated with toxins, you get quicker results, more permanent results, and you quench the fire of inflammation. Inflammation means too much of the bad and not enough of the good. That's what we have pioneered. And documented with actually more studies and more evidence and more testimonials than any other company. Most of the supplement companies unfortunately want you to believe that they are okay. They are well marketed, but they don't have studies to show that the nutrients in their products actually get in and in a helpful way. For example, many products include chloride. Chloride is a molecule. Sodium chloride means table salt. And what that means is too much of the The acidifying chloride and often too much of the sodium. We need more potassium. We need more of the helpful minerals that make your body jumpstart the repair process. We need less of the sodium, less of the chloride. And many people, if you actually measure, many people are acidic. They are not alkaline. We have a book called The Joy of Living the Alkaline Way, which means getting enough of the nutrients that reduce the acid load, put the acids in your urine and your poop and provide the alkaline counterbalancing nutrients that jumpstart the repair process. The reason that our products deliver more of the good and less of the bad is because we study the biochemistry, not just the physical chemistry of these nutrients. I can see that you want to add to this. So what is your view, Dr. Stillman?

Yes, I wanted to jump in and just say that one of the things that we find in practice is that There's a lack of education of patients around all of these nutrients rather than just the ones they're supplementing with. So you mentioned 2 that often don't get enough attention in the counseling that patients receive, sodium and potassium. I've been very interested to find, because I, what I arrived at looking at all these problems was that indeed, as you mentioned, you need a right sodium to potassium ratio for patients. But what's so interesting is that patients will Often not know what their balance is. And we can sort that out, but it does take a little bit of time. It does take a little bit of history taking on our side as a team. And then as the, on the patient side is sort of calculating what are they actually eating and what are the, is the contents, right? And it's one of the things that ends up getting lost in translation in the health and wellness info spaces is sodium and potassium. Why? Because they're not high margin supplements. They're very cheap. So what ends up, and you know, funnily enough, the supplements that I often see being marketed have a very high sodium to potassium ratio. Now that's appropriate in certain contexts, like Like you're replacing sodium losses from a salt-wasting disease. You're replacing sodium losses from serious exercise or sauna, right? But what we would often observe is that patients would come in and when we actually did the data on their diet, we would find, oh, you have what we call an inverted sodium to potassium ratio in your diet, which just means we need to change your food selection to fix these mineral levels because they're part of your problem. I call potassium the redheaded stepchild of the supplement industry because nobody makes any money on it. So nobody talks about it. And I'm actually really enthusiastic about talking about it because what we've found is that if people don't fix this ratio and optimize it for their biochemistry, they may be frustrated with a lack of results, which is why we tend to attract people who are, I've tried all these supplements. I've been on this newsletter, listening to this podcast for so many years. I feel like I've tried everything and I'm, what's next? This is one of the things we focus on with them. And you mentioned acidity as well. This is something that people get so turned around, right? People will say, oh, well, you can't change the pH of the body because, you know, it's very tightly regulated and you just pee out whatever's excess. Other people will say, well, you've gotta absolutely, you know, do this, this, and this in order to alkalinize your body. What you'll find in actual practice is patients have a really variable pH and it will depend upon what are they eating? How much are they eating it? How are they preparing it? You know, I just learned something new. If you soak collards and chard and other high oxalate vegetables in baking soda before cooking them, You will actually radically change the flavor, which then leads to eating more of them, which is a good thing, I would argue. And you're also reducing the oxalate load on the body, which may be important for some people with oxalate issues. Right. And all of this tailoring and personalizing is what I think is so important for patients to have, because, you know, when we see patients flourishing and doing well, it's not because we just added stuff. We added the right things in a very focused, coherent way. And then we pulled things back too. And so all of this is really important context for patients to have because This is the stuff that really works in clinical practice versus what gets, for whatever reason, like marketed through social media and the internet and so on and so forth.

Now, an example of what you're talking about is that it is true that ascorbate, vitamin C, does produce a small, small, tiny amount of oxalate.

Yes.

You can measure oxalate after 2 weeks being on our vitamin C, and you will see a tiny amount of oxalate, but that is really small. And what you said I would translate as more organic or biodynamic foods, whole foods, which are rich in the nutrients that you want and low in the oxalates and the nutrients that you don't want. My son started a permaculture biodynamic food forest in our front yard. We have the good fortune to be able to eat from this from Memorial Day to the end of fall. And right now our Our biodynamic food forest is flourishing. We have lots of parsley, which is good for your eyes. We have lots of basil, which is good for all of you. We have lots of food that nourishes and replenishes your body. And I would suggest that people follow this guidance: more of the good, less of the bad.

I totally agree. And I often get asked by patients about this supplement or that supplement. I have a workshop coming up for our online community, which if you want, access, book an assessment. It's only currently, it's only $45. That may change in the future, but it's $45 to sit down with a member of my team and learn what we do, how we do, and whether or not it's right for you. And in this workshop, I'm going to be showing them, here are the actual changes in nutrient density and load between average people's diets, the diet we recommend, and then the diet we recommend with an at-home detox recipe we share with patients and members of our community that we've seen really move the needle for people that I couldn't replicate with something off of the Off the shelf in the supplement industry. One day I'd love to, I'll package and ship this myself, but we're not there yet. And the differences are stark. I mean, it's really stark. Patients often come to me saying, I'm looking at this supplement or that supplement, and what do you think about it? And I'll say, well, look, you know, first let's get your diet right. Because things you mentioned, you mentioned parsley for the eyes, the phytonutrients, specifically carotenoids and other antioxidants in fruits and vegetables that are so good for the eyes that are often marketed as preventing things like macular degeneration. People don't realize that a small serving of vegetables may contain that and more. So they're being marketed this supplement, but the reality is like, look, you've got to lead with your diet. I often hear seasoned practitioners, experienced practitioners say things like, you can't out-supplement a bad diet. And I just see that happening over and over again in the world. And, you know, bad needs to be taken in context. You know, we've seen such a variety of different diets work for people largely because of their immune responses, which we'll talk about later. But I just want people to know, you know, what Dr. Jaffe is saying about getting the food out of your diet or out of your garden, out of your local environment. You know, we, for example, take the time to source— I just texted my farmer this morning— pork, beef, lamb from a local farmer. There's a huge difference in flavor. That is a huge difference in nutrient quality and also toxin burden, which I think people may miss. You know, our food unfortunately has a lot of contamination from toxins because of what the animals are fed, because of how they're kept, Because of how the produce and the fruit are processed or raised or whatever. Fortunately, I think social media is actually really helping people understand this. You know, I saw a reel the other day of like a worker in a hazmat suit dipping roses in like some kind of chemical that requires him to have the hazmat suit and he passes it to somebody else in a hazmat suit. And I'm thinking, I just bought my wife flowers for Mother's Day. Oh no, there's roses. I guess we can't buy roses anymore. Not to say you can't buy roses anymore, but these things People are becoming more and more aware of them.

But for example, in our— yes, but for example, in our garden, we have heritage roses that are really fragrant. You don't want a dead item in your diet.

Thank you, Dr. Jaffe, for joining me. It's been a pleasure. Thank you all for joining us. I hope you found this podcast educational, informative, inspiring, helpful. We appreciate all your support for the show. Thanks for listening again. Take care and have a great day. Thank you for listening to Integrative Medicine with Dr. Leland Stillman. If this conversation felt uncomfortably familiar and you're ready for someone to take your story seriously, your next step is to book a call with myself or a member of my team. Go to stillmanmd.com and click book a call. Choose a time that works for you and confirm it. On that call, we'll look at your story in more detail and see whether our framework is a good fit for your situation. If it is, We'll outline what a realistic path forward could look like for you. This is not emergency care and it's not a guarantee of results. It's a calm, structured assessment where we'll create a plan to help you achieve your health goals. We have a limited number of calls available each month, so if you see a time that fits your schedule, book it right away. Again, the link is stillmanmd.com. If you find this podcast helpful, subscribe, leave a review, or share this episode with a friend or family member. who needs help getting their health back. I'm Dr. Leland Stillman. Thank you for listening, and until next time, be well.