Gut Check: Navigating Diet for a Vibrant Body + Mind (RUNGA LIVE)

Foreign.

Okay, who here listens to podcasts? Wow, that was maybe like 70%. Today is really special because we have 3 of the world renowned experts on gut health here, and we're recording the Wellness and Wisdom podcast, which I'm the host of, so y' all get to follow me. It's Elness Force on Instagram. Now, before we get there, let's introduce our panel. So the first person right here on my left is Dr. Tanya Dempsey. She was inspired by her maternal grandmother to go into the field she's in. Next is Dr. Leland Stillman. He's been on the podcast, so technically this is his second appearance on the podcast. Leland, tell us a little bit about your center and what you do in the world. We'll go right back to Tanya before we get to Michael Ruscio.

I practice natural and integrative medicine in.

Florida, and virtually he also is an amazing cook. Now let's go to Tanya. Tanya, tell us about the AEM Center.

Yeah, the AEM center is in Purchase, New York. It's Westchester county, where we would take care of basically lots of complex chronic diseases mixed with wellness, of course, too. But I have an interest in more of the complex multisystem illnesses. Gut health, hormones, mast cell activation syndrome.

And on the very Left here is Dr. Michael Ruscio. This is technically your fifth time on the podcast, which is like, that's got to be a record. I don't know if I ever interviewed somebody five times. Tell them just a bit about you. Super high level. Don't go too deep yet. Who are you? What do you do in the world?

Are you stuck with me yet?

No, I have a lot to learn.

Getting there.

Yeah.

Similar to natural medicine, mainly focus on gut health and also do some clinical research.

Okay. So does everybody in the audience today. And also out there on Apple and Spotify, is your gut perfect? Do you have any? Raise your hand if your gut is completely perfect. Okay, cool. That's honest. Yeah. None of us. Gut health is really fascinating. It is this field that is ever changing. It's like, what do we need to know about synbiotics, probiotics, postbiotics, all the biotics? And to me, what's utterly fascinating is that as fast as this landscape changes, the there are some common denominators for health. Right. We all know that probably eating food without a label is the best possible thing you could do. Drinking clean water, being around healthy, happy people, all these things affect the microbiome in your gut. So I'm gonna throw this out to the panel here for starting Us here, there's four biotics. There is the probiotics, the prebiotics, the synbiotics and the metabiotics, AKA postbiotics. What's the difference of all these things popcorn style? Who's going to begin? TANYA ruscio, I'll just say that probiotics are the bacteria.

The prebiotics are the stuff that feeds the bacteria. The postbiotics are the metabolites from the bacteria, like butyrate. And what was the fourth one you mentioned?

There's postbiotics. Has everybody heard of postbiotics? Okay, this is that was brand new for me this morning as well.

There's different labels. So yeah, I'll throw that out there to get the ball rolling.

Yeah, I think what's really interesting too is that the timing of these matter, but also, do we eat them with food? Do we not eat food with our supplements? Think about the way that we even begin life. And this is close to my heart because in the audience is Kerry Michelle, my partner and my daughter is being warned by her. She's five months old. Is there we all start life right from our mother. That's how we begin. That's really where the microbiome is imprinted. It's how we begin life on the planet. So is there a maybe, Tanya, you can speak to this. Is there a difference between cesarean birth and vaginal birth? How does that impact lifelong health for us as a human being? What's the research show us on that?

Yeah, the research does show that when a child is born through the vaginal canal where there's lots of probiotics, right? Bacteria, yeast, lots of stuff. When the baby is born that way and gets exposed immediately, it sort of that stuff gets colonized. The baby gets colonized with it, the gut gets colonized with it, versus the cesarean section where there's an incision, the baby's taken out, it's not exposed to the mother's flora. And those babies, listen, if you were born C section or if you needed a C section, there's no judgment. It just is that maybe those babies have different gut flora. Maybe they're more susceptible to certain things. Maybe they're immune system is a little bit different than babies that are born through the vaginal canal where they're getting the mother's flora. And so what they're doing now, they showed studies where babies were born with C section.

Put your mic away.

Wow.

I think maybe we turn the volume on the mics down a little bit.

Yes, you're trying to turn the volume on the mics.

Yeah, we all talk pretty loud, I think.

Thank you, sir.

So what I. Can you hear me? Okay? So when, when I have, let's say, patients who are going to have a C section, we'll have them actually get like an infant probiotic and either swab the baby or take the vaginal, swab the mother's vagina and basically swab the baby after the baby's born. C section so that they get exposed to that, because that seems to set off the immune system. That's one of the things that sets off the immune system.

So it's like a jail sentence. I mean, if you're born vaginal or cesarean, however you come to the world, there's always a way that we can improve. I mean, how many, literally hundreds of thousands of people that come into the world are born cesarean? And those rates are going up and up and up. I think about the way that we start life, it's through our mother's milk and all the ways that we learn how to digest and assimilate food. I don't know the exact date, I think it's six months that babies start eating something like that. What are the optimal foods? It's so interesting how we've convoluted and we've complicated this really, really simple topic of like, the foods that don't have labels. These are the things that we get to eat. These are the things that matter the most. I'll pass it to Leland on this one. Many of the patients that you see, they just simply have maybe an education barrier. It's not always just a health issue. Remember we did our recent podcast where it was like, how much mindset goes into the way that we can actually be healthy in the world? Is there an optimal diet for gut health? Does it depend on each person? I kind of feel like it does. But I'm curious, you know, from a clinical perspective, like, what do you feel is the optimal diet for having the best gut health possible?

That's a great question. Although it's very hard to respond to because there's. There's like so many things that it makes me think of. And ultimately in my practice, what I found, I did. I did hundreds of stool tests, three day stool collection, studies from Genova, Diagnostics, the GI effect. It's a great test. But I did hundreds of these tests over two or three years at the prompting of a mentor of mine who said, you'll get great clinical data, patients will love it, you'll get great results. And I did get good results. But then as I started to work with more and more people, I realized that basically for me to optimize their gut health, it came down to really a very small number of ingredients. First of all, I think a lot of people forget that before you get into the prebiotics, postbiotics, probiotics, symbiotics, whatever biotics they come up with next, you have to remember that the gut starts in the mouth and it starts after the mouth with the stomach. So you can count on having problems with your microbiome when you have problems with your stomach acid or problems with people not slowing down chewing their food. And obviously you've got to pick your foods wisely. And to your actual question, which you asked me, I really adjust the diet based on the clinical picture because, you know, I had this case and I use this often as an example. I think someone, I think we have another question, another panel about oats. So I won't get too into this, but people will go out there and they'll talk smack about oats. And oats are one of my favorite foods. And one of the reasons for this is that I had a very interesting case a couple years ago. He's a 68 year old man who came to me 150 pounds and 6, 3, which if you don't like know, that's a very, very thin six foot three man. And he was so thin because he had had a stomach surgery for gastric ulcers years in the past. And now he was dealing with lots of GI issues. Constipation, nausea, vomiting, IBS type picture, plus severe anemia, severe fatigue. But because his stomach was surgically altered, it was very small. And so I had to feed him in boluses of like 200, 300 calories. The average 6, 3 man can put away an 800 to 1000 calorie meal, especially post workout. So I had to really tailor that to him. And oats were one of the things I used because it was very palatable. It actually he needed insulin in order to put on lean muscle mass, he needed those calories, he needed those carbs. And so, yeah, I tailor it. And then, you know, Tanya can talk about the fact that she puts lots of people on carnivore diets and gets lots of good results with, you know, GI issues, I'm sure. So, but that actually is another, another thing that is really important for people to understand is that people get lost in focusing on their diet when they're focusing on their gut health. And the other reason why I stopped asking so many questions about gut health and getting so nitpicky about supplements or probiotics or prebiotics or symbiotics was that I found that the more we focus on the lifestyle and we fix that, and then we also fixed the diet, not to mention mindset, then the gut kind of came back into balance. It's a tube that's inside your body. If you fix everything around the body, it's going to have the tendency to fix problems within that tube.

One of the things that's really fascinating to me is has anybody in the audience ever felt like your stomach hurt when you're around a person who's super negative? Yes. Have you ever felt great in your stomach when you're around a loving person, a happy person? Well, there is the enteric nervous system that has basically as many nerve endings and axons and dendrites than there are stars in the sky. Michael, we did a deep podcast on this. The enteric nervous system the way. Let's talk about what it is and let's talk about actual. What does it do for mental health? Not just the actual physiological structures of the brain neurology, but also just our mood and who we are as a human being. So paint a picture of that for people that don't know anything about the enteric nervous system.

Yeah, well said. Simply, it's the nervous system in your gut. But I think what you said we should double back to, which is the connection between the brain and the gut. And this year has been a really interesting year in a series of studies that look at people who are either healthy or depressed or anxious and scanned their limbic systems through functional MRIs. What we've learned, especially this year, is that what's going on in the limbic system correlates with how pro inflammatory. I know you studied this, Tanya. Someone's blood is. So if someone has an amygdala that's overactive due to fear, stress, prior trauma, what's going on in the brain influences the entire immune system. And so the connection between the gut and the brain is huge. So there is this partial local regulation of the enteric nervous system. But to your point about. And your point about healthy lifestyle, if people who had overactive limbic systems then went for a walk in nature and got back in the functional MRI and had another scan, the amount of activation was greatly attenuated. And that level of activation correlates with how pro inflammatory your blood is. So if there's any gut leakage, the immune system is what is going to react to particles that leak through. And part of that's governed by what's going on in the brain, and part of what's going on in the brain is governed by your lifestyle.

So literally, when we have a leaky gut, and maybe we can ask the panel, popcorn style here, when we have a leaky gut, maybe it's through food sensitivities, food allergies, or just foods that have red dye number 40 in it, which I know no one here eats. None of us do that. But it's in Cheetos and it's in all these foods that so many of Americans and also global people choose to eat as well. Do you think it's really an educational barrier? Do people simply not know? Is it unconscious incompetence or do they know and it's more of a behavioral thing? Because if leaky gut leads us to be an asshole or it leads us to not feel good in our body, why would we possibly do it? Why would we consciously eat or consume things that we know are going to poke holes in our gut lining? Why would we do that? Is it an education piece or is it simply do they need that satisfaction through the food itself? And that feeling of, ah, relief and deep breath is actually more important than any deleterious things that might happen to their gut?

I mean it's probably both and depends on the person, right? If someone has lower education, they may not know all the deleterious effects of processed food. Some people may have food that they eat as a coping mechanism. I think we've all been super stressed at one point and reached for a cookie or whatever. So it's probably multifold.

Coconut ice cream is my favorite. Now let's circle back because Leland was talking about the big four of the biotics and maybe Tanya, you can comment on this too. After Leland, the supplements we eat, are they just as important or more important than food? Because I could essentially, if we go back to our ancestors, they were eating berries, maybe some occasional seasonal veggies and mostly animal protein. That was depending on where they were on the earth. Are supplements that, do we really need probiotics? Do we really need symbiotics in this modern day world? And that's the caveat on the question. If we were living back in the caveman days where we were just hanging out, we had perfect circadian rhythm, we were making love all the time, we were laying out in the sun, we were drinking water. All the good things that y' all are doing here at Ranga, but we're not there. That's just not the place we're at anymore. We're in this modern world, we're in modernity. Start us off with that answer. In modernity, is it important for us to actually consume these biotics or can we get everything we need from real food?

Can I answer that?

Okay, yes.

Well, I'd love to think that we can get everything from real food. And patients ask me that all the time. And yeah, ideally that's what we're going to work patients towards, right? We're going to get their gut not leaking as much, absorbing their nutrients. They're going to eat better foods that they're going to get better nutrients from. So that's what we're working towards. So I think it's possible. But I would say that for the majority of us in the stressful world we live in, where our guts may not be perfectly not leaky, where the food supply may not be perfect, right. I think it's impossible to do that without some supplementation. And I think that there's some work that has to be done. Leland referred to the fact that I use the carnivore diet a lot. I use a lot of diets. I don't think there's a right diet for anybody. I mean, I think there's a right diet for everybody, but it may not be the same one for everyone. Right? But what I find with carnivore diets is that you're really kind of getting an ancestral type of diet where your enzymes in your body, your digestive tract, all those things are actually geared towards digesting meat and not actually, I don't know if many of you know this, but we don't actually have enzymes to digest plants. We don't have cellulase to break down cellulose that's found in all plant matter. We just don't, we don't have that. Cows have that, we don't have that. So, so I like to think about that. And, and so I think that people, once you start eating that way and more ancestrally, I think that yes, things start to heal and things can, and you can start to absorb your nutrients. But to get there, I use supplements, I use probiotics, I use butyrate, I use lots of other things to try to get the person there. But plus the lifestyle and obviously the meditation, the mindfulness, the gut brain connection, there's so many pieces to this. Right? But, but the point is that my goal with everyone is to get them to a place where they don't have to take a thousand supplements a day.

What do you feel about that?

Can I just piggyback on that? Because if you had asked me the question, can you get ample probiotics from food maybe five years ago, I would have said, no, you need supplement. We recently re reviewed this data and we have a video on YouTube that published maybe three months ago where we really detail this. But you can get ample probiotics from food. If you compare it to common supplements, you can get 10 billion, up to maybe 100 billion. Different foods have different densities, and the way that they're made and how fresh they are will impact this. Kimchi is probably the most dense in terms of probiotics per serving. You can get a similar amount of probiotics from food as you can a supplement. But that being said, there's just so many trials with probiotic supplementation improving things from infant colic all the way up through mild cognitive impairment in the elderly. So although I, I prefer to be food first for a lot of people, I think it's just going to be much easier to get them on a supplement. And also if people are somewhat food reactive, then using the food as a vehicle for the probiotic may increase the likelihood of negative reactions to the food. So you can do it, but it might be easier at least out of the gate, to use some sort of supplement.

And that's obviously individual. It's like people always ask me, and I'm sure they definitely ask the three of you, because this is your specialty in the world, what probiotics should I take? What's the thing? What's the one pill that I should take? It doesn't exist. There's no such thing as, like, one pill we're going to take and it's going to heal us, it's going to fix us. But Leland, you know, was interesting, and I'll be totally transparent with y'.

All.

I've actually worked as a patient with both Ruscio and Leland. It was phenomenal because I got to learn so much about my body through the data that was actually shown to me. In other words, what gets measured gets managed. And so from there, we were able to start and say, okay, well, what now? Probiotic is going to be the best. What is actually the approach that we should take based on the data? But I'll pass the mic to you again, Leland, because this question of, like, should I do the probiotic or should I eat the natural foods? You actually had told me that it's okay to eat vegetables, which was interesting. Now, that might go against some of the people here on the Panel or in the crowd. I get mine through organifi, which I love. Shout out to Organifi on the podcast. Tell us about that. Now, that was unique to me. I'm not saying that you're giving medical advice here that everybody should be drinking greens powder, but how have you seen that play out in your practice?

Yeah, great question. So, gosh, that's such a big question. You ask me these big questions make it hard to respond.

Aren't they more fun? The big questions are way more fun.

I actually want to go back and address something you mentioned which was, can we get all of what we need from food?

Yes.

That's really what you meant. Whether it's probiotics or prebiotics, symbiotics, postbiotics, minerals, vitamins, amino acids, whatever. Right. I always look at this and step back and say, well, first of all, what's supply and what's demand in the body? And then even when you're looking at supply, like somebody can be eating a lot of a food, whether they digesting it, are they absorbing it and then are they excreting it? Right. Or is it being used up in a process? I have this tendency in my practice where when I have like these really on the go all the time high intensity CEOs, I cannot raise their serum magnesium level. If you guys have any pointers for me, just let me know. But I'm serious. I will dump magnesium into these typically men and they'll kind of look at me at month three or six when they're doing like the second or the third level and they're like, where did all that magnesium go? And I'm like, look, I don't know. But I know that you guys are all these high octane guys and you're burning it up. You have a higher demand. So stress, in order to meet the demands of stress, you will use nutrients to do it. So when I did my first Nutrival from Genova Diagnostics, it was one of my first. It was actually my first organic acid test. Some of my first, like big panels with minerals and things like that on it. And I had my methylation was off B6 pathways. All kinds of things were deranged. And when I looked back at what pathways those nutrients run, they run your response to cold therapy. So I would do things like jump into a cold plunge that I had to break the ice on, and that was, you know, truly zero degrees freezing. And I'd stay in there for 15 minutes. So I know this plays out in the labs. It depends on what Stress you have. So in taking care of people, when I'm talking about their diet and their supplements, I'm always trying to figure out what stress is in their life and how is it affecting them. And that's where understanding stress becomes a huge part of what I do. Because I had a patient recently, we actually take care of almost the whole family, except for the husband. And she told me that when I started to work with her, I start often to explain to people what narcissistic and psychopathic behavior or personality types look like and what that abuse looks like, because that abuse is a stress. And she ends up getting a divorce, not because of me, but after I explain all this. And she said a lot of her medical problems that she was coming to me for just went away. Her chronic Lyme, her ibs, what she thought was mold sensitivity. So stress is. I think people find how much stress affects them to be very unbelievable. And this absolutely has to do with gut health all the time. You know, we'll have people come in who say, yeah, you know, I ended a relationship and my IBS was just gone. Or they stopped sleeping on the wrong side of a wall from a smart meter. And their IBS is just. It disappears. And IBS is just one example of this. It could be labeled whatever kind of gut issue you're dealing with. And that's really important and underappreciated because when you're talking about, can you get enough nutrition from your food? I sometimes joke with my patients. The short version of what I do is sell your worldly possessions and move to a tropical location and eat a local seasonal diet that's rich in fish and shellfish, because that's going to give you a ton. I have one patient who's taking me up.

Sounds really good.

I'm not kidding. He moved to Uvita, Costa Rica, and now just runs Airbnbs. But that's the short version of what I do. And the more stress you're going to pile on top of that, the more we need to be on top of looking at your nutrient levels, your hrv, other metrics of health, whichever one you want in order to understand. Where are you? Where are you going? How do we anticipate disease? How do we prevent disease? And then if you've got active medical problems, how do we reverse those?

Can I feed? I want to feed off of what you just said and take it a step further. So stress is just one thing that you deal with in your environment. It's a huge thing. Right? Everyone deals with stress differently. And Stress can be in the form of traumas. Stress can be in the form of just mental stress or emotional stress, or you have a paper due or you have assignment due. It could be stress like that. But there's also all these other stressors in our environment that we're exposed to every single day. We are exposed to infections and viruses and bacteria. We're exposed to metals, we're exposed to plastics. Our immune systems, our bodies have gone into this point where we're in this fight or flight mode all the time. Our immune system is not just our nervous system, but also our immune system. We have these cells in our body. I'm a little bit obsessed about these cells. They're called mast cells. They're these cells in the body that help you fight what's bad in the environment. They're like your first line of defense. And they will explode when they see things they don't like in the environment. That's one of the mechan work through. So they release things like histamine is one that maybe some of you have heard of. There are lots of other chemicals that these mast cells release. And you have tons of mast cells in the gut, tons of them. They're actually in every organ in the body and they're in the brain. And so when you're exposed to stress and you're exposed to these infections and environmental chemicals and all this stuff, these mast cells explode and they explode and they release all these different chemicals. And in the gut, they basically will help to break down the gut and cause more leak. And the gut and the brain talk to each other, and there are lots of mast cells in the brain. And so then the brain starts to get affected and the neurotransmitters there get affected. And so now you're more stressed the more that the gut mast cells are reacting. And so it becomes this really vicious cycle. And so I agree, Leland, that really managing the stress or removing those triggers can be a really big part of the healing process. My practice, it takes a little more than that. But you REM triggers, whatever those triggers are, that's such an important first step. Even before we talk about the diet, even before we talk about the supplements. It's what is in your life, what is in your environment, what are you eating, what are you drinking? That could be actually promoting this constant state of arousal, of stress, of fight or flight.

What's really fascinating to me, and it's funny, Michael and I were just talking before we went on this panel. He, at some point during his move to Austin, encountered And Leland, we talked about this on the podcast, and y' all have all heard of mold. Mold is not good, right? Raise your hand if you know that. Mold is not good. Okay. Mold is not something that we should be acclimatized to or get used to. Yet it's in so many homes across America and also globally. There's a mindset that comes to healing. Obviously, the goal is to never fall into the hole, right? We never want to get into a cytokine storm. We never want to have autoimmune issues. We never want to fall in the hole. But what do we do when we fall in the hole? We have to have a certain mindset in order to climb out of the hole. Not from scarcity, not from fear, but from empowerment, from self love. And so how does that play out? How did that play out for you personally? Not to put you on the spot or anything, but let's go for it. And also, how do you see that play out with patience? There's a mindset to get out of the hole.

Yeah, it's a really tricky mindset because what can happen is conversations like these put on your radar all the things that could be bad for you. You and the limbic system is. It's a danger acknowledgement system, right? Like hunter gatherers. We were going for a walk. You said, hey, I'm gonna eat some of these berries. Then I watch you throw up for an hour and die. So my limbic system wants to say, ooh, you never forget those berries. It pushes it deep into your. Into your memory. The problem is modern day. Anytime you have a symptom, you can go online. Symptoms of mold, right? And you're gonna find your symptoms not every. And so this is where, like, the balance is really important. Not everyone has a reaction to mold. So I was at the Marriott in Connecticut. I forget where in Connecticut. It was a friend's wedding, right? When I opened the door to my room, it's damp, moist. I said, ah, I bet you there's gonna be mold in here, right? I go to bed and I'm just tossing and turning, and I know what it feels like when there's mold in the environment. I fall asleep for about two minutes, wake up for about three, fall asleep for two, wake up for three. It's torturous. So I literally drove to my parents house an hour and a half away to sleep that night. That can kind of freak you out and that can mess with you. Now. Two other people said, hey, we think you were right. We woke up really congested. We didn't sleep well, but seven other people had no problem at all. So it's crucially important not to think that all these things are problems for people all the time. One, and then two, like we were talking about. These things can become these ethereal boogeymen, where every time you go somewhere, now you're worried about mold, or you think that the mold I was exposed to six months ago is why I have a little bit of fatigue right now. And you can really easily create this amalgamation of all the things that you think were triggers are now this really big boogeyman that leads you to be worried about stuff all the time. So my perspective on mold has been, if you have a problem with mold, it'll be somewhat obvious. Like, for me, I couldn't sleep. It just happened. When I had mold when I moved to Austin, wasn't an issue until summer came. And then all of a sudden, I'm going from happy and clear mind to foggy within 30 minutes of the H Vac turning on. Oh, like, why am I irritable? Why am I foggy?

Right.

Inspector comes out. It wasn't this witch hunt for, like, the speck of mold that may have been in a baseboard in the garage, which, by the way, one consultant said, oh, you gotta rip out all your Sheetrock negative pressure. I said, wait, for the. For the one baseboard in the garage? Is that really an issue? And when I press on, the consultant, he said, well, that's probably not. Not a big issue. What's the issue is probably the photographic evidence of just mold built up in your H Vac.

Right.

So when we remediated the obvious mold, I had no more issues with the H Vac. The, you know, the baseboard in the garage wasn't so much so an issue. Also, I would notice that if I. If I left my home, I'd feel better within an hour or two. And so, you know, these are really important to keep in mind, because if you don't have some objective criteria, you can start to think that everything is a problem, and then it's like this maddening storm of chasing your tail.

Yeah. Has anybody ever done a YouTube search for something that you've been struggling with? Like, maybe it's even, like, how to hang a picture frame. There's always some expert with, like, 10 million views. And so, unfortunately, you know, y' all have made an incredible investment energetically, financially, emotionally, to be here. So kudos for you. I mean, you're in the 1% of 1% just for being here. And so the people that maybe don't have the advantage that you do of being here, or the advantage of being here with us or having an entire lifetime or career built on human health, is that what they come in contact with could unfortunately, osmotically be absorbed by them as quote, truth. So let's open up this part of the conversation when it comes to the truth about how to gather information. Probably don't get it specifically from YouTube or from Dr. Google. What are some of the ways that we can find what we're struggling with, what we're dealing with online? Are there safe spaces? I kind of hate that word, safe spaces, but are there places that are safe to actually get information for your health that can make a true difference?

Well, I've got a lot of thoughts on this. Firstly, the algorithms of Google and YouTube suck from the perspective of. Of alarmism gets rewarded, Right. So that tends to be what you see more of are the people who, you know, vegetables are bad or all carbs are bad like that. This tends to be liver king, right? What. What gets rewarded?

Yeah.

Not to call anyone out, right.

But he also did steroids. I don't know if y' all saw that.

Not that there's anything wrong with steroids.

Yeah, well, that's a whole nother podcast. But seriously, there's such a facade online, so please continue.

What I would say is look for people who have a reasonable perspective and don't speak in absolute terms and are nuanced. And you'll just pick up qualifiers like, well, I could be wrong. Or you hear them say every once in a while, you know, I haven't looked too deeply into this, but my.

Thinking is X. I always say, in my experience.

Yeah, so you're just looking for those qualifiers that they don't come across like they know everything and things are so black and white. Because that's usually someone who is probably ignoring any data that contradicts what they feel, and it's just confirmation bias all the way down.

I can definitely say that I'm 43 now, and I've gone through many different health journeys. I used to be 280 pounds. And so a lot of what brought me into health was, okay, how do I look in my physical body? But there are a lot of looking healthy people that are truly sick. Just because you look a certain way does not actually mean that your gut is going to be healthy or that you are a whole and holistic healthy human. Are there biomarkers, like maybe the top three to five that would show us that we are Truly healthy when it comes to the gut specifically. I mean, there is probably so many we could talk about, but which ones float up to the top in the lab test, in clinical practice that really move the needle for us?

Before we jump into that, I actually want to add something to what Dr. Ruschio said. The Google algorithm is changing a lot and it's changed a lot in the last few years. You used to be able to enter questions or topics and have a real interesting diversity of sites and people come up. And that's really changed. You're only getting the Cleveland Clinics, the Mayo Clinics, the big names in conventional medicine now, and some of the best material out there in integrative natural medicine, real, verified, researched, cited. I mean, top shelf information is getting memory hold by big tech. And we don't need to get into why that's happening, but it's happening. And so when it comes to resources, the most important thing that I do is I make sure I'm on the email newsletters of the people who I know who are going to give me the good information and the important information and also commentary on news. That's why I'm on Josh's mailing list. I'm not on your mailing list, but I will be now and I'm gonna have to join yours too. Yeah. So that's really important because the other thing is if people get. Cause the other you'll find in this space now you can say things that you think are not controversial on Instagram, Facebook, YouTube, whatever, and they'll say, we didn't like what you said. And no, we're not really going to give you a whole lot of information about why we didn't like it. And you have very little opportunity to appeal this. I'm sure you've run into this.

There was just an update March 15th. You'll see this in the health space where if you're watching your monthly web traffic, it's trucking along. And then. So March 15th. Yes, rolled out, said, you know, one of many set updates and it's always prioritizing for, you know, the, the big clinics, which in part I get because they're trying to, at least I like to think, protect against heresy. But regulation, it's a really slippery slope.

Yeah. And I always say follow the money. And, and obviously you can follow the money to pharmacological interest when it comes to any type of health modality. But they're also, if you follow the money, there's good money to be spent as well. You know, a lot of times in Podcasts and maybe in the health world, we're so focused on, like, what's not working and how evil the pharmaceutical insurance and medical triangle are, which they are. But we're not focused on that right now. I want to talk about the good side of following the money. So where in the world is the money being spent on our health? Who are some of the companies, some of the movements, some of the things? I mean, look, shout out to Force of Nature. I've actually gone. Carrie and I went to their ranch and they walk their talk like these animals are roaming around eating grass and living a really healthy life. They're not fed antibiotics. We're not getting all the mycotoxins from their fat. We're not eating their antibiotics that they ate. So for the entire panel, what are some of the things that excite you about the good money being spent in the world on making our health good? Making our health great?

It.

Well, I mean, I'll just throw out one out out there. I don't know of outfits in particular that I would mention other than just saying one of the things I've noticed in this space without, you know, disparaging people, is some people gain a lot of media exposure in our very space. And you see, it just seems to be about more books, more supplements, more courses. And then I look to see, have they published any papers? Are they doing any research? And disappointingly, I see an overwhelming majority who don't. So my two cents, and I'm probably getting some stuff here wrong and painting with too broad of a brush. But look for clinicians who are actually participating in the scientific research process and publishing, which is hard to do and it uses a lot of resources, but it's resources toward the betterment of the field, rather than just saying, well, let me insert myself in front of the next trend and write more books and sell more supplements.

That's.

Anyone else on that topic?

Yeah, well, I have to agree with that. And I think, look, I think that health is becoming more and more important. I think, at least in the communities that I see and the people that I see, I still think that we have a problem worldwide. And that's a whole other conversation, because there are lots of people who don't get medical care. We're not talking about that right now. That's really an issue, a huge issue. But I think that for those of us who are out there trying to figure out what's wrong, I think there are more and more people looking for what's wrong. I see people reaching out to my Clinic so many more people who are sicker than ever than like five years ago or 10 years ago. So the problem is that I think that people are getting more interested in health. I'm hoping that they're going to be people who are going to support that. I'm hoping that money, I don't know where money's going. Right. It's difficult. But I'm just saying that in general we have a more unhealthy population. People are getting sicker, but more people are getting more interested in their health, thankfully. So I'm hoping that with time we're going to have other industries that are going to help to support that and hopefully reverse that trend because it's a disturbing trend.

I would say that the first of all, there's so many good supplements out there, there's lots of bad supplements out there, you know, full disclosure. But the supplement space is, continues to explode partly because the amount of stress and new stress people are under. So there's more need for these nutrients and also because the public is just becoming more and more interested and engaged and then you'll get amazing results with sometimes just one or two supplements, even in difficult cases. So I really, I mean there's a huge place for nutritional supplements and I've, I've also liked the pivot that I've seen happening into more glandulars, organ based supplements. I'm not, I mean people, if you, if you follow me, you know, I'm wary of using things like beef liver that have incredibly high amounts of copper in them because I see lots of problems with mineral balance in my practice. And so I'm wary of, of taking beef liver and other things like it that have a lot of mineral density. Without clear guidance and labs beyond the supplements, the peptide space is really exciting right now. It's becoming more and more accessible. They're becoming more and more affordable. I feel like 10 years ago almost no one was talking about peptides. 5 years ago was just beginning to be seen at places like a 4M. Now, you know, it's like NJ is going to talk about this later. Jay Campbell now it seems like it's everywhere and some of the things these things can do are really incredible. And then the synergy between peptides and supplements, Copper is another great example. That's like copper. Copper as a mineral is very, very effective, very essential, right? For many different things. But the problem is that unbound copper can create a lot of problems. And so something like ghkcu, copper peptide, ahkcu, copper peptide. These are peptides that take the copper that you may have enough of and they actually harness it rather than just you're loading more and more copper into the system and the system can't assimilate it and use it. And then the other big one would be the bioregulator space, which I know very little about now, but I also don't know how available it is. It's one of the things I'm looking forward to looking into. And it sounds like that research is going to be something that blows up just like peptides stuff.

We live in a really exciting time. Like, does everyone feel the swell of just momentum around health and wellness? It's kind of like Oliver Twist, you know, it's like the worst of times with what's going on in the world, and it's the best of times at the same time. You know, case in point, coffee enemas. That's the nice segue. I love coffee enemas. But I just. I'm very curious for the panel. You know, there's some research that I've read around coffee enemas that actually stimulate glutathione response, balance glutathione production. But, you know, for some of us that maybe are interested in detoxification using coffee enemas, is that something beneficial for everyone? Are there certain people. I've always wondered about this. Are there certain people that should not be doing coffee enemas?

People who don't have a rectum?

I think we all have one.

You'd be surprised.

Okay, all right.

I'm not a huge fan of just enemas. Categorically. We wrote an article on this maybe a year ago. They do have some benefit, but when we reviewed the evidence on them, I wasn't too impressed. So coffee enema specifically, I haven't done the deep dive on that, but enema's just categorically. Unless someone's really constipated and it's the only way that they can move. It's not something I typically recommend because there's so many other therapeutics that are well studied that I think can help with. With a lot of what people are using enemas for.

Yeah, I totally agree. Yeah. I don't remember the last time I recommended a coffee enema of any kind. I mean, people are using it to detox.

Right.

And they're using it. So there are other ways to do it. You know, if I'm going to put anything up the rectum, I'm going to put ozone actually over coffee. So even that we don't do that often, but sometimes.

Yeah.

Okay.

Yeah. On that note, so this is where I just got into HTMA about a year ago. Hair tissue mineral analysis. And it's very common in that world for practitioners to recommend coffee enemas for people who are having acute detox reactions. And anecdotally, from practitioner to practitioner, whose work I've read or who I've talked to directly, they're extremely helpful at helping people to manage the symptoms of those reactions. Right. But no one's published that stuff. Stuff. So it's not in the literature. And I am not. I don't. I can't remember the last time I actually recommended them either. But I think the. The point is, you know, I don't recommend them broadly, and I think if you're going to do them, you should do them under the. Under the supervision of a practitioner who's experienced in their use.

Okay. So it's more important. What I heard from everyone on the panel is that it's more important what's going in your mouth and managing the microbiome than what's going in your butt, which is essentially a more intelligent path.

Unless you're talking about the weekends, then you can do whatever.

Sure. That's a totally. Yeah. Which is. That's a whole nother style of podcast. Now, let's shift gears, because I Personally, I did the 23andMe test, and I don't know about y', all, but I have a dairy sensitivity, so I don't do well with dairy. I can remember being a little boy, actually, and I'd be at middle school, elementary school, just hunched over in the morning, like, massive stomach pain. My parents, God bless them, they just didn't connect the dots. They had no idea that the cereal and Captain Crunch they were feeding me in the morning were making me sick. And then I had a lifetime of sinusitis and just inflammation issues. I'm curious for the panel here, when it comes to. Let's talk about specifically inflammation, Sinusitis, maybe. Lili, we can start with you. I know you had ADHD and sinus and ear infections when you were young. Is dairy a main culprit of that? Is dairy something that people could take an honest look at? And how do you actually test for something like that for somebody that's dealing with autoimmune or inflammation? Inflammation or sinusitis?

Yeah. I would say the first thing is that the immune system is very much. It's extremely controversial because in some respects, it's very hard to measure. And this is a historical. This Is actually, this is a really interesting sort of story. In the history of science, there's been tons of controversies over the immune system. Dr. Tanya and I talked about this last night at dinner. We're going back into the 40s and 50s and 60s disease. There's basically always been two camps in the world of immunology and allergy. And in one camp they say, wow, the immune system can do all kinds of crazy stuff. You wouldn't believe the weird reactions we've documented and seen. And then the other camp says, no, the immune system is very clear and much more discreet and we can only document this and that and the other thing. And the reason I let you all know that is you're going to hear different things from people and it's going to be confusing if you don't have that background, that it's very controversial. But. But basically, from my experience, the immune system can cause any variety of symptoms in response to something in your environment or your diet. So you'll have one person who eats dairy and they get headaches and you cut the dairy out and all of a sudden the headaches are just gone. I've seen all kinds of weird reactions. I mean, from eggs to chocolate, coffee, tea. That stuff's from something. Or the field we would call formerly clinical ecology. It became environmental medicine. People like Theron Randolph and Ralph Moss and the American Academy of Environmental Medicine. And so, yes, it can play a role. But then how do you determine that? The testing for that, because the immune system is so nebulous, can be hard. And that's where having access to a bunch of different testing. I never order those tests without a history on the patient. Because the other thing is sometimes you can do a test, but the real question is, how is it going to change what we do? And do you really want to spend the money on the test when you could just eliminate something so, you know, you have someone who thinks they're having headaches because they're drinking coffee. Well, go two weeks without drinking coffee and see what happens. You don't need to spend money on that test. I'll have other people. Because this is the other problem, right? There's hundreds of and thousands of ingredients in the food we eat. And maybe you just happen to be that one person who has weird reactions to red number 40. And wouldn't it be great if you could do a test that would identify that so you didn't have to rotate through all these ingredients? Because if you were to do a rotating elimination diet for even just three days, right, For Three days, you eliminate one ingredient, then three days, another ingredient, then another ingredient, then another ingredient. You know, you can take weeks to eliminate just a handful of different things. That's very cumbersome. And that's where the testing becomes helpful, potentially.

Yeah. And I want to just take that one step further. If we're just talking about dairy, never mind all the other things, right. There are lots of different reactions. And what Leland's referring to is that, you know, for some people dairy is going to be an allergy. We have a specific way that our body deals with allergy. For some people, dairy may be a lactose intolerance. Right. So they're missing the enzyme. They're not allergic to dairy, but they're missing the enzyme to break down dairy.

Right.

That's going to cause a reaction, but they're also are other reactions through those cells that I mentioned before, mast cells that cause a non allergic reaction to dairy that you actually can't measure because there's no test to measure the non allergic reaction to dairy. And a lot of the problems that I see with my patients is not just dairy, but with everything is that they know they're having an allergic type reaction to various foods and they go to the allergist and the allergist says the allergy testing is perfect. You're not allergic to anything. But the patients clearly are feeling it.

Right.

They know that they're reacting to something. And so that goes back to. Yeah, I think that, yeah, patients, as you yourselves, you have to be, you have to listen to your body, you have to advocate for yourself, unfortunately. And you listen because you or you make somebody else listen to you. And if that doctor doesn't listen to you, you move on. Because there's a reason why something's not working right. And if you haven't figured out what it. A lot of my patients can't identify whether it's the dairy or the coffee or gluten or anything else. Then we work together to try to figure out what it is. And sometimes it's not even those specific things, but it's the immune system itself that's completely confused and it doesn't know if it's reacting to gluten or dairy or anything else. So it's a process of trying to recover the immune system. And sometimes people can grow out of dairy reactions or other reactions when their gut and their immune system is recovered.

Yeah, sometimes. And just to piggyback on that, fully agree. And one of the most destructive tests I see patients do are food allergy tests because they'll start avoiding foods that they don't have reactions to, limiting their diet and then eating foods that they may have reactions to. But the test told me that I could.

Good.

And there's all these reasons why you can have a reaction that's non immune based or it's not able to be elucidated on the immune testing. It could be the fodmaps, it could be enzymes. And as we repair the gut, we release more enzymes, we have less reactivity. So yeah, one of the worst things I think people can do is a food allergy test to try to figure out what they should eat.

So let's talk about elimination diets. I mean, I learned this back in 2008. Shout out to Paul check, my original wellness godfather. And he talked about, you know, just taking food out of your diet. Imagine that you don't have to pay thousands of dollars to a lab to figure out if you're sensitive to food or not. You can just remove the food from your diet. So let's talk about this on the panel. I think this is a really huge take home for everybody listening in their car right now, watching on Spotify, sitting here with us in the audience, like this is a really, really big rock that people can move to just literally taking out food that could be pro inflammatory from their diet. Let's start with you, Tanya. How do you approach elimination diets when it comes to gut health and allergies and sensitivities with patients?

Yeah, look, it really is very personalized and it has to be individualized because I can't say that I have a specific elimination diet that I use for everyone. Right. I have patients who come to me who might really already be on an elimination diet. They really can only eat five foods. They know those foods. I'm actually working to try to get more foods back, not eliminating more. Then I have others who are eating everything and we can't figure out why they're sick. Right. So I'm going to figure out with them what makes sense for their lifestyle, for their genetics, their body, their biomarkers that we didn't actually get a chance to even talk about the biomarkers. But there are things that I'll look at. And so, you know, the carnivore diet can work really well because it eliminates a lot of the top allergens or, or it may not be allergens, but foods that people react to. Like you're eliminating dairy and soy and eggs and things like that. There's a big problem a little bit of an epidemic that we're starting to see called Alpha Gal, which is a allergy to meat that you get from a tick bite. And so eating meat is not going to be something I'm going to recommend to people who have Alpha Gal.

Why did they name it? That's, that's Alpha gal.

Yeah.

So it's.

No, no, go ahead.

Yeah, so I actually worked in this guy's lab, I, who first started to document it and back in medical school. And it's for the moiety that you're, that's the, the chemical of the meat that you're reacting to. So it's alpha galactose, two, three, something, something. Yeah.

Okay. I just wanted to make sure it's.

Like a type of sugar in meat that, that this ticket bite basically transmits this sort of immune response that your body undergoes. And then you can't eat meat. So those are going to be people who don't eat meat. They're going to be people who for various reasons can only be vegan. And I respect that, I would never change that. But within their dietary constraints, we're going to figure out what may be the thing that's going to be pushing them over the edge. And I think it's going through. That's why I go through everyone's diets at length. I have them keep a three day diary. We go through every single thing you put in your mouth. Because a lot of people will say, well, yeah, and I don't really eat anything bad. And they tell me, you know, they might tell me breakfast or they may tell me lunch, but then all these other like snacks and other things that they forget is not part of their, really their diet. Once they keep a log, then we can go through. And sometimes it's so obvious it will just pop out at you like, you're like, yeah, that could be the thing. But elimination diets are really not, you know, you don't want to stop at an elimination diet.

Right.

You don't want to take all these foods out and then become more reactive to not having those foods in your diet when you reintroduce. For me, I think gluten, I don't really think anyone should be eating gluten, but that's a whole other conversation. I think dairy is mixed depending on the person, but generally other foods, I really just, I don't want to restrict forever for, for some people because I think that can be problematic as well. So again, it's a, it's a balance.

All right, so we're getting to the End of the podcast today. Thank you all for being here. It's been fun. Have you learned anything? I mean, I definitely have. The coolest part about learning is that we can let go of our ego as to what we think we are right about. So very quickly, what is something that you used to think you were right about? We'll start with Rucio that you learned you actually were not right about, and it was a celebration because you learned something new.

Yeah, well, it's a long list, right? It's quite a long list. But one just recently we had on the podcast Dr. Antonio Bianco. He's the former president of the American Thyroid association. And I think we're pretty good about knowing our numbers. But he helped me to re establish what the prevalence of hypothyroidism is. Now, we have been citing NHANES data from up to 2007, and the NHANES data set clocks in at about 0.3% of the population being truly hypothyroid thyroid, not sluggish thyroid, which is a whole nother can of worms and is kind of, in my opinion, irresponsibly. People are being labeled as sluggish thyroid and given hormone that they don't need. Outside of that debate, that issue, the prevalence of true hypothyroidism, he cited a more recent study from the Journal of Endocrinology and Metabolism. I believe they took a more recent NHANES data set. They combined it with insurance data so they could see from the insurance system who was on medication and what the criteria were for diagnosing them. And that brings a prevalence to about 5%. So it's more than an order of magnitude shift. It's still, I think, important to, for me to contextualize that it's not the 50% that I think some providers would have you believe, like, are you tired and have dry skin, you're hypothyroid. If we can find any nuance and balance in your labor work, your hypothyroid, I think that's really wrong. So, you know, it's still not anywhere near where I think some gurus are kind of portraying it, but that was a big shift for me from 0.3 to 5%.

What about you, Leland? What's something that you used to feel right about and then it was relieving that you were wrong?

So this has to be the importance of eating a deuterium depleted diet. So out there in the quantum medicine sort of biohacker world old, there's a lot of and I Can't go through this because it's a long topic. But there's this thing called deuterium and there's a specific diet you can eat to have a low deuterium diet. And I tried that for months and felt horrible. And part of it was like eating a lot of seafood. I also, as part of that, I thought that I underestimated the problem of mercury and seafood. And then I started to get mercury levels on people in blood, and then I started to get them in the hair. And, wow, we had some really high levels in the practice. And those people felt so much better when we helped them detox from the mercury. And that's now. I mean, probably. Gosh, I don't know. I would say it feels like 80% of what I do now clinically is helping people balance their minerals while also fixing problems with methylation and stuff like that. But I'm glad you asked this question. And it reminds me of one of my favorite quotes, which is, an expert is merely someone who has committed all the mistakes possible within a very narrow field of study. And that was Niels Bohr, one of the founders of quantum physics.

Thank you, Tanya. Take us home.

So I'm going to say something a little bit controversial here for this meeting because I started my practice really was internal medicine in the traditional allopathic world. And then I went into integrative medicine. And I really was so focused and passionate about keeping my patients off of medication. You mentioned the pharmaceutical companies and all that. My drive was, okay, if they had high blood pressure, I was going to figure out the route. If they had high cholesterol, I was going to figure out the route. But we're going to get their diet better, we're going to get their stress better, we're going to deal with all those root causes, and they're going to avoid medication. And that was for a very long time. My mo. And I will tell you that I have learned a lot, and that is that medication saves lives. There are places and times for medication that not everything can be done with supplements. I love supplements. I take a lot of supplements myself. But the reality is that there's a reason that we have pharmaceutical products and it's okay to have to use medication for blood pressure or thyroid or cholesterol when you figure out the patient's risk factors. If I have a patient who, in fact I have this one patient who had a heart attack, I think he was 35, his first heart attack, has a family history of death very early in life, life in males in the family. Right. Guess what? He needs cholesterol medication because I don't want him to die of a heart attack. Right. So it's really about thinking, you know, personalizing and individualizing everything that I do. And I've learned that I can't be so dogmatic about. All right, we're going to do this all naturally. We have to understand that there's a way to integrate it, and that's really where you get the most success.

Well, I love the way we ended this podcast, this panel today. Thank you, Dr. Ruscio. Dr. Stillman, thank you. And Dr. Tanya, thank you for being here. And thank y' all for dedicating your life, at least in this moment, to your health. Appreciate you being here. Now, until we see you again, we're all four of us wishing everyone love and wellness. We'll talk to you very, very soon. Check out some of the videos on this screen that are perfectly curated based on the video you just saw. Make sure you follow me, and I'll see you in the next video.