Welcome to AIM For Health: Root-Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

Hello, we are back with our podcast “Ask Dr. Jim Bob”.  I am James Robert Biddle, MD, board certified internist, and here to help me is our new-patient coordinator, Joy Lambert.

Hello Dr. Biddle – Hello everyone!

So today is October 1^st, 2020, and we are going to not talk directly about medical things today, but we are going to talk about why.

Why.

Why.

Why are you here?

Why are we going to talk about why?

We are going to talk about why because why is the core as to why people come to us and why we do what we do.

Right.

It’s the motivation, it’s the hope, it’s the reason. 

A couple of years ago I wrote this little book called “Reclaim Your Health – an Integrative Medicine Pathway” and I spent quite a bit of time writing about “why”.  Because I see patients who are very motivated to reclaim their health.

Yes.

And they are the ones who have a very strong why.  They are there doing it for their kids, for their wife, for their Lord, you know, whatever it is that is motivating them.  You have got to figure out your why.  And then we see people who are not so motivated.  And then they have a hard time being part of the team.

Yes.

And in this type of medicine we don’t get results unless the client is the biggest part of the team.

Right.  There’s a lot we can do, but there is a lot we need each person to do as well. 

Right.  So we are very interested in clients finding their why and understanding their why, and using their why as a motivator.

Absolutely.

And we are going to talk a little bit today about our whys in two levels, maybe more…

We will see where this goes.

When I woke up at 5:00 this morning I was laying in bed thinking about this talk and our whys, and I was thinking about my own whys.  And I just did a little meditation retreat last weekend looking at some of that, and there is the level of why like “why do I get out of bed today?”  Up close and personal why – right?  Just why not stay in bed?

Some days that would be easier.

Right.  And then there is kind of a level of “Why keep this practice running?”  And we have talked – I could double or triple my income, go work in the system and be a regular Internal Medicine doctor and not work as hard, and make two or three times more money, but instead I choose to keep this practice running.

Yes you do – for 23 years now I might add.

And we will talk about that why.  And then there is the bigger why.  A lot of people are struggling, I meet people who are suicidal, and they are having a hard time finding their why to even stay in a body.

Right.

I meet a lot of people who are sick and suffering, and they have got to have kind of that bigger why.

Why is it worth it?

Why is it worth it – that’s right.  And if you can’t find that, you have got to dig into your belief system which is part of what I was polishing up last weekend doing this meditation retreat, you know, finding that why again.  I haven’t lost that why, I was just needing some reinforcement because times are hard.

They are very hard!

I’ve got to stay motivated.  So my why for getting up in the morning is definitely my family – right?  I’ve got a little girl Raina who just turned 5.  She is a delight!

Yes, she is.

I am an older dad.  I’ve also got a 22-year-old, and a 17 year-old stepdaughter, and a wonderful wife.  And these are my why – I want to support them.

Right.

I want to be a good example for them.  And I want to create some amount of financial security for them, and I want to help cocreate a world that is a better place for them to live in.

Absolutely.  It’s all about passing that on to the next generation, hopefully something better.

Right.  Tell me something about your whys.

Oh, goodness.  Well which one do we start with?  Why did I come here in the first place, or why do we do what we do every day for me?

Well, tell me why you were attracted to our practice.  You have been working here for 5 years now.

Five years actually next week.

Next week?

Yes.

We hired you right after Raina was born.

Right – you interviewed me the day you delivered her.

That’s right!  I didn’t plan on delivering my own child, but the midwife was 5 minutes late –

She was a little early!

My daughter was quick, and she was born at home in a birthing tub in our bedroom, and it was a delight to be able to – you know, it’s funny to be able to say I delivered her, because it sounds like I did some work.  My wife delivered her.  I just happened to put my hands in the water –

You caught her!

I caught her, right.

So why I wound up here goes back to when I was 20.  Up until that point in my life I thought I was perfectly healthy, perfectly typical, no health problems, and I was just in college.  And one month I started having pain in my lower abdomen, and thought “That’s funny”, but I was in college, I was studying, I was working hard and distracted.  So I didn’t think much about it, but it persisted, and a couple of months later I was diagnosed with endometriosis, and they only diagnosed me through surgery.  They said there was no test.  All the imaging studies were negative, and with that diagnosis they told me then, and I had just turned 21 – they said “You’re never going to have kids.” And that was probably the most heartbreaking moment of my life, and the doctor I saw was an hour away from my college campus, and I don’t know how I made it home, because the entire car ride home I just was bawling uncontrollably. And I wanted to fight it, but I didn’t know what my options were.  I went through the system, I went through all the typical care, the conventional care, what little they had to offer, because they said we don’t know much about this.  And in 5 years I went through 5 surgeries, all kinds of hormone treatments, some even experimental, some made my situation worse.  And it finally culminated with me having a full hysterectomy at 25.

Ouch.

And it took me years to even begin to come to grips with that.  I still struggle with the ramifications of that.

Sure.

Because I always wanted children, I still do.  But I just know that I never wanted to suffer like that again.  I mean 5 years of pain and pain killers, and more surgeries and procedures than I can remember.  You know it’s not a good thing when you know each of the OR nursing staff by name, when you are going in there every few months, and after that last surgery it did seem to remedy my situation and I could finally at 25 remember what it felt like to live life without being in excruciating pain every moment of the day.  And later when my husband and I moved to Asheville because of what this town has to offer, we started hearing about organic food, and it really piqued our curiosity and we quickly became almost obsessed.  You know, we were researching what we were eating with every meal and it opened the door to us, and in time I knew that I wanted to do something to be a part of helping people actually be healthier, actually feel better, and have more options out there.  Have hope out there.  Because I felt betrayed.

You did everything inside the medical paradigm box.

And then some.

And then some.  And that didn’t help, but nobody ever showed you what was outside that box.

Never.  And I asked – I asked can I change what I eat, is there anything else I can do?

Right.  But all those doctors are trapped in the box.

And they did the best they could. 

They did the best they could.  They want to help.  But they have golden handcuffs on.

Right. 

And they are not going to think outside the box.

No, and it took a while for me to learn, even hear the word Integrative Medicine, and I was like “What’s that?” and I just wanted to get into it, and I sought it out, I sought you out.

Right.

And I have been here for 5 years now and what really clenched it in my mind that this is the path for me, this is the place for me, is when I had a visit with you.  The first time I saw you, I had been working with you for months – I knew you, I trusted you, I felt confident, but when it was time for my first appointment, I can’t tell you how much I cried coming in to work that day, because it was that old fear of “What am I about to start?”  And it was such a different experience.  You gave me information, you gave me hope again, and you gave me the sense that I can control to an extent my destiny with my health and my body.  I’m not just the ping-pong ball bouncing between medical paddles; that I could do something for myself and I did not have to suffer like that again.  And that is why I am here for me, and why I want to be here for our clients –  I don’t want to suffer like that again.  I wish I knew then what I know now and if there is anything I can do to help someone not have to go through something like that, then I have to.  It feels like a duty.

Right.  There is the grieving of your loss and part of dealing with that grieving is being able to help other people avoid that loss and realize that there are treatments for endometriosis.  When I first started practice here, I saw a whole slew of women who were in exactly your same situation, who had had hysterectomies in their 20s for endometriosis and so I really went into learning what that was about, and then discovered that that is really about the toxicities.

Which that was another heartbreaking revelation, that it could have been caused from something that I was exposed to and I didn’t even know it. 

Right.

Or I didn’t know how to deal with the toxins enough to maybe mitigate it or reverse it.

Right, you’re just living in a society where it’s ubiquitous.

Right.

Well, thanks for sharing that.

Thank you for asking.  It’s a lot, but that really is what gets me up every day and makes me excited.  When people call and I can hear the suffering in their voice, I am encouraged for them, because I know that there is hope and that there is usually something we can do.

Right.  Some of my colleagues, they have some really profound single story to tell about how they got into alternative medicine.  You know, they had a child that was sick with autism or something like that.  For example John Wilson across town, he had a son who had issues and it was through looking for additional ways to treat his son that he ended up going outside of conventional family practice to learn how to do that.

Right.

And a chiropractor coach that I have worked with, even his mom had breast cancer and he helped her survive that without chemotherapy and then that got him into his why of being in metabolic alternative medicine, kind of.  Mine is not so straight forward, mine was a bit slower and it’s really almost attributable to a personality disorder that I have called oppositional defiance disorder.

Tell me about that.

Well, in oppositional defiance disorder you basically question authority.  For example in medical school, in my third year of medical school in my medicine rotation I questioned authority and my professor kind of appreciated that, like the questioning mind.  Rather than just accepting what they said, I would go – why is that?  Even to the point of the word tinnitus, or tinnitus, the ringing in your ears.  I was on rounds and presented to him and said it one way and he corrected me and told me it was the other way.  And I was like – OK? And then before he could look it up on-line, I went to the medical library and pulled out a medical dictionary and saw that it was appropriate to say it either way.  And I photocopied that page, highlighted it and stuck it in my pocket, and the next day did the presentation and said it the same way and he corrected me again, and I pulled that piece of paper out and he laughed and said he really appreciated the fact that I had made my case –

You were ready!

And he liked that, and I ended up with an A in medicine.  However, on my surgery rotation I tried something very similar and a resident pulled my nametag off, threw it on the ground, and stomped on it and said this is what I really think about your opinion.

Wow!

He actually stomped on my nametag.  And I got a C in surgery, even though I had gotten an A on every test, because they didn’t like people questioning them.  It’s a very authoritarian, I don’t know what surgery residency is like now, but 30 something years ago you get through surgery by keeping your head down and saying yes sir, no sir, yes ma’am, no ma’am.

Right.

That has never quite been my personality, and so I have always kind of questioned – why, why is that?  And when I was in residency I was exposed to alternative healers, naturopaths – I was in Portland, Oregon which is really a mecca of acupuncturists and chiropractors and naturopathics, and people like this.  And my third year of residency I rotated with some of them, and just got my eyes opened to there are other things outside that paradigm box of what big pharma tells us.

So what was tickling your brain about that?  Or what area of alternative healing was tickling your brain?

Well all of it really.  But it just opened my mind that all my colleagues, all they would do is either surgery or something like that, or prescribe prescription medications, but they would never look at anything like heavy metals, like nutrient levels of magnesium or essential fatty acids, or B-12, or something like that.

Right.

Or, now I know even more about things like heavy metals and chronic infections and hormone levels.  The example I used on introductory talks like in thyroid, the conversion of T4 to T3.  My residency director was an endocrinologist and if you mentioned getting natural thyroid rather than Synthroid his head would explode.

Right – you just didn’t do it!

Right.  So it really just kind of gradually dawned on me and then my first year out of residency I opened up a little practice in Portland, Oregon in a clinic run by a naturopathic doctor.

Really?

But, I was taking Medicare and after about 8 months I was actually in the red – I was losing money, and I was moonlighting every weekend in the emergency room and I was basically subsidizing my practice.  So I was working my butt off to subsidize taking care of these people, and realized I didn’t really know much about Integrative Medicine, so I went and worked full-time in the ER for 3 years after that, because emergency room medicine I think is really the best of conventional medicine.

And why is that?

Well, if I put a chain saw on my leg or if I am in a car accident, I don’t want homeopathy.

No!

I want a surgeon!  I want somebody to put me back together –

Stop the bleeding, stitch it up…

Right.  So I am a big fan of conventional medicine and what it has to offer.  I don’t throw the baby out with the bathwater.  So that is why I really like that.  And during that 3 years I started studying more and more.  I had the luxury – I had the income and the free time – to actually study more about Alternative Medicine, and then that gave me the basis when I moved here to end up starting this practice.  So it was kind of a gradual process for me, but I can answer the question better about why I keep doing it.

Well, why do you keep doing it?

Integrity.  I can’t not do it now, because I can see how it helps people and I can see if I went back and took a job in regular medicine how I would be limited that the only thing I could do is prescribe conventional medicines.  And if I tried to give somebody magnesium or zinc or look at their heavy metals or rebalance their hormones or look for chronic Lyme disease or reactivated mono, that they would throw me out.

You couldn’t do that.

And so for example – we have in front of us right here one testimonial that just came in this week.  So this guy has given me permission to say this.  His name is Craig, he is 64 years old, and he had a diagnosis of sarcoidosis, he still has a diagnosis of sarcoidosis.  And he went to everybody for years, and he went to the leading specialist in the country who deals with sarcoidosis, and they basically said “Look, there is no good treatment for this, you’re going to die from it”.

Wow!

You get a death sentence, you know?  And he also had uncontrolled diabetes, he had non-healing diabetic wounds on his feet.  He lost a toe or two.  And they basically said you need to follow the diabetic diet, which is of course 60% carbs, 20% fat, and 20% protein, which will give you diabetes.

Right – we know better than that.

You can’t eat 60% carbs because that is what is causing the blood sugar to go up in the first place.  And he came here and it has been I believe about 3 years now.

Yes, that sounds right.

And now he has lost 100 pounds, his last blood sugar level was in the normal range, not even prediabetes; he is in the nondiabetic range now.  He no longer has problems with skin ulcers, and his sarcoidosis, which does have a cause, it’s just that conventional medicine won’t accept that sarcoid and all these other autoimmune diseases are caused by chronic infections and toxicities, but we did find those and we treated them, and his sarcoid is arrested.  It is not cured, but it is no longer progressing, and it’s not going to kill him.  And he is feeling better and better.

That’s wonderful!

So he said “The leading specialist told us I would take this to the grave.  Dr. Biddle didn’t even flinch.  He handed me a protocol to start immediately.  I am pleased to say that there are no signs or symptoms that the sarcoid has spread further, and my lungs feel great.  My wife and I are so grateful that we found AIM, Dr. Biddle, and the empathic staff that has given us such a new lease on life looking forward to a healthy future.”

I can’t even imagine how rewarding that must feel for you, being able to impact people’s lives in that way.

It’s great.  Right, and we could sit here all day long and tell stories.

Oh absolutely!

My favorite is the one I give on the video that people watch before they become our client, about the 3 ½ year old boy who was severely autistic, a child with severe autism.  For example he would not wear clothing, he had projectile vomiting, projectile diarrhea, he would thrash about banging his head.  He would not make eye contact, his mother could not hold him.  And that was after being perfectly normal at 18 months, and speaking, and of course went in for his vaccinations and had a fever for 5 days and was never the same again.

So sad!

And we worked with him for 2 years, then they went on, they moved, and worked with other people.  And then a couple of years ago I got a picture of him – captain of the soccer team, top of his class, most popular in school –

Just thriving!

Thriving, a normal healthy kid.  It took 10-12 years of working hard.

It’s a journey, it’s absolutely a journey. 

But this is a kid that doctors had told his mother to institutionalize him and forget about him because he would never be normal.

And the courage it must have taken her to do this anyway – even with those recommendations.

That’s right.  And here is how the system responds to that.  I requested his medical records from his primary doctor and rather than send me the medical records the primary doctor complained to the medical board.  And so I had a 3 ½ year investigation of the medical board coming after me for treating this child with autism, and that cost me like $50,000.00 of fees plus a lot of gray hair and lost sleep, and traveling to Raleigh for medical board interviews, things like that.

Oh, I bet!

And finally after 3 ½ years they dropped the case, mostly because we changed the state law on how they do this, but they could not find anything wrong except for the fact that I didn’t have the diagnosis of autism well-established in the chart because the primary doctor hadn’t sent me the records.

Really!?  All that!

If you want to read that letter, it is still on the Medical Board website.  Just go the North Carolina Medical Board website and look me up, and there is this letter of reprimand on there because the primary doctor had not sent me the records which is where the diagnosis was established.  But did the Medical Board investigate him for not doing that?  That was the illegal act.

I bet they didn’t. 

They didn’t, that’s right.  So there is an old saying – Do you know how you recognize the pioneer?

No, how do recognize the pioneer?

He’s got the arrows in his back.

But, would I change any of that?  To have helped that boy to live a normal life?  That’s well worth it.

Absolutely. 

Right.  So that is why we love doing what we do, and that is a big part of our why, is why we keep doing this.  It’s because we know that people have to go outside the system.  Now the strangest thing and what’s making that harder for people is the Affordable Care Act about 10-11 years ago.  Because when people were actually now forced to buy insurance they didn’t have enough money left over to go outside the system and pay for their own healthcare.  Because insurance pays for what is inside that medical paradigm box.  And to go outside that you have to pay cash, and so it seems very expensive to people and it does feel that way, because they are already paying $500, $1000, $1500, $2000 a month for their insurance, so now they feel obligated to use it and not do something else.

Right.

Before that people would just choose not to buy insurance and they would come spend that $500 a month on reclaiming their health.  And they understood that.  But that put the average people of middle class, or anything less than upper middle class income in a bind, really.

You stay within the system that you are kind of spinning your wheels in.  A lot of people feel stuck in that, like they are not making the progress they want to make, but yet, where do you come up with providing your own medical care out-of-pocket.

Yes, but that’s the investment that one has to make in order to truly reclaim their health.  If the medical system has not achieved it for them.

Which brings us back to – Why?  Why are you willing to invest in this?  Why does it matter to you?

That’s right.

What is it worth, I mean really – can you put a monetary value on thinking about your life in a year from now?  Two years from now?  Three years from now?  If I could have seen you 20 years ago and have half a dozen kids in the room right now – I would have paid anything.

Right, exactly.

You know, there is just no question about that.

And for a child to still have their grandfather or grandmother around – right?

Or for a child to be able to grow up and have a typical life!

That’s right.  And even just from a straight monetary point of view, if we can help you reclaim you life and that took, well let’s say it is a $3000-5000 investment the first year, and then another $1200 the next year to do that.  But then you are able to get back to work and rather than making $30,000 a year now you are making $55,000 a year because you can work fulltime.  Did that not pay for itself?

A lot, and then some. 

If you stopped having to go the ER three to four times a year, and get hospitalized for this unknown abdominal pain, or a psychiatric breakdown, or whatever it is – would that not pay for itself pretty quickly?

And that’s even more of a short-term perspective.  When you look at long-term as we age and especially things like the cost of private assisted living…

Right.

How long can you take care of yourself versus –

If you’re keeping off that dementia or physical frailty; you know, keeping away that hip fracture.  Or even quality of life, let’s say, and again on our video, we have a woman in her 60s or 70s talking about basically reclaiming her sexual health postmenopausally when the doctor said “No, we don’t give hormones anymore”.

Right.

And then reclaiming that and part of that being meeting a new husband and now having years of a wonderful marriage, a second marriage that is thriving and nurturing.

Why not?

What price would you put on that?

I don’t know if you could.

Those are turning your rusted years into your golden years.

Absolutely.

So that’s what I’m looking forward to is my golden years.  One thing about why is retirement – I hear over and over again from people who have retired, it is overrated.  Because a lot of people lose their why, especially guys.

There’s a big phenomenon of guys suffering once they retire. 

That’s right.  So my advice to them is if you can, don’t fully retire; evolve your job into being something that you really love if you can.  And if not, if you do retire, get yourself involved in something else, because you need a why to get up in the morning.

We all need purpose.

That’s right.  Well what else should we say about this topic?

Well I just challenge everyone to think about what is your why.  Why are you doing what you’re doing?  Why are you accepting things that you may not be satisfied with?  What is stopping you from moving forward and claiming a better life for yourself?

That’s right.  And if you are having a hard time with that my first concrete suggestion is a gratitude journal.  Just writing it down, and you can formalize this like once a day you’re just going to write down 10 things you are grateful for, and then that will start to build.

It’s hard not to smile just thinking about one thing you are grateful for.  It changes your perspective, your whole thought process.

It’s a wonderful meditation actually, to dwell on that and feel how that feels in the body and kind of follow that feeling and let it grow, and then feed it with other things you are grateful for.  Because that changes hundreds of chemicals in your body.  It really changes which genes are turned on and off, so be grateful, find your why, and I’ve got to tell you something – you’re why is rarely as simple as “I don’t want to suffer” or “I want to grow old”.  It is almost always outside yourself and how you can be of service to somebody else.  What’s you role as a husband or wife? a mother or father, a sister, a grandparent?  a coworker, a neighbor, a church member?  And how are you contributing to the love and health of your community?

Absolutely.

All right – with that we’ll let you go, and any topics you want to hear about, send them to askdrjimbob@info@docbiddle.com and Joy will respond to you.

Absolutely, I look forward to hearing your questions.

Welcome to AIM For Health: Root-Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

Hi, welcome back.  This is “Ask Dr. Jim Bob”.  I am Dr. James Robert Biddle, I am a medical doctor, I am board-certified in internal medicine, and I have been running Asheville Integrative Medicine for 23 years now, and to help us today is our ever-present new-patient coordinator, Joy Lambert.  Hi Joy!

Hi Dr. Biddle – Hi everyone!

Today we are talking about –

Today we are talking about men!

Men?

We’re talking about men. 

Men at work?

No – men and their hormones.

Oh, their hormones.

I know it’s a myth, so I thought we would start off by busting that myth.  Do men have hormones?

Men have lots of hormones. The big difference is men’s hormones are steady-state rather than cycling, which is why there is that myth.  So women’s hormones change through the month as they go through their cycles, once they are between the ages of like 13 and 50.  But men have testosterone every day of the year which is their blessing and their curse.

Well, let’s learn more about that.

Right.  So men do go through male menopause and we call that andropause. And the big difference is that women go through menopause predictably, somewhere between age 45 and 55 for most women with the average around age 50-52, although I have known women who have gone to age 62 before they really go into menopause.

Wow – that late!

Yes, it’s amazing.

That’s interesting. 

But, they are going to go through menopause because evolutionarily, if they get pregnant after age 60 they are going to die during childbirth probably, and so the ovaries shut down and they are not going to get pregnant, so that is a way to keep them alive longer so they can contribute to their community and their grandchildren and children and great-grandchildren, and all that.

So there’s a reason why women go through menopause.

There’s a reason why women go through menopause, but men never get pregnant, so they don’t need to go through andropause.  At age 50 5% of guys are low in testosterone and at age 70 it is 70% in America.  So there is a very steep curve between 50 and 70, but if you can, be like Jack LaLane and be 80 and still have normal testosterone and good muscle mass and all that.

Absolutely!

So when you start to lose your testosterone in men you get symptoms and those symptoms include fatigue, apathy, grumpy old man syndrome,

That never happens…

Mood instability, erectile dysfunction, lack of muscle mass, putting on more fat mass – you just lose your get up and go.  It’s also associated with some serious stuff like increasing risk of diabetes, heart disease, and dementia.  So it is one of the major predictors of who ends up in a nursing home and who doesn’t.

Their testosterone levels?

Their testosterone levels.

Well I am excited to learn more about this.  So it sounds like men don’t have to go through andropause but if those symptoms are presenting themselves, that’s an indicator that something is not in balance.

Yes, they may be going through it.

All right, ok.  Well, my first question is about testosterone.  Does testosterone drive men’s hormones, all of their hormones, or do their other hormones or glands drive the testosterone – how does that work?

Well, testosterone has a precursor called DHEA and DHEA is made both by the testicles and the adrenal glands, and we can take DHEA to raise the testosterone.  The problem is the DHEA can also turn into estrogen.  If you are low in something, often it is because there is a pathway that is blocked, so for example if I am low in testosterone and I take DHEA, I might end up with more estrogen than more testosterone.  So I am not a big fan of using precursors for that reason.  But, yes, testosterone is really important and we don’t want it to get low.  All the other hormones, just like in women, thyroid hormone, adrenal hormones – they all play a concert, but men have a lot less thyroid problems than women do, they in general have a little bit less adrenal problems than women do, and we talked about all those separately.

Right.

So men are generally more stable, but they are susceptible to suppression by excessive cortisol release.

Really?

So when we get these surges of cortisol, it gives a feedback from our pituitary which kind of shuts down the signal to the testicles.  So common causes of excess cortisol are psychological stress.

Right.

Everything from financial stress to sitting in traffic to chronic anger, just worry about what is happening politically, financially, ecologically – all these are stressors, but then personal stressors like blood sugar rollercoaster, blood sugar going up and down.

Right.

And untreated sleep apnea, so if you are not treating your sleep apnea and every time your airway occludes which can be 15-45 times an hour, you get a cortisol spike and a stress response, and down goes your testosterone.

Well that’s not good!

That’s not good.

And that is part of why we always want to look at underlying sleep apnea and there is a previous podcast about that everyone, so if you haven’t listened to that one, please go do so because it is very important!

Yes, it’s a huge epidemic.

So you’re talking about declining testosterone amounts.  Let’s talk some about how do we measure that both in the conventional medical field and then what are we looking at.

Right.  So blood tests are the usual, if you want to be really accurate you get a morning blood test because men’s testosterone is higher in the morning.  If you are more sensitive you get an afternoon testosterone, you know, if you want to see how low it’s going.

Oh ok, that makes sense.

The problem with the reference ranges is they are too wide.  They will go from 250 to like 1200 and the next problem is men don’t have a baseline from when they were young and healthy.  So let’s say a guy comes in and he is 60 years old, and you check his testosterone and it is 300.  Well that’s normal, doctor says it’s normal.  But if you would have had a baseline at 45 you would have known that his baseline testosterone was 900 when he was closer to his prime.

That’s a significant drop.

It’s not even a third of what you were just 15 years earlier, but the doctor is telling you you’re normal, that’s not your issue.

I bet that doesn’t feel normal.

It doesn’t feel normal at all.  So there is a difference between what is kind of average and what is good and healthy.  We are looking at much tighter reference ranges when it comes to interpretation.  We can also do saliva testosterone, you can do a urine testosterone, we can do a complete panel that looks at testosterone and adrenal hormones and all the estrogens called a DUTCH test that is a urine paper blot so it is really easy to send in.  You don’t have to collect a big jug of urine.

No, you just get to pee on things.

Right, you just get to pee on the paper.  So there are lots of different ways to look at it.  When you are talking about once you are on replacement therapy, you need a more standardized way.  Then the urine and the saliva are not so good and you really need to use the blood tests to be standardized.

So let’s talk about conventional replacement therapy and then things that we can do.

Well, so one of the things that I think doctors do wrong is as soon as a guy’s testosterone is low they put him on testosterone shots or patches or creams.  And the problem with that is once you start testosterone you are going to be on it for life because you get a negative feedback loop inhibition.  Your pituitary stops making LH, your testicles shrink and you stop making your own testosterone.  If you now stop your testosterone replacement therapy you are worse than you were when you started.  Which is OK if you’re 70 or 75 right?  But if you are 45 years old, now you’re looking at 40 years of testosterone shots in front of you.

No thank you!

Yes.  So what we are looking at is what causes the low testosterone and often just reversing that can cure the problem.  Iron overload is another common cause, unrecognized.

Of low testosterone?

Yes, iron insiderates into organs like the pancreas and the liver and increases diabetes, it insiderates into the heart, increases heart disease.  But it insiderates into the testicles and turns them off.  It basically rusts them.  You have rusted testicles.

Oh no – that’s terrible!

Terrible!  I can’t imagine walking around – that sounds like it would be a big chaffing problem.  But anyway, it causes low testosterone.  So we can often treat your sleep apnea, lower your iron – you know, we can fix that.  And then your testosterone may come back to normal, or we might goose your testicles and get them working again.

And how would we do that?

Well, the first way is to use some herbs.  There are a variety of different herbs like Tribulus and horny goat weed, and different things that we have a combination called Men’s Support that has all those in it, and that will work for some guys.  If it doesn’t work then we will use fertility drugs.  Fertility drugs given to women to get them to pop out more eggs will also goose the testicles.  Yes, so the first one is called Clomid or clomiphene.

What does that do?

It’s a pill, a very easy to take pill.   We usually give ½ a pill 3 x a week for a cycle of 6-7 weeks, and you actually, guys will report “my testicles are kind of sore, kind of like when I went through puberty”, starting to swell a little bit, and that can double your testosterone level and kind of puts you back through puberty.  And then we alternate that with pregnancy hormone called HCG, human chorionic gonadotropin, so that is also used in fertility for women, same sort of thing.  And if we go back and forth between those it actually stimulate and re-matures the testicles, not only to start making more testosterone again, but also if they are low in sperm count it can bring that up if they are interested in fertility.

Really!

Yes, so that is a way to restore that in men.

Now what sort of time frame would one expect if they are going to go through that sort of rehabilitation?

Pretty quickly.  I mean we’ll put them on the Clomid and then check levels at 6 weeks and then switch to the HCG and check levels after another 6 weeks on that, and for some guys one round like that will get them going again if we have reversed the underlying cause.  Other guys might need more cycles and then they can take time off and be fine for a while, and maybe they need intermittent cycles.  Some guys will need it continuously.  But it’s at least not suppressing their system the way testosterone would.  So I have had guys on that either continuously or intermittently for a decade for example.  And then when they finally get up to 65, 70 years of ages, maybe 75, then I might switch them over to the testosterone shots.

Wow – well that’s very interesting and nice to have that option to not have to have shots every week for the rest of your life.

Yes, so I call that testicular rehabilitation.  Now the HCG is a shot, but it’s just a subcutaneous shot 3 x a week, so under the skin, as opposed to the testosterone shots which is an intramuscular shot in the muscle of your thigh, usually once a week, with a little bit deeper needle.  So the complications with that process is it can drive up estrogens, so we are very cautious to watch the estrogens and if guys are getting high estrogen we give them a medication called anastrazole or Arimidex is the trade name.  That blocks the enzyme that converts testosterone to estrogen.  That enzyme is called aromatase and it is in fat cells so the heavier you are the more of that enzyme you have.  This medication, the anastrazole, is actually given to women with breast cancer to lower their estrogens.

Oh, I see.

So in women, when you read about side effects, it has terrible side effects of acute menopause, all the symptoms of terrible acute menopause.  You know, hot flashes and all that, but in men we are giving a lot lower dose.  We are not giving a whole pill a day, we are giving ½ a pill twice a week.

Got it.

Or maybe 3 x a week if you are a big guy.  But that works really well to keep the estrogen down.  Now when you go to testosterone replacement therapy, you can use creams to go through the skin, but there are a couple of problems with that.  One is the cream may not stay on you.

Right – it can rub off if it isn’t absorbed.

Yes, and especially rub off onto your wife or your girlfriend, and all of a sudden she may be having a lot higher libido, but she may also have a beard, so that can be a problem.  It may rub off onto your grandchildren, that can be a real problem, or your guinea pig – I don’t know.  The creams are ok but I worry about them not staying on the person we are treating.

Right.

Then you have patches and the patches work really well but they can be like $400.00 a month.

Ouch!

Yes, big pharma is really extracting a big price for that, for something that should be like – and even the creams from big pharma are $200 to $400 a month.  We can make creams from a compounding pharmacy for about $50.00 a month, you can get that down.

Well, yes, I mean especially if this is going to help prevent men from needing nursing home care later in life, like why wouldn’t you want to do that, or make it accessible.

Sure.  But the shots are about $10.00 a month, if you do them yourself.  It is really inexpensive to do testosterone shots and we can teach people to do them themselves.  So that is what I prefer and you get less transition into the estrogen that way.  Because if you put it through the skin it’s going right into the fat cells, so you get more estrogens.  So I prefer the shots when we can do it, which is 9 out of 10 times guys can do it, and then the 10^th guy just comes in here once a week for the shot and we charge him $20.00 for the shot.

Sure.

So that is how we get around that.  Now there are a couple of complications of testosterone that you have to be aware of.  It can make thick blood.

Thick blood.

Thick.  It stimulates your bone marrow to crank out more red blood cells, so your hemoglobin and hematocrit can go up.  Actually one-third of the time in guys.  And we have got to keep an eye on that.

Now why don’t you want thicker or higher viscosity blood?

Because you can get clogging of your artery and have a heart attack or a stroke.

Definitely not good!

And that is why there is mixed results on studies giving testosterone in guys with heart disease.  The good studies, it shows it decreases heart disease, but the poorly designed studies where they are not taking this into account and following this, they are having this complication of a short-term increase in heart attacks because of the thick blood.  But it is very easy when you are checking the testosterone in followup, you just check a blood count, a CBC, and track that.  And of course 2 other things that cause thick blood –

Iron.

Iron overload and sleep apnea.

Exactly!

Because of the low oxygen, right?   So we want to be looking at those.

Definitely have to have that whole picture in place for everything to make sense.

Right.  And then the other complication is it can turn into estrogens which we talked about, or it can turn into dihydrotestosterone and dihydrotestosterone can make men lose their hair faster if they are prone to that, with male pattern baldness genes.  And it can make more enlargement of the prostate gland.  Now testosterone itself does not cause enlargement of the prostate and does not cause prostate cancer, but estrogens and DHT do cause that.  And if you already have a prostate cancer any testosterone can make it grow faster, so you have to keep an eye on the PSA, the prostate specific antigen, in the bloodstream.

So not only do men have hormones, it’s important to keep an eye on them and to know what’s going on.

That’s right.  Because your hormone levels predict physical and mental frailty in men, and there is even one study on early dementia and if guys had low testosterone and you replace it, a lot of early dementia gets reversed.

Really!

Yes.  I am looking at this study, it was published in 1997 actually, about protecting against Alzheimer’s disease.

Wow.  Now these are some, a variety of things that we do in terms of rehabilitation and replacing testosterone.  Aren’t there some other things though that may help? or that may play a factor?

Yes.  Some of the things, I mean just keeping yourself in good shape, keeping your fat mass down into the appropriate range so you are not obese, exercising regularly and keeping your muscle mass up, because muscle mass is metabolically active, it helps you keep your hormones in shape.  So not only does testosterone help you build muscle, but muscle helps you build testosterone.  And then cold showers.

Cold showers!

Cold showers or cold plunges.  So I personally-  two years ago my testosterone had dipped a little bit and without doing anything else I just started doing cold showers every day or twice a day, and I raised it by 25%.

Really?  Now how, I mean, how cold is cold? I’m going to say that lukewarm is cold, but what is actually cold for therapeutic effect?

I just turn on the cold water, and water comes out of the tap at 55 degrees because that is the temperature of the earth, it is usually 55 to 57 degrees, the water if you are just running cold water.  And then I take my shower, and I save a lot of money on hot water.  But don’t worry, the women in the house use enough.

I bet you take faster showers now too!

I do.  That’s right!  And interestingly I have less skin problems because the hot water strips oil out of your skin so you get more dry skin, especially in the winter.  So not taking those hot showers is actually good for your skin.  And then I have a hot tub and next to my hot tub I have a cold plunge and I have a 100 gallon tank that is two-thirds filled with cold water and after cycles in the hot tub, I get in the cold plunge and I stay there for 20-30 breaths.

Breaths, not minutes.

Not minutes, breaths.   So that turns out to be like 3 to 5 minutes usually.  And try to actually drop your core temperature a little bit and that has been shown – there is a guy name Wim Hof, and he has popularized this whole thing about cold showers.  You can look him up and read about that and how it helps with antiaging and endurance and all sorts of things.

Really.

But like I said, you have got to be a man to do it!

(Laughing)

It might make you scream like a girl though!

I do!

You jump into icy water!

It’s one of the secrets – l scream every time!

Now, you also mentioned before that cold showers can, can’t that be helpful with weight loss?  Would that in effect be helpful with your hormone balancing?

It does, because one of the things it does is it turns your white fat into brown fat, and the white fat is completely non-metabolically active, it’s just sitting there doing nothing.  But brown fat is kind of like muscles – it’s burning energy, it’s making hormones, it’s helping you metabolically, and it is thought to help your immune system.  So this is a big secret about of course how Scandinavian peoples get through their long cold winters right?  They do the saunas or hot tubs alternating with the cold plunges, and then they kind of become immune.  And here’s a secret especially in the winter when you do something like a sauna or a hot tub.  If you just get out all your pores are open and then you lose your heat and you start to shiver and get cold really quickly.  But if you end with a cold plunge, then all your pores close and you retain all that heat and I can walk around in the middle of winter with just my towel on for like 5 minutes before I even start to feel the cold.  You get nice and dried off and get dressed, and you don’t get cold again because you retain that heat.

Well that’s fascinating!

You want to seal that heat in.

I would have thought you don’t feel the cold because you’re so numb from the cold plunge.

No it’s not that.

Huh, all right.  And so if someone wants to try it, does it have to be every day for cold showers in terms of raising testosterone levels?

No.  Well, who knows?  I don’t think that has been studied well, but I will say the best time to begin taking cold showers is right after a very vigorous workout when you are all hot and sweaty anyway and it feels good.

That makes sense.

And then most people then take their usual showers and then do the last 1 to 1 ½ minutes cold and they can tolerate that, and then gradually just kind of do less and less hot in your showers, but you get to – I am just to the point where I just turn that cold water on, look at it, then take a step forward and stick my face right into it, let out a little bit of air and go ahhh, and then I’m good.

Just take the plunge!

Take the plunge, and it really wakes me up.

So have you seen, you mentioned muscles before, so with muscle mass if someone has lower muscle mass and they do appropriate muscle strength training and they are able to build that – so that alone can help balance or help build testosterone levels?

Yes, that low muscle mass with aging is called sarcopenia.

Sarco-penia.

Yes, penia means not enough and sarco means muscle, red muscle specifically.  So yes, that can help.

And then what about food and how that relates to our hormone health and balance?  Particularly for men.

Well the most important thing about food is not to be eating hormones.  So when you eat nonorganic dairy products, especially concentrated ones like cheese and butter, and cream, those cows that are not raised organically have an estrogen pellet inserted under the skin of their ear so they make more milk, and then we drink that estrogen and that is a big cause of the very steep rises in prostate cancer and breast cancer, but also why our little girls are going through puberty –

Oh yes.

It’s supposed to be at 13 to 14 to 15 years of age.

Now it’s 8, 9-

Now it’s 8, 9, 10.  Obesity also contributes to that, but a lot of it is the nonorganic dairy products.  And then even meats will often be given hormones too, so I think meat and dairy are the most important foods to eat organically if you are going to be eating them.  And then soy – soy is problematic.  It has phytoestrogens which in some ways are good for women because they are less strong than the other estrogens, so it actually decreases breast cancer risk, but men aren’t supposed to have that much and you can get real problems.  There are these interesting studies on babies given soy infant formula and you calculate it out and they are getting like 10 x per body weight more estrogens than postmenopausal hormone replacement therapy, for example.  So it is really problematic for men to eat too much soy because of getting all that estrogens.  Soy has other problems – if it is not fermented it has enzyme inhibitors which I think we talked about in the nutrition series.

Yes.  So generally avoiding soy would be a good idea and at least having hormone-free, antibiotic-free meat and dairy products would be a good start.

Yes.  And I think men can eat some soy, as long as it is fermented like tempeh and miso, but organic foods are really important for this particular issue.

All right.  On to the next question.

The sensitive topic.

Yes.  The thing that no one wants to talk about, but we’re going to go there.  And we are going to talk about it.

Yes.

Let’s talk about ED.

Erectile dysfunction.

Yes, and what role do hormones play with that?

Well, testosterone is definitely related.  If you have no testosterone you’re not going to have the libido and you’re unlikely to have good erections.  And having said that, I meet men who are very sensitive to this.  If their testosterone gets a little bit low they do have problems, and I also meet men who have very low testosterones and while their libido is down, they are like “Yeah, no problem, I can have erections”.  So it’s not the only thing going on there and it varies a lot.  But there are at least 4 other causes for erectile dysfunction.  So medication side effects is a big one, especially beta blockers, a blood pressure medicine, and some of the psychiatric drugs for depression.  Then there’s vascular, if you have clogging of your arteries everywhere else, then you can have clogging of the arteries in your pelvis and you’re not getting blood flow there.  And that is a very challenging thing to treat.  I have treated men with chelation therapy and gotten improvement in blood flow and reversed that for guys.

That’s great!

It takes about 30-40 IV treatments to achieve that, and then maintenance therapy, so that’s an investment.  And then there is nerve damage, and that’s usually diabetics.  If you are getting neuropathy in your feet, you’re probably also getting neuropathy in your private parts.

Right.

And that’s a big cause of erectile dysfunction, a little bit easier to treat because it does respond to treatments better than the vascular issues for example.  The other unusual thing is people who ride bikes for extended periods of time.

I’ve heard about that.

Yes, there’s a little nerve called the pudendal nerve.  In medical school we are taught “L-2, 3, and 4 keeps your penis off the floor”.  So that’s the lumbar nerves of level 2, 3, and 4 contribute to the pudendal nerve and that gets crunched when you ride a bicycle for long periods of time.

Now is it the configuration of the bike seat itself, or just sitting for long period of time?

It’s the bike seat itself, yes.  If you are sitting in a flat chair that doesn’t happen.  So that’s why the men’s bikes will have a special design kind of to take the pressure off of that.  But it’s still problematic because if you are riding 100 miles, even with a good seat, that can be problematic for sure.

Yes.

And then psychological.  So once men have an unsuccessful attempt, once they have an erectile dysfunction, the next time they go to have sex it is very hard to be relaxed.

Right.

And erections are actually a product of your parasympathetic or relaxation response.  Ejaculation is a product of the sympathetic or excitatory response.

So you need to relax first before you can be aroused.

You need to relax to be aroused – exactly.  And once you’re worried about it then you have a thing called the critical observer that a large part of your psychic energy is spent watching to see if you have an erection rather than enjoying your partner, what’s going on, and that’s not relaxing and it’s not sexy, and you’re not going to have an erection.  So I actually train guys in how to gag the critical observer and it is a process called sensate focus.

Sensate focus?

Yes, you focus on your senses.  You get your brain so busy in the present moment that it doesn’t have space to wonder about whether you have an erection or not.  So you use your eyes and then when you find your mind wandering then you use your ears, and you listen to your partner.  You use your nose and you smell your partner, use your mouth and you taste your partner.  You use your skin and you feel, and you just keep yourself immersed in your senses which is one technique for remaining in the present moment and it takes you out of your head and into your body.

That’s good to know.

That’s the basic exercise for overcoming and with a little help from the medications like Viagra or Cialis.  So that is one of the best uses for those is giving men a little confidence because then they are less reliant upon what is going on in their head and they are going to have a good track record of success and then they can relax.

All right.  Let’s see if we have any other questions for today, or points to share.  Oh, yes.  I’m curious to know if balding has anything to do with hormones. 

It does.

Because I have heard you say there is a genetic component, but is there a hormonal component as well?

Well it does in that testosterone does not cause balding unless you have those genes, and a lot of women have male pattern baldness genes and until menopause there is no problem.   But when they get perimenopausal or postmenopausal, if they don’t take female hormones, their male hormones become dominant because their adrenal glands are getting pushed by these very high levels from their pituitary which are trying to drive unresponsive ovaries and then their adrenal glands are making DHEA and androstenedione which are male-ish hormones and then they get bald whereas other women who don’t have these genes won’t have a problem.   So, yes, there is a genetic pattern that is uncovered by the testosterone.

Interesting. 

So just because a guy is bald doesn’t necessarily mean he has high testosterone, but it just means he has those genes which are uncovered by even normal amounts of testosterone.

Got it.  All right.

All right.  Well I hope this is useful in learning more about the male hormone of testosterone and andropause.  And thanks Joy for participating.  And if you have questions or topics you want us to address at Ask Dr. Jim Bob then send them to Joy at info@docbiddle.com.

All right.  Thanks Dr. Jim Bob!  Thanks for listening everyone – we’ll talk to you again soon!

Welcome to AIM For Health: Root-Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

Welcome back – This is Ask Dr. Jim Bob.  I am James Robert Biddle, medical doctor, internist, and here to help me with this question and answer session is our new-patient coordinator Joy Lambert.

Hello everyone, hello Dr. Jim Bob!

Today we are going to talk about –

We’re going to talk about heart disease.  That’s a big topic but it’s something we all need to know about.

What in the world is heart disease?

You know, I was about to ask you that question.

Oh yes, that’s right.

That’s right – you’re the doctor, tell me about it.

All right.  So every muscle in our hearts – the heart is a big muscle that pumps blood.  And muscles need a lot of blood flow themselves.  So not only does the heart pump blood to every other part of your body, but it pumps blood to itself.  So the main artery that comes out of the top of your heart is the aorta.  And right after it exits the heart there are these little holes that carry arteries that carry blood to the heart muscle itself.  Those are called the coronary arteries.

Ok.

Because they feed the heart.  And it is when those get clogged that you develop heart disease.

Then the heart cannot feed itself which makes it hard for it to do its job.

Right.  So if you get a gradual blockage of those arteries, usually from plaque, cholesterol plaquing, then you get a relative lack of blood flow to the heart called ischemia and that results in a heart pain called angina.  And if you get a sudden blockage of that artery from a plaque rupture causing a blood clot, then you get a heart attack or a miocardial infarction.

Oh, here’s a quiz – What is the most common first symptom of heart disease?

Well, I think I know the answer.

What is it?

Death.

Sudden death, you’ve heard this before.

Yes. 

It’s not angina or a heart attack that you survive.  That’s what we know about because we meet those people, and that’s what all the money is spent on, but usually people don’t know they have heart disease and the first thing that happens is the widow maker event.

Which is terrible.

So that is what we are trying to avoid.

Exactly.

And the studies that conventional doctors do like a stress test – well they do a whole bunch of things to look for risk factors, we’re going to talk a lot about risk factors for heart disease, but if you go into the cardiologist and say do I have heart disease?  They will put you on a treadmill test, do a stress test on you – right?

Right, make you run, and hook all the electrodes up to you and print off some graphs and see what is going on.

Well guess what?  A stress test has almost zero predictive value for the future.

And why is that?

Because a stress test tells you right at this moment are you having ischemia, in other words if you are having a symptom like chest pain, is that chest pain angina from your heart? Or is it acid reflux with a contraction of your esophagus?  Or is it pleurisy with inflammation of the lining of your lung? Or is it chest wall pain with a rib that is out?  Or something like that – so that is what a stress test is actually good for, is answering the question – What is this chest pain?  Is this chest pain caused from ischemia right now?  But I could have a normal stress test today and then tomorrow morning wake up, rupture a plaque inside one of my coronary arteries, get a clot forming there, and have a heart attack and die.

That would not be good.

That would not be good.  So it’s not a very good test for predicting the future.

Now when you talk about rupturing a plaque, and you mentioned cholesterol a moment ago.  A question we get all the time from people is “I have elevated cholesterol on my lab work – does that mean I’m going to have a heart attack? Just from that.  And then what is the correlation between cholesterol levels and plaque actually laying down in the arteries. 

Yes, that is an excellent question and in conventional medicine that’s the biggest thing they look at is your cholesterol levels.  But actually there is very little correlation between your cholesterol levels and your risk of heart disease.  In other words of people with heart disease, half of them have normal cholesterol.  Of people with high cholesterol, half of them don’t have heart disease.

How does that work?

Well, because cholesterol is just one risk factor of many risk factors for heart disease.  And it is not a very strong one, but it is the one that conventional medicine makes a lot of money off of, and big pharma makes a lot of money off of – it’s one of the top 10 money makers in big pharma.  Probably out of the top ten, 3 or 4 of them are probably cholesterol medications and then you have the antidepressants.

Right.  Once you get a certain age it’s just expected that you go on certain medications to prevent that from being a problem.

Right.  So we can dig really deep into what causes high cholesterol, but the real question is “Are you a plaque-former or not?”  The way to determine that is a test that is almost never done in conventional medicine and it’s called a coronary artery calcium score.  So this is a 5-minute CT scan of your heart without contrast, there is no IV, it’s not covered by insurance because it’s a screening test.

Right.

It’s a funny world we live in.

Seriously.

Locally it costs about $230.00 to have this done, although that can change in a heartbeat.

I see what you did!

It’s called gated, because obviously your heart is moving, so it’s hard to do a CT scan on a moving object, so they hook you up to a kind of an EKG monitor and they take a slice of the CT at the same point in the electrical rhythm every time so your heart’s in the same position.  So that is how they can get the CT scan of your heart.  So they simply measure how many calcium pixels are in your coronary arteries.  So I had a grandfather die of heart disease and I had this test done about 2 years ago and I had a big fat 0.

Did you ever think you would be so happy to be a 0 in your whole life?

That’s right, I’m a big fat 0.  I don’t have any plaque – so I started smoking cigarettes.

No you didn’t.

No I didn’t.  But I am never going to die of heart disease, I never have to have another score, really I never need to check my cholesterol.  There are four main reasons people die for the most part.  It’s vascular disease, it’s cancer, it’s growing old and feeble, and it’s dementia, physical frailty.  So, there’s one out of those four I don’t have to worry about that one, because I am not a plaque former.

Yes.

So if there is no plaque in those arteries, there’s not going to be much plaque anywhere else in my body either, you know in my neck or my brain, or things like that.

Right. 

So, that is one of the first tests we order, and once you come back with a 0 score, just don’t worry about it anymore.  Stop measuring your cholesterol.

Right – you don’t need the stress of worrying about your heart to contribute to further problems down the road. 

Right.  And certainly don’t take statin drugs to lower your cholesterol.  Now I find 0 scores on people all the time and their doctor is still trying to put them on cholesterol medications.  They are like – oh, but your cholesterol is high, your cholesterol is high!  It’s like so what – there are wonderful studies that show when you are older you actually age better with high cholesterol.

Well, your body needs it, right? Aren’t our brains made out of it?

You need it.  It’s a part of every cell membrane in your body and it’s the precursor for all your hormones, all your gender hormones like estrogen, progesterone, testosterone, and cortisol.  This is where it starts is in cholesterol.

So cholesterol in and of itself is not the devil.

It’s not the devil.  It’s natural to have.  Now – if you are in insulin resistance, which if you listen to our podcast regularly, you should have an idea of what that is.

Right.

Basically if your waist is bigger than your hips you are in insulin resistance.  And insulin, it means you are making too much insulin.  Insulin tells the liver to make cholesterol.  If you’re hormone deficient, if you are postmenopausal or andropausal and you are not on hormones, your body says let’s make more cholesterol so we can get our hormones.

Right.

So those are very common reasons of high cholesterol.

But not necessarily indicative of whether or not you’ve got plaque forming in your arteries.

Exactly.  And it’s very clear what causes plaque.  The unified theory of plaque formation is inflammation in the lining of the arteries called the endothelial lining.

Inflammation.

Inflammation.  So, for example the types of things that are well known to cause heart disease include gingivitis which is inflammation in your gums around your teeth.

Now how does that get to your heart?

Well, because it increases inflammation throughout your body, that kind of disease.  For example, if you have an autoimmune disease like lupus or rheumatoid arthritis you triple your risk of vascular disease like heart disease.

Because it’s causing inflammation throughout the body.

Right.  These markers in your blood stream like a CRP, a C-reactive protein, or a sed rate, an ESR, are elevated in these conditions.  So inflammation is actually the worst common risk factor.  And I’m going to look at all the things that cause inflammation.  It turns out that chronic infections cause inflammation also.  So that is one of the things that we will look at.

But let’s talk about the usual risk factors for heart disease.

Yes, let’s go through those.  What’s first?

Well, we talked about cholesterol, and I’m not going to talk more about cholesterol, because I end up ignoring it a lot.  Or if it needs to be treated I let the cardiologist treat it.

Sure. 

So, blood pressure – hypertension.  And most people think stress, right?  And stress can certainly raise your blood pressure and if you are chronically stressed which is more of a psychological than a physical phenomenon generally, that can make a difference.  But the three big reversible causes of high blood pressure are weight, being overweight; having unrecognized, untreated sleep apnea which we did a whole show on.

Right, we have talked about that.

We talked about that.  And having high heavy metal burden, which we just did a 4-part series on.  But it turns out in 2003 in the Journal of the American Medical Association, they published that lead leaking out of their own bones is the leading cause of high blood pressure in postmenopausal women.  So all that lead went there when they were children and teenagers and young adults.  It follows calcium into the bones and then after menopause with no hormones and a sedentary lifestyle, all that calcium is coming out of the bones, you’re getting osteoporosis, all the lead is coming out of the bones.

Well, that’s another really good reason then to pay attention to bone density as we age.

Exactly.  That’s why we are big fans – for example one of the many advantages of hormone replacement therapy and exercise.

Yes.

It’s bad enough to have lead, but if you have it, keep it locked in your bones where it’s not really doing that much damage.

Right, absolutely. 

Next is diabetes, and a very important issue.  We can’t cover diabetes here but…

And we did do an episode on that, so you can go back to that.

And of course, you know smoking, cigarette smoking.

Yes.

And, what should I say about cigarette smoking?

Don’t do it!

Yes, don’t do it!

And if you are doing it, please quit.

Yes, unless you have Crohn’s disease.  That’s the only people who are allowed to smoke, because it actually cuts Crohn’s disease.

Really?

Yes.  If you have Crohn’s disease and you try to stop cigarettes, you double your risk of recurrence.  But you know a great treatment for Crohn’s disease?

What’s that?

Getting yourself infected with intestinal worms.

I’m sorry – say what?

Yes, you can get roundworms, hookworms, or pig worms, either from Germany or Mexico and it cuts Crohn’s disease like really well.  Yes, it’s an anti-inflammatory; you get yourself infected with intestinal worms.

Well that’s certainly something you don’t hear about every day!

Yes, I just had a great result with it in a young man who got them mailed to him from Mexico, from ________________, Mexico.  And you drink the eggs.  So there’s an exciting topic!

Yes, we might have to talk about that someday in more depth!

Yes!  All right.  And then the metals are a big risk factor, but it’s not one of the usual risk factors.  So those are the usual risk factors, and then there’s what I call undervalued risk factors.  They are looked at in conventional medicine but they are not really paid much attention to and that’s stress and social isolation.

We all certainly know a thing about that this year!

Yes, it’s much worse this year.  When you look at studies for example like the Ornish program for heart disease, or studies in cancer, they have these support groups.  And it turns out a large benefit is the support group itself.  Like in the Dean Ornish, certainly the diet may help, he’s on this low fat diet and stuff, but it turns out its support group itself makes the big differenced.

Community, connection.

Yes, connection.  It actually reduces stress and it can triple your survival in advanced cancer, so it is a big deal to stay connected.  Obesity and a sedentary lifestyle.  So when you go to the regular doctor they will certainly tell you – oh yes, you are overweight, you should fix that.

But what do you do?

What do you do!

There’s so many reasons why you could be carrying extra weight – what are you supposed to do?

Right.  So we have a whole – nutrition and exercise are your responsibility, but even then they don’t really teach you how to do that very well.  So it’s one of the things that we do, is we teach people how to do that and then we coach them, and cajole them, and irritate them, and tease them…

Hold your hand, kick your butt, and we even made a class for you to watch, so we did all the homework for you too.

That’s right.  Make sure people actually do it, and exercise is the same thing – you’ve got to actually coach people through doing it.  But then there is a whole list of sabotages on weight.

Oh, yes.

So we go through that whole list of sabotages, like sleep apnea, like food allergies, like heavy metals, like chronic infections for why people aren’t losing weight.  And I have a wonderful article, a couple of articles actually, that says the theory on the leading cause of obesity worldwide is actually toxicities and not just heavy metal toxicities but all the thousands of chemicals that we are exposed to, so plastics and petrochemicals and pesticides and all these things, solvents.

Oh yes, food manufacturing alone can expose us to a lot, especially if you are eating a lot of processed foods. 

Right, and then the kicker is – let’s say you lose 20 lbs. of fat and you’re so proud of yourself.  But where did all the toxins go that were in that 20 lbs. of fat.  You know they are fat soluble toxins; they don’t come out in your urine very well.

And most people aren’t chelating. 

They are not chelating.

So where does it go?

It goes into the rest of your body, including your brain which is fat, and then you’re brain says “Oh, I want to dilute this.  I know how to dilute this.  Get fatter, and therefore my toxicity levels go down”.

So it’s encapsulating it, like making toxic pearls out of your own fat.

Kind of.  It’s enlarging the pool, so now, let’s say you have a 10,000 gallon swimming pool and you put so much dye in it.  Well if you now enlarge that to a 20,000 gallon swimming pool that dye is not as concentrated.

Right, you may not even see it.

And that’s what the toxins are doing.  That’s what your body is doing with toxins by putting on fat is diluting the fat soluble toxins.

So you lose the weight and then you inevitably gain it back.

You gain it back, right.  So that is one of the big sabotages for weight control.

So, what I want to get into is the things that are really missed that cause heart disease.

Yes, please.

So let’s start with the simplest.  Vitamin D deficiency.

Vitamin D.

Vitamin D as in dog, yup.

Which we would usually get from the sun.

We get it from the sun, but who’s going out in the sun?  No, because you get skin cancer.

Right.

So almost everybody needs to take vitamin D.  Now vitamin D deficiency is also a very strong predictor for poor outcome for Covid-19 infection.  It is one of the predictors, and it is easy to cure vitamin D deficiency.

Take some vitamin D.

You can take 5000 units a day.  Now they are changing how you measure vitamin D.  It will no longer be in IUs soon – it will be in micrograms.  So 1000 units is equivalent to 25 mcg, so it would be 125 mcg of vitamin D a day for most people will be fine.  That costs about $1.00 a week.

And vitamin D really is a foundation for our immune system – is it not?

Yes, it actually changes our genetics.  It’s actually not a vitamin, it’s a hormone.

Really?

Yes.

I did not know that.

How about that!  And it has nuclear receptors just like our other hormones.  It goes right through the cell membrane to our nuclear receptors and it turns on and off many many genes.  Yes, so it’s really foundational.  Another really easy one is iron, and exactly the same thing.  Iron overload is a very bad outcome predictor for heart disease, but also for Covid-19 infection.  Which we talked about on the Covid-19 podcast a couple of months ago.  I will do another one here, probably next month sometime, as data is accumulating.  But free iron is inflammatory.

Right, and if you have an overload of it, doesn’t it thicken the blood?

It can.  Yes, you can make too many red blood cells and get thick blood – from that, from high altitude, from untreated sleep apnea, and from too much testosterone replacement.  These are all things that can cause thick blood like that, but even without thick blood, a high iron – it oxidizes, it rusts.  It rusts you from the inside out.  It ruins all your antioxidants.

That’s not a pleasant thought!

So you are taking vitamin C, and you’re taking this and that antioxidant.  Well, guess what?  You’re using it all up if you have high iron.  We like to measure iron 2 different ways.  One is the conventional way with an iron level and iron saturation, and the second way to do it is a ferritin.

Yes.

F E R R I T I N.  And it’s a carrier protein made by the liver.  So that can be falsely elevated with other sites of inflammation if you have an autoimmune disease or infection or something like that, you can’t trust it.  But it will never be falsely low from that, it will just be falsely high.

Right.  And having your iron too low is another problem in itself, but that’s another episode.

That’s a whole other episode.  But – how much does it cost you to lower your iron level if it is too high?

It’s free!  It’s free and you might save someone else’s life doing it !

You might, and you can get a free Covid-19 test if you go donate blood!  Now don’t donate blood if you don’t know what your iron level is.  Because if you are already low in iron, then you are going to be more low in iron.  So you have to have your iron measured before you donate blood, especially if you are a menstruating female.  So that’s an easy one.  And for example, the reference range for ferritin goes from about 20-400.  That’s a really wide range.

That’s a huge range!  And that’s the conventional range.

That’s the conventional range.  They are saying, because the way the reference ranges are made is not looking at any science on what’s good for you, it’s just looking at what the average is in the population.

But the average of the population isn’t always that healthy.

Not very healthy, no.

I don’t want to be average.

No.  So our reference range is 50-100.  While at 220 you double your risk for diabetes and heart disease on the ferritin, when your iron is that high.  So you can be 399 and still be “normal”.

But yet you are at risk.

But you’re at risk because there is no money in treating high iron levels, because the treatment is free or cheap.  If you can’t go to the Red Cross and donate blood – which if you do by the way, don’t tell them you have high iron because they won’t take your blood, they think if you’re using them as your therapeutic phlebotomist, then you’re going to lie to them about your risk factors and get somebody sick.  But we can also do phlebotomy in the clinic.  Now we have to charge you because while you can take your blood and pour it down the drain or put it on your garden as blood meal, to us, we have to pay somebody to incinerate it as a toxic medical waste.

Right, but it is still a pretty small fee if that is a service you need to get back in range.

That’s right.  We charge $35.00 for ½ a pint that we draw.  We don’t draw off more than ½ pint because we don’t want you passing out.

No. 

We don’t have cookies and juice for you.

We do have juice!  But no cookies.

All right – what’s another simple risk factor?  Gout.

What’s gout?

Gout is high uric acid which forms crystals and you get painful joints, usually at the base of your big toe.

Why do you get gout?

Well, it’s usually genetic actually and it is exacerbated by eating too many purines which is a type of nucleic acid actually found especially high in shellfish, shrimp, and things like that.  So, this is a genetic issue mostly, and partially a dietary issue.  But if you don’t have the genetics for gout it is never an issue.

Got it.

Yes.  But if you have genetics then you have to watch your diet.

A not so simple risk factor is PCOS, polycystic ovarian syndrome.

And what is that?

That’s women who have multiple cysts on their ovaries and with the full-blown syndrome they also have hirsutism which means they have to do hair removal from parts of their body that women don’t usually have to do hair removal from.  And they tend to gain weight easily and get acne.  Now, in conventional medicine PCOS is kind of one of those black and white things – you’ve either got it or you don’t.  But it’s not just one gene, it’s a whole collection of genes and you can have a little bit of PCOS.

Is there a way to test for that?

There’s not a good test.  I mean, you do a pelvic ultrasound to look at the ovaries for the cysts, and if you have multiple cysts you have pretty much nailed it.  But there are other aspects too.   So women who have that issue though, many of them know they have it, but they don’t necessarily know they are at increased risk for cardiovascular disease.

Is PCOS hard to treat?

Well, we actually have great success in treating PCOS.  It is of course lifelong treatment because it’s genetic.  It gets a little bit easier after menopause, but there are many many things you can do to help PCOS.  Especially one of the best is a nutritional supplement called inositol.

And what does that do?

It apparently improves the receptor on your ovaries for receiving the signal from your pituitary called luteinizing hormone, because it is resistant to that signal that seems to be the biggest driver of PCOS.  Because then the pituitary yells louder if the ovaries aren’t listening and LH goes up but the extra signal goes to the adrenal glands which make male-ish hormones and so that is part of the problem with the excessive hairiness.

I see!

Yes, and actually the very same thing happens in postmenopausal women.

Right.

I they take hormones then their pituitary is screaming and their adrenal glands make too many male hormones and then they get chin hairs and male pattern baldness.

All right – the next one, again we have talked a lot about sleep apnea, and sleep apnea is epidemic.  I have terrible sleep apnea, it’s because I had 4 wisdom teeth pulled, I had 4 teeth pulled for braces, 4 premolars.  They try not to do that anymore, but…and so there is not enough room in my mouth for my tongue.

Right.

You wouldn’t know that by how much I talk, but –

(Laughing)

But when I sleep, then the base of my tongue blocks my airway.

Which is obstructive sleep apnea.

Obstructive sleep apnea, that’s right.  And then central sleep apnea is from a head injury or a stroke usually, or an infection or something like that in the brain.  We mentioned autoimmune diseases.  And then the real interesting one – we talked about iron overload, and then testosterone deficiency.

Testosterone deficiency?  Being a risk factor for heart disease?

Right.

How does that work?

Well, I don’t really know.  I think it increases inflammation.  You know, there is this idea out there that testosterone makes you aggressive, but what is really interesting is that men who have good levels of testosterone are actually usually very calm.

Really?

Yes, unless they are overdosed.  Now if you overdose on testosterone, then that can make you aggressive.  And women will certainly feel that if they go for hormone pellet therapy; they often get overdosed on testosterone in that situation.  They will complain about acne, hair loss, road rage, and things like that.  But testosterone deficiency shows up as grumpy old man syndrome.  It’s like when you are low in testosterone, that is when you are really a bear.

Really?

Yes.  And I don’t know exactly why testosterone deficiency causes heart disease but there is a very strong correlation to that, and early dementia.  So we are very big on measuring that and correcting it when we can, and again, that is a whole other topic on how to correct testosterone deficiency.

Right.  Because isn’t that another scenario where the reference range is huge, but we actually want a tighter range to make sure that things are as they should be.

And usually guys have not had a baseline done when they were young and healthy.  So the reference range goes all the way from like 250 to maybe 1100 on testosterone levels.  So you go into your doctor and you are 300 on your testosterone.  But 5 years ago maybe you were 900.

So no longer normal to yourself.

Yes, you’ve dropped to 1/3 of what you were 5 years ago and you are not going to feel normal.

Right.

And then all the things that come with that testosterone deficiency which is loss of muscle mass, too much fat mass, apathy, grumpy old man syndrome, lower libido and erections – that all weighs on people, but also increased risk of dementia and heart disease.  Now, interestingly giving testosterone has been shown to reverse early dementia in guys who are low in it.

Ok.

But the studies on giving testosterone for heart disease are very mixed and here’s why.  I think if you did it right you would have good results, but most doctor’s don’t know the risks to giving testosterone and when you give testosterone, guys can get thick blood.  It tells the bone marrow to make more red blood cells and then you have this secondary polycythemia or too many red blood cells, also called erythrocytosis.  And that can cause heart attacks or strokes.  So when you give testosterone you have to follow the blood count to make sure you are not doing that.  And it occurs one out of three times when you give testosterone, so it is really common.  You have to keep a really close eye on it and I just don’t think doctors pay close enough attention to that, or many of them don’t even know it.  And I have seen so many people come in here and they are a little bit low in testosterone and the doctor just puts them on testosterone shots.  So to me that is the last thing you do.  We have a whole program that we call testicular rehabilitation.

Yes.  Because sometimes you don’t start with giving testosterone – you try to help the body make its own again.

That’s right.  You look for why did this happen?  Is it sleep apnea that dampened that down?  Is it heavy metals?  Is it a lack of something else?  Nutritional deficiency, some other stressor?  Is it a medication?  And then we can use fertility drugs usually given to women who are having fertility issues.  We can give them to men too and it gooses their testicles into making testosterone again.  So 2/3 of the time we don’t have to give testosterone.  We can actually get the w______________ working again.

Up and running on your own.

That’s right.  And then the heavy metals which is of course one of my favorite topics and we just talked about it, but here’s an amazing study that was done through the VA Hospital and they used an x-ray machine to look at how much lead is in your kneecap.

Kneecap.

Your patella, of guys, and what they found is a huge increased risk of dying from heart disease.  And what they do is they take the top 20% or pentile and compare them to the lowest 20% which is a standard we look at – either the top 20% or the top 25% compared to the lowest 20% or 25% and they see what the difference is.  So for example, if you do this with diabetes you have about a three-fold increased risk of dying from heart disease, if you are diabetic versus non-diabetic.

Right.

You can do it for smokers; you have about a three-fold increased risk of heart disease.  That’s a relative risk of 3 which means you are 300% more likely to die of heart disease if you are a smoker versus a nonsmoker.  Well it’s about 9-fold for lead.  So being in the top 20% of lead like I used to be is like being a smoking diabetic as far as your risk factor of dying from a plaque rupture causing a blood clot.

So you could be doing all the right things in your lifestyle and if you’re not even aware of this lead burden it could still be sabotaging you. 

It could still get you – that’s exactly right.  And this is one of those things that are never looked at in conventional medicine, even though it was published in a major medical journal and straight from the VA system.

I bet there is not a lot of money in it.

There’s not a lot of money in it, that’s exactly right.  Which brings us to chelation therapy.

Yes – how do we treat it?

You treat lead and you can stabilize plaque in the arteries with chelation therapy and what is that?  Chele means claw in Greek and basically chelation means one thing grabs on to another thing.  Now that can be very simple, nutrition supplements for example.  We use a chelated magnesium because if you hook that magnesium onto an amino acid your gut absorbs it better.

Which is good!

Which is good – you get better absorption.  Right.  Here you are using synthetic amino acids to grab on to heavy metals, so the one that we give by IV generally is EDTA.

What does that stand for?  I bet that’s a mouthful.

Ethylene diamine tetraacetic acid.

I’ll take your word for it.

All right.  And this was first used actually in World War II because of embargos on acetic acid is used in the textile industry to grab onto the metals that were making clothing not the right color in the water.

Interesting!

Yes.  And then it was used to treat actually lead toxicity in people who worked, especially men who worked in shipyards spraying leaded paint onto ships and people who worked in foundries and things like that.  And so they would do blood lead tests and if you were high they would give you these IV treatments of EDTA chelation therapy in the 1950s to lower your lead levels, and some of those people happened to have heart disease and angina, and low and behold their angina got better.  In the 1950s chelation therapy was for 5 years the new thing for treating heart disease until the first bypass surgery.

Which you make a lot more money off of surgery period.

A lot more money.  Because chelation is not simple and quick like just cracking your chest – well that’s not simple I guess – but it’s quick!  You crack your chest open and you harvest some veins out of your leg and you-bypass means you make this other little artery, you turn a vein into an artery and you bypass the blockage in the artery.

Make a new connection.

Yes, just like if there is traffic, you take a side road to go around the traffic.  Just like that.  But, if you have clogging of an artery, what’s happening to all the other miles of arteries in the rest of your body?  It’s also getting clogged up.

Yes, exactly!  It doesn’t just lay down in the heart.

That’s right.  And ever since then chelation therapy has been the black sheep of medicine for treating heart disease, in fact it is illegal in Tennessee to do this, and was almost illegal in North Carolina but there was a 10-year legal battle fought in the 1990s so that we can do this.

I’m glad for that.

Yes.  And so it looks like a series of IVs at the most twice a week.  Usually once a week, depending on how dire straights you are in.  And you usually have to do like 30-40 IVs, so it’s a commitment.

It’s a commitment but it’s worth doing.

Yes.  And a whole series of studies show, and in my personal experience, about 75-80% of the time you can avoid or significantly delay for years getting a stent or a bypass surgery.

So what exactly does the chelation do to the plaque in the arteries?

It makes it stabilized.  It stabilizes the plaque.  It makes it lay down flatter.  Because the plaques that rupture have a soft gooey center and it’s called vulnerable plaque.  It’s kind of like the inside of pimple or a zit.  You know what happens to a pimple?

They pop.

They pop.  Yes, usually on the mirror.  But here it pops to the inside of your artery and then all this gooey stuff causes your clotting factors in your bloodstream to make a blood clot and that is when you have a heart attack, is when you have this sudden blockage of the artery from a plaque rupture of vulnerable plaque.  So chelation, a series of IV chelation therapies basically turns vulnerable plaque into stable plaque so that it doesn’t rupture.  It does not get rid of plaque.

Is it like squishing a marshmallow then – it’s still the same amount of material but you’re just changing the volume of it?

Right.  It does not make your coronary artery calcium score go down, it does not remove the calcium from your arteries, and it does not change the progression of your heart disease.  For that you have to get rid of your risk factors.  You have to change your diet, change your exercise, get rid of your diabetes, control your blood pressure, get rid of your heavy metals, treat your sleep apnea – all those things.  Now I recently had a woman unfortunately that has been coming in for chelation therapy and for 10 years I have been arguing with her about all these things and she is like “I don’t have to do all that because I am doing chelation therapy”.  I’m like no, it doesn’t work that way!  And now she is in trouble and she is mad because the chelation therapy didn’t save her and, you know, there is no pill to save you from your poor lifestyle choices.

Right.  We all need to take responsibility for ourselves as best we can, and we have to commit to it, and it’s a long-term commitment.

That’s right.  So our whole philosophy in our practice is, there are two things happening here.  One is we get to teach, educate, and coach you around those lifestyle things, but that is your responsibility, you still have to do it.  And then secondly we get to play Sherlock Holmes and find those things – there is no way you can find out on your own if you have high iron.

No.

Or heavy metals.

And not all other practitioners are going to be looking at these things.

Exactly.   And so that is why we love our job.  Because we can find these things and we can really help people.  Now luckily this woman is now – now she gets it finally.  It’s like OK, I’m actually going to control my diabetes, change my lifestyle, and eat differently.  I see so many people, they work so hard.  You know, they work the job for 20-30 years and they get to that point in their life, it’s like “I get to live the good life now!”

Yup, put your feet up and relax – do whatever you want!

Eat rich foods, drink every night!

Sure, why not?  You’re retired!

That’s right, but that’s actually not what the good life looks like.  What the good life looks like is eating real food, a good diet, exercising at least moderately, being active, doing your stress management, and not being sedentary.

You know, if you don’t use it, you lose it.

Exactly.  You say to me all the time – “Your best move is your next move, keep moving”.

That’s right.  And sitting too long.  Your best position is your next position.

Right.

Exactly.  All right.  Well I think that’s it.  Do we have any other questions to do for heart disease?

Hyperbaric oxygen therapy.

You know I can’t go an episode without finding a way to bring it up.

Well, you love it.  It’s a great therapy.

I love it and I love to talk to people about it too.

Now I have seen studies that if you are in an acute coronary syndrome, meaning you are having ischemia right now, then there are places in Europe that will put you into a hyperbaric chamber and that will help.  Here in America they take you to the cath lab and open up your artery.  And that’s also good.  I am not saying that stents and catheterization and bypass are bad, but I can go deeply into the information that about 70-75% of the time they are not justified by conventional medicine’s own criteria.

And there’s always risks.  And why put yourself through it if you could prevent it or delay it.

If you could prevent it or delay it, right.  Well hyperbaric oxygen therapy  is really good for is cardiomyopathy and that’s when you have a floppy heart.

A floppy heart.

A floppy heart, and that floppy heart can be for example from Covid-19 is causing floppy hearts.  It’s where the heart muscle has been damaged.  The most common cause of cardiomyopathy is ischemic cardiomyopathy where you have had heart attacks and therefore pieces of your heart muscle were dead and scarred.

Which weakens the surrounding area I would imagine.

Yes, it does.  But just like in your brain when you have a stroke, there are pieces – you can’t do anything about a spot in the brain that is dead.  Or a spot on the heart that is dead.  But around that there is an area called the penumbrum.  It’s the border between dead and healthy.

Stunned.

It’s stunned.  It’s not working.  It not dead, but it’s not working, and that is what hyperbaric oxygen can wake up in either the brain or the heart.  So for example, stroke victims will see usually at least a 25%, often a 50-75% recovery even years later, and head injuries, but in the heart the same thing.  So just recently had a guy, a dear gentleman that I have known for 20 years, who had an ejection fraction down around 10-15% from ischemic cardiomyopathy.  During this winter when he was isolated with Covid he had a silent heart attack, didn’t know he had it, and developed congestive heart failure afterwards.  And with doing a series of hyperbarics and chelation, now his ejection fraction is 20-25%.  Well that will get you out of that severe congestive heart failure range.

That’s amazing. 

Yes, you can live for the rest of your life with 25% ejection fraction.  A normal is 50%, 45-55% is a normal ejection fraction.  So he is not normal but he is going to be fine as long as he prevents further events.  He can live a long time with that.  So that’s very exciting.  Viral cardiomyopathy is the next most common.

Viral.

Viral.  So you can have a number of viruses that are, like the common cold, can end up in your heart and cause heart damage, but also the Covid-19 has a very high rate of that.  And then interestingly, a very interesting study was done, not widely known in conventional medicine, but toxic metals are a big cause of floppy cardiomyopathy.  They did heart biopsies when they were investigating and they found extremely high levels of heavy metals in these hearts that had idiopathic cardiomyopathy.  Now idiopathic means we are idiots and we don’t know why they have it.

Does it really?

Yes.  That’s what it means.  Idio – pathic.  The pathology is unknown.  Because we are idiots.

But it sounds so technical and official.

That’s right.  Doctors love to give something a name and then they think they have done something good by- Oh, well you have lupus.  OK, what are we going to do about it?  Well, I don’t know about that, but you have lupus.  They feel good, they have named it.  They haven’t really helped you but they have named it and they think they have done their job.

All right.  So that’s a short primer on what we do for ischemic heart disease.  I hope that is helpful for you all.

Yes, absolutely.  And please continue to send in your questions.  Let us know what you want to know about, and we hope you have a great day.

And we will be back with ask Dr. Jim Bob some more questions.

Yes, we will.  Bye-bye.

Bye-bye.

Welcome to AIM For Health: Root-Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

All right – Welcome back to Ask Dr. Jim Bob!  I am Dr. James Robert Biddle, MD.  I am an internist, I run Asheville Integrative Medicine, and we do this show to answer your questions and educate the public about important topics in Integrative and natural medicine.  Here to help me out is our new patient coordinator Joy.

Hello every one, hello Dr. Jim Bob! 

Hello – and today we don’t have a big topic like we sometimes do.  We just did a series of like 4 talks on heavy metal toxicity, for example.

That’s right.

But we are going to have the potpourri or the smorgasbord, or potluck if you will, of Integrative Medicine today.

Yes – so we have been listening to what people are saying when they call in to talk to us for various reasons, and we have been fielding questions from the public, what you want to know, and so today we have put together a list of questions that we are just going to go through and answer them.  If this inspires you and you want to learn more, please send us more questions so we can keep on.

Keep on keeping on.  What’s our first question?

So our first question today, which kind of dovetails off the series we just finished on metals, is – What are 3 simple lifestyle tips to help reduce exposure to metals and toxins?

Right.  I don’t know how simple these are going to be, but the first thing is don’t use antiperspirants because almost all antiperspirants have aluminum which absorbs into your body, goes to your brain, increases your risk of Alzheimer’s and other problems.  And the aluminum poisons your sweat glands.  That’s why it keeps you from sweating.  But it is poisoning you.

And we need to sweat – that’s part of how we detox.

We need to sweat.  You can use deodorants, preferably more natural deodorants, and that keeps your sweat from stinking so much. You can bathe regularly, and you can even sneak off in the middle of the day several times and get a wet paper towel and do a sponge bath of your armpits, which is basically my way of managing it for the most part.  But you don’t want to use antiperspirants, that’s #1.

Dr. Biddle, can I tell you a secret?

Sure.

I have gotten off of antiperspirants and deodorants for over 2 years now.  I use nothing. Because I went through a lot of detoxing protocols that you helped me with, and to be honest everyone – that first week or two when you go off antiperspirant it can be brutal in terms of the odiferous factor coming out from under your arms, but once you clear that out and really help your body cleanse and detox, the smell dissipates.

Right.

And so now I don’t use anything.

Right.  The next thing I am going to say is not so simple, but it is very challenging.  Don’t live in an old house.  And here’s the problem – houses built before 1984 have lead paint and that lead paint also has mercury in it as a fungicide to keep the fungus from growing on your walls, and so older houses – you can paint over the lead paint everywhere except for the windows.  Windows that open and close you have to actually completely replace those windows to get rid of all that lead.  So people who are living in houses build before 1982-1984 are really in a pickle, and then they also have mold issues.

Right.

So I was happy to finally be able to build my own house, not that I built it – I contracted to have a house built about 4 years ago.

You’re very talented!

Yes.  And that can make a world of difference for your overall health.  Not everybody is in a situation to do that, so that is not necessarily an easy simple thing, but when you are house shopping it is very romantic to look at these old Victorian houses, but they are going to have lead paint and they are going to have unfinished basements, and that is going to be a humidity control issues all along and I’ve met a number of people that got really toxic trying to rehab those themselves, which is the same way I got really lead toxic scraping old lead paint off of old houses when I was a house painter.

Is the mercury in the paint something that would be from a topical exposure of touching the walls or is it releasing vapor into the air?

I think all of it, but especially topical.

Ok. 

Yes, and what’s interesting for example, adults absorb 10% of the lead that lands on their skin, but children absorb 50% of the lead that lands on their skin in dust form like that.  So it is a much bigger issue for kids.

Absolutely.

Right.  And the other thing that is not very cheap or easy or simple is to get rid of your silver mercury amalgam fillings.  I had 12 of those suckers and I got them all replaced.  Not only do they release mercury for as long as they are there – the older they get the more pitted they get, the more surface area they have, and the more mercury vapor they release.  They do not run out of mercury relatively speaking and they are only designed to last for 15-20 years.  So if you’re 50 years old and you have fillings that were put in there when you were 15 years old, they are now 35 years old and they have far outlived their functional lifespan and they also expand and contract with changes in heat – so you drink an ice tea, you have hot coffee, they’re expanding and contracting and they crack your teeth.  The new ceramic and resin plastic fillings are actually better.  They hold your teeth together; they don’t crack your teeth.

Wow – that’s great to know!

Yes.  Now if you have amalgam fillings it is not only expensive, but risky to have them replaced in two ways.  One is if you do it with a nonbiological dentist you are going to get a huge mercury exposure, because they don’t really understand how to take those out of you safely.  They are going to drill into those amalgam fillings and you are going to get vapor, and we absorb 80% of that vapor very effectively.  It goes straight to your brain.

That’s an incredibly high percentage.

It’s a high percentage.  And the second way it’s dangerous is when you take a filling out you have to make a bigger hole to get a nice clean edge to put the new filling in and that filling may have to be replaced with a cap, a crown, or the tooth may fail and crack and you might get a root canal or lose the tooth and need an implant or a bridge.  There is no perfect solution at that point, so that’s always a risk.  So when I had my 12 fillings replaced I ended up with 2 crowns to replace a couple of the large molar fillings.

But back to simpler things you can do – shopping organically.  It’s a great time; people are eating out less right now with the pandemic.  They are cooking at home more.  It is very hard to eat organically when you eat out.  Even if you go to a restaurant that’s serving Hickory Nut Gap beef hamburgers – the cheese on your cheeseburger is not organic cheese.  The bread on the bun is not organic bread.

No it’s not.

So you still have all these different issues, especially with dairy products when you eat out.  So eat organic foods.  And the most important foods to be organic are dairy products: butter, cheese, ice cream –

Absolutely!

Because dairy cows that are not organic have this estrogen pellet under the skin of their ears to make them make more milk, but all that estrogen goes into the milk and then we drink it and it causes this epidemic of prostate cancer and breast cancer – it makes our little girls go through puberty at 9 or 10 rather than 13 or 14 like they’re supposed to.

Right.

So it’s very challenging.  I like to eat out sometimes.  I like pizza, but every time I give my almost 5 year-old daughter pizza I go – oh, is she going to go through puberty a week earlier now?

It’s something to think about.

It’s really rough!  Because I don’t want her to be a freak around food and feel like she is being deprived, but I also want to protect her as much as possible.  So that is very challenging.  But when you eat at home that is a lot easier to do.

Because you can control what you are bringing in your home.

You can control that.  So besides the meats and the dairy products, when you get to the produce we have a list called the “Dirty Dozen” so the things that are the worst because they are thin-skinned and they absorb a lot of pesticides, and that includes strawberries, spinach, nectarines, apples, grapes, peaches, cherries, pears, tomatoes, celery, potatoes, and bell peppers.  And then you have some things that are classically GMO so the only way not to have GMO and a bunch Round-Up on them is to buy them organically and that is corn –

Corn is a big offender.  And GMO is genetically modified organisms.

That’s right.  And they are modified to resist Round-Up so that you can just saturate, and frankly wheat.  So all the things made out of wheat, they actually spray Round-Up on it while it is growing to kill off the weeds, but they also use it as a desiccant.  Right before they harvest the wheat they really spray a lot of Round-Up on it to dry it out so it’s easier on their harvesting machinery, and then we are eating all that stuff.  And the only way to avoid that is to get organic bread and other wheat products.

Exactly.

Right.  So what are the ones that you don’t need to be organic?  Because we all have a budget, right?

Oh, exactly!

So it is good to know that too.  So you don’t need to spend extra money on bananas, avocadoes, pineapple, cabbage, onions, sweet peas, asparagus, mango, eggplant, honeydew melon, kiwi, cantaloupe, cauliflower, broccoli, mushrooms, and papaya.

So those are our clean 15.

Those are the cleanest.  Now I like to get the cauliflower and broccoli organic personally, but the other ones – you know, there is a big difference between the price of organic bananas and not organic, and there is really not much difference.  They are very thick skinned, they are high up in the trees, you are not really getting that much of a difference.  So that is probably one of the simplest things people can do.

And we have all got to eat!

We’ve all got to eat, that’s right.  So that is a great place to invest your health care dollar, is actually taking care of your health.

Right, and not trying to manage symptoms after the fact.

That’s right.

All right – are we ready for the next question?

Go for it.

All right, next.  People want to know what is the difference between folate and folic acid?

Right – well, I’m going to start with why is it so important?  Folate is a methylator like   B-12, and it has been – people know about folate and folic acid because if you are low in it and you are a lady and you get pregnant, your baby has an increased risk for a neural tube defect, which is basically incomplete development of their brain and spinal cord.  And they can be born with a very serious condition called spina bifida that can range from very mild where the tip of the spinal cord is just open in the pelvis right above the butt, to horrible that their entire brain is open and they die after birth.  So this has been known for 40 years.  And an example of the horrible role of the FDA is not allowing companies to label nutrients for medical conditions.  So it took over 20 years of lawsuits to be able to put on bottles of folic acid “helps prevent neural tube defects”.

I am glad they are finally able to do that.

Yes, which is ridiculous.  So folate is the natural form that is in foods.  Folic acid is the synthetic or semisynthetic form that we put into foods to supplement them, and into vitamins generally.  It is more heat stable.  The folate is not very stable and doesn’t last very long.

And so if it is in the foods and it is not heat stable, then would the cooking process –

Breaks it down.

Breaks it down, so we’re not getting as much.

Right.  So if your eating raw foods straight out of the garden, that’s great, but if you are eating canned foods, or foods that have been stored long, or foods that have been cooked, there is not much folate left in there.  So the folic acid supplementation helps with that, but it’s kind of a mute point because the real issue is what form of folic acid do you use?  Because 41% of the population has a genetic defect in methylating their folic acid and B-12 called an MTHFR defect of one sort or another in varying degrees.

And you can find that out from genetic testing?

You can find that out from “23 and Me” and other genetic testing, whether you have that or not.  That’s right.  But it is more than a one in three chance – it is almost a 50/50 chance that you have that issue.  And then you can’t methylate your own B-12 and folic acid and use it very well, so what is important about that is in your multivitamin or in your supplement, you should take a methylate folic acid and a methylated B-12, and so that’s what we put into our supplements that we sell in our store.

Alright – good to know!  Next question: totally switching topics here.  How does screen time affect our bodies and is there such thing as too much and is this ok for our kids?

Yes, I’m getting a personal experience of this just this morning.  My girl who turns 5 next week was begging for her own computer screen.

Really?

That’s what she wants for her birthday.  “I want my own computer screen” and it’s always about earning screen time, and we let her have 20-30 minutes of screen time a day so she can watch her little cartoons and stuff, but it’s so addictive.  Even cartoons – everybody who is developing products, they actually develop it to make you addicted to it.  We know that from Facebook, we know the algorithms are all made so that you are more addicted and by tweaking your dopamine, just like gaming.  They actually develop these video games to make you addicted to them by giving you these little dopamine bursts, and Facebook does it too, and all the cartoons do it.  So you can make an argument that any amount is too much.  And I have friends who are raising their kids out in the woods with no Wi-Fi and these are wonderful kids who progress very early in reading and writing and things like that, and emotional health, and for most of us that is not very realistic. We need it as the occasional half hour of babysitting kind of, for this and that, if nothing else and we may find that we display some addictive behaviors ourself to our screen time.

If we are being honest.

If we are being honest, and that’s an important fact to look at.  So the way it affects our body is it creates surges of feel-good neurotransmitters like dopamine and then the problem with that is you can also get that from various drugs like marijuana and alcohol, and a lot of these do the same thing and if you keep doing that you get accustomed to doing it and then when you don’t do it you feel like life is not worth living.  You feel like life is flat.

Withdrawal – it feels like that.

You are getting withdrawal. You are having a drug withdrawal and you can notice kids will break down, have emotional breakdowns if they don’t get their screen time.

Oh yes!

Yes.  So I believe as little as possible and it’s a really tough topic.

All right.  Next question: anxiety and depression.  Is it always an emotional state? or are there things that we can do to medically address that?

Yes.  There are all kinds of levels to this.  We just talked about one, right, with screen time.  You spend 4 or 5, 6 hours a day on social media, you are going to start to develop anxiety and depression.

That’s why I got off of social media.

Almost guaranteed.  There is the emotional levels, a lot of depression is unprocessed, un-metabolized grief.  So grief is a very natural phenomenon that often takes up to 2 years, even when you actively grieve.  Most Americans are taught to avoid adverse uncomfortable emotions, so therefore they don’t grieve properly.  Greif is like weather fronts moving through.  Today we have hurricane Sally moving through and it’s going to be storming and maybe even flash flooding, and all that.  But you know what – we are going to survive it and in a couple of days its going to be sunny and the grass is going to grow and the flowers will be there.  So grief just kind of comes through in waves and the best approach to grief I believe is to kind of compartmentalize it, because we don’t live in a society where you can take 6 months and just wear black and nobody expects anything from you.

Right.

You still have to perform – right?  But set aside time.  Two, three, five times a week where you make a little altar to the person you lost or the dog or the cat, or whatever it is you’re grieving – the relationship, the foot – whatever it is you lost, and process that and be there with it for 15 to 20 minutes at time and allow those emotions to come in a way that at least contained so that you are not breaking down in front of the person running cash register at the grocery store.  How are you?  (crying sounds)

Been there.  Yes, it’s not a comfortable moment.

And the way to do that is called the ocean wave breath.  And this is a very simple breathing technique.  There’s no effort in it except the observation to not hold your breath.  Because as soon as emotions come up, the way we keep from feeling our emotions is we lock up our chest wall and we stop breathing.  So the ocean, you know if you are sitting there at the ocean on the beach watching the waves, they never stop.  They are moving in, they are moving out, and that top and the bottom, it’s not like they stop and the wave just stops at the top for 5 seconds.  As soon as it reaches its top it immediately starts going back out again.  And that’s the ocean wave breath.  And you don’t try to breathe more shallow, or more deep.  You just keep it moving and your observation is to see when it starts to lock up and as soon as you’re into that for a few minutes and you let yourself think about the topic at hand, those emotions will come up and you will notice that you try to stop breathing.  And if you just relax and keep breathing those emotions will then flow and you will cry, you will have an emotional release and then you will feel better.  And if you just keep doing that, you are going to process and metabolize that grief, and then you’re going to not be depressed.  If you don’t do that, you’re going to end up depressed.

Now do you recommend using any sort of visual or auditory aid in practicing that breathing?

Absolutely.  Like if you’ve lost a mother let’s say, or father, or heaven forbid, a child or sibling.  Have a picture of them there.  But even stronger, have something that smells like them, because smell is our sense that is most closely associated with our emotions and our memories.  So for example, if you have their hair brush, or if you have their pillowcase that they use, or something like that.  There is actually a company now, if you can get their smell, they can chemically reproduce that and you can have a bottle of their smell for the rest of your life.

Really?

Yes, there is a company on-line that does that now.  The science has gotten that good about this.  So, I wish I would have done that with my baby’s head.  You ever smell a baby’s head?

Oh, nothing like a newborn!

Nothing like that!

Just make sure you are smelling the head!

Right!

So there’s the grief.  And then there is neurotransmitter production.  So part of our anxiety and depression can be a lack of making enough neurotransmitters, especially dopamine and serotonin, and those all require factors and cofactors.  So for example, the precursor for serotonin is tryptophan, an amino acid.  The precursor for dopamine is tyrosine, an amino acid.  We can take those, we can frontload those and we can support our own body making more of those neurotransmitters rather than going to prescription drug of Prozac or something like that.  And then those enzymes that make our neurotransmitters have certain needs.  They need B-12, B-6, they need magnesium most importantly of all.  So we look at people’s nutrition and first we measure and identify deficiencies and those are the most important ones to replace and two thirds of Americans are deficient in magnesium.

Oh, absolutely.

So every time doctors prescribe any psychiatric medication they should always give magnesium.  Every time they prescribe any blood pressure medicine they should always give magnesium, but it never happens because it is not FDA approved.  And then gut health, I mean –

Wait, gut health?

Yes, you ever had gut feelings?

Oohhh, it’s a gut feeling – yes!

It’s a gut feeling, yes.  Well it turns out that the gut is called our second brain.  There is a whole book written about this.  And we make dopamine and serotonin in our gut too, so what is going on in your gut as far as gut health? Are you getting enough fiber for the good bacteria to ferment?  It is one of the most important things.  Americans are chronically constipated, we not getting rid of toxins, and they don’t have enough fiber to have the good probiotics ferment into the good stuff.  That’s how we make these neurotransmitters in our gut is by fermenting the right stuff, which is fiber.  So we always put people on ground flax seeds or acacia fiber or something like that, and of course eat actually real food, fruits and vegetables, and less processed food like bread and such.

That’s quite a powerful connection to think about our gut health having an influence over our emotional state of being. 

Right and we can do stool studies and see what is growing in your gut.  We often see people with excessive yeast and yeast makes neurotransmitters that basically hijacks you and turn you into a 5-foot 4, 120 lb. carb-craving machine to feed the yeast.  And now you are not Joy, you’re just a feeder for your yeast once they got hold of your brain, and that can be very powerful.  And the other thing is infections, so especially for example with obsessive compulsive disorder and ADHD, and anxiety all mixed together. There are a variety of infections, especially reactivated strep.

Right, which we have talked about before.

Yes, called PANDAS, Pediatric Autoimmune Neurological Disorder Associated with Strep and when the strep is reactivated which does not feel clinically at all like strep, in fact it may be in your gut, not in your throat.  It can be in your ears, your sinuses.  And we check that with a blood test called an ASO titer, but these types of things really affect your emotions.

All right.  Moving right along I believe to the next question.  Salt?  Sodium? Why does this make our blood pressure go up if we eat too much?

Because we did not evolve with ready access to sodium.  We evolved eating lots of magnesium and potassium and very little calcium and sodium.  So our kidneys are designed to pee off magnesium and potassium.  You can almost – as long as you have healthy kidneys, it’s almost impossible to overdose on potassium or magnesium, unless you are on medications that make you retain potassium.

Ok.

Now I don’t suggest you test that out, because high potassium is very dangerous.

Right!

It’s almost impossible for that to happen with healthy kidneys unless you are on medications, whereas, we tend to hang on to the sodium, because it was rare.  I mean Gandhi, with the peaceful resistance, it’s because the English taxed salt and you cannot live without salt.  We are always trying to hang on to salt.  Now if you’re a thin person like me with adrenal fatigue, you need more salt.  But if you are a heavier person at all, especially if you have high blood pressure, then you easily retain too much salt.

And it’s the retention of too much salt that can drive up our blood pressure.

Yes, if you are in the category.  There are other things that cause high blood pressure for sure, like sleep apnea and lead toxicity and such.  Hardening of the arteries….but once you have high blood pressure salt will exacerbate it.

All right.  Next question – Why does acne happen:

Well, that depends upon the person.

Because it is not just for teenagers.

It’s not just for teenagers.  Certainly hormones because you hardly ever see kids with acne.

Right, not usually.

Right before puberty, and you hardly ever see postmenopausal people with acne, although a little bit.  But that is because postmenopausal women once they stop making estrogen and progesterone, their pituitary is still trying to drive their ovaries, but instead the adrenals respond with male hormones.  So postmenopausal women are making male hormones from their adrenal glands which is why they get chin hairs, and acne sometimes.  So it’s those types of hormones affecting things, but also nutrient deficiencies, and we know that vitamin A, zinc, and selenium are intimately involved with this.  And I just had a an 18 year-old patient who had terrible acne, had been to the dermatologist, and then eventually – they tried everything and they wanted to put her on birth control pills and she didn’t want to do that.  And we did a bunch of testing on her, but before we even got the test results back, just the simple nutrients we gave her cleared it up.

Wow – that’s wonderful!

After years of suffering, so that is a wonderful thing to see.  That’s the way to change somebody’s life in one visit.  It is just awesome to see.

So this is not just a fact of whether or not you wash your face enough.

It’s not.  You have to have the right nutrients.  Sometimes too much toxins can cause it, and hormones are definitely involved.

Ok.  And our last question for today – Am I actually hungry just because I feel hungry?

No, not necessarily.  Very rarely in fact.  Often you are thirsty.

Thirsty!

Most Americans misinterpret thirst signals as hunger signals, and if you just start drinking water, then you will notice that that goes down a lot.  I already mentioned yeast.  If you have been eating too much carbohydrates, especially refined carbohydrates, then you are feeding your yeasty beasties and they are having a party and they are making chemicals and they are hijacking your brain and telling you you are hungry for – again my 5 year-old will say “I’m hungry” so we will offer her dinner types stuff.  She goes “oh, no – I’m snacky”.

Snacky!  So that’s not her, that is literally her gut bacteria telling the brain “Hey, we want more!”

Yes, probably.  I mean, it’s kind of like that dopamine surge right?  You eat sugar, I mean you feel what it is like when you eat sugar and then you want more sugar.  So it’s the neurotransmitters, it can be the gut.  I hate to think that my 5 year-old has yeast, but we all have yeast.

To an extent.

It’s like staph on your skin – you can’t eradicate it.  It’s part of the natural flora.  We all have yeast in our gut, but you can easily overgrow it and that becomes a problem.  And then I think a lot of people also misinterpret other emotions.  They hide their emotions with a feeling of hunger.  We eat to medicate ourselves very often.

Well, the whole comfort food.

Comfort food – exactly.  So there is one local nutritionist who has an ad that says “What are you really hungry for?”  And it is about working through those compulsive eating patterns by self-realization and healing the emotional issues.

Well, and cravings – sometimes you get specific cravings, I mean so specific that it’s like I really want this protein, or I really need this vegetable, or I really want this treat.

And that might be body wisdom.  When I eat okra my body goes “yes – eat more of that”.  Maybe there is a nutrient in okra that I need.  Maybe the slimy stuff is healing to my gut which is irritated from too much coffee.  (laughing)  Some of that is healthy and some of it is probably dysfunctional, so you have to try to figure out what’s the healthy and why when I eat a seaweed salad I get the same reaction.  It’s like, well there’s probably something in there that is really good for my body.  It’s not like it’s a dysfunctional – like people are getting sick off of seaweed salad, it’s not making yeast grow, right?  So with those things it’s probably something very good signal from my body.

So if I think I am hungry, but it maybe hasn’t been that long since I had a meal, maybe just try some water?

Try some water, maybe go for a walk, activity.  And maybe you’re bored, or maybe you’re avoiding an uncomfortable emotion, so sit down for 10 minutes and do the ocean wave breath and see what comes up.  Maybe – it takes a lot of work to keep what I call being emotionally current.  Are you up-to-date on processing your emotions?

Not enough.

I practice medicine – right?  I went through medical school and residency, and I remember people would die and I cannot sit and grieve, I’ve got to go take care of the next person.

Right.

So, I’ve got to catch up with that later.  I’ve got to be present to that.  Otherwise I am going to stuff that and I am going to be reactive in some way later on and not be the best doctor I can be.

Yes, we have to take time with ourselves.

Exactly.  So keep emotionally current and see if that’s part of it.

All right – well thank you so much!  And please send in your questions for next time.

Y’all come back now, ya hear!

Welcome to AIM For Health: Root-Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

All right – so we are back talking about heavy metal chelation and treatment of toxic metals.  This is Ask Dr. Jim Bob, I am James Robert Biddle.  I run Asheville Integrative Medicine and our new patient coordinator Joy is here to help me out.

Hello.

And today is the 10^th of September 2020.  We just talked about testing strategies for heavy metals and now we are going to talk about treatment strategies.

Yes, what do we finally do with all this information?

The first thing I have to decide when I find somebody with heavy metals is Do they also have vascular disease?

And what sort of impact does that play?

Well, because if you have clogging of the arteries to your heart, your neck and head, your pelvis, your lower extremities – then that really increases our desire to do IV long chelations on you.  The magnesium-EDTA chelations which are 1 ½ to 3 hours, because those will open up those arteries by making the plaque lay down flatter.

Compressing it.

Yes.  It doesn’t get rid of the plaque, but it compresses the plaque by making vulnerable fluffy plaque into stable plaque, and that has been shown to decrease the risk of plaque rupture, and therefore heart attacks.  Now people will often get very disappointed, because they will do a calcium score which is a CT scan of your heart to see how much plaque is in your arteries.  Then they will do chelation for a while, and then do another calcium score and they will be in a rage that their calcium score went up, even when they are doing chelation.  I try to explain to them in advance it does not stop the progression of the heart disease.  It just keeps you from having an event.  What stops the progression of the heart disease is your lifestyle.

Exactly.

How you eat and how you exercise, and then working on your risk factors.  Treating blood pressure, sleep apnea, diabetes, and What is the biggest risk factor ever studied for heart disease?  It’s elevation of heavy metals.  So it does treat that risk factor also, but it is only one risk factor among many.  So if you have heart disease also, then it makes IV chelation a lot more attractive.  If you don’t have heart disease, IV chelation may be unnecessarily expensive and inconvenient.  Because you have to come here and pay extra and all that.  So we can often do chelation orally for heavy metals.

Something you can take at home.

Something you can take at home.  So again, starting with EDTA – until recently EDTA was not very useful orally because only about 7% is absorbed.

7?

Only about 7%.  If I give you 100 mg of EDTA, 93% comes out the other end and only about 7% goes into you.

Because it’s going through the digestive system.

Yes.  It is just not a very absorbable molecule, but in the last few years a liposomal form has come out.

And what is liposomal?

It’s where you take that molecule and surround it with a fat molecule, you put it right in the middle of a fat globule, and that then makes that highly absorbable to where you are getting more than 50% absorption.  And so now we are able to use a liposomal oral EDTA to take out all the heavy metals except for mercury.  So that is one of our prime strategies now.

If someone is very sensitive to chelating and they have a lot of toxins and they get the brain fog and all of the symptoms at first, until they get some of these metals out and get used to it, would it be preferable for them to use not the liposomal EDTA, if they are only absorbing less of it to reduce that reaction.

Yes.  We have a non-liposomal form of EDTA called Cardio-Chelates to help treat the heart.  And you take it regularly.  It does work some I believe, and it is more gentle because you are getting a lower dosage.  So you can use that first to start scraping off the excess and then more to the liposomal once you get that scraped off, because people become more resilient.  So that is very useful and if people have mercury also, then my favorite thing to use is called IMD – intestinal metal detox – and this is from a company called Quicksilver Scientific, quicksilver being the other word for mercury.  And this is basically a silica molecule that was roughed up and had 2 sulfhydryl groups put onto it by a guy named Crushade who is a chemist who had mercury toxicity and was too sensitive to take all the usual mercury chelators like DMSA and DMPS.  So he made this to be not absorbed.  So this little powder, you take very tiny amounts like 1/64^th of a tsp. up to 1/8 tsp. at maximum dose per day on an empty stomach.  And that goes in your mouth and then out your rectum, but pulls mercury out of your gut wall.  And by doing that day after day for long periods of time, like a couple of years, you can reduce your total body burden of mercury, especially your gut level, but even in your whole body because it goes down in concentration gradients over time.

A question I have had about the IMD from a lot of people is – is it worth doing it and trying to get the mercury out if I still have amalgam fillings?

It is, but the first rule of treating toxicity is to get rid of the source of toxicity.  So you want to get rid of the source of toxicity as quick as you possible can –

Safely too.

Safely.  And so you need to have a biological dentist.  If you have a lot of work to do, until the Covid-19 pandemic we sent people to American trained biological dentists, but they are in Mexico or in Costa Rica, and they could have it done for ¼ of 1/5 of the cost.  And even one of our nurses went down there and had that done and got very good results.  Rather than spending $10,000.00 to have the dental work done, was able to have it done for $2,000.000 and had a nice weeklong vacation.

Nice vacation to boot!

That’s right.  So it is important to get the dental work done and get the source of the toxicity out of your teeth if you are dealing with mercury and stop eating big fish like tuna fish and shark and swordfish.

Little fish are better.

Little fish are better, lower on the food chain, that’s right.  So we will use the IMD, we will use the DMSA, again if people can tolerate it.  DMSA for 70 years was over-the-counter.  Last year the FDA took it away and made it only available through compounding pharmacies, so that unfortunately usually triples or quadruples the price of things.

Right.

So it is not as affordable as it used to be, but it is still useful.  There are many different ways to do that.  There are protocols where you take it 4 x a day for 3 days and then take 11 days off, and then 4 x a day for 3 days, and – those protocols are interesting.  There is no scientific data behind this, it’s just that some doctor 50 years ago started doing it that way and other doctors kind of copied that.

Followed suit?

Yes.  You can take a tiny dose once a day – I generally do a moderate dose 3 x a week for people as kind of a compromise between that.

Is that to give the body some time off in-between?

Yes.  But there are lots of different ways to do it, and I will have people read different people and decide for themselves what they want to do.  So, one of the problems with fields of medicine that have not very good funding is the scientific rigor has not been applied the way we would like it to be for different treatment protocols.  So we do the best we can and then observe through time and keep evolving that way.  We can use the IVs of the calcium-EDTA, even the magnesium-EDTA, the DMPS.  Now I have found that if you use IV DMPS too often people become allergic to it.

Really – why so?

Well , because it has sulfhydryl groups on it.  You have to have sulfhydryl groups – that is what makes rotten eggs smell like rotten eggs.

Right, the sulfury smell.

The sulfury smell, garlic, onions, all that – to bind mercury.  So lead is pretty easy to bind.  Mercury is one of the trickiest metals to bind and arsenic not far behind it, because you have to have sulfhydryl groups to do that.  And what are the most common antibiotics people become allergic to?  Well, the sulfa antibiotics because of those sulfhydryl groups.  So I have limited it that people can only have an IV DMPS every 6 weeks; then I find people don’t get allergic to it.  But it used to be we would give it as often as every 2 weeks.  Now the EDTA we can give up to twice a week and nobody ever becomes allergic to that because there are no sulfhydryl groups on it.

Interesting!  I didn’t know that.

Yes.  So we can give the DMPS, we usually give it by IV.  You can get oral DMPS through compounding pharmacies.  The main reason we usually don’t is that it is almost just as expensive to take it orally as it is to give it by IV.  It’s generally like tenfold more expensive than DMSA.

And if you are taking it orally would it be less effective than the IV because it has to go through the gut?

Not necessarily.  I think it has pretty good absorption and pretty good tolerance, and I will occasionally use it that way.  You could use it again like 3 times a week or once a week, depending on how you wanted to work that.  Some people will just chelate on the weekends because they get the brain fog from chelating, so they don’t want to have that when they are going to work.

Sounds like it might be a nice option for our long-distance clients too.  Sometimes it is difficult to travel just to get in here for IVs all the time.

Right.  And then there is the whole list of natural things which I don’t think I am going to go into too much, but all the way from cilantro, and chlorella, and lipoic acid, NAC – all the things that boost your own glutathione which is kind of your own basic common pathway of detoxification, so all those things we may use on an individual basis, but people get overwhelmed with taking too many things.  What is interesting is people will come in overwhelmed from taking too many things and two-thirds of the things on their list are not things that I told them to take – it is things they added on their own by looking articles on the web site or newsletters that they are getting.

Dr. Google!

Yes.  And we have got to start thinning out their supplement list because they can grow; we start with 5 or 6 of the main most important supplements, and then all of a sudden they are taking 56 different things –

Right.  Well and if you are taking a lot of stuff, we first of all can’t know what you are responding to, and you don’t want to stress the body out by doing too much at once.

Right.  So I find myself simplifying people’s supplement list an awful lot that way.

Now can you take the oral and the IV chelators in conjunction with each other?

Sure, and I myself – if you know how you respond to them, I would take oral DMSA on the same day I would take IV EDTA and IV DMPS and do it all at the same time and then chase it with binders like charcoal and chlorella and get great results.  Now you asked me to tell this one story – when I had those really high lead levels and started doing IV chelation, it was back in the mid 90s when we had a drought in Asheville so we weren’t flushing the toilets and so I was peeing in my yard.  And I went out and peed in my yard after an IV chelation and I had a dead spot in the yard for 2 years.

From the lead.

I had that much lead coming out in my urine, that you could see for 2 years where I peed that one time.  So I learned not to do that anymore.

Yes – then the whole yard would just die!

Yes, so when you are chelating don’t use your urine on the compost pile.

No.

And I will say another thing about chelation is you don’t try to detoxify if you’re pregnant or if you’re trying to get pregnant.

Now why is that?

Well, you don’t want to be moving heavy metals around in the body when there is a fetus because it will concentrate into the fetus.  So when we have a woman who is trying to get pregnant and she needs to be detoxifying, what I will do is have her wait until she starts her menstrual period and then start detoxifying for 2 weeks and then stop.  And then at the end she has a pregnancy test to make sure she is not pregnant before she starts chelating again.

Hum, that’s clever.  Now with all of the chelating and detoxification, what sort of timeframe are we looking at for one to expect to be able to actually reduce and get close to eliminating their metal burden?

Well you never get to zero because it is stored deep in your body – right?  So it is about scraping it off.  And people feel better when you get just a little bit off.  People with say that their vision clears up, they think better, they feel better, their emotions stabilize – all those things.  Seeing the results of the chelation challenge is really quite variable.  It took me about 5 years to get mine from very high levels down to really close to normal.  A lot of that has to do with how persistent and consistent you are working at it.  I was pretty on it because I run a clinic that works on this.

And you are here every day.

I am here every day, so it is easy and relatively inexpensive for me to do all that.  But it is harder for other people.  This woman who had that suicidal problem for 3 days after the chelation challenge?  Twenty years later she is still working on detoxifying her mercury, because she is very fragile and it is very hard for her to get a handle on it.  She feels better every year, but it is still a challenge, so it can take a long time.  I think – I have a concept of getting it down to a reasonable level by working on it aggressively for one to three years and then going onto a maintenance program where you just kind of keep scraping it off.  I will still take some chelating agents every once in a while.  Every few months I will take a burst of them and kind of scrape off what is leaking out of my bones.

Right.  Now is there a preferable age to start into this venture of dealing with your metals?  Is there an ideal range?

Well, when you are motivated.  That is really the time is when you are motivated.   As young as possible.  We love to work with women before they get pregnant – to detoxify them before they choose to get pregnant because we know they are going to dump the toxins into their fetus six-fold compared to mom’s body.

Right.

But the classic age is midline because you know you are building your bones up until age 25-30, but certainly after age 50 it is all downhill from there –

For your bones!

Especially for your bones, but for everything.  I have already lost an inch in height.  But especially when women go through menopause.  You know, we talked about in one of our earlier episodes that lead leaking out of their own bones is the leading cause of high blood pressure in postmenopausal women, so then you show up as high blood pressure, that is a good time to look at heavy metals.

Right.

So, it is when you are coming down with health challenges is when most people are motivated.  Most people are not going out there and proactively investing in their health when they feel fine.

But that would be great to do.

That would be great to do, but I am as guilty as everybody else.  Frankly, the only reason I did it is because I started this clinic and I figured I should test myself.

Right.

I didn’t really have any issues.  I mean I never would have connected loss of photographic memory and gum recession to oh, that must be lead toxicity.

Right.

But it turns out it probably was.  And I think we talked about my mother’s birth mark that disappeared when she chelated out her lead and mercury.

And it just went away completely?

It went away completely – that’s right.  So what is fascinating is that we see all kinds of things get better when we lower the burden of heavy metals in the body, and we see all kinds of things refuse to get better when we don’t do that.  And I have especially worked with people with chronic infections all the way from Lyme disease to reactivated mono to walking pneumonia, and we find a number of people that will go after those infections, try to get them suppressed, will get partial results and then as soon as you back off, the people are sick again.  And it is not until we go after the heavy metals that they can they suppress their reactivated chronic infections.

Well you said that the metals really do affect every cell in our body – it matters.

That’s right.  One of my teachers, Dietrich Klinghardt wrote a very interesting paper about this.  He says it goes two ways – not only are the infections reactivated because your immune system is being inhibited by the metals, but your body actually lets for example candida yeast grow in your gut because it helps bind the mercury for you.  It is actually your ally in reducing mercury toxicities.  So he says one of the best ways to clean up a spill of mercury is to pour a vat of candida on top of it.

Seriously?

Kind of like putting kitty litter on an oil spill.  I used to be a remodeler’s assistant, so sometimes you spill something and we would always just throw a bunch of kitty litter on it and then you scrub it around and then you pick up the kitty litter and you have picked up the oil spill.  Well that is how you can pick up mercury is with candida.  Because it binds mercury very well.

So could that be a cause of candida overgrowth for some people?

Exactly.  We find that repeatedly.  Especially women with recurrent yeast and it will never really stay away until you get rid of their mercury burden.

That’s incredible.  I had no idea.

Yes, I see that over and over again.  That’s right, you might say well why didn’t Joy know that, she works in the clinic.  Well Joy is a new patient coordinator, she is a clerical person in the clinic, not a medical person in the clinic, so our nurse practitioner would know that, but not our clerical staff necessarily.

That’s part of why I love doing these podcasts is I get to learn with everyone else all these things that I didn’t know.

The medical side of it – that’s right.  So what else should we say about heavy metals?  I tell people don’t be in a hurry.  If you try to hurry chelation you will suffer more adverse side effects.  You have to start really slow and gentle, go into it gradually and see how you respond.  It is fairy predictable if you are clinically fragile, you are going to have a harder time.  If you are clinically robust you are going to have an easier time, but you are less likely to be in my clinic as a patient.

Right.

So the majority of people that we treat are somewhat fragile, so we want to treat them with kid gloves and we have learned to help them through that over the years.  And binders – let’s talk more about binders.

Yes – what are binders?

Well binders are things that you take to put into your gut to prevent reabsorption.  So let’s say I take some oral DMSA, that goes into my body, it absorbs pretty well.  It goes into my body and pulls out mercury, then it gets cleared through the liver, and then that mercury and lead get dumped into my bile and get excreted into my small intestine and travel down to my colon, and I am supposed to poop it out.  Now some of it I will pee out and some of it I will poop out – right?  But the colon, its job is to reabsorb water.  It turns the liquid from the small intestine into your poop which hopefully is not constant diarrhea.  It is the colon’s job of reabsorbing the water why its not, why you have formed bowel movements rather than loose ones all the time, hopefully.  But while it is reabsorbing the water it is very good at reabsorbing all kinds of toxins from estrogens to heavy metals, and that enterohepatic circulation or the circulation from your gut to your liver and then around to your body is what causes a lot of the side effects of brain fog.  So you notice it will be 6-12 hours after you take the chelating agents that you really start to get those adverse side effects and it is when you are reabsorbing the metals from your colon.  So the more fiber and binders you can put into your bowel, the less you are going to reabsorb and the more you poop out, so you can use everything from eating apples for fiber to oatmeal to ground flax seeds – just more fiber in your diet, but then specifically we will use things like charcoal which is a universal binder, and zeolites which is like kind of fossilized rock dust that is shaped the right way to cage all these things.  And we will have people take that on an empty stomach anywhere from ½ hour to 2 hours after the chelating agent to kind of chase those out, and that can reduce a lot of the symptoms.

I used to struggle a lot when you and now Kamila have me going through these chelation protocols, with the brain fog and kind of headaches and wooziness, and just kind of almost felt like a hangover.

Right.

And now that I have gotten on that routine – I like the new Ultra Binder we have.  I take that ½ hour after I take the liposomal EDTA and it just knocks it all out.  The headaches aren’t there anymore, the fogginess – it makes such a difference.

And the Ultra Binder comes from that same company that makes the IMD, the Quicksilver Company, and besides the charcoal, it also has gum, zeolites, bentonite clay, chyasin which is the outer shell of like crawdads and lobsters and such, ground up in aloe and silica.  So all those things kind of help bind all the different things.  And then also you don’t want to be constipated.  You want to be pooping well, so magnesium, probiotics, lots of fiber, lots of water, and even a laxative if you need it.  You just don’t want to be constipated when you are chelating because you get more reabsorption.

Right, it negates the purpose.

Yes, and again, we have talked about this before, but the average American poops 3 times a week and we want the average patient to poop 3 times a day – food in, food out.

Exactly.

Maybe twice a day if you are only eating twice a day and doing intermittent fasting, but for the most part 3 times a day.  So the solution for that is exercise, water, magnesium, and supplemental fiber.

Absolutely.

Those are the best ways to go about that.  All right – any last things about treating heavy metal toxicity?  I have to say, it has to be individualized.  People can try to do this on their own, but you really can’t test yourself on your own, so it’s hard to know what kind of progress you are making, and you have to get some good guidance on it generally.

Right, because depending on what your metal burden is, that determines what chelators we need to use, how sensitive you are, what other factors you have going on – there is just so much to put it altogether that you need support.

That’s right, and the next point I will make is you are never really done.  You have to have some sort of maintenance program.  I’ve seen people who saw another doctor in Florida and that was 10-15 years ago and then they haven’t done much, and then you test them again and the levels are back up again because it has leaked out of their liver and their bones, so you have to kind of go at it again.  The older you get the more is going to be coming out of your bones.  So the corollary of that is to keep exercising and working your bones so that you don’t get osteoporosis, because you would rather keep that lead locked into your bones than having it go to your heart and brain.

Yes, exactly. 

All right – well thanks Joy.

Thanks Dr. Jim Bob.

Thanks everyone!

Welcome to AIM For Health: Root-Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

Welcome back!  We are doing a podcast called “Ask Dr. Jim Bob”.  I am James Robert Biddle, MD.  I am a board-certified internist running Asheville Integrative Medicine for the last 23 years and with me to help me out is our new-patient coordinator Joy.

Hello – Hey Dr. Jim Bob, hey everyone!

We are continuing to talk about heavy metal toxicity.

Yes we are.

And what is on our agenda today?

Well, just to recap in case anyone is just joining us now for the first time – we have already talked about what metals and minerals are, the ways in which some of them benefit us, and we spent the past episode or two talking about heavy metals and the ways they can harm our health.

Right.

So now that we have all that background information, today we are going to talk about how do we test for these metals and then if we find them, how do we get them out of our bodies?

Good.  And I will mention today is September 10^th of 2020.

So the first test we do for just about anyone who is becoming a new practice member with us is a hair analysis.  So Dr. Biddle – what is a hair analysis? And why do we do it?

A hair analysis is the test to most likely get me called a quack.

Why’s that?

Because conventional doctors don’t understand it and don’t believe it, and with some good reason.  But I would like to point out that the medical board of North Carolina will use a hair analysis on doctor’s to see if they have been abusing drugs.  So obviously the medical profession does believe in hair analysis for measuring substances – right?

Right.

So, basically we cut your hair – we take the inch closest to the scalp, and we can see all kinds of things about this.

What do we see?

You can even use toenails and fingernails.  For example, I believe they used toenails from the body of Napoleon Bonaparte to show that he was poisoned with arsenic.

Really?!

Yes.  So we can see both nutritional minerals like calcium, magnesium, zinc, boron, molybdenum – all those different things in the hair, and we can see heavy metals like lead, mercury, cadmium, aluminum, arsenic, and all the rest of them.  What is wonderful about a hair analysis is you get a whole bunch of data points for around $100.00-150.00.

Right.  Currently running about $115.00?

$115.00 is what we are charging for a hair analysis.  We can get all these data points.  However, the hair analysis is not for the amateur to interpret because you can have some problems with a hair analysis.

Like what?

You can have the lack of excretion –

Poor excretors.

Poor excretors or time passage.  So for example, I didn’t have my first hair analysis until 15 years after I was a house painter and got toxic in lead, and so only a tiny bit of lead showed in my hair 15 years later because it is all stored in my bones.

I see.

And we will talk more about the chelation challenge; we saw a lot more come out in my urine.   The next is you can have poor excretors, so people have got chemical sensitivities and low molybdenum, and they are not really able to put the metals out into their hair, so we won’t see them in the hair.

I fell into that category. 

Right.

Which at first, I looked at the hair analysis and it was like “Oh, sweet! I don’t have any metals at all!” Except – we needed to do more testing. 

Right.  So you can’t believe a negative hair analysis on heavy metals.  If you see heavy metals, then you have to see – do you have external contamination?  So for example, we see aluminum on the hair because there is – if you are using a shampoo and conditioner that is not organic, then it almost always has aluminum in it.  And we can’t tell from the hair – is that aluminium on your hair or in your hair coming from your antiperspirant and through your body.

Right.

So then we have to confirm that with another test.  We often see uranium high in the hair analysis because well water in granite mountains like here breaks down into uranium, so all the water has uranium here.  And it is not radioactive uranium.

Right – we talked about that last time.

We talked about that.  But it does show on the hair, so now we don’t know if it is actually on the hair or in the body.  And then you can also have some displacement.  So for example, we often see very high zinc in a hair analysis, but in fact mercury and cadmium both sit right below zinc on the periodic table of elements, so they tend to kick the zinc out into the hair, which is what showed in my hair analysis.

Mine had the same thing.

And then it actually means you are low in zinc because you are having wasting of zinc from your body and you need to supplement with zinc, usually for at least 2 years to build it back up again.  And then for my hair analysis, I started off with very high zinc and then when I took zinc for 2 years and took out the heavy metals, my zinc returned to normal.  So you can have a paradoxical elevation.  And then there are some things that are just not worth at all looking at in the hair, but it shows up in the hair analysis –

Like what?

Like sodium and potassium, and germanium.  There are a number of things I wish they would take off the hair analysis form.  But, having said all that, it is still a very useful test and if you know what you are doing in interpreting it, you can gain a lot of information on the cheap.

Now, question.  If someone is a poor excretor of heavy metals in their hair, does that mean they will also be a poor excretor of the good minerals we want to see in their hair, where they are at with that?

No.  In the hair analysis the reference range, you know heavy metals should all be very very low, right?  So the reference range starts at 1N and then it goes up from some threshold.  Desired is 0, right?  But then there is a threshold of how high it can be before you are too high.  Whereas nutrient minerals start in the middle – you want them all in the middle of the reference range, and they can go either high or low.  So nutrient minerals are much more predictable in that way.  But we will see people with diffuse deficiency patterns.

Ok – say that again?

Diffuse deficiency patterns.

And what does that mean?

Nutrient minerals – it means almost all the nutrients of minerals are low in their hair.  And that almost universally means they either have a really lousy diet for decades, or they are low in stomach acid.  So when people come in and they have been on like PPI stomach acid blockers for 20 years, they are going to have a complete lack of minerals in their hair, because their whole body is deficient, which is why they get osteoporosis and dementia and kidney failure, and all the other things that have been associated with acid blocking medicines.

Wow!  I never would have thought you could see all that just through your hair!

You can see all that.  And if they are not on acid blockers, then we know they have a problem in their stomach.

Absorbing.

Absorbing.  And they either have H. pylori in their stomach lining, which is the bug that causes ulcers but can also cause low stomach acid in the long run, or they have autoimmune gastritis, which is an autoimmune attack on your stomach lining.

Ok – well those are good things to be aware of.  Now, regardless of how the hair analysis comes back, we often want to investigate further, to make sure we have the most accurate picture.  So what is next in the step of testing for metals?

Right.  So I want to review the way conventional medicine defines heavy metal toxicity, and we talked about this before, is an elevated blood level or an elevated 24-hour urine without provocation, you have not taken any medicine or anything like that, you just take a random 24-hour urine collection.  And if those are high then you have a diagnosis of heavy metal toxicity.  All the tests we do do not define heavy metal toxicity, they only show us that you have an elevated body burden which is not a diagnosis under conventional medicine, because conventional medicine just ignores this issue.  So, with a chelation challenge what we do is give you something that binds heavy metals and then collect your urine and see what comes out.

So kind of like shaking the bucket.

Yes, you shake the bucket.  And you can do this many many ways.  I started off in practice 23 years ago giving a 24-hour urine collection, but found compliance was really challenging.  So then we went to a 12-hour urine collection, but then I saw data that showed that 90% of the metals are out within 6 hours.  So now we do a 6-hour urine collection and compliance is much easier that way.

It is a lot easier to commit to 6 hours than 12 or 24.

Right.  And then we can use an oral agent to challenge with, and I don’t like to do that because what I have discovered is I don’t know how much of that oral agent you are going to absorb versus somebody else.  So I give you an oral chelating agent – you may absorb 10%, whereas I might absorb 50%.

Oh, OK.

So I don’t really know what I am challenging you with.

Right – it’s not consistent from person to person.

Yes.  So we can do that, but what I prefer to do is use an IV challenge, and that way I know exactly what is going in, it is 100% absorbed, there is no variability, and we can reproduce it from time to time.

And if we are doing the IV chelation challenge, what does one expect?  That is a big question we get a lot of times from our new clients, is what am I going to feel?  What should I expect?  Is this going to knock me out for the day or will I just go about my business?

Right.  And we will come back and talk about what we challenge with, but the challenge with challenges is are they challenging?  We are challenging your system to pull the metals out.  And if you are a healthy, a relatively healthy robust person, that is fine.  I feel great when I take chelating agents.  I feel better, I feel sharper, my vision clears up, I can think better – all those things.  But, if you are a fragile, and usually in one of two ways – either you are emotionally fragile and tend towards a lot of anxiety and depression, or if you are chemically fragile meaning that you have chemical sensitivities and it is hard for you to be exposed to perfume or detergent smells, or things like that – you get symptoms, brain fog, migraines, stuff like that.

Right.

You are going to feel lousy with chelating agents.  And I learned this the hard way.  You know, they call this a medical practice –

Right, we are practicing.

We practice all the time, and we try to get better all the time.  But I had one dear woman who is still a patient 20 years later and still working out her mercury toxicity, but she is a redhead and she was emotionally fragile, and I gave her a full chelation challenge and she was suicidally depressed for 3 days afterwards.

Oh, that’s terrible!

And I have seen other people who can feel really bad, so we try to be very picky and cautious about who we challenge.

Right.  Not everyone is going to be an appropriate choice for this test.

Not everyone is going to be an appropriate choice.

Whereas some of us, we know we will be OK and even if we feel lousy for a little bit, we just kind of bear it and get through the test.

Right.  Now fortunately in my almost 25 years of using these agents, I have never seen anybody actually damaged with them.  It is all just “Oh, I feel lousy for a number of days or weeks, and then I am OK”.

Right.  I only felt lousy for a few hours. 

For a few hours.  And that is more classic.  So the agents that we use for a chelation challenge; one is calcium-EDTA and EDTA is ethylene diamine tetra acetic acid.  It is a classic chelator for lead, but does not bind mercury very well.  It binds a lot of the other heavy metals, and the calcium form of that is just a 5-minute push on the IV.

So you are not sitting there for hours with the IV dripping into the arm, into the vein.  It really is just a push.

Right.  That long chelation is the magnesium-EDTA which is used to flatten the plaque in the arteries for people with vascular disease like heart disease.

Flatten the plaque?

It flattens the plaque.  That is how it works is that is makes vulnerable fluffy plaque which might rupture and cause a heart attack and clot, into stable plaque which is flatter and by making it flatter it opens up the artery some.  So we are not going to talk a whole lot about chelation and heart disease, but that is the –

That’s a whole other podcast!

That’s a whole other podcast.

We are going to get there though.

Right.  But that is 1 ½ to 3 hours for that IV, but the calcium-EDTA is better at binding the heavy metals because it is going in fast and gets a higher peak in the blood stream, so that is what we use for testing the heavy metals and for treating them.  Then the second agent we use is called DMPS and that is specifically used to bind the mercury because the EDTA does not bind the mercury very well.  The DMPS is in a funny regulatory position and that is not actually FDA approved, but it is FDA available because it has been studied, it has been recognized as generally safe, and it is available through compounding pharmacies.  We thought we almost lost it this last year, but we are still able to get it.  We may lose it in the future at some point.  And then the other thing we can use for challenges is DMSA and DMSA binds all the metals, but it is not used by IV, it is only orally.  So when I do need to give an oral chelation challenge, either because somebody has lousy veins, or they live at a long distance away, and can’t get here in person for the IV, then we will use oral DMSA for that.  But in my experience, DMSA is the harshest of the chelators and has the most side effects.  It causes the most brain fog and such of any of the chelators, and the DMPS and EDTA combination is actually much better tolerated by more people.

Which is great.  We want it to be tolerable.

Right.  So then they collect, you empty your bladder before the IV, then after the IV you get a jug, and any urine you make over the next 6 hours goes in the jug, and then you shake it up and pour off a test tube and mail it directly to the lab.  You don’t bring it back to us.

No, we give you a kit and everything with all the packaging and the stickers that you need.  So they will pick it up at your home, and then 2-3 weeks later we find out.

We know exactly how much came out, which correlates pretty well most likely to what your body burden is.  Your total lifetime accumulation.  And, to talk about myself with that – my hair only showed a little bit of lead but a lot of mercury, whereas my urine showed a little bit of mercury but a lot of lead.  What that meant is that my lead was an old but large exposure, from being a house painter, and my mercury was a more recent ongoing exposure because I had 12 amalgam fillings and used to eat tuna fish, but I was doing a pretty good job of excreting it along the way and taking care of it, whereas the lead was all hidden in my bones.  But after a few years of detoxification, I repeated my chelation challenge and they are both down to almost normal.

Now you were saying that certain chelators bind better to certain metals.  If someone like you shows that they have lead and mercury, and we talked in the last podcast about both of those extensively, which one do you go after first?  Or does it matter?

Well, it depends on who the person is and what they tolerate.  For myself, partly because I have the clinic and I have the IVs available, I used everything.  I used IV EDTA, I used IV DMPS, I used oral DMSA.  If people are very fragile, we don’t use the oral DMSA, but if they are pretty robust, we do.  One of the challenges with a practice like this is most of people we see are a bit fragile, so we are always trying to be careful with them.

Absolutely.

Perfectly healthy people do not usually go invest in seeing a doctor.  Although we really appreciate the people who do, because people do come in here and say “Hey, I want to age gracefully”.

Exactly, an ounce of prevention.

So, I used it all, but it is really very individualized, and besides those three we also have other chelators which we will talk about, for treatment.

Sure.  Now if we find that someone for whatever reason might be too fragile to do that chelation challenge, what option is left to them other than the hair analysis?

Right.  We didn’t used to have an option, but I discovered a guy, when I was in charge of the education for ACAM about 14-15 years ago, I invited this gentleman who had spent 30 years at the University of Washington in Seattle studying porphyrins and how they relate to heavy metals.  Porphyrins are the recycling products of your red blood cells.  So your red blood cells get recycled every 3 months.  Your spleen filters out the old ones and then sends the parts to the liver which puts them through what is called a porphyrin pathway which is a series about like 9 different molecules that they go through, and then they get sent back to your bone marrow to make new red blood cells.   I love biology!

So it really is a recycling program – I didn’t know that!

It’s a recycling program.  And it turns out that the different heavy metals will block certain enzymes in that pathway to cause characteristic elevations of certain components in that pathway that can tell us without doing a chelation challenge whether you are being poisoned at the cellular level by different heavy metals.  So we do a urine porphyrin test.  This guy after 30 years – conventional medicine completely ignored him – so I invited him to a conference in Las Vegas in about 2006 I believe it was, and from that conference then porphyrins got adopted in the alternative medical community as a way to get an idea – you can’t diagnose heavy metals, but you can get an idea that somebody has a heavy metal issue.

More definitive so then if they were a poor excretor and we didn’t really get a clear picture out of their hair analysis?

Right.  And then we don’t have to put them through a chelation challenge to get started, and it will tell us – is it most likely lead? Is it most likely mercury? Is it most likely arsenic? Is it something else?  And then we can work on them for a while, usually a year to 2 years, sometimes 3 years, and then after detoxifying what shows up, then they are usually not so fragile and then we can do a chelation challenge on them and then they will usually tolerate that and then we can get a more empiric solid measurement of what the heavy metals are left in their body at that point in time.

I see.  So just to make sure we are all clear – with the porphyrins test it is unprovoked, in that we are not giving them any chelating agents at all prior to the urine collection.

Right.  It is unprovoked, but then the results are more qualitative, not quantitative.  So it says yes, you have a problem, and the problem is with lead.  But it does not tell you what your lead level is in your body whereas then in the urine it will tell you – OK, on a scale of 0-4 – when I did my test the scale was up to 5 and my level of lead was 85 in the urine.

Wow!  That’s pretty high!

That’s pretty high.  I have only found 5 people worse than me in the last 23 years.  One of them had a bullet lodged in his spine, one of them owned a tire balancing shop with the lead weights, one of them owned a shooting range with all the lead, and one was a painter like I was, and the 5^th woman I don’t know where she got hers, but some way or another she got lead toxicity.

So in terms of testing, we are looking at either a hair analysis, a chelation challenge, or porphyrins test. And then once we have –

And usually it is a hair analysis, and then either a porphyrin test or a chelation challenge.  Because the other tests don’t tell us anything about your nutritional status of minerals.  So the hair analysis is unique in that we get a very inexpensive look at your zinc, copper, molybdenum, chromium, vanadium, selenium – all those different minerals, and if you are starting off deficient in any of those, then chelation is going to be much harder on you because the chelating agents are not so specific.  They do have an affinity order.

What’s an affinity order?

Well affinity order says which metal does it bind best?  It will grab that first and then, which metal does it bind second best, and then third best, and then fourth best?  So for example, EDTA starts with the lead and then goes down the line.  DMPS starts with mercury, lead, silver, cadmium, nickel, arsenic, antimony, bismuth, chromium, cobalt, molybdenum, copper, then on down the line.  DMSA starts with lead, then cadmium, then mercury.  So they have a little bit different order.  So based on what your metal is, it helps us pick which chelating agent to treat you with.

I see.  Along with testing our own bodies, you mentioned well water earlier also.  We also have the option to test our water to see what we are drinking and constantly putting into our bodies.

Right, so we can find out Is your water a source of the toxicity?

Yes.

And we usually assume that if you are on city water it is not likely to be, unless it is in the pipes going to your house itself.  But if you are on well water, you can definitely have contamination from industrial exposures.  Another thing – back to the nutrients.  If you are starting off for example very low in selenium and then we start to chelate you and make you even worse low in selenium, then you could feel worse, that is one of the reasons to feel worse.  And so the hair analysis tells us that we need to be supplementing selenium in-between doses of the chelating agents, or whatever mineral you are low in.

That way we are not depleting what you need and you are already low on.

Right.  And then we will repeat your hair analysis every year, 1 ½ to 2 years then to make sure we are on the right tract.

Got it.  All right.

All right.  Maybe that is a good place to have a pause.

Yes.

And then we are going to come back and do a part 2 of this particular episode and talk more about the treatment.

Yes.  Ongoing treatment. 

Ongoing treatment.

Welcome to AIM For Health: Root-Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

All right, welcome back to our podcast, Ask Dr. Jim Bob.  I am Dr. James Robert Biddle.  I run Asheville Integrative Medicine, and I have our new patient coordinator Joy to help us out today.

Hello everyone!  So the next one on (our heavy metals) list is cadmium.

Cadmium.

What is cadmium?

Cadmium – let’s see.  I have a little note here: cadmium was identified in 1817 by a guy in Germany and named after a mythological Greek character Cadmis.  Anyway, cadmium is another heavy metal that is used in paint pigments a lot, like cadmium red.  So we can see artists who are painting on canvas and such who are not protecting themselves, not ventilating well and getting this on their skin can become cadmium toxic.  And cadmium is also concentrated by tobacco – cigarette smokers have high cadmium levels.

Would that apply also to secondhand smoke exposure? 

It also does apply to secondhand smoke, that’s right.  What I find interesting is all of these were used as medicines like 100-150 years ago.

Really?

Yes.  I have a little book, it’s the 1899 version of the Merck Manual.  Because I bought the 1999 Centennial edition and they sent out the 1899 version and there is a whole bunch of cadmium preparations, a whole bunch of lead preparations, a whole bunch of mercury preparations…

Why do you think they were using it as medicine?

Well because in some ways it temporarily inhibits your immune response so it can decrease inflammation just like steroids do.  It makes you worse in the long run, but it can make you feel less inflamed in the short run.

A little bit of immediate relief.

A little bit of immediate relief, right.  Meanwhile you are kind of poisoning yourself.

So cadmium, what I know about cadmium as far as it toxicity levels is cadmium has an estrogenic toxicity.  So cadmium is associated with increased risk of breast cancer.

Really?

Besides that I don’t know a whole lot about the other.  Here it is talked about causing enlarged joints and glands, but I don’t know a whole lot about the actual symptoms of cadmium.  I know a bit more about the next one which is antimony.

Antimony – what’s that?

Antimony is often used in gunpowder, so that is the place I’ve seen it.  It has also been used as a malarial treatment before, for tropical diseases, for parasites.  It can also be in well water as an industrial contaminant, and I have seen a few kids high in antimony and they all had aggressive issues.  They are the kids who are hitting the other kids over the head with toys in the playground.

Really?

Yes, so antimony can be a problem.

Next we have aluminum, and I think most people have heard about aluminum being an issue in dementia risk.

Right, because it goes to the brain, does it not?

It does tend to go to the brain.  It’s found in the brain plaques.  Interestingly aluminum is the most abundant metal in the crust of the earth, yet it is never found free in nature, it is always bound up.  Obviously we mine it and then isolate it and use it in all kinds of things from aluminum foil to cans and utensils.

And we put it directly on our bodies in antiperspirants and it’s even in baking powder.

Right.

Really important things to keep an eye out for so that you are not just placing it directly on your body.

Sure.  And aluminum is a bit tricky because it is in, for example, a lot of shampoos and conditioners.  We see it as an external contaminant in the hair analysis.  So when I see a high aluminum in the hair, it might be coming from the body, but it might just be on the hair, not in the hair.  So then we want to confirm that with a chelation challenge and see if it is actually in the urine coming out after a chelation.  Along with aluminum is uranium and uranium is a heavy metal but it is quite common around here because granite mountains break down and granite breaks down into uranium.  It is not radioactive uranium. But all the well water around here has uranium in it.

Really – I did not know that.

Yes.  Which is why even if you are on a well you should probably filter your drinking water with a filter that takes out 99% of the heavy metals like lead and mercury and uranium.  So we routinely see it high in the hair just like we sometimes see aluminum high in the hair.  And then we have to see in the urine, you know, is it really high in the body or is it just an external contaminant onto the hair.  Uranium doesn’t have a lot of specific symptoms.  I have seen it be associated with chronic fatigue when it is actually high in the body.  I did discover having one person’s well tested that they actually had radioactive uranium.  Apparently they were downstream from the groundwater of where the atomic bombs were made over in Tennessee.

Oh wow!  So their actual well was radioactively contaminated.

Yes, it was.

That’s terrible!

Yes.  And they shut down news about that pretty quickly.

I bet.

What’s our next one?

Nickel.

Nickel.  Yes, nickel is what, you know, people will get rashes on their wrist or finger from wearing cheap jewelry that has too much nickel in it when it is supposed to have gold instead.  So that is what most people know about nickel.  It has been used to make bronze all the way back 4500 years ago in Syria and weapons in China, it was called white copper.  And I also don’t know a whole lot about nickel toxicity.  We don’t see as much nickel toxicity these days.  I think there is just less of it used.

Well that’s good.

Yes, that’s good.

We also have tin and arsenic on the list. 

Right, so we do see arsenic and arsenic was made famous in a movie with I believe Cary Grant called “Of Arsenic and Old Lace” where the old ladies were poisoning vagrants with the blackberry brandy which is funny because it is a comedy.

Well sometimes when we see people come back with the high arsenic level, sometimes the men will look at their wives and say “what are you doing to me?”

Right.  Well, so arsenic is one of those that can, as you can tell from that story line, if you get a lot of it right away, it can kill you right up front.  Otherwise it is also just one of those kinds of general metal toxicities that does not have a whole lot of specific symptoms.  But all these metals, the problem with them is they just poison every single cell in your body, so often it is not specific symptoms, but what they all have in common is they disrupt your gut in nonspecific ways, they disrupt your brain in nonspecific ways, and so they are all associated with kind of the same sort of fatigue, malaise, brain fog, anxiety.  You go in to your doctor and start complaining about all that, what are they going to do?

Give you prescriptions for all sorts of things.

Give you Prozac and valium, or Xanax.  They are going to give you antidepressants and anti-anxiety medications, but they are never really going to investigate the root causes of it, and especially looking at heavy metals.

Right, and detoxing.

And detoxifying you.

Now, I wanted to ask you specifically about two things that are actually used in medical testing that people can get exposed to – barium and gadolinium.

Yes, so barium is using mostly in swallowing, or in an enema.

As a contrast.

As a contrast.  So you swallow it and they can do a barium swallow and then do an x-ray while you are swallowing it and see if the muscles in your esophagus work appropriately and in synchrony or if they are disordered.  And they can see how well your stomach empties, how long stuff stays in your stomach versus how long it goes down, to see if you have gastroparesis which is paralysis of your stomach, usually from diabetic neuropathy.  And they can do a barium enema as kind of an alternative to doing a colonoscopy or a flexible sigmoidoscopy.  They don’t do that as much anymore because it only finds one out of three cancers and misses two out of three, so it’s – but if for some reason somebody doesn’t tolerate a colonoscopy, if they medically can’t do it, then they will still look for lesions that way.

Huh, I hadn’t heard of that method.

And of course the big question is “How much gets absorbed?”  So the doctors tell us that it goes right through you, it comes on out and none of it gets absorbed.  But barium is a heavy metal, it is a toxic metal, and we are seeing it more and more in people.  I don’t know what to think about this, but supposedly that is what is being sprayed out of the airplanes in chem-trails as geo-engineering.  They can control the weather or something.

Barium?

Barium is one of the things that – and I don’t know what to do with that information.  Where do I go with that?  I don’t know.  All I can do is measure people, see if they have it, and then help them get rid of it.

Right.  Well I was curious about that one.  I have had to do those barium swallows before and it is not pleasant!

No, it is not pleasant, and I don’t know how much of that actually absorbs.  You know, they say not much.

That would be nice to think as you’re drinking it.  And gadolinium?

Yes, the gadolinium is more problematic because gadolinium is injected into your vein as an IV contrast for MRIs.

And some people have some pretty strong reactions to it.

Right.  It has been known to, if you have borderline kidney function, to tip you over the edge and cause kidney failure or worsen your kidney functioning.  And it can cause painful skin all over your body as it builds up.  The action movie star Chuck Norris who was the Texas Ranger in that one TV series, well his wife had a series of I believe like 9 to 11 MRIs and they injected gadolinium every single time and she ended up with gadolinium toxicity.  When we are doing a chelation challenge on people and they had had an MVI in the last year or two, we routinely see very high levels of gadolinium come out.  Now sometimes you do have to have gadolinium to get a good MRI.  Sometimes if you can do without it that’s great.  Sometimes you can still learn what you need to learn without the gadolinium and I encourage you to avoid it if you can, but if you have to have the gadolinium then I would want to do chelation.  Do a series of chelations afterwards to get it out.

Yes, absolutely.  I would imagine the sooner the better.

The sooner the better, yes, to get that level down.

And you would want to come see someone like us for that.  That is not something I have ever heard of as being offered in a hospital although that would be nice.

No, they would never do it.  You actually can – we will get more into that.  There is an oral EDTA called liposomal EDTA.  EDTA doesn’t absorb very well orally, but if you put it into a liposome which is a fat molecule that wraps around it and protects it and allows it to go across your gut wall, then you could self-treat and use that to get the gadolinium out.

It is nice to have options.

Yes.  And then the last one is fluoride – Right?

Yes, that is a big topic.

Yes.  And fluoride – it is hard to talk about fluoride without going right down the rabbit hole.  I have on my bookshelf right behind me a book called The Fluoride Deception and this is all from – government stuff is classified for 50 years and then released, and so all this stuff from World War II is now declassified and so when the Manhattan Project was making atomic bombs, fluoride is one of the byproducts and DuPont (the chemical company) was helping them and they had a plant in New Jersey and they had a fluoride escape spill that killed basically every farm animal across two counties.

Oh my word!

And this was I believe in about 1943 or so.

That’s a large area – two counties!

Yes, that’s a large area and nobody ever mentions, like, what happened to the people.

Right.

So fluoride became a PR issue and so the Defense Department hired the same researchers in a university in upstate New York who had done research on radioactivity and injected US citizens without their consent or knowledge with radioactive materials just to see what would happen to them.

That’s horrifying.

And those very same researchers published the first study showing that fluoride is good for your teeth, by ingesting it.  And so it is now thought that that research was totally bogus, that it never showed that, was never even done perhaps, but this allowed – when those studies were published then – allowed the PR movement to say look – fluoride is good for you.  And then they started getting rid of it by diluting it into our water supply.

Right – it’s industrial waste!

And now we all drink this industrial waste of fluoride and I has never actually been shown to be good for your teeth by drinking it.  It is good for your teeth to put it on your teeth.

Topically.

Topically.  But when you drink it, it actually is very bad for your bones and teeth.  It makes your teeth and bones soft.  It causes bone cancer to some degree, in young men especially.  And now one out of three teenagers in the United States actually has dental fluorosis which is damage to their teeth from the excessive fluoride.  And we tried to get it out of the water supply here in Asheville some 15 years ago.

Right.

And myself and a few other Integrative doctors and dentists in town got spanked at City Council.  The American Dental Association came in with all these experts and called us “baby haters” and showed us – look at all these horrible surgeries children have to use, and they couldn’t even get that, well, these are children who are drinking the fluoridated water!  It’s not saving them!  You’re showing me pictures of kids who were drinking fluoridated water who now have to have dental surgeries.  But the most – my one point I was able to make in the two minutes I was given to speak was that the American Pediatric Association says you should not give newborn children formula that is mixed with fluoridated water.

You know, what really breaks my heart is when I go to the grocery store and if I am picking up a couple gallons of spring water, you see the nursery water and it specifically says nursery water with fluoride for baby.

Yes.  You are not supposed to do that.

That makes me so sad to see that.

No – because it actually causes damage.  So you’re specifically not supposed to give infants fluoridated water, but if you are a minority low socioeconomic person, you cannot go out and buy bottled water to mix for your baby, so this is another racial economic discrimination and it is the only medication that we give people without their consent and without any appropriate dosing.

Right.  If any doctor in the country gave everyone the same medication at the same dose, they would lose their license in a split second. 

We don’t even have control of the dose.  What if this one person is exercising a whole lot and drinking a gallon of water a day.  How much fluoride are they getting compared to somebody else that is drinking 3 or 4 glasses of water a day?

Right – and is there even any consistency with how much is getting put in each water supply?

Right.  So fluoride is a big problem and not only does it cause the bone issues and the teeth issues, but it also causes calcification of our pineal gland which nobody exactly knows how bad that is.  But it causes sedation in some ways.  You know, because it displaces iodine from our thyroid gland, so one of the things that has been done in places of mass incarceration where you want to make the inmates more docile is to give them a lot of overdose of fluoride.

Seriously?

Seriously.  Because it makes, just like high-dose lithium, it can make them a little bit hypothyroid which then takes away their motivation to protest and revolt and things like that.

Wow.

So that has been used through history.

Welcome to AIM For Health: Root-Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

All right, welcome back to our podcast, Ask Dr. Jim Bob.  I am Dr. James Robert Biddle.  I run Asheville Integrative Medicine, and I have our new patient coordinator Joy to help us out today.

Hello everyone!

Today being September 2^nd, 2020 and this is part 2 of Heavy Metal Toxicities.

Right, so in the past two episodes we have been discussing what heavy metals and minerals are in relationship to the periodic table and how they can impact the body.  We focused on helpful minerals and how we need them to function properly last time.  In these next episodes we are going to dig in to how heavy metals specifically and sadly harm the body and why it is so important to get them out.  Then we will wrap up this series later with a look at how we actually get the metals and toxins out of our body.  So we have a lot of ground to cover today.

That’s a lot of ground to cover.  So – this is actually part 3 then, because we split that first recording into two.

Right, and this is probably going to be a 2-part today as well everyone, so buckle in – there is a lot of information. 

So to clarify – the how we talked about last time.  The how of how heavy metals poison us is because they look like nutrient minerals and they poison enzymes.  That’s the main mechanism.  There are several others – they cause oxidative damage the same way that free radicals cause oxidative damage like rancid fat and things like that, but that is the main one.  So what we are actually looking at is the data showing the damage that they do.  The types of damage that shows up, and we are going to take these metal by metal.  We are going to start with lead.

Yes.

And I put together a list of some data a long time ago concerning kids and how these different metals, especially lead and mercury affect kids.  So I am going to go through some of these in kids, starting right from birth.  So here is a study in 1999 from the American Journal of Obstetrics and Gynecology showing that in neonatal kids, right after birth, even if you look at moms who have normal lead levels – so the blood level is considered normal up to 10 mcg/dL.  So a level of 10 in the bloodstream.  So this is less than 10, but if you take the high normal compared to the low normal, there is a dose effect trend in poorer attention and poorer motor control.  So right at birth you can measure deficits in children on high-normal lead levels from the mother.

And aren’t blood levels in and of themselves tricky or a little bit deceptive in terms of whether or not you actually have a lead burden? 

Yes, they do show a lead burden we are finding, but the normal range is so generous that almost nobody is above the normal range and the only time that the blood levels are really useful is when you have a job where you have ongoing lead exposure – so if you are working in a battery factory or a smelter, or something like that –

Right.

And they are monitoring you for occupational exposure, then blood lead levels or mercury levels make sense.  But they do not show what happened to you years or decades ago.  So we’ll see – well, I’ll talk about it right now.  There is a study done by the VA Hospital system looking at lead levels and heart disease risk in male veterans.  And there was no difference in blood levels – everybody’s blood lead level was basically the same.

Ok.

But they used x-rays looking at how much lead is in your kneecap.

Kneecap?

In your kneecap.  Now this is experimental, we can’t do this in practice.

Now you mean floating around the kneecap or actually in the bone itself?

No – in the bone.  How much lead is in your bones.

Stored in your bones.

Stored in your bones.  Because that is where lead goes.  Lead follows calcium into your bones and then when you get older, for example there is a study published in JAMA in 2003 that showed that lead leaking out of women’s bone in postmenopausal women is the leading cause of high blood pressure in postmenopausal women.  So when you are growing up all the lead is going into your bones, and then as you get old all the lead comes back out of your bones, just like the calcium comes out of your bones.

And makes you sick.

And makes you sick.  The leading cause of high blood pressure in postmenopausal women is lead leaking out of their own bones.

And I am willing to bet is also probably incredibly overlooked as a cause of high blood pressure.

Completely overlooked.  Nobody is looking at this.

Now I think Wolverine is as cool as the next superhero character, but I am not feeling good about having metal in my bones.

Right, so in this study in the VA, they used x-rays to determine what your lead – we call it body burden – what your lead body burden is.  And they compared the – they put it into what is called a quintile, so the top 20% compared to the bottom 20%.  Like who is the worst compared – and this is the strongest risk factor ever studied for heart disease.  So for example when you are smoking cigarettes you triple your risk of heart disease.  That is called a relative risk of 3.

Right.

Like 300% more.  If you are a diabetic you triple your risk of heart disease.  If you have the top 20% of lead levels, you have a 9-fold increased risk of dying from heart disease.  So having lead in your bones from your youth is like being a smoking diabetic for your heart disease risk.

Or worse!

Or worse.

That’s terrible!

It is really terrible.  Yes, and it’s not like 3+3, it’s 3×3.  So it is really worse.  So that is an example of – you know, how you diagnosed heavy metal toxicity in conventional medicine is a blood test.  Or a non provoked 24-hour urine test.  But that is only useful for ongoing recent exposures.

Right.  If your exposure was 10 years ago, 20 years ago, 30 years ago – it is not the best test.

You’re not going to find it.  So the test we use, we do a hair analysis.  It is a decent test for heavy metals.  It is a better test for nutrient minerals like magnesium, calcium, zinc, selenium, boron, molybdenum – but again, it only shows fairly recent stuff.  So the definitive test for heavy metals is a provoked urine sample.  So we give an IV of stuff that binds lead and mercury.  We use calcium-EDTA for the lead and other heavy metals and then IV DMPS for the mercury and other heavy metals, and between those two we get all the heavy metals coming out and then for the next 6 hours you collect your urine in a jug and then you shake it up, pour off a test tube, mail it to Chicago, and see what’s there.  And that does not diagnose heavy metal toxicity, but it diagnoses elevated body burden.

Got it.

And then we can treat you for a while.  We usually treat for like a year, 1 ½ to 2 years, and then retest and see how much have we lowered this.

Right, because this is going to be a process.  We can’t just get all the metals out at once.

Right.  So I had extremely high levels and it took me like 4-5 years to get mine down to normal.

All right, so going back to the kids, by age 2 even low levels of lead, again in the bloodstream, low-normal compared to high-normal, correlated with decreased IQ.  In preschoolers blood lead levels that are now diagnostic at the 10 level, up to 25 mcg, directly associated measurable behavioral changes compared to less than 10.

And that is still with what they are considering to be low lead levels.

Well, back then.  Yes.  So the reference range for lead is becoming tighter and tighter.  So since then they have lowered it from like 10 to 7 to 5.  Because the more studies that come out it shows that there is no tolerable lead level.  Like if you study it closely enough, any lead causes problems.  You can measure problems if you look at enough people.

Right, there is no safe amount – it’s just not supposed to be in our bodies.

No safe amount.  Exactly.  Here is a great one, it’s from way back in 1996 using hair analysis – look at the lead levels in hair and it shows it correlates with classroom disruption and attention deficit behavior.  There are some of the types of studies that were done, including looking at hair, that got lead removed from paint and from gasoline in the 1980s.  But this is even more recent.

Here is from age 7 to 11, you’re looking at bone lead levels, correlate with antisocial and delinquent behaviors, aggression, and attention deficits, and that is right out of JAMA in 1996.  Ages 4 to 12 – hyperactive kids have higher blood lead levels and higher urine lead levels after chelation challenge than non-hyperactive kids.  And that was actually studied in Lancet in 1972.  And this is one of the ones they used to get lead out.  So here in the Lancet in 1972 they are using a chelation challenge to measure lead levels, but I had to defend my licence against the medical board for using a chelation challenge to measure lead levels.

Right – and they were doing it on children.

And they were doing it 50 years ago on kids.

Wow.

And showing it’s perfectly safe to do that – it has been studied over and over again, it’s perfectly safe.  Here is another study, this one out of the American Journal of Epidemiology in 1989 looking at kids age 11 to 13.  The lifetime low lead exposure correlates with emotional and behavioral deficits.  Here is one out of the Archives of General Psychiatry in 1983 age 8 to 13 hyperactive kids have higher urine lead after chelation – so they were also using a chelation challenge here.

So, I have to ask the question, this might be treading on controversial waters, but if we are talking about children and preteens and earliteens, and attention deficit behavior issues, things like that – if this is stemming from lead or other metals, is using medication to treat their behaviors going to be effective?

Well, it’s a Band-Aid, right?  It’s like you have, you are driving your car and your check engine light comes on.  And you take it to your mechanic and they reset the check engine light and say “Hey, you’re good to go, go on your way.”  

That’s not going to be good, no!

It’s not going to be good because they didn’t change the problem that was occurring.  So you take it back to the mechanic and say “Hey, the check engine light is on” and he goes “ok, I can fix that”, and he puts a piece of electrical tape over that light on your dashboard, so now you can’t see the check engine light – you’re good to go – keep driving!

Except your not.

That’s what the medications are doing.  It’s not identifying why the check engine light is on and getting rid of the causes.

So the issues will persist. 

And I’m not saying that lead is the only cause of ADD.

Right, of course.

It is one cause.  And there is a whole list of other potential biological causes that can be treated and reversed, but these kids are not deficient in Ritalin.

No.

They don’t have a genetic deficiency of Ritalin.

No one does.

No one does.  So that is not the proper way to treat it.  The proper way is to identify why they have the problem.  Now I don’t have this in front of me, but there is a whole series of studies showing men in prison routinely have higher lead levels.  Lead makes you aggressive, and even more importantly, it gives you poor impulse control.  So most people in prison are actually not significantly more criminal than people not in prison, but they have poor impulse control so they get caught.  And they have racial differences, and socioeconomic differences.  So people with good impulse control who are not a minority and who are not poor, may do the very same things but they don’t get caught and they don’t get convicted and they don’t get imprisoned.  So – yes, impulse control is a big deal.

Yes.

So that is just some examples of lead.  I mean, we could talk all day long about all the studies that show that lead is bad for us and the ways it is bad for us.  So I have mentioned heart disease, high blood pressure, it causes osteoporosis, and then attention behaviors.

Now is the osteoporosis because of lead taking up bone space?

Yes.  Because you have lead rather than calcium and things don’t quite fit together right that way.

So when you chelate then, if you have lead stored in your bones, is that making your bones more brittle because it is taking out what is filling in that space with the metals?

Well, if you are chelating in a clinic that is taking care of the whole person, they are also going to be giving you things like vitamin D, vitamin K, magnesium, and calcium to help rebuild your bones.  So we do not, in my clinic we have not seen chelation cause bone loss and most of my patients actually gain 3-5% per year on their bone density.

Wow, that’s great!

Yes, without using medications.  So, an interesting question that has not been studied that I know of.

Shall we move to mercury?

Yes.

We have a lot to cover.

A lot to cover with mercury.

I have a personal interest in mercury also.  Besides having lead, I had mercury and my mom had very high mercury.  I have a big poster of mercury on my wall.  Our sources of mercury are fish, especially big predator fish because it concentrates up the food chain, so tuna and shark and swordfish are very high in mercury.  And then our dental amalgam fillings release mercury vapor 24/7, and then there is of course unfortunately mercury in thimerosal in vaccines.  And even though they have taken the thimerosal out of childhood vaccines, they have not taken it out of the flu vaccine.  So all these kids getting shot with the flu vaccine, they are still getting their mercury doses.

Now, do you know why – how is mercury getting in large fish specifically.  Why is that occurring?

It comes mostly from us burning coal and some from oil.  We talked about the opening up Pandora’s box last time, and digging all these up and spreading these toxic metals around, so the coal byproducts go up into the atmosphere and they travel all around the world.  It rains, it goes down into the ocean.  The microplankton and stuff in the ocean picks it up, bio-converts it into methyl mercury, and then the small fish eat it, the big fish eat them, and up the food chain it goes.

So that that is how it gets concentrated in the big fish.

Right, so you have a serving of tuna and you’re getting as much mercury as what is in 10,000 tiny fish.   Which is why it is way better to eat sardines which are low on the food chain than big fish.  So you should always eat vegetarians if you can. 

(laughs)

So, what does mercury do to you?  Well the classic symptom of mercury is you’re mad as a hatter.

Right.

So in Alice in Wonderland, the arc type of the hatter, the hatters used mercury to cure the felt hats and before that even the beaver skin hats and things like that, to make them pliable and shape, and they all got mercury toxic and they all ended up in insane asylums, because it makes you anxious and paranoid, and depressed, and you think everybody is out to get you.  It is one of the most toxic substances on earth.  It is much more toxic per molecule than lead is.

That must put dentists at a pretty high exposure rate.

It does.  Dentists have the highest rate of any profession of divorces and of suicide, and dental technicians have the highest rates of miscarriages and infertility, so it is really problematic in the dental profession.  Now when I started practice 80% of the fillings put in in the United States 23 years ago were still mercury.  Now it is down to about 20-30% just because, mostly for cosmetic reasons.  Because I think dentists are kind of getting that in a rational world the lawsuit on dental mercury would make tobacco look like tiddlywinks.  I mean really – it just so much damage has been done.  It is a toxic waste before you put it in, it’s a toxic waste after you take it out.  It’s not safe while it’s in your tooth.

No – not at all.

And I had 12 of these suckers.  So 80% of the mercury vapor that is coming off of those dental amalgams gets absorbed into the body and that was given to congress in a 2000 page report in December of 1997 by the EPA.

And once mercury is absorbed into the body, isn’t the half life of it something like 50 years?

Yes, 25-50 years which means –

It’s never going to dissipate.

Yes.  While 50 years later you still have half of it, that is what a half life means.  So you have only gotten rid of half off it in 50 years.  Coal-burning power plants release 40 tons of mercury into the air and mercury causes brain damage in 60,000 babies born in the United States every year.  60,000 US babies born with brain damage every year just from mercury and mom concentrates mercury into the baby 6-fold.

Really?

So baby is born with 6 times more mercury pound for pound than mom had.  Because Mom used baby as a toxic waste dump.

So the mom’s body is literally just shunting it away to the baby.

Shunting it away, right.  And then also putting it into the breast milk.  So mercury crosses the placenta and also into breast milk.  And so here’s one published in 1997 “Biological Trace Element Research” that shows that is concentrated into both sheep and human breast milk.

Now we have had some people as part of their prepregnancy plan go through chelation, right?

Right – we have done that a lot.  And it makes a lot of sense.

To help reduce possibly passing that on to your child.

Yes.  We did that in my wife before we chose to get pregnant, did detox first.

Here’s an interesting study looking at kids at age 7 and looking back at data from their prenatal mercury exposure levels.  You can show cognitive defects in the 7 year old kids from the prenatal exposure to methyl mercury which is basically what is in tuna fish and the vaccines.

Wow.

So giving vaccines to pregnant women when those vaccines have thimerosal in it really should be illegal.

Right.  Because you are basically just giving that to the baby. 

To the baby.  Yes, mom is going dump that into baby, into baby’s brain.  So that is just a touch of mercury.  Mercury is also associated with about a 3-fold increased risk of heart disease compared to lead having a 9-fold increased risk.  Mercury is associated with a lot of autoimmune disease, besides the neurological things with anxiety and depression, mercury is associated with cardiac arrhythmias and then with increasing autoimmunity.

That’s a lot of risk.

That’s a lot of risk, yes.  So mercury is a big deal and mercury is actually harder to treat.  It is harder to get out of the body than lead is because it is trickier.  There are not as many things that bind it, and it is not as easy to pull out.  You have to have sulfhydryl groups to bind the mercury.  Sulfhydryl groups is what gives rotten eggs its unique smell.

That sulfury smell?

That sulfury smell, yes.  So natural things that have sulfhydryl include eggs, garlic, onions, things like that.  But all the chelators which we will talk more about – they all have a strong sulfury smell to them if they are going to bind mercury.  So again –

So there are plenty of good reasons to get it out!

Lots of good reasons to get it out – that’s right.

Welcome to AIM For Health: Root-Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

Right.  So what is the next thing to talk about with heavy metals.

Well, one of the things I wanted to know more about was testing.

Oh, you wanted to talk more about different nutritional minerals.

Oh sure!

Right.  So I started talking about zinc and zinc is the second most important one.

Is there a first most important one?

Magnesium.

Yes. 

Magnesium runs over 400 known enzymes in the body, including your ability to make neurotransmitters, your ability to relax your muscles.  It’s like too numerous to count.

Right.

Now luckily I don’t know of heavy metals that particularly poison magnesium within the enzymes.

So if you are low in it, it’s just a matter of supplementing or getting it in.

Right.  About two thirds of Americans are low in it.  Half of them are low in zinc, two thirds – so it is the most deficient enzyme and it is the most important one.  Every time you eat sugar you waste magnesium.  Every time you drink alcohol you waste magnesium.  All diabetics are low in magnesium.  So what sits right under magnesium is calcium on the periodic table of elements.  So what is nature’s calcium channel blocker? Magnesium.  So anything that your doctor is treating you with a calcium channel blocker they should also give you magnesium and then if you get enough magnesium you may be able to give up that calcium channel blocker, whether that is cardiac arrhythmia or high blood pressure, relaxing smooth muscles, but also any time they prescribe you an antidepressant, those enzymes in your brain that make your dopamine and your serotonin, your feel-good neurotransmitters, that you are trying to get more of by taking an SSRI like Prozac – they would all work, all those medications would work better if you give them with magnesium, but no doctors ever prescribe magnesium.

There’s no money in it.

There’s no money it in and you get kicked out of the country club.  I actually know two medical practitioners in Asheville – one was a physician and one was a nurse practitioner, one was in cardiology, one was in psychiatry, and then started prescribing magnesium.  And of course they don’t practice solo, so –

Other people knew what they were doing.

Right, they were in practices with 10-20 other practitioners and they get called in to the boss’s office and told to stop doing that or else they will be fired.   Not because there is anything wrong with giving magnesium.  You cannot overdose somebody on magnesium unless they have kidney damage.  If you have healthy kidneys, you will pee off extra magnesium and if you take too much magnesium, you just get the runs and you will stop doing that.

Unless you are chronically constipated – some people do that on purpose. 

Right, but you still won’t overdose yourself unless you have kidney damage.  So this magnesium is the one thing we put everybody, every single person – that is the first thing I want on their supplement list is magnesium.  And zinc, about half the people end up on zinc.  You can tell zinc – interesting little thing, white spots on your fingernails is a sure sign of zinc deficiency.  If you have little white spots on your fingernails, that is a sign of zinc deficiency.

You know, I never knew what that was from.

That’s what it is from.

Huh.

Now we can talk about calcium and I don’t give a lot of calcium because if your vitamin D level is normal and you eat a fairly healthy diet, you will extract calcium from your food and dairy is not a great source of calcium by the way – that is just something put out there for 50 years by the dairy industry.

To sell more milk.

Right.  To help the four food groups – I mean is dairy really one of the four food groups?  No.  I mean it is, but that is not scientific, that was politics.

It is only a food group for baby cows.

That’s right, or any baby mammal.  But calcium interestingly does look like lead even though magnesium doesn’t seem to.  And lead follows calcium into bones and so first of all, lead displaces calcium and causes osteoporosis, and secondly, it stores there for decades and then later in life when you start to get osteoporosis, the calcium comes out of your bones and so does all that lead stored there in childhood.

So then you’re auto-toxifying yourself and you don’t even know it.

You don’t even know it, but it was published in JAMA, the Journal of the American Medical Association, that lead coming out of women’s bones after menopause is the leading cause of high blood pressure in postmenopausal women.  So the information is there, it is just ignored because doctors look at it and go “well that is out of my paradigm, I don’t know what to do with that – what am I going to do about that?”

Right, and if people aren’t even aware that that’s where it could be coming from , then you are spinning your wheels, you’re doing this testing, you’re feeling guilty, and just have nowhere to go.

Yes, they don’t even do the testing.  And it’s not like it shows up in blood levels because you don’t have an elevated blood level of lead.

Not unless you’ve had a very recent exposure.

A very recent exposure, right.  So recent exposures of lead, like if you work in a lead smelting plant or a battery factory or something like that, then you get periodic blood draws of lead to see if you are having ongoing exposure.  That makes sense and that works.  But, if like me you were a house painter decades ago, scraping old leaded paint off, and now you do a blood lead level, it’s going to be perfectly normal.  So we test in other ways which we will get to later, but lead is there and it causes big problems.  Iodine –

Iodine – is a beneficial mineral.

It is a beneficial mineral, and like all minerals it has a therapeutic window meaning if you don’t have enough it is problematic, and if you get too much it’s a problem.  And iodine is poisoned by fluoride, displaced by fluoride because they are in same family on the periodic table of elements.

I did not know that.

Well here it is – look, here’s the periodic table of elements.  So fluoride sits above iodine, far above it.  Fluoride is #9, iodine is #53, bromide and chloride are in-between them.  So it wouldn’t surprise you to learn that excessive bromide and chlorine can also poison iodine.

Well how hard must that be for everyone’s poor thyroid glands to do what they need to do if we are drinking floriated water all the time and something we talk about in one of our classes here is if you eat a lot of raw cruciferous vegetables, doesn’t that also make it hard for the body to use iodine?

No, that’s about enzyme inhibitors.

Oh, that’s enzyme inhibitors.

It’s not about the iodine.

Ok.

Yes.  But, even for example my hot tub, you know, we try to use less chlorine, so what you put in there is bromide.  So I worry about that and in the 1990s baked goods used to be made with iodine and they replaced that with bromide.  And also in the 1990s people started eating this fancy sea salt like Himalayan pink sea salt and things like that.  Right?

Right?

And why is salt iodized?

Because people were getting goiters.

Because people were getting goiters, right?

Especially in the Midwest was it, there was a goiter belt?

That’s right.  So in the 1800s and early 1900s, the majority of people in the northern Midwest had goiters and so that is why they started putting iodine into the salt, to replace that.  But now, we are all eating fancy sea salt without iodine, and we are seeing a resurgence of goiters and thyroid nodules because of that, and then the excess bromide, if you don’t filter the chlorine out of your drinking water, and then you throw in a bunch of fluoride on top of it and don’t filter it out of your drinking water… I will say fluoride works topically on your teeth.

Sure.

It is ok to use fluoridated toothpaste as long as you spit it out and don’t swallow it, and it is ok to do those fluoride rinses and fluoride treatments at the dentist as long as you don’t swallow it, but swallowing fluoride has never been shown to work and it actually poisons teeth and bones and makes them more brittle, not more strong and that has been well published ___________________ and fluoride is a potent neurotoxin, so it is really problematic, and it causes bone cancer, especially in young men.  So iodine is important and we love iodine and we love to do what is called an iodine paint test.  You can test iodine in several ways, but we like to paint iodine on the skin and then see how long it takes to absorb.  The theory here is the more deficient you are, the faster the stain goes away.

Oh yes, sometimes you see people see it has been gone in 2 hours!

Right.  And predictably as they keep painting it day after day, then after 2 weeks, 3 weeks, 6 weeks, sometimes 12 weeks, then the stain will last for 6 hours.  This is not just any old iodine you buy at the store.  This is a particular concentration of iodine made in a compounding pharmacy that we get.

It’s pretty inexpensive too.

It’s like $13.00 a bottle.  Yes, and so that is a way to put iodine into the body and then get a feedback loop on how much iodine, because too much iodine can also be a problem even when you put iodine into the salt, you triple the risk of Hashimoto’s thyroiditis in the population.  Now it’s worth it because you have gotten rid of all the goiters and hypothyroidism.

Are we trading one thyroid problem for another?

You are, but the statistics – it’s a thousand-fold difference.  I mean you are getting rid of 1000 goiters to get one case of Hashimoto’s and when you have hypothyroid people, especially women, if they are hypothyroid and don’t know it, and then they have babies, you have low IQ humans.  Used to be called Cretans, the old name for it which is not socially appropriate anymore.  This is congenital hypothyroidism, but it ain’t no good and it has lifelong low IQ problem, so that is to be avoided.

So, I do like to tell people to replace their iodine.  Go ahead and use your fancy sea salt but get iodine a different way.  But when you get too much iodine you can induce Hashimoto’s and then, some of my colleagues are treating thyroid problems with very high dose iodine.  Now it is thought that the appropriate dose of iodine is somewhere around 1-2 mg a day, but a lot of doctors are giving 25-50 mg a couple of times a day.

What would be the reasoning for that?

Well, there is one and he is a buddy of mine, David Brownstein, and he is well-published and he teaches all over, but they see a lot of people have remarkable improvements in a variety of issues given high-dose iodine, and that is true, but I catch some of the castoffs who end up getting Graves’ disease which is a worse more aggressive form of autoimmune thyroiditis, an autoimmune attack on your thyroid gland, and much harder to treat, and the Hashimoto’s flares.  So I have become more cautious in this practice about high-dose iodine that way.

So what are some of our other good nutritional minerals?  Selenium – an interesting study was done trying to lower the risk of skin cancer by giving selenium –

Really?

Didn’t work; it did not lower skin cancer risk, but it did lower 17 other cancers, including pancreatic cancer especially.

Well, what does selenium do?

Well, selenium just runs other enzymes, at least 50 known enzymes.  It is particularly involved in thyroid functioning, particularly involved in the immune system – so like on our Covid-19 protocol we have zinc and selenium as nutritional minerals on there.

So is it in terms of trying to put things into a package of understanding, that the function of vital minerals is to run enzymatic functions?

It is to run enzymatic functions – that’s what they do.  And you know, selenium is less – I guess calcium is structural too – right?  But selenium – I don’t have as clear idea of the things it does exactly like the zinc and magnesium, but it does do a whole host of things, and what comes to my mind is making digestive enzymes.

Ok, that is very important!

Right, and decrease in cancer risk.  And then running the thyroid enzymes and your immune system.

What about potassium?  Is that a mineral?

I would not call potassium – maybe it is a mineral, I don’t know.  I consider lithium, it’s a mineral, so in the first column of the periodic table is the lithium, sodium, potassium, and rubidium.  Here is what I know about sodium and potassium.  Our brain makes electricity, all of our neurons in our body make electrical signals and talk to each other based upon sodium and potassium channels, so you sequester sodium over here, potassium over here, and then you let them go and they flux across the membrane and then you sequester them back again, and then you have created electricity.  But, lithium sits right above sodium and potassium, and rubidium sits right below them.  Lithium is #3, the smallest element after helium and hydrogen, and rubidium is #37, more a heavy mineral.  They stabilize and augment that electrical activity, and most doctors and even lay people only think of lithium as being used to treat bipolar disorder when you are manic.

Right.  There is a heavy connotation for that.

That’s right.  But they use very high doses like 1200 mg to 1500 mg a day and what it does is it shuts off your electrical activity in your brain – so now you are not manic anymore because everything just slows down, but it also shuts off your thyroid and your kidneys, so predictably that dose causes hypothyroidism and kidney damage over time.

Not good.

Not so good.  Now what we give is a vitamin strength from 5 mg up to 20 mg of lithium and we find lithium to be the most common mineral deficiency when we test a hair analysis.

And that was actually going to be my next question is how do we test for these vital minerals?

Right.  We can test them several ways.  We start with a hair analysis because it is the least expensive.  Right now it is $115.00 and you see a whole bunch of minerals and a whole bunch of heavy metals.  It is not a perfect test because you can have external contamination.

Right.

Or lack of excretion, either because time has passed, or you are a lousy excretor and you’re worn out.  Usually you have chemical sensitivities when you are to that point where you can no longer get rid of your toxins, but it is a good test and there are many things about it we can believe.  Especially when minerals are low and we see lithium low in 4 out of 5 people.  Because lithium is not in our food chain, it is not in our water supply, it is not in our vitamins.  The only place you find it naturally is in lithium spring water and very few people get to drink lithium spring water, but lithium deficiency has been shown to be associated with an increased risk of anxiety, depression, and later on dementia.  The reason for that is you have uncontrolled electricity in your brain burning off your neurons.

Wow.

Yes, and rubidium – less research is done but basically the same information.  Now the difference is that lithium, you have to take it for life, because if you stop taking it you are just going to go deficient again because is it #3 and just goes away.

Right – you can’t replenish it.

Well, you are not getting it anywhere naturally.  You’ve got to kind of keep taking it, so we have people take 5 mg a day for the first year, and then 10 mg a week the rest of their lives just for a little bit of nutritional lithium.

Now could one assume if you do consume spring water on a regular basis that you are getting some?

No – because not all spring water is lithium spring water.

Ok. 

I hear there is a spring in Montreat that has it, so –

Now we do have a way of testing water that we can talk to people about too.

We can, yes.  We send it off to a lab in Chicago called DDI – Doctor’s Data International.  So you can get a hold of them by looking them on-line and it only costs –

$120.00, they look for minerals, metals, and fluoride, even in wells.

Yes, you can see if you have lead and copper coming out of your water pipes, things like that.   And then rubidium we have a little liquid, and that we usually just give people 2-3 bottles and assume it is going to stay there because it is a heavier metal.  You don’t need to take it forever.  But then we would get a hair analysis in a year, 1 ½ years, or 2 years and see how we are doing on those things.  So other things we see on the hair analysis is we will see manganese which we talked about.  We will see boron which we talked about.  Other nutrient minerals like the magnesium and calcium.  It is not a good test for iron but we do test iron in the blood, and then chromium and vanadium.  Chromium and vanadium have to do with blood sugar stabilization.  I am sure they run other things, but what I am familiar with is they help run the insulin receptor site, and so when people show up low in chromium and vanadium I can pretty much tell that they have been a sugar binger, because every time you eat sugar you are using up your chromium and vanadium.

Now I have heard of chromium for a while, because it has been touted as a weight loss supplement.

Yes, but it only works if you are deficient in it.  You know, if you are deficient in chromium then you have a hard time controlling your blood sugar which then makes you put on weight and then taking chromium replaces the deficiency and you no longer have that particular sabotage, but taking extra chromium won’t help, you’ll just become toxic in chromium.  You can become toxic.  Now the chromium that Erin Brockovich found –

Right.

Right – was not this chromium.  That was hexavalent chromium which is a different isotope that is a toxic byproduct of manufacturing.  If it gets into water it poisons people.  And then vanadium is used by body builders to get more cut by helping decrease the subcutaneous fat, but again, it is kind of the same thing.  Taking extra vanadium I don’t think is a good idea, but if you are deficient in vanadium you want to replace that so you have enough.

Makes sense.

Yes.  And then molybdenum – molybdenum, which is rather challenging to say – helps detoxify heavy metals.

Really?

It runs – I am sure it does other things – but it runs an enzyme in the liver that especially helps you get rid of mercury.

Where would one get molybdenum?

I have no idea – usually nuts and seeds, whole grains, and greens.  When people ask me where do you get minerals, that is always the answer.  Now I have a book back here I can turn around and look and find it.  You can go to Wikipedia and look up molybdenum and see where you get it nutritionally, but we get it from a bottle – if you are low in it, and when I see people low in molybdenum, they also have no heavy metals in their hair because they can no longer excrete them.  They are stuck with them – they have lost their ability to get rid of heavy metals, so they cannot put them into their hair and usually they have multiple chemical sensitivities and they are very fragile.  So they walk into a store and go into the detergent aisle and they start to have brain fog and a headache, and if they are really bad and somebody walks by with strong perfume and they will be out of commission for 1 ½ – 3 days, right?

Right.

So when we start giving molybdenum, they start to detoxify.  Interestingly, when you start to give molybdenum you have to watch out if you have a family h/o gout, you can get an acute gouty attack and things like lead and other heavy metals have been associated with increase risk of gout.  So those are some of my favorite nutritional minerals.  I guess copper is in there – copper we occasionally see low.  We usually worry more about copper being high.

And why is that?

Well because people get low in zinc.  Zinc and copper balance each other.  Now you can become deficient in copper if you take too much zinc.  The zinc that we have has a little bit of copper in it to keep that balance there, but high copper has been associated with ADD-like brain dysfunction, so is low iron.  Interestingly, I see that they sit very near each other on the periodic table of elements here.

Right, so those are some of the nutrient minerals and there are certain toxic metals that tend to poison those nutritional minerals.

It sounds like an incredible balancing act to kind of get it all just right, and a lot of this comes from what we eat.

Yes, and people say “Doc, I don’t want to pick up all these bottles and take these minerals – I want to get my nutrition from my food!”  And I respect that, I think that is great.

Sure.

And I say first of all, you don’t live in the Garden of Eden, secondly, because the soils that we grow food in have been depleted.  Now it has been well published that food grown organically in organic farming practices has higher levels of nutrient minerals in it.  Because otherwise all you are doing is like – what’s triple fertilizer?

Triple fertilizer?

Yes, you know what triple fertilizer is?

No, I have never heard of it.

Potassium, phosphate, and nitrogen.  NKP – nitrogen, phosphate, and potassium.

Ok – what does that do?

Well, that is what you put on your lawn, your garden.  You know, there are different ratios for establishing a lawn, versus maintaining it, and your garden, but that’s all it has in it is those 3 things.

Just replenishing what gets depleted out from prior growers?

And that will make plants grow, but then those plants won’t have molybdenum, they won’t have selenium, they won’t have zinc, copper, – they won’t have any of that.  That is what you get from your compost and from manure, from recycling everything.  But soils become depleted in those nutrient minerals, all these nutrient minerals if we are using these artificial fertilizers.

So our food is not as nutritious as it used to be. 

That’s right.  And the particular way, also in vitamins, the different vitamins are low, but the minerals are the big things that they are low in and that has been well published.  So we have got to change how we are farming and gardening and such.

All right.  Well that has been a really great start, and a lot of information.  I am going to be thinking about this one for a while, just trying to absorb it all.  And I want to kind of tease in to the next segment.   Not all minerals and metals have these benefits for us though.  Some of them are not good period.

At all.

And that is what we are going to be delving into next time.

That’s right.  And I will just say lead, mercury, arsenic, cadmium, uranium – you don’t need any of these, and so those are the ones we will be focusing on.

Sounds good.  Now why are you focused on this?  Why is this important to you?

Right.  I come from a working class background.  I put myself through college.  My parents would give me just a little check every semester, but I had to donate plasma every Sunday in order to eat, because my dorm did not serve Sunday dinner, so I would get $30.00 a week and that would get me a 6-pack and Sunday dinner.  Maybe something like that.  To put myself through college I was a remodeler’s assistant for a couple of years, and then had my own business painting houses, so I was scraping old leaded paint off of old houses in downtown St. Louis for summers.  While my friends would go skiing in Colorado on spring break, I would go scrape the paint on these houses in Columbia, Missouri where I went to college and medical school.  So I did that for years and I got gum recession.  Luckily – knock on wood – I lost 4 teeth in junior high to get braces.  They pulled 4 premolars and then they pulled 4 wisdom teeth when I was 18 or so, and I still have all my other teeth but they are all barely hanging in there, because my gums receded and of course they blamed it on me.  “Oh, you are brushing too aggressively, you caused your gum recession.”

Really!

Right.  But now I see that both lead and mercury cause gum recession and root resorption.  Then I had 12 amalgam fillings in my mouth and used to eat tuna fish, and I had severe lead toxicity and I didn’t of course find this out until I started this practice, and tested myself way back in 1997, and found – since then I have only found 5 people with higher lead than me.  And we will talk next time about how I tested.

Sure.

But after treating myself for several years I got those down to normal, so I don’t have to die of heart disease like one grandfather did, or dementia like the other one did.  Now my gums never grew back, but they stabilized.

Now didn’t this also have a pretty profound impact on your memory at the time?

It did – I was blessed to have a photographic memory, I remember in high school taking tests and I would just close my eyes and flick through the book until I could see the page the answer was on, and I would just reread the page in my mind and it was always there for me.  And that went away and I got part of that back.  My mother grew up in a foundry town called Festus, Missouri and she had a birth mark the size of an egg on her thigh, and she was one of my receptionists for 7 years in my practice, and as part of that – we tested her.  She was also profoundly high in lead and mercury, and when we chelated her, her birthmark disappeared.

It disappeared?

It disappeared.  I remember when I was a kid, about that high, following her around and I could tell it was my mom, not somebody else’s mom at the pool, because I could see that birthmark, you know when you are just that high.

Right – that is eye level!

Right.  One time in a grocery store, she was wearing a skirt and I would look up and all of sudden I am hanging on to some other woman’s skirt and I was like “Ahhhh”!

You’re not my mother!

Right!  So my mother said she had never been able her entire life to visualize in her mind’s eye.  You know, you can close your eyes and you could see your mother’s face – right?  She couldn’t see even her children’s faces and she gained that ability for the first time in her 60s when we got her heavy metals out.

That’s incredible!

She said it was amazing.  “Now I know what people are talking about when they say close your eyes and envision this.”  She did not have the ability to do that until she was in her 60s and we got her heavy metals out.

Welcome to AIM For Health – Root Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

Well welcome back – this is our podcast called “Ask Dr. Jim Bob”.  I am Dr. James Robert Biddle, Board Certified Internal Medicine, and here to help me out is our new patient coordinator at Asheville Integrative Medicine, Joy Lambert.

Hello everyone – good afternoon.

Well, I don’t need to ask you what we are going to talk about – we are going to talk about heavy metal toxicity.

Yes we are!

For this podcast and the next two or three!

Yes, this is a huge topic, it is one of the cornerstones of what we do here and something that people generally just want to learn more about.  So we are going to break this up into a series, so we have a lot to look forward to in the coming weeks of learning.

Right, and I would just start by saying why it is such a huge topic – because it’s hidden.  It is completely ignored by conventional medicine.  Why?  Because there is no money in it for big pharma.

Nope.

It affects every cell in your body and therefore every organ system.  It is not owned by any discipline of medicine because it crosses cardiology and GI and neurology and – everything.  I have had my own personal experience with it.

Yes, and I want to ask you about that a little later on as to why this is so important, even personally.

Yes, so we dig down deeper and deeper into people’s cases and more than half the time in people with chronic illnesses we end up finding significant toxic heavy metals as their kind of deepest sabotage.  We find that we cannot get chronic infections resolved until we get rid of it.  We can’t get the metabolism straightened out until we get rid of it, so I don’t know how I would really practice Sherlock Holmes medicine without dealing with heavy metal toxicity.

Right, the cornerstone of what we do is that we want to practice root cause medicine and so many times this is at the root.

This is at the root – the deepest root.

Yes, exactly.  Well let’s dive in, I am excited to start learning more!

Yes.

Ok – so, we are going to start off with more of an introduction today to get everyone’s ears tuning, make sure we have good foundational information.  So Dr. Biddle – What are metals?

Nobody knows.

What?

You didn’t expect that did you?

No, I didn’t!

I caught her off guard!  You know, I did a deep dive in this back in about 2006 because I was on the board of ACAM, the American College for the Advancement of Medicine for 6 years and I was chairman of the educational program.  I taught the introduction to heavy metal class to other doctors.  At one time ACAM was the largest group in the United States of Integrative doctors, and it is still the largest group that teaches chelation therapy which is how you get heavy metals out of the body.

Right.

So for 6 years I basically taught other doctors about heavy metals and at the start of that process I did a deep dive into heavy metals and what I learned is they are poorly defined, because not all toxic metals are heavy, not all things on the periodic table that are toxins are metals.  So what we really end up focusing on is what is toxic to the body that the body should never have.  There are many things that you do need that can become toxic at any dose.

Too much of a good thing.

If I give you 5 gallons of water to drink right now and make you drink it – that can kill you.

Oh, absolutely, and I wouldn’t want to do that!

Right!  So if I give you pure oxygen to breathe, that can damage you.  So all these things that we have to have, anything can be excess.  So the basic definition of a toxin, the toxin is in the dose, but there are many things that we don’t need any of, and you shouldn’t have any of them, and that is one of the things that we look at.

And so some of those fall into the categories of metals. 

Right.

Now am I correct in using the word metals then or –

Yes, some of them are metals, and basically a metal is defined as having a luster.  You know, if it is something that is solid and has a luster to it, but even the solid part isn’t necessarily true because mercury is liquid at room temperature, and even until very cold.  I don’t even know what the freezing point of mercury is, but it is extreme before you are making mercury into a solid.  So some of them conduct electricity, and there are all different things you could talk about, but I just want to say it is very poorly defined.  I can list some of the things and tell you certain things about them.  You know lead; people know you can make bullets out of it, used to make toy soldiers out of it, used to make fishing weights out of it –

Windows – window panes.

Window pain – we still balance your tires with lead weights, which is why the roadways in America are very toxic because those little lead weights fall off and get ground down and so there is this huge amount of lead.  Mercury – people know that is toxic and most people have played with mercury when you broke a thermometer as a child, and they put mercury into dental fillings, and we will go deeper into that at some point, but it is odd that it is a toxic hazardous waste before they put it in and it is a toxic waste after they take it out, but once it is in your tooth somehow it is perfectly safe!

That is certainly going to be something to talk about – that is a big topic in and of itself.

Right.  There is arsenic as in arsenic in old lace, you know, don’t drink the blackberry brandy.  There is cadmium as a pigment in paints like cadmium red.  So, very common exposures there, and cadmium inside cigarettes.  There is aluminum which everybody knows about, it has been associated with dementia risk.

Right, and it is in antiperspirant which we are applying directly to our bodies every day!

It is in antiperspirants, it is in baking powder of most forms, people wrap their food in it, aluminum foil, they cook in it.  There are problems with that – aluminum pans.  So all those are obviously metals, even if mercury is a liquid, you can look at them and tell they are metals.  But how about fluoride?  Fluoride for example is only #9 on the periodic table of elements.  It sits above chlorine and bromide and iodide, but it is toxic.  It not really a metal; it has beneficial uses –

Topically.

Topically – it is toxic if you ingest it.  It should not be ingested from my way of thinking, and there is a whole story to tell about fluoride, maybe we will get there.

Yes, I hope so.

With a waste product of making a ton of bombs in the Manhattan Project in WWII.

Oh, I didn’t know about that!

Yes, there is a whole story to tell about that, about how it started being put in the water and that had to do with atomic bombs and the Manhattan Project.  So it is possible that fluoride is actually necessary for us at some level, but obviously there is a toxicity problem with fluoride too because it poisons the iodine system, you know for your thyroid and things like that.

Right – and doesn’t it also contribute towards the calcification of the pineal gland?

The calcification of the pineal gland – that’s right, so that you won’t become spiritually enlightened.

Don’t drink the water…

Don’t drink the water, that’s right.  So there are all kinds of different things, and then there are many things that are considered nutritional minerals, but if you get too much of those they can be toxic too, for example manganese.  You’ve got to have manganese in order to have proper joint cartilage.  There was a basketball player on the Portland Trailblazers 20 or 30 years ago named Bill Walton, and he was manganese deficient and developed ankle problems.  They gave him manganese and he got better; but too much manganese causes Parkinson’s-like illness –

Really?

And when they took lead out of gasoline in the 1980s, they put manganese into the gasoline so that your car won’t knock.  So if you stand there and smell the gasoline while you are pumping gas into your car you can get manganese toxic.

Not a good form of supplementation!

But yet we find people low in manganese and we give them pills of manganese at the same time.

Right – it’s about the balance.

Right.  And the same is true with boron.  Boron for example runs your hormone receptors, so if you are boron deficient you may have enough hormones but your cells are not going to get the signal, and boron is also in cockroach poison and ant poison.  It is a little white powder you can sprinkle around on the edges of your garage – I have done that myself, and I have seen many people boron toxic from crawling around in their crawl spaces.

Really?

Especially people coming up from Florida where the cockroaches are immense.  Of course in South Carolina they don’t have cockroaches, they have palmetto bugs.

Water bugs…

Palmetto bugs…

They’re gross either way!

Right.  So that’s showing how some things have a very narrow therapeutic index.  Iron – you have to have iron right – or else you have anemia.

Absolutely – but you don’t want too much.

But you don’t want too much because iron rusts, it can rust you from the inside out.  And right now with Covid-19, high iron is one of the predictors of bad outcome because the Covid-19 knocks the iron off your hemoglobin and you get hypoxic.  That is part of how it causes low oxygen long before it causes lung damage, but then that free iron that was knocked off is a severe inflammatory molecule.  It is a reactive oxygen species and so then that is part of inducing that cytokine storm and you get so much inflammatory damage throughout your body.  So I went and donated blood a couple of months ago just to lower my iron so in case I get it I will have better odds.

Right – there is definitely a balance to be struck with that.

Yes.  So you can overdose on zinc, copper, selenium – all these things that are not particularly toxic, but if you get too much of them they can be toxic, and they would be considered nutritional minerals, I wouldn’t call them metals, but they are minerals.  So that is that first question of what is a metal?  It is a tough question and I was shocked myself back in the 2000s when I first started studying that deeply.

Well my next question is – Where do these metals or minerals typically come from in nature? And how have they traversed into the realm of humans and getting into our bodies?

Right.

Because you have got some good stories about this.

You are talking about Pandora’s box.

I am…

This is Pandora’s box.

It is wide open.

Right.  So they are in the crust of the earth and we mine them.  Now I want you to imagine if you will hundreds of millions of years ago when dinosaurs roamed the earth, there was a lot more volcanic activity than there is now.  Now we still have active volcanoes – right?

Oh sure.

Mount St. Helen’s for example.  But back then there was a lot more.  And then over hundreds of millions of years, the vast rain forests and jungles and animals and plants all kind of absorbed a lot of those metals and then got buried.  And now we look at them as fossils.

Fossil fuels.

And fossil fuels.  So we as mammals evolved in a climate with far less lead and mercury and other heavy metals in the atmosphere than the dinosaurs had.  So we did not evolve to tolerate higher levels of those very well.  And now when we dig up coal and oil and frack for natural gas, we mobilize these heavy metals and spew them back out into the atmosphere, so we are opening up Pandora’s box and spreading it around.

That’s a lot to think about.

That’s a lot to think about, that’s right.  I have all kinds of stats about that, about how many millions of tons of lead and mercury have been put out.  One of my favorites is mercury is used in gold mining.

I didn’t know that.

It is.  And right now in the Amazon basin there is a lot of illegal mining going on and huge problems with mercury toxicity, but the San Francisco Bay with the gold rush of the 1850s I believe…

The forty-niners.

The forty-niners – right, that is when it started.  It is estimated that I believe the figure is 100 million tons of mercury was put into the San Francisco Bay over a few decades back then.

But isn’t the half-life of mercury pretty long?

Well, it’s forever.  Now you’re talking about the half-life in your body.  In our body there is a half life of metals, for example lead and mercury it is about 25-50 years, so if I get exposed to lead, it takes 25 years before I have reduced that to half of what I originally absorbed.  In the environment it is forever.  They don’t – the alchemists in the Middle Ages thought they could turn lead or iron into gold by using mercury.  And so they thought they could change one thing into another, but metals do not change from one thing into another, except through nuclear fusion or nuclear fission.  So in the sun they change from one thing to another and in nuclear power plants they do, but otherwise mercury stays mercury and lead stays lead.   Now they can change isotopes, so for example I have a big picture on my wall right here and it talks about 3 types of mercury.  It talks about metallic mercury which has no charge on it and then ionic mercury which has one charge on it, and then double ionic mercury which has two charges on it, so those are all a little bit different, and then you have methyl mercury which has a methyl group just like methyl B-12 has a methyl group on it compared to regular B-12 and that makes it more reactive.   But metals stay metals – they do not really change into something else.

Minerals are the same? Or –

They are the same, yes.  Right.  Magnesium stays magnesium; it doesn’t turn into something else.

Got it.  And so it is through industry and then things like lead pipes and what not that we have exposed ourselves. 

Right.  And classic lead pipes were in the Roman Empire, and they were thought to be part of the downfall of the Roman Empire.

Too much lead.

There was too much lead, right.  And then especially in the Middle Ages in Europe, they still did not quite understand lead toxicity and they made their plates; you know pewter would have lead in it, and they made pewter plates and goblets and especially wine would extract the lead quite efficiently and dose you with it.

If I remember right, even make-up – I think that was suspected to be a contributing factor to Elizabeth the First’s downfall.

Right – lead is in the make-up.  And when I hear about make-up and heavy metals, it is recently, meaning within like as recent as 20 years ago, skin lightening formulas, especially for people of color, had mercury in it here in the United States.

Really?

So this whole society value of lighter skin, people trying to lighten their skin, people would get heavy metal toxicity from that.

That’s terrible.

Truly horrendous.

Now there is so much to talk about with the heavy metals and the negative effects, that that is really going to be the bulk of the next episode.  We have touched a little bit on minerals that are good for us and that our body needs, and I want to learn a little bit more about that – start off with the good. 

The good ones!

The good ones – the ones you need.  So yes, what are some of the minerals that we need, and how do we get them?

Right, and I want to preface this to understand the importance of this is because the main way – there are 4 main ways that metals poison us, but I want to focus on one of them.  And that is they look like nutrient minerals and kick them out of enzymes, the heavy metal, and then poison the enzyme and that is the main way that heavy metals poison us.  The example I like to use is zinc and mercury.

I didn’t know about this until we did my hair test.

Right.  So even my hair analysis 23 years ago showed that I was high in mercury, because I had 12 amalgam fillings in my mouth from when I was a teenager, and my zinc showed high.  But a high zinc in a hair analysis does not mean that you have too much zinc in your body – it means that the zinc is being kicked out of your body by mercury because mercury sits right below cadmium on the periodic table of elements which sits right below zinc, so both cadmium and mercury look like zinc meaning the outer electron structure with the valance looks the same as zinc, so therefore it can slip into an enzyme in our body that runs on zinc and 200 known enzymes run on zinc in our body.

200 for zinc?

200. For example, enzymes in your thyroid gland, for making thyroid and other ones in your tissues for activating thyroid by converting it from T4 to T3. There is an enzyme in your stomach lining that makes hydrochloric acid that runs on zinc, and if you then become deficient in zinc or poison those zinc enzymes, you can’t make hydrochloric acid and then you can’t absorb your B-12 and you get dementia and fatigue, and then you can’t break down your proteins and you get food allergies, and a whole host of bad things happen when you poison these enzymes.  But it is because the heavy metals look like the nutritional minerals.

So if you have metals that are binding with those same receptors that say zinc would, does that mean that our body is not able to use zinc even if we supplement it, or it’s just harder to mobilize?

Well you can push back against it.  You want to load against it.  So in some of these they are irreversible bonds, so for example, an atom of mercury in your nerve cells irreversibly binds to I believe its an actin particle, and then turns that off, and I have a great video from the University of Calgary showing these large snail neurons, the largest neurons in the world.  But pretty much identical to our neurons, just a little bit larger, growing in a petri dish and then they introduce a mercury vapor that is relevant to about the same amount of mercury vapor that exists in our mouth when you have about 6 amalgam fillings – right?

Those amalgams are releasing that vapor…

They gas 24/7 for their entire existence.  And you can see this neuron which is growing all of a sudden start to shed back and peel.  It damages the myelin sheath covering the neuron and causes irreparable damage to that neuron and so that is the type of damage that happens.  So some of these are irreversible binding and some of them are reversible binding.  The reversible ones – this is so fascinating to watch on electron microscopy, I mean I love biology – but this is almost more chemistry and physics.  Because for example, we’ve got to talk about enzymes.

Ok.

So an enzyme can do two things.  An enzyme is a protein that is shaped just the right way, like a lock, that keys fit into it.  And almost all enzymes have some nutritional mineral in the middle of it and so we are talking about the zinc-run enzymes and there are 200 known zinc-run enzymes.  So there is a zinc molecule right in the middle of this protein structure and you can either take two things and hook them together, or take one thing and split it apart.  That is all the enzymes can ever do, but if you then substitute a mercury atom for that zinc atom in that protein enzyme, then it can’t do that anymore.  It stops doing it.  But when you watch this in electron microscopy, things bounce in and out of this enzyme on the average about 50 x per second.

Per second!

Per second.  You’ve got to realize that there are tens of thousands of other molecules around that don’t fit this, so the particular molecules that are going to be hooked together or split apart just happen to find the right place to land in that enzyme 50 times per second, sometimes up to 200 times per second, depending on the enzyme and what it is doing.  Sometimes a little bit slower.  But you have to slow it down on electron microscopy to even see it.

Sure!

So sometimes that zinc is actually trading places with the mercury, they are kind of bouncing in and out, and so some of those may be completely poisoned, some of them may be partially poisoned.

So if the mercury comes out, then it can function normally again with the zinc as it is supposed to?

Right.  Or if it can’t, or if it is permanently then you have to make a new enzyme and put a zinc in there and hope that you get rid of the one that is damaged by the zinc and you have to excrete it and get rid of it, but you have to kind of start over making new enzymes.  Which we do all day anyway.  So as you can see, this is a deep dive to kind of understand how heavy metals poison us and then what to do about them.   And this is something that I was taught, really I don’t remember any teaching about this in medical school or residency.  I mean we had a class in toxicology and I guess maybe they talked about the gross signs and always the most common signs of heavy metal toxicities are gut disruption first; people have nausea, vomiting, diarrhea, and all kinds of gut disruptions with acute heavy metal toxicity, and then central nervous system disruption with everything from brain fog to come, depending on how bad it is.  But we weren’t taught anything about chronic heavy metal toxicity which is what we are really dealing with.

Now since this can be the root cause of so many health issues, and people in the medical field want to resolve health issues, even with the lack of money aside, why do you think it is that this isn’t being addressed?

Golden handcuffs.  You know, doctors are great people, all the doctors I know, 99% of the doctors I have ever met, are great people and they want to help their patients.  But they do what they are told for the most part and unfortunately what they are told to do is the curriculum taught to them in medical school and residency and that all derives from the medical journals and what controls what is published in the medical journals are the advertisers in the medical journals and the only advertisers in the medical journals are big pharma.  So if it doesn’t make money for big pharma, there are no articles published about it, it is not taught in medical school or residency, and doctors therefore think that it must be worthless because of a process called cognitive dissonance.  And cognitive dissonance means that if you are invested in a particular way of thinking, then all evidence that contradicts that will be ignored.  That is called a ruling paradigm.  So, you know, 500 years ago the whole world knew that the world was flat.

Right – that was a given.

So all evidence to the contrary was ignored.

You were crazy if you thought otherwise.

And persecuted.  So Copernicus was threatened with torture and had to renounce that the earth revolves around the sun, even though the evidence showed that it did.  So eventually that paradigm shifted and now most of us believe that the world is round.

Most of us!

Most of us!  You can go onto you-tube and find the people who don’t.  So it’s a paradigm shift.

Right.

So doctors will almost never prescribe anything except for prescription medications that are FDA approved for something, and the FDA approval process on the average takes 100 million dollars and so you cannot get a natural substance FDA approved for something because you cannot patent it and make your hundred million dollars back.

You never would.

Yes, right.  So that is just why when you go to the doctor, the only thing that happens is you get a prescription.  And part of that is the average life of the visit is 7 minutes and what I saw back when I was working in conventional medicine is that giving you a prescription on a piece of paper (now it is on the computer) is a license for me to end the interview and get out of the room.

You don’t need to do anything else at that point.

Well, that’s the only way I can get out of the room and move on to the next patient.  And if you have to see 6 or 7 people an hour, you’re going to get to the prescription as fast as possible and you are not really going – you don’t have any room to investigate why the person is sick in the first place.

I’m glad we don’t do things that way.

No, it is challenging to practice medicine this way but it is fulfilling because you get to help people and see deeper results.

Absolutely.

Welcome to AIM For Health – Root Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

Hello. Welcome to our podcast called ask Dr. Jim Bob. I’m Dr. James Robert Biddle. Yes, that’s Jim Bob, if you take “James Robert”.

>>   Yes, it is!

At Asheville Integrative Medicine and I have our new patient coordinator, Joy Lambert, here to help me out.

>>   Hello everybody. Welcome back.

And Joy, what will we talk about today?

>>   Today we are going to talk about Epstein BARR, virus, something many people may not have heard much about or heard that phrase before.

Mono!

 >>   Also called mono. 

Teenagers kissing disease.

>>   Apparently it’s gone beyond that. And well, this is actually something I’d love to learn a lot about because come to find out, I’ve recently dealt with reactivated mono or reactivated EBV, and I didn’t know I had it in the first place so I thought, this is something to learn about! 

And me too, I got sick this winter. I’ve got a four year old in a preschool, at least until COVID-19, and got four different infections right in a row, right before and after Christmas, and then I couldn’t recover, so I worked myself up, and turned out to be a reactivated mono. And I felt like I was going to die!

>>   Oh yeah, the exhaustion was unbelievable. There’s not enough caffeine in the world. 

Right, right. Did not want to get doing anything. And what surprised me even more than the exhaustion was the apathy.

>>   Right. I didn’t care. It’s like, I want to, but I didn’t even have enough energy for that! 

I want to want to, but I couldn’t.

>>   And it’s upsetting because it’s like, is this me? And it’s like, no, it’s the illness. But what is it? And so that’s what we’re going to talk about today.

What it is…it’s a virus and it’s a virus in the herpes family. There’s a number of viruses in the herpes family. So Epstein BARR virus causes a disease called mononucleosis when it’s acute, but we generally all talk about it and call it reactivated mono. Because when you have your monocytes, which are particular type of white blood cell goes up….And if we’re a little bit muffled, I apologize, but since Joy and I are in the same room talking to you, we’re each wearing a mask to protect each other from the COVID-19 virus should we be asymptomatic carriers at the present moment. So we’re a bit muffled. I apologize for that. We’ll be as clear as we can be. So there are different types of herpes viruses. Most of us, the first one we get is a chicken pox, of course, but you don’t get it any more cause they get vaccinated against chicken pox, but I had chicken pox.

>>   I did too. In fact, I, I went to a chicken pox party to get it over with. 

Yeah, me too. I was the youngest of four children. So my chances were good and I definitely got it. I still have a scar on my wrist from it. Then later in life you can get shingles also called herpes zoster.

>>   What’s that?

That is reactivated chicken pox or varicella virus. So that once you have that virus, it lives in your spinal cord for the rest of your life. And then it can come out along any distribution, and it causes a painful, itchy, blistering rash on one side of the body, usually, unless it’s right on your sacrum, then it’s right in the midline. Then otherwise it’s on one side of your body. It can be on your face. If it’s on your eye, it’s very dangerous, or it can be on your chest or your butt. And worst of all, it can cause a damage to the nerves and cause lifelong postherpetic neuralgia, or nerve pain.

>>   That’s terrible.

It’s terrible. These herpes viruses are nasty. Everybody knows about cold sores. They’re caused by herpes type one, and then genital herpes which is caused by herpes type two. Once you have these, you take them to the grave. And you know, this joke, What is the difference between true love and herpes, Joy?

>>   I don’t know Dr. Jim. Bob.

Yes you do. What is the difference between true love herpes? True love. No, no..it’s the other way. Herpes lasts forever! Yeah.

>>   Yes. 

And that’s just a very cynical joke to point out just how serious it is. I tell that to my patients to point out to them just how serious this is, that once you have this, you have it forever. You’re never going to get rid of it and it can become reactivated again, but you don’t have to have a herpes outbreak every month. There are things you can do to suppress it. And I recovered from reactivated mono. You recovered from reactivated mono

>>   Yes, thankfully. But I want to know more about it because it completely blindsided me. I never knew or was aware of the fact that I even had mono in the first place at any point in my life.  So how do you get it? 

Well, a lot of people get it actually from their own relatives when they’re young. So by the time people hit adolescence, a large percentage have already had it. So when you get it after puberty, then it’s a lot more symptoms. And that’s when you get a lot more of the symptoms of a fever, sore throat, really bad fatigue, and also swelling of your liver and your spleen. And so that’s why people it’s called infectious mononucleosis. You catch it from somebody else. And as a teenager, that’s the kissing disease where you go on your first dates and then you get it from the person you’re kissing. And then you can’t play football for a year because you might rupture your spleen.

>>   That would not be good.

Not good.

>>   And besides you wouldn’t want to play football for the next three months anyway, because you’d be too tired. You wouldn’t even care.

You wouldn’t even care.

>>   Now, if you’re very young below teenage…

You wouldn’t even have any symptoms or not enough to worry about you, I mean, you might look like you had a mild case of strep or something for a week, but it doesn’t usually make little kids really sick obviously.

>>   And if you’re getting it when you’re little, then that would imply that it’s being passed along within the family.

Yeah.

>>   So grandma’s sugars!

Or sharing a glass, or “here sweetie, taste this off of my fork.” You know, it can be spread all those ways. So it is infectious and people ask me all the time, Well, am I infectious? And certainly if you’re actively reactivated, you’re definitely infectious. But even if you’re not consciously reactivated, you’re probably mildly infectious all along, which is how you end up spreading it. So it’s thought that by adulthood, in late adulthood, 60 to 90% of Americans have had it at some point or another.

>>   That high!? That’s almost everyone.

Almost everyone. Right.

>>   So we should be aware of what this is and how it can affect us because we might be dealing with it and not even know it.

Exactly. And then how does it get reactivated? Well, like I said a series of other infections can knock your immune system down and then boom, this virus looks for the opportunity. It’s an opportunist. A car wreck, a divorce, financial stress, social stress. I’ve seen more cases of reactivated mono in the last six months than ever before in my career.

>>   Guilty as charged for me.

Yeah. And part of that may be the fact that I had it myself and so I started testing more for it. Part of it’s the fact that we researched how to do a really inexpensive test now for just $30 to see if people are reactivated. It used to be a couple of hundred dollars. So now we’re able to test more people with no burden financially to them. But I think part of it’s the social, the COVID-19 stress and the political stress that people are stressed out. And this is one of the ways that shows up.

>>   Right. So what are some symptoms that most adults would be looking for since you said children aren’t as likely to have symptoms of it, if we’re talking specifically about reactivated mono. 

Yeah. Right. Well, you know what besides the fatigue, my main symptom was fullness in my head and ringing in my ears…was kind of, it felt like I had a constant low level sinus or ear infection, and I’ve had several other patients have that type of symptom.

>>   When you say ringing in the ears, do you mean like tinnitus?

It was a bit like tinnitus. It was almost more like a water or running water sound than a ringing for me, or the echoing sound like when you go up and down a plane and your ears haven’t popped yet. Stuffy.

>>   I also felt stuffy when mine was reactivated. 

Yeah. Some people will get a sore throat. All of that’s not really common. Yeah. And some people will have abnormal blood counts with the high monocytes, although that’s not as common with the reactivation is with the acute illness. So really you just have to have a high degree of suspicion to test for it, which is why it’s great to finally have an inexpensive test that we can test a lot more people when they’re coming through. Because the number one complaint of all primary care physician visits in the United States is fatigue. Fatigue is the thing that people come in complaining about. And we certainly see it in our practice all the time, you know, because we are the people where we’re the doctor that people go to after they’ve been to the regular doctors and they’re still fatigued. And so this is something we’re wanting to screen everybody for now who are feeling fatigued.

>>   So you mentioned that there’s a test we can do and it’s about $30. So in general, what is that test and are there other ways to test? 

Yeah. If you do a full Epstein BARR virus panel for about $200, it tests four different antibodies to different parts of the virus. The one that talks about reactivation is called the early antigen. And if this is positive, you probably have had a reactivation, at least within the last two years, if it’s at least three to four times the upper limit of normal, which is about 10. So if yours is 30 or 40 on this test, then it’s probably reactivated right now or at least in the last couple of months. Yeah. And if it’s negative, I can tell you that you have not had a reactivation here in the last few months. And it’s not the culprit. Yeah. So the EBV early antigen IgG antibody to be specific.

>>   Good to know. So it sounds like it is absolutely possible to have already had this without knowing it, is it possible to have reactivated mono without knowing it or do you know it always, follow the fatigue and the other symptoms..?

I imagine if you’re an otherwise perfectly healthy person, you’re not likely to have reactivated mono. And if you have reactivated mono, there’s probably something going on in your life that made it reactivated. And if you have reactivated mono, you’re probably not going to feel a hundred percent. Now having said that there’s a lot of people in America walking around far less than a hundred percent chronically, so they may not kind of know the difference. Like, okay, I feel bad now, but I felt bad last year. And I felt bad two years ago how much worse do I feel this year? So they may not kind of get it now. How long can it stay reactivated? I don’t really know. I imagine if you don’t take care of it, it could be reactivated for years kind of reproducing in your body.

>>   So just pervasive fatigue. I mean, it’s almost to the point of brain fog. It’s really hard to function.

Very hard to function with this being very active. But I imagine there are people walking around with a low level reactivation for years at a time. I don’t really know though.

>>   So would you say that reactivated mono in and of itself, I don’t want to use the word curable because we’ve already talked about the fact that we take it to the grave, but is it suppressible?

Is definitely suppressible. Yeah. We reworked our EBV reactivated mono protocol four or five times since you and I came down with it as winter. And our nurse practitioner, Kamilla Fiore, has been really instrumental in doing a lot of that research and reworking that protocol.

>>   She actually first suspected that I had reactivated mono, if not currently in the past, because of the fact that I’ve also been diagnosed with Hashimoto’s, which we’ve talked about before is thyroid autoimmune. And we have lots of things to do for that. But apparently a lot of people who have Hashimoto’s thyroiditis have had or have reactivated Epstein BARR .

That’s right. So one of the triggers for autoimmune disease and especially for autoimmune disease of the thyroid is mono, and especially reactivated mono. I just read on my first paper this week, showing the COVID-19 also causes Hashimoto’s thyroiditis, which is not surprising, it’s a virus, and a variety of other autoimmune diseases, including more incidences of rheumatoid arthritis. So auto immune diseases…when we’re looking at autoimmune disease, reactivated mono is one of the tests that we always run there. So again, like you said, we talked, did a whole show on thyroiditis, so I’m just resisting the impulse to go into that topic deeper right now.

>>   Yes but please feel free to go back and listen or pause us and listen to that show and come back to this, because it always keeps coming back around all these topics. There’s so much overlap in content that there’s just a whole lot of information and it keeps coming back around.

Right. So I guess the real question is what else can reactivate mono cause between besides  fatigue and brain fog and apathy and thyroiditis? Well, there’s a number of autoimmune diseases like rheumatoid arthritis and Sjogren’s syndrome.

>>   What’s that?

Sjogren’s syndrome is dry eyes and dry mouth. So it’s an auto immune attack that causes dry eyes and dry mouth.

>>   Now, is Rheumatoid arthritis…do you think that’s usually, or most of the time that is stemming from autoimmune issue? 

Yeah. Rheumatoid arthritis is always autoimmune. And the question is what’s the triggers and we look at toxicities like heavy metals, and some nutritional deficiencies, but really chronic reactivated infections, and particularly for rheumatoid mycoplasma pneumonia, which is one of the walking pneumonias, has been historically in my field of medicine, not in conventional medicine, but in my field of medicine, thought to be one of the biggest triggers. But there is an association between mono also.

>>   And I’m glad you mentioned conventional medicine because that leads me to the next question, how is mono or EBV typically dealt with in conventional medicine?  

Go home and rest for three months.

>>   That’s it?  

That’s it. They got nothing because conventional medicine mostly relies on big pharma medications. They’ve been patented. They have a big profit margin and there’s nothing, there is no prescription drug that treats mono, you can treat herpes type one and two and herpes type six with the antiviral medications, like acyclovir and like Valtrex, but there is no prescription drug that treats the mono, unfortunately.

>>   And that is why I am so glad to be here, connected with this practice, because I know that we have things we can do to help treat this, besides just telling people to go home and rest, even though resting is really the only thing you want to do, but there is more to it than that. 

Exactly. So how do we treat mono? Well, first of all you do need to rest. And you need to eat right….and you stop eating sugar, you need to give your immune system a chance. But we want to use a number of nutritional supplements. So we kind of put together a protocol. And when I see somebody with a new diagnosis of this, I had them do number one through six. And if they get better, great, if they don’t get better than I add in seven, eight and nine. And if you get better, great, if they don’t do better than I’m gonna recommend more aggressive things like IV vitamin C or Hyperbaric Oxygen Therapy.

>>   Yes! And I’m a big fan of that.

And luckily, because we have this clinic, I was able to access those right away and I got better quickly. And then I relapsed for just like one week and I could just feel it come on. And I got better again, after more hyperbaric treatments. So it was like a switch turning on and off. Really.

>>   Yeah. It’s amazing how the body really will tell you, I need more, or this isn’t working. You need to step it up.

So one through six on the protocol, number one is vitamin C. And what we want is 500 to a thousand milligrams, three to six times a day.

>>   And what is the vitamin C doing for our immune system?

What is the, you know, that is a great question!

>>   I’m putting on spot. 

There’s just an article published this week. I was just looking at it. It’s a small group. It’s only 42 patients, 21 in each arm, but it was using a multivitamin, a versus placebo. And the multivitamin especially had zinc in it and a thousand milligrams of vitamin C, which is high for a multivitamin. And they were looking at the common cold and this study was done before the COVID-19, but it was just published this week. And of the people who got the common cold, those in the treatment group, their symptoms lasted an average of three days. And those in the control group, their symptoms lasted six days.

>>   Really?

Yeah. So this really supports Linus Pauling’s work on vitamin C and helping decrease and avoid the common cold symptoms. And then he took that on to treating cancer also. So I believe what vitamin C does…one of the things it does is your white blood cells basically use iron and vitamin C to create hydrogen peroxide, to then kill invaders. With viruses you don’t really kill them, you deactivate them. A bacteria you can kill. Viruses aren’t alive so you can’t kill them. They’re like little nanobots that are just hijacking your software and replicating…taking your hardware and replicating themselves. Right. But they deactivate that and slow down the reproduction with the hydrogen peroxide, which is why it’s also important not to have low iron.

>>  Right! Being anemic does not help the situation.

Does not help the situation.

>>   And just so there’s no confusion, you need to have enough vitamin C in your system for your body to do what it can do to make the hydrogen peroxide. You don’t just want to go drinking hydrogen peroxide or anything like that. You can not consume it. Your body will do this on its own.

You know, it’s possible that hydrogen peroxide can be useful, but I have never really supported experimenting with that. I think it could be risky, and vitamin C doesn’t last very long in the body. So you’ve got to take it multiple times. So I like to just take a water bottle and take powdered vitamin C, put it in your drinking water and carry around, drink it all day. Now Vitamin C will have a gut limitation. If you take more at one time then you can absorb, it goes into your colon and causes diarrhea, and it causes a gassy bloody diarrhea and you’ll know it. So that’s called bowel tolerance. And if you’re acutely ill, you want to push it up to bowel tolerance and then back off a little bit, find your bowel tolerance. And when you’re acutely ill, the bowel tolerance can be really quite high. It can be 20 or 30,000 milligrams a day.

>>   So it’s not something that you can overdose on, with vitamin C…to keep taking it?

Nope. Keep taking it. And when you get loose stools, take less.

>>   Now, what are some other vitamin C options?

Well, besides IV vitamin C and powdered, you can take capsules I’m not a big fan of chewables because they tear the enamel off your teeth.

>>   Well, that’s good to know.

Yeah. But otherwise, usually the capsules come in 500 or a thousand milligrams or tablets. But, but I really liked the powder because it’s like emergen-C, but a jug of powdered vitamin C is about a fourth the cost per dose as emergen-C is.

>>   And then you don’t have to think about it. Every time you drink, you’re getting it in. You don’t have to have that moment of, I forgot to take my supplements!

Right. Supplement number two is Lysine. L-Lysine is an amino acid. It looks like L-Arginine and herpes viruses like to eat L-arginine. L-arginine happens to be high in nuts and seeds. So when you’re sick with one of these herpes viruses, you don’t want to be eating a lot of nuts. In general nuts are great foods. I prescribe nuts as part of a healthy diet all the time, but this is the one aspect that, and being allergic to nuts, you want to cut down on them. So the L-lysine and looks like the L-Arginine and the viruses gag on it as a metaphor, if it slows down the reproduction, that’s what happens. And the next one, the third one is Lauric acid.

>>   What does that do?

Lauric acid is the short chain fatty acid in coconut oil that does the same thing the lysine does. It kind of gags the herpes viruses and slows down their reproduction. So we have a product called mono-lauren, it’s specifically designed to treat mono. There’s also a product called Laura Suydam. Suydam means to kill. So it’s Lauric acid to kill the mono.

>>   And what about just eating lots of coconut oil?

Lots of coconut oil is a great longterm strategy. That’s right. Acutely, you’re not going to get enough to treat the acute mono, but once you recover to stay recovered and keep it suppressed, you want to work the coconut oil into your diet about two tablespoons a day.

>>   Excellent. I’ve already got that down.

The third thing is Transfer Factor. And Transfer Factor is an active ingredient of colostrum and colostrum is that clear fluid that comes out of the breast for the first week after a baby is born and is full of things to support the immune system of the baby. And we steal this from baby cows. I always have a moment of sadness for the baby cows, but it’s good for us. And it’s usually two to three capsules, acutely twice a day. And then for maintenance once a day on an empty stomach.

>>   And why is that? 

Because it gets broken down otherwise and lost in the food. The lysine should be on empty stomach tube cause amino acids kind of get lost into proteins and then you don’t get good blood levels. So in order to get the blood levels for the L-lysine and for the Transfer Factor, you want those on an empty stomach, the Lauric acid, since it’s a fatty acid, it goes better with food.

>>   And what’s the general rule of thumb for an empty stomach designation?

About 20 to 30 minutes before you eat or two to three hours after you eat, depending on how good your digestion is.  And by the way, the dosage on the Lauric acid, we have as capsules of 600 milligrams. So you’re going to be doing three of those twice a day to start with, or the granules, it’s about the same. So 1800 milligrams twice a day. And then a couple of minerals, zinc and selenium. So zinc 30 milligrams and selenium 200 micrograms with food. Never take those on an empty stomach. You always want to them with food.

>>   They are hard on the stomach.

That’s right. And you can start off twice a day with those, but then pretty soon drop back to once a day, meaning after the first few weeks probably, and then we have this thing called Cat’s Claw, that’s an herb, but a cat’s claw doesn’t absorb really well, it can be hard on the stomach. So this is processed into a product called Cat’s Claw Elite. Meaning it’s mixed with phospholipids and lemon balm and Rose oil…and the phospholipids kind of make it into a liposome so that that can go right into your system way better than  the bulk herb does have the cat’s claw. Cat’s claws also used to treat things like Lyme disease, for example. So it’s very nonspecific. It’s good for what ails you, if you’re infected with almost anything. And that’s like a three pumps, three times a day to start and then gradually go down to two pumps twice a day.

>>   And that is something that we have here at the supplement store direct, so people can get that.

That’s right. So that’s number one through six vitamin C lysine, Monolauren, and Transfer Factor, zinc and selenium I put together as number five, and then Cat’s Claw Elite. And then people say, well, you know, how long should I continue with those? And the answer is, I don’t know, until you feel better. And then, and then cut the doses in half and, and make sure you keep feeling better. And then after a few weeks, cut the doses in half again. And then after a few weeks, if you’re good, then you can really back off on them. And you might just stay on some vitamin C and lysine longer term and some coconut oil for maintenance.

>>   Oh, absolutely. I mean, especially if they’re good for being antiviral in general and not just this, it’s good to have in your arsenal. 

Now, if you don’t get better, then you add in seven, eight, nine, which is colloidal silver, humic and fulvic acid, and oregano oil capsules. So colloidal silver this is one of those things….it took me 20 years before I was brave enough to recommend colloidal silver to people.

>>   Why is that?

Because of the medical board, because silver is a toxic heavy metal. So I could…my rule of thumb in my practices, I close my eyes and I imagine myself on a witness stand in a hostile courtroom with a nasty lawyer, badgering me. “Well, Dr. Biddle, how can you possibly prescribe silver for people?” And if I can’t defend myself, I’m not going to use it in my practice because first of all, I’ve got to keep my medical license to keep helping people, right?

>>   Yes. We want to stay in practice!

Right. And finally, there’s enough experience and research out there that I believe colloidal silver is effective and safe if it’s a good brand. And the whole theory on this is the smaller the particles, the more dangerous it is for the bugs and the less dangerous it is for us. That’s the theory. And I believe that that turns out to be true. So you don’t want to try making your own silver at home. There are these little kits we can make your own colloidal silver. Don’t do that because there is no treatment for silver toxicity or argyria, and you’ll end up blue for the rest of your life.

>>   Blue, sad?

Blue colored skin, like the Smurfs. Like the color of your surgical mask, permanently. And there’s no treatment for it.

>>   That would be hard to adjust to.

You want to buy the really good stuff. The brand we use is called our Argentin-23. So, the dosage, you can spray it, you can gargle with it. The dosages can be anywhere from a few sprays a day to several tablespoons a day.

>>   So it sounds like silver would be something that’s more of a short term measure.

Yeah. Short term measure. I don’t really like it longterm, like a few weeks at a time generally. Even though I believe it’s safe, I’m cautious with things. And then the humic fulvic acid I frankly know less about, but I am convinced it helps, and Kamila’s done deeper research on it and she’s really convinced it helps. It’s stuff taken from ancient not really fossil beds, but ancient soils that have been fermenting for thousands of years. And somehow that helps our immune system and the availability of our nutrients. And then oregano oil capsules. So these are just what they sound like. They’re little capsules with a oregano oil. You can’t just drink liquid oregano oil.

>>   Oh, that would burn a lot. 

Yeah. We have that because we give it to people to put underneath their toenails to treat their toenail fungus. Right. It’s good for that. Yes. And you want to take oregano oil with food. You want to take it in the middle of the meal cause you’re going to belch it up otherwise. And if you do belch it up, you can put it in the freezer and swollen, frozen. And your belch them up less.

>>   The capsules?

The capsules. Swallow them frozen.

>>   I never would’ve thought of that.

Yeah. And the other main side effect of oregano oil is that Italian men will chase you down the street.  You’re going to reek of oregano.

>>   Now the oregano oil, it’s specifically created in a way, it’s not quite the same as just, you know, whatever oregano spices you have in the house.

Yeah. It’s concentrated from that. I mean, it takes pounds and pounds to make a bottle of oregano oil. It really works. We used it long ago for suppressing gut yeast and we still use it for that, but it really does work systemically to for many different things. Almost any infection it’s good for. And those are the things we’ll go on to you is olive leaf extract, echinacea, berberine, licorice, reishi mushrooms, sometimes supporting your adrenal glands is really important. If you tend to be an adrenal person, this is a time where your adrenal glands take a huge hit. So there’s the whole adrenal protocol to do…beta glucan, a low dose naltrexone. I’m not going to go into that today, but if you can look up low dose naltrexone and how it boosts the immune system, and then if all else fails you get a series of IV vitamin C and that’s usually 25 to 50,000 milligrams. Now there are places you can go to and get this, but I believe at Hydrate the most they’ll give you is 15 grams at a time without a doctor’s order specifically. And it gets pretty expensive, especially there. But we’ll give 25 to 50,000 milligrams or 50 grams at a time and try to do it for a couple of times a week for several weeks, then that that’s really good at suppressing viral infections or other infections, and then hyperbaric oxygen, which is the pressure treatment. And have we done a show on hyperbarics yet?

>>   We have not done a podcast on it yet. There is a brief video on our website, so people can start with that. But I always love talking about hyperbarics. So I think there should be a podcast coming up soon.

Right. So almost all infections hate oxygen. The only infections that like oxygen are malaria and  Babesia – a tickborne disease related to malaria and they’re parasites, they’re not a bacteria or or a virus. There are actually multicellular parasite organisms growing in us. So that can be why they like oxygen, but otherwise all the infections hate oxygen and if you put yourself under pressure it forces the oxygen into your bloodstream, much like a bubbles in a soda bottle, under pressure. And that gets to where the bugs are a lot better. And I think that’s, I don’t think I was able to get the IC vitamin C just from the schedule being so tight and full, but I was able to come in after hours and get the hyperbarics and that really made a difference for me with these infections. And we have the hyperbaric chambers that you can take home, you can rent them, take them home, set them up at home. If you do that for two weeks, it’s only $42 a treatment. In the hospital it’s a thousand dollars a treatment.

>>  Oh yes. If you can get it covered.

Yeah. Yeah. And they won’t even let you do it for stuff like this.

>>   Right. This would be off label. 

In clinics like this it’s $100 …$175 to $200 a treatment often. So it’s great to take one home. And if you got reactivated mono you’ll think that’s the best $1,200 you ever spent to get it suppressed.

>>   Absolutely. Plus you can take a nap while you’re in the chamber having your treatment.

Yeah. And you can also be on your device in the chamber. It’s not a flame risk. These are low pressure, low oxygen chambers so there’s really no danger. One in 10,000 people will rupture an ear drum…that’s, that’s the worst thing that happens.

>>   Right. And we tell people the warning signs to look out for to hopefully prevent that from even happening at all.

And I’ve had two ruptured eardrums, not from that, but from other things. And I’m still, you know, they healed. They heal just fine. Yeah. So that’s how we treat the Epstein BARR virus.

>>   Question. What about vitamin D?

Yeah. Vitamin D deficiency. It has been one of those things that has been shown to be a bad outcome for almost every infection. Lately the COVID-19, I assume it’s a bad outcome for this. So we want to crank people’s vitamin D level up. We want most people on five to 10,000 units a day at 10,000 years a day in my experience about 5% of people will be overdosed. So you’ve got to start measuring levels when you have to higher doses to make sure you don’t overdose. But then we also check a vitamin D ratio.

>>    And what is that?

A relationship between vitamin D, which is scientifically known as 25 hydroxy vitamin D, to it’s downstream metabolite called calcitriol, which is scientifically known as 125 dihydroxy vitamin D. These two things should be even-steven in your bloodstream. Like if your vitamin D level is 50, then your calcitirol level should be around 50. But if your calcitriol, if you’re sick with a chronic reactivated infection like mono or walking, pneumonia or heaven forbid, Lyme disease or something like that, then you’ll have a high vitamin D ratio where you convert vitamin D accessibly into calcitriol, and you’ll have a ratio greater than 1.5 or even greater than two. So your vitamin D will look low at like 20, but then your calcitriol will be 60. So that gives you a vitamin D ratio of three. Now we know you’re really sick and we know it’s from an infection and that’s a great clue.

It’s not a perfect clue, but it’s a really good clue that helps us determine what realm we should look in. You know, are you feeling lousy because you’re infected or is it that you have a mercury from eating too much tuna in your sushi, or led from scraping the paint off your house, or is it that you’re completely low in B12 or…why is it that you’re feeling so bad and this vitamin D ratio is one of those things to help us head a certain direction of chronic reactivated infection.

>>   So as you do better, and especially if you’re vitamin D deficient, a supplement to get it back in your system, or spend more time in the sun, you’ll see that ratio become restored?

Exactly.

>>   That is really comforting to hear because I was deficient last year and I just did some testing a few weeks ago and my ratio came back right at one. So that makes me feel a lot better.

So that’s an additional, because that’s going to normalize faster than your Epstein BARR virus early antigen is going to drop. So we do measure sequentially this Epstein BARR virus, but you’re not going to remeasure that for three to four months. And it’s just going to go down a little bit. It’s still going to be positive. It’s going to be a little bit lower than it was, and that’s going to be good news, but it’s going to take…it’s going to take a year or two for it to go negative all together.  Because it’s an antibody. It’s going to hang it out for a while.

>>   And like you said, who knows, who knows how long we may have been walking around with this reactivated…

But now if you feel better and your vitamin D ratio is normalized, then we can be confident we’ve done our job.

>>   Yes, absolutely.

All right. Well, thanks for joining us and you keep doing your job of protecting yourself and protecting each other and thank you, Joy, for helping out today.

Welcome to Aim For Health: Root Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

Hey, Joy. Welcome back.

>>   Welcome back, Dr. Jim Bob.

So we’re listening to ‘Ask Dr. Jim Bob’, I’m James Robert Biddle M.D. and I run Asheville Integrative Medicine, and our new patient coordinator, Joy Lambert is here. We’re doing part two of diabetes podcast on July 23rd, 2020. And part one covered, “What is diabetes? How do people get diabetes and what are conventional treatments for diabetes?” Now we’re going to talk about how do you get rid of type two diabetes.

>>    Right! Because you left us with the hope that this is reversible. So what are we going to do?

That’s right. Well, since the last time we talked about medications, I’m going to just reiterate that we do like Metformin. And there’s a group called Life Extension Foundation that puts out a magazine, and they sell supplements and they sell “do it yourself” labs. And they usually don’t like any prescription medications, but they wrote a 10 page article a couple of years ago in favor of Metformin, for the same reasons I’m in favor of it, in that it decreases obesity, helps you lose weight, decreases insulin resistance, and helps you recover from diabetes at the same time as decreasing cancer risk.

>>  Those sound like good thing!.

That’s right. And we talked about some people don’t tolerate Metformin because it gives them gut irritation and loose stools and the major side effect you gotta watch out from Metformin is it can make you  B12 deficient. So you’ve got to watch out for B12, besides that it’s extremely inexpensive and most people tolerate it well in lower dosages. So we use that a lot, but the fundamentals before that is diet and exercise…it’s lifestyle!

>>   Absolutely!

And we’ve got to see the stress response. We talked last time about testing for sleep apnea. So we’re not going to go into that again, but we do an overnight pulse oximeter on people. We have to teach them how to eat. And we talked about the fundamentals of that is you need adequate protein. You need healthy fats, and to know a healthy fat from an unhealthy fat, and, you need lots of fiber, and you need less carbs. And that’s all an individual kind of a calculation for people based upon what they weigh. How much of that is muscle versus fat, how much insulin resistance they have, how much they exercise, how old they are.

>>   And this is something we can help all of our clients figure it out as they get started. 

We can help our clients figure that out. That’s right. I mean, the fundamentals are: eat less sugar and starch, eat more fiber. I’ll say more about fiber….the American eats about 15 to 20 grams of fiber a day.

>>   Is that enough?

No, not nearly. The recommendations are about 30 grams of fiber a day. What’s really good is about 40 to 50 grams of fiber a day. What indigenous cultures eat is about 80 to 100 grams of fiber a day and fiber stabilizes blood sugar, cause it slows down how fast we absorb the sugar. It is the substrate for your good gut bacteria, your probiotics, right? Everybody’s talking about the biome, right? The microbiome. And the only two things that actually have been shown to change your microbiome are how well you eat, meaning how much fiber you eat, and how well you avoid pesticides, like Roundup in your diet, and how well you exercise.

So there’s that. And then fiber binds toxins. So you poop them out rather than constantly reabsorbing them in your colon wall. Fiber decreases your risk of diabetes, heart disease, many types of cancer, colon cancer, breast cancer, prostate cancer. So we’re big fans of fiber. And I particularly like ground flax seeds. Most people tolerate them. They have healthy fats. We want you to grind them up fresh, not getting pre-ground cause they go rancid quickly. Once you grind them, if you want to grind a big batch, just to put them in a Mason jar and put them in the freezer.

>>   That’s where I keep mine is in the freezer. And then it’s super easy. I just mix them in water and drink it with food, or put it in soups, or put it on food. 

Yep. Our allergy nurse, Jan likes hers on salads. I like mine and smoothies or an oatmeal. But there’s lots of ways you can get your flaxseeds in. Usually about two tablespoons a day is good. If you don’t tolerate that for one reason or another then we use Acacia fiber, and it’s a brand called Heather’s Tummy Fiber because it’s purely soluble fiber. And therefore it does not cause the gas and bloating, which is why people don’t tolerate the flax seeds sometimes is gas and bloating.

>>   And it really is a completely tasteless. You mix it in water. I’ve tried it before. You can’t even tell that it’s in there.

Yeh, you can give it to kids.

>>  It’s an easy way to get fiber. And just because we cannot stress this enough, how many times a day, since we’re talking about fiber and all the good things it does in our gut, how many times a day should we be pooping? 

How many times a day do you eat?

>>   Three.

** To continue reading the transcript, click here and scroll to page 3.

Hello, this is James Robert Biddle, MD at Asheville Integrative Medicine. We’re doing a show called ask Dr. Jim Bob. And today is July 23rd, 2020. And our new patient coordinator, Joy Lambert, is here to help us out.

>>    Hi everyone. Good to see you. Good to hear with you, haha.

What are we going to talk about today?

>>   So today we are going to talk about a very big topic that can affect a lot of people, diabetes. We hear a lot about it, but I want to know more.

Diabetes. What do you want to hear more about?

>>    Well, first of all, I want to make sure I have a solid understanding of what it is. So I’d like to go back to the basics and start with, what diabetes?

Right. Well, very simply it is uncontrolled blood sugar. And why is uncontrolled blood sugar so bad for us? The answer is caramel.

>> Caramel? Like the ice cream topping?

Yeah, like the ice cream topping. It caramelizes us. Have you ever made caramel?

>>   Yes.  You just put sugar in the pot, cook it.

With what?

>>   Butter.

And butter has protein in it. It’s a dairy protein. And what happens when you cook it is the sugar gloms onto the protein and makes that caramel.

>>   And you’re saying that happens in our body?

In our bodies! It is a normal part of aging. We are all getting caramelized, constantly. It is the major way that we age….is the proteins in our bodies get “sugared” and destroyed. Once you caramelize a protein it is no longer functional. So the proteins here that are very important are the proteins on our tiny nerves, and our tiny blood vessels, and our kidneys, and our eyes and our heart. And when your blood sugar is high, they caramelize at a much higher rate. And that causes premature aging, which then causes diabetic damage and complications.

>>    So consuming sugar is literally fueling the fire of aging and the caramelization process with it.  

It is, but if you’re not diabetic, you can consume sugar and your blood sugar won’t move.

>>   How do you do that?

Well your pancreas releases a hormone called insulin, which controls blood sugar, because keeping that blood sugar normal – between about 80 to a 100 is vitally important because our we are a wonderful product of (insert your belief system here)…..but in biology we have these wonderful mechanisms for what’s called homeostasis and keeping things at good levels. And so the most important thing to understand about blood sugar is that it will make you age prematurely through caramelization. And then this is what causes the diabetic complications. But again, if you’re not diabetic yet, your blood sugar will never get very far out of range because your pancreas releases insulin.

>>    And so the insulin regulates our blood sugar? 

Right. And how does it do that? Where does the blood sugar go?

>>  Where does it go?

So you eat a lollipop and your blood sugar tries to spike and your pancreas goes, Oh, no, let’s make some insulin. And the insulin says to all the cells in your body “take up the sugar”, and what do we do with it? We have two choices. We can either burn it for energy or stored as fat. So insulin says, especially to the liver and the blood vessel walls and other places, “store fat, store fat, store fat.”

>>   Well, we need fat, especially if we’re potentially facing times of famine or crisis. We want to have those reserves to weather the storm. 

We do need fat, but the majority of Americans are now overweight. So most of them don’t need more fat. And when you drive your body into a chronic messaging system of “store fat, store fat, store fat”, you can no longer “burn fat, burn fat, burn fat”. So you have a metabolic choice to make of either storing fat or burning fat. And that message of being stuck in “store fat” is called insulin dominance or insulin resistance, so that you’re making more insulin on a chronic basis than people should be making. And here’s an interesting thing, I’m a big fan of medical trivia, our pancreases are actually bigger than they were a hundred years ago.

>>   To compensate for our sugar consumption? 

Yeah. So in the year 1900, the average amount of sugar eaten per year by an American was five pounds per year. Now it’s over 150 pounds per year, plus throwing in about 24 pounds of artificial sweeteners per person, per year.

>>    Now, when you say sugar, are we talking about just processed sugar, white sugar, cane sugar…or? And what about fruit?

Now this is a great question. Natural sugars do generally process slower than refined sugars, mostly because they’re bound up in fiber, and then they have nutrients to help your body process them. But the being bound up in fiber slows everything down. And so for example, if you’re eating refined sugar versus chewing on a stock of sugar cane, you’re going to get a much different blood sugar surge on the refined sugar, cause it’s no longer bound up in fiber.

>>    So then it sounds like it’s better if you’re going to have something sweet to have something that has fiber with it to slow down the insulin spike?

That’s right. Sure. And so, even though fruits can certainly raise your sugar, the type of sugar in it, and the fact that it’s still bound up in a natural substrate helps mitigate that some, yeah. But one of the things that people get very confused about is they will go “avoid sugars”, but then they continue to eat starches…

To continue reading the transcript, click here.

Hey, this is Dr. James Biddle, otherwise known as Dr. Jim Bob, and this is the 18th of June, 2020. We’re going to talk about sleep apnea! And this is our new patient coordinator, Joy Lambert, to help me out with this. If our voices are a bit muffled is because we’re sitting across the desk from each other with masks on because we’re still in the pandemic. So we are doing our physical distancing, not social distancing, but physical distancing, and protecting each other by wearing masks. So sleep apnea.

>>    Right? What is sleep apnea? Because it really provokes an emotional response from people. And I thought, maybe we should understand that. 

Yeah, nobody wants to have it, right!?

>>   No!

Nobody even wants to be tested for it, because they don’t even want the risk of having it. They don’t want to find out about it. Well, apnea is the absence of breathing. And so sleep apnea is when you stop breathing when you’re asleep – not to be confused with insomnia, which is when you don’t sleep, you only have sleep apnea when you’re asleep. So therefore you usually don’t know you have it because you’re asleep and you’re not there to watch it.

>>    Now, when you say stop breathing, what does that mean, exactly? How long?

Well, it can be anywhere from about 15 seconds to almost two minutes.

>>   Almost two minutes?

Yeah.

>>   But at three minutes without oxygen, isn’t that when you start having problems?

Yeah. Yeah. And I had one patient in his thirties forget his C-PAP machine when he went to spend the night at his girlfriend’s house, and he slept on her couch and woke up dead. Well, she found him dead in the morning. So this can be…..that’s an extreme case…but this can be lethal. My own brother will not go to sleep without his treatment device because he wakes up gasping. But that’s rare. The vast majority of people with sleep apnea don’t know they have it. And that’s the big problem. Because then they’re in denial and all they know about is they don’t want to wear this mask on their face that they associate with Darth Vader.

>>    Well then the question stands, if you don’t even know that you have it, if you’re not aware of it, you’re not waking up gasping in the middle of the night, then why do we need to be concerned about it?

Right, why bother? Yeah, I guess it wouldn’t matter except it causes a whole host of medical issues. So when you block your airway off at night, and most apnea is obstructive sleep apnea where the base of your tongue blocks the back of your throat, and we’ll talk about the other type (central sleep apnea) a bit later, but most of it is obstructive sleep apnea. And when you’re in the deepest stages of sleep, then your muscles of your jaw and your neck relax, and the base of your tongue blocks your airway and you stop breathing. And then you come out of deep sleep in shallow sleep, you kind of roll and flop around and you open up your airway and you know, SNORT, right, to start breathing again.

>>   Yeh, the gasping.

But usually that does not wake you up. It just keeps you from getting deep sleep. But if you don’t have long stretches of deep sleep, like at least 20 minutes at a time, you don’t transfer your your short term memories into long term memories. So now you have a cognitive deficit cause you can’t remember what happened yesterday very well. And you have learning difficulties, and you know, your job performance is going to go down and your school performance is going to go down. So that’s the tip of the iceberg. The next thing that happens is a stress response. So this is as if I sneak into your bedroom and choke you and then right before you die and you start to flop around and wake up, I let go and hide. And then I choke you again.

And this, this might just happen, you know, the cutoff is five times per hour to treat people, but I’ve seen people where it’s happening every 45 seconds.

>>   That must be an incredible adrenal response.

Yeh 30 -40 seconds. Exactly. So you’re having a stress response. You’re releasing cortisol, you’re releasing adrenaline, which is epinephrine and norepinephrine. And so the cortisol is causing weight gain, it’s causing blood sugar spikes, it’s causing pre-diabetes and diabetes, it’s causing high blood pressure…. So untreated sleep apnea is one of the leading causes of fatigue, obesity, high blood pressure, diabetes, and strokes. So these have major health consequences when left untreated. So it’s a big deal, and it’s a really under valued problem. It’s under recognized by conventional doctors. And we talk about this over and over again, whenever we ask the question, why is this not recognized enough by conventional doctors? And the answer is always…

>>   Because there’s no money in it!

Because there’s no money in it for Big Pharma, right!? Now, there is going to be money in it for doctors who test and treat sleep apnea who do sleep studies and such, and we’ll get in… when we get into the treatment we’ll talk about ways you can avoid paying out the big bucks, you know, and treat it more effectively yourself, for the most part.

>>   Now, can this set you up with inflammation throughout body as well?

Sure. Yeah, absolutely. You know, all that cortisol and excessive…it can cause inflammation, all the obesity does that, for sure. But fatigue…when people are dealing with fatigue, which is the number one complaint and why people go to the doctor’s office is chronic…having fatigue. This is one of the things you got to test for. So let’s talk about testing.

>>   Yes, how do we do that?

The usual way to do that is to go to a sleep center and spend the night in a lab with all kinds of wires and cameras hooked up to you, and it costs $1,500 to $2,000 and you get observed and that works very well. But it’s expensive and there’s often a wait time. And then even if you’re positive, you have to go back again to get treated. We do a $35 overnight pulse oximeter which is just a little machine you wear on your finger. It’s a finger clip! But this one has a little computer hooked up to it. So it graphs your oxygen all night long. And we print that out and we can see if your oxygen is remaining normal, in which case you’re fine. Or if you’re having a zigzag pattern because your oxygen is dropping below 90% every time you’re going, SNORT!

>>   Right.

So, you know, that’s just a screening test. It’s not perfect, but it’s good enough that we can identify, separate out who is a high risk versus who is a very low risk for this.

>>    Well, it sounds pretty noninvasive then as a way of getting started.

Yeh, it’s very noninvasive. Getting started and an inexpensive way to do it. And then there are conservative ways to treat it. So you can pull the base of the jaw forward by using dental devices. And if you go to a dentist, these cost around $1,500 to have made custom fitted, but you can get them for less than a hundred dollars over the counter that are semi-custom that you kind of adjust it to yourself, you boil it, you fit it, you bite it. And about half of people can treat their sleep apnea that way. Now you have to have good teeth. You can’t have bridges. If you have implants, you’ve got to check with your dentist first. You can’t have missing teeth, loose teeth….I can’t do that because I have gum recession and I tried that and my teeth moved on me, because they’re not rooted deep enough, but that can work for a lot of people.

>>    So that just physically holds your jaw in place so that it doesn’t slide back and block your airway. Right? 

Right, because the base of your tongue is attached to the jaw there. And the other thing you can do is side sleeping. For most people, their sleep apnea is much worse when they’re flat on their back, but much better when they’re on their side. And we like to distinguish between forced side sleeping versus hopeful side sleeping. Every day somebody will tell me, “Oh, I sleep on my side, I go to bed on my side and I wake up on my side.” And I say, “but look, your PulseOx shows that you have these four times in the night where you have about a half hour to 45 minutes where you’re having a really dense sleep apnea. Guess what, you were on your back, you rolled over, you rolled over you’re asleep!” You don’t know. So that’s hopeful side sleeping. Forced side sleeping is where you actually position yourself so you can not roll on your back. And ways to do that are big pillows and the weighted blankets, or wearing something. We like people to get a tight t-shirt and a sock and three or four tennis balls and stick the tennis balls down the sock. And then sew it or staple it to the back of the t-shirt. So you looked like a dragon, and then you’re not going to roll…you’re not going to lay flat on your back then.

>>   No, no, you wouldn’t be able to!

People also sell these things that look kind of like a bra worn backwards that have blow up balloons that you put back there and they can do the same thing. But that can help a lot as forced side sleeping, and then you can use tongue devices. So I actually use one of these.  It is kind of a little suction thing and you put it on your tongue and there is a part that sticks out in front of your teeth and it basically holds your tongue forward. And if I do that and forced side sleeping, then I can treat my sleep apnea. And I did that for years until I had shoulder surgery a year ago and then I couldn’t sleep on my side. So then I went to the standard treatment and that is a C-PAP, which stands for Continuous Positive Airway Pressure.

Now I actually recommend not getting a C-PAP, but instead getting an auto titrate bipap, and the bipap part of that means you have a higher pressure when you’re breathing in and a lower pressure when you’re breathing out. So you don’t feel so suffocated on the machine and you’ll still keep your airway open much easier to breathe with that.  And the auto titrate means there’s a pressure range. So the settings on these are measured in a column of a centimeters of water. So an average pressure would be like 8 to 13 centimeters of water of pressure. But my inhale, for example, might be set at 8 to 13 and my exhale might be set at 5 to 10, so that I’m never having that same pressure on the inhale exhale, but yet it changes should I gain or lose 20 pounds, or be on my back versus my side, the little computer on the machine can change it minute to minute.

>>    It’ll adjust with you!?.

It’ll just all night long, yeah. And that makes complaints way better. It makes it more comfortable. Because the biggest problem people have with the C-PAP is feeling claustrophobic or suffocated with it, and this really helps reduce that.

>>   And they’re not what they used to be, not at all!

They’re not what they used to be! They’re smaller, they’re quieter, they have humidifiers, and I’ll tell you what, when I first got mine about a year ago, I felt so much better. When my sleep apnea was even better treated, I wake up in the morning with a clear head rather than this foggy head and with more energy and kind of ready to go. And that makes a big difference for people.

>>   Absolutely!

Makes a huge difference. But it is amazing…this is the area I get the most pushback from clients even wanting to test them. A vast majority of people are like, Oh, I don’t have sleep apnea. Well, how do you know? Well, I, I just don’t. Because there’s the psychological resistance because they just don’t want to think they have it…because they don’t want to end up with a CPAP machine, or they’ll never try the CPAP machine because they’re assuming that they won’t tolerate it. But people…actually the vast majority of them love their C-PAP machines!

>>   Right! So much better.

Do you know anybody who does?

>>   Absolutely. Yeah. I have family members who use it and they just cannot believe the difference it makes…and that it’s quiet! You still have to run a fan if you like the white noise at night, because they’re so quiet that it doesn’t keep anyone else up. And I have to admit, I fell into that category the first time you asked me to do the overnight PulseOx. I was like, no, I don’t have sleep apnea, because I never was told that I snored or anything like that, and I just didn’t feel like I was not breathing at night. But I was surprised to find out that I did. And now I can do something about it. 

Yeah. Exactly. Now I guess the next thing to talk about maybe is the central sleep apnea.

>>   Yes.

So central means it’s coming from your central nervous system, or your brain. And so the obstructive sleep apnea, the blocking of your airway, the central sleep apnea is where your brain forgets to breathe. And this is almost exclusively caused by prior head trauma like concussions and such, whether that’s blows to the head or falling down, or football or soccer or car wrecks, domestic abuse…whatever it is that people have suffered, those blows to the head can cause post-concussion sequelae that can show up as a brain that’s not functioning right to send signals to keep you breathing. And so you just stop breathing. And the problem is the C-PAP doesn’t treat that effectively because the C-PAP waits for you to initiate a breath and then augments it, you know?

And so if you don’t initiate a breath, it’s not going to initiate one for you. So that has to be diagnosed, and you have to get a special type of …it’s almost like a ventilator, obviously they’re not putting a tube down your throat, but it’s kinda like a pacemaker where if you don’t breathe for a while, it will start a breath for you, right!? It’ll kick in. But even better than that is to get rid of the central sleep apnea. And this is another thing that conventional medicine misses, because the only way I know of to treat central sleep apnea and reverse it is with hyperbaric oxygen therapy.

>>    So you’re saying it could actually be cured? 

You can heal those parts of the damaged brain by doing an extensive series of treatments in an HBOT.

>>   And how does that work?

Well, this is a chamber that you get into, and it has higher pressure and higher oxygen, and it pushes that oxygen into your bloodstream. And if you just breathe oxygen that goes onto your red blood cells, but the problem is your red blood cells never leave your bloodstream. So they don’t get into those wounded areas of the brain as good. But, for example, when you open up a beer or a soda pop, those bubbles come out, and why are they dissolved..those bubbles of gas dissolved into the liquid? It’s pressure. It’s a gas law. And by having higher pressure we can actually push oxygen into your serum or plasma. And the serum or plasma exchanges across the capillaries with the interstitial fluid and that actually does get increased oxygen to your brain, especially to the mitochondria in those brain cells.

Because a lot of these brain injuries, what happens is that part of the brain isn’t actually dead or there’s a little part that is dead, but there’s an area surrounding it called the penumbra. And the penumbra is in shock. It is idlingIt’s stunned. It’s not dead, but it’s not working. And we can wake that back up again. So for example, in stroke victims, we can see a 25% to 50% recovery and functioning with hyperbaric oxygen, even years later, sometimes the earlier the better. It has great promise for brain healing. Again, unfortunately, conventional medicine won’t let you use their hyperbaric oxygen chambers for brain conditions. They only use it for non-healing wounds or gangrene, right?

>>   Mmm, it’s that approved for that.

It’s not FDA approved for that, but then neither am I. But I still work!

>>   Hahaha, Yes!

But HBOT still works to heal injured brains. So that is how we treat central sleep apnea.

>>    How long do you think someone would need to do HBOT treat the central sleep apnea?

I think you need at least  40 to 60 treatments for a good start. So it’s an investment for sure. But you know, having that recovered brain is amazing. Because people see other things change in their life that didn’t even realize. They can see depression and anxiety get better, their thinking get better….all kinds of things that they didn’t even realize had happened because of that brain injury can get better.

>>    And is there a chance then that they may not even need to use a C-PAP? If it’s central sleep apnea?

Yeah. If it’s primarily central and non-obstructive, that could happen. Most people have a combination though. Yeah, for sure. All right. Let’s also talk about the treatment. Again, the usual treatment is to go for a sleep study and then get a CPAP. And usually people are trying to use Medicare or their private insurance to pay for all that.

>>   Right, it’s expensive!

It’s expensive. And sometimes if you have a high deductible and if you have copays, you can still end up with thousands of dollars out of pocket with all that. And you’re never going to get the bipap or the auto titrate bipap. You’re only going to get the straightforward C-PAP cause that’s all that Medicare or insurance are going to pay for. So a lot of the times what we’ll do is have people buy their own machines with cash out of pocket, and you’ve got to buy a machine, you’ve got to buy a mask ,and you’ve got to buy a cleaner. There’s an ozonator cleaner called SoClean and that is $300. So all together that’s going to be somewhere between $1,200 to $1,500 investment, but that can be less than your copay. And you’re going to get a better outcome from it. This is what I did is I didn’t mess with my insurance, trying to get them to cover all this. I just paid for it. And I got the best thing, the best, most up-to-date machine out there and works really well.

There’s a company called second windC-PAP, there’s a few others, but second wind C-PAP dot com. And they’re really good at walking you through this. And then you’re not tied to, you know, going to see a physician every six months to make sure it’s all good and paying vendors a huge amount of money. So it saves you money in the long run also.

>>   I was impressed, I had a family member need to get a newer bipap and got it from second wind C-PAP, got the first one from there, and the price was almost half as much in a matter of three years… recently got one for about $500.

Is it going down, like a calculators, back in the day.

>>   Oh yeah. Right.

And by the way, we don’t own stock in a second wind CPAP. We don’t make any money off of them.

>>   No! Just glad to have access to it.

Just glad to have access to it. Yeah. So it’s good that people can have that. Now, I would like to go back to the question of why in the world do we have sleep apnea because I don’t know the exact prevalence, but I’ll tell you it’s way more common than people think. And one of my patients is a retired high school biology teacher, and he couldn’t believe that he’d have C-PAP because he was like, it doesn’t make sense for us to evolve, to have sleep apnea. That doesn’t make any sense. Well, maybe we didn’t evolve that way. Maybe it’s a condition caused by our environment. And in fact, there’s a dentist named Weston A Price, who 110 years ago traveled the world because he wondered why in the world Americans had to have their wisdom teeth pulled and had crooked teeth and had to get braces, because it didn’t make sense to him…it didn’t make sense to him why that would be the case. And when he studied indigenous peoples all over the world who ate primitive diets, rather than refined Western diets, he found that their jaws are bigger than ours. And they had a room in their mouth for all their teeth, including their wisdom teeth. And they had broad faces. They were universally very happy, no anxiety and depression. You have no mental health issues. Of course, you know, they also lived in tribal cultures. So they were connected. So social disconnection is the cause for a lot of our psychological issues. But I believe that that very same problem of having small jaws is why we have sleep apnea. Now. I had four wisdom teeth pulled.

>>   So did I.

And I had four premolars pulled for braces in high school. So I’m missing eight teeth. Imagine how much bigger my jaw would be with eight more teeth.

>>   You would have to be!

I would have more room my mouth for my tongue, and it would not be pushed to the back of my throat and blocking my airway. So I believe that that is the reason. So this is why I give my preschooler a piece of xylitol gum to chew every day…when I think of it…to try to strengthen her jaw, because there’s two components, one is on a refined diet, you’re missing nutrients. And the second is you’re missing exercise of your jaw muscles, and all of our muscles grow bigger when you use them the right way. And even our bones will grow denser and stronger. So like if you have osteoporosis, what’s one of the primary treatments? Exercise.

>>   Absolutely. Weight bearing exercise.

Weight bearing exercise, right!? To make those bones grow denser, even in elderly people. Well, when you’re young, not only do they grow denser, but they grow bigger. So you got to use that jaw and I’m not talking about flapping it talking.

>>   No, we’re talking about gnawing on some carrots!

Talking about gnawing on some raw carrots. There you go.

>>   Now, is that something that we could do as adults to try to help strengthen our jaws or would it not actually change the size of it? 

No, it’s not going to change the size of it, and the dentists love to do surgery. So there are ways to…you can operate on people. For example, my sister in law and the Netherlands, she actually had a type of surgery done on the back of her palate that cured her sleep apnea. As far as I’ve seen in the United States, that only is successful less than half the time. And it’s quite an invasive surgery. The dentists like to split your jaw and advance your jaw and artificially lengthen your jaw. I’m not very interested in that procedure, but you know, there are some surgical approaches, but that’s, that’s not my niche. You know, my niche is trying to get things resolved as efficiently and with the least invasive….and the least expense approach. So that’s what, that’s what we’re after. That’s where we’re often using the conservative measures for this. So, what else….do you cover about sleep apnea?

>>   Well, because you encounter so much resistance to it, and, and I hear about it a lot from people calling with questions, I was just wondering if you just had a, just kind of a message  you wanted everyone to know, about how you really feel about it and why this is so important to you?

Well, breathing is fundamental…and at first I really got this the time that my brother said that he would not go to bed without his CPAP machine, because it scared him, he’s afraid he’s gonna die. And then I had that young patient die. And then I myself got diagnosed. So I’m a really healthy person. If I can have it, anybody can have it. And I’m not overweight. A lot of people think of Pickwickian syndrome, which is from a Charles Dickens novel, a guy named Pickwick who was a big fat guy, is the classic person with sleep apnea back then, and I know my grandmother had sleep apnea. We used to make fun of her. She’d fall asleep in her chair and go SNORT SNORT and we’d all laugh and stuff. But now I realize that was killing her. But you know, I’m not overweight, I’m at perfect body weight, and perfect health. And so if I can have it, anybody can have it. And you don’t even have to feel bad to have it, but it can still be aging you prematurely.

>>   Right. It has such a detrimental effect.

Such a detrimental effect in the long run. And here’s the interesting thing about stress is that heavy people get heavier and thin people get thinner, because thin people deal with adrenal fatigue. So I was dealing with adrenal fatigue and entry to sleep apnea makes that worse. And then you actually lose weight and get even thinner. Whereas people who are tending towards obesity will get heavier.

>>   From the cortisol.

From the cortisol. So stress kind of goes opposite directions for those two camps of people and sleep apnea is a fundamental stress that we’ve got to resolve to really have perfect health.

I think that’s about it, right? So don’t be afraid to get tested, but you don’t have to go spend thousands of dollars. You can do a simple, overnight pulse oximeter to get tested and screened, and you can often resolve it with conservative means. So this is Dr. James Biddle, aka: Dr. Jim Bob, and we’ll talk to you next week. Bye bye.

Hi, this is Dr. James Robert Biddle. I’m at Asheville Integrative Medicine. Today is the 16th of July, 2020. We’re doing a little show, a podcast we call ask Dr. Jim Bob.

>>    Hello everyone. This is Joy Lambert, new patient coordinator with you as well.

And, Joy, what we’re going to talk about today?

>>    So today we’re going to talk about PANDAS. That’s right, I said PANDAS, but I’m not talking about the cute black and white teddy bears.

I love the teddy bears!

>>   I do too, but there’s another type of PANDAS that not a lot of people know about, and this is something I don’t know a lot about, so I’m looking forward to learning as well. I’ve got a whole bunch of questions for you… 

It will not give you warm fuzzies…

>>   … No, unfortunately not, but I wanted to talk about PANDAS. We’ve had some inquiries about it, so I thought this would be a good one to jump into.

So what is PANDAS?
PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep. And what that means is, you get a strep infection and then there’s a protein on the strep that your immune system starts to attack, that happens to look like a protein on your brain.

>>    And when you say strep, you mean strep like we all think of you get strep (throat)?

Yeah. Group A beta hemolytic strep. There’s lots of types of strep. There’s good strep in your gut, there strep that grows in women’s private parts, there’s all kinds of different types of strep. You know, there’s a strep from under-cooked hamburger (which is) a little bit different…

>>   Right, but we’re talking about strep throat.

We’re talking about strep throat, but the funny thing is you don’t have to have an obvious strep throat to get this. And this is actually the classic example used in medical school to teach doctors that infections can precipitate autoimmune disease. Because before 60 years ago in the United States, one of the leading cause of heart problems (and congestive heart failure) was damage to your heart valves from rheumatic fever and rheumatic valvular heart disease. And that was the very same thing, but the target, rather than being on your brain was a protein on the heart called an M protein for myocardium protein.

So you would get a strep infection, it would get untreated or out of control, and you get rheumatic fever, which means you have these really high fevers and skin rashes. Scarlet fever goes with this same…sort of thing, same thing basically. And then you end up with an auto immune disease of your immune system attacking and destroying your heart valves. Now I have never seen a single case of this in my entire career. I’ve seen people who had it when they were kids who are now old people and have pig valves and mechanical valves because their valves were destroyed, but I’ve never seen an actual case. And I assumed it had gone away completely. I just looked it up…it turns out in developed countries, there are still about three cases per a hundred thousand populations. That means, you know, in Asheville, we should have three people who still have this.

Now this is prevalence, not incidence. This is not per year. This is per lifetime. So in Asheville, three people in their lifetime will have rheumatic valvular heart disease stemming from strep, but in non developed countries, especially in Sub-Saharan Africa and parts of Southeast Asia, it can be up to 444 per hundred thousand. Which means if you looked at the city and size of Asheville, then there’d be almost 500 people with this problem during their lifetime, and that is because of lack of medical care, lack of antibiotics, less hygiene, those things. So I didn’t realize that rheumatic valvular heart disease was still around on a worldwide scale, or even still in the United States. But what’s interesting is that it has evolved now into this other thing called PANDAS.

>>    Does it matter if you get strep once or you have strep 10 times? Is there a cutoff point where once you have it this many times, you’re likely to have it turn into something else?

I don’t know. In fact, the majority of kids that I’ve had, you don’t have to be a kid, but the majority of kids I’ve had with this did not actually have obvious clinical strep throat. So you can have this situation without having strep throat. So what does PANDAS look like?

Well, PANDAS looks like inflammation of the brain and it shows up as other diagnoses, including obsessive compulsive disorder or OCD, Tourette’s syndrome, which is ticks and vocalizations that you don’t intend to do, anxiety, depression, and especially separation anxiety…and the kids who weren’t having separation anxiety start having separation anxiety when their parents leave them at school or something like that….and then meltdowns and rages. I know somebody personally who has this and when their strep is activated, they have the volume knob on the radio on increments of five. They have to, has to be a volume of 20 or 25 or 30. It can’t be 22 or 23. That’s the type of OCD. And this can come out of the blue or it can kind of be stuttering for years.

>>    Does it seem to matter or have more prevalence between boys or girls?

It’s actually thought to be more common in boys, but in my practice I’ve seen it be about even, So I’m not really sure, but it can be either. It does seem to run in families. And I don’t know if that’s genetic or if it’s environmental….

>>    Well, because of all these symptoms you’re talking about, and it seems like it can be manifesting in different ways, is it possible for it to be confused with other disorders and be missed altogether? 

Well, I think the disorders get diagnosed. Their anxiety gets diagnosed, their OCD gets diagnosed…it can show up as ADD –  attention deficit disorder….those things can get diagnosed, but then the cause for it is what’s getting missed, because like I said, you don’t have to have obvious strep and you’re not going to do a blood strep test for a more chronic strep unless you think of it. And it’s just a matter of thinking about it. And this is not necessarily alternative medicine. This comes straight out of university professors in pediatric neurology figuring this out, but it takes usually 20 to 30 years between the time that people, meaning scientists and researchers, discover stuff like this to the time it actually becomes medical practice in the hands of primary care physicians.

And that is usually only sped up if there’s some brand new drug with a huge profit margin, that Big Pharma is detailing doctors on. And that’s not the case here because all you do is give antibiotics for this. So when these kids are diagnosed, the usual treatment is to give the 10 days of antibiotics and the types of antibiotics are usually the penicillin antibiotics, like a amoxicillin, Augmentin is the best medication for this…Zithromax, which is also called a Zithromycin works and Cefdinir, which is called Omnicef, works for this. And if all else fails, I’ve seen penicillin shots work. Now, literally they are a pain in the ass and moderately expensive, but that was the treatment for rheumatic valvular heart disease…is that you would get penicillin shots starting twice a week, and then once a week, and then once every two weeks, and then once a month for years or decades, because if you didn’t people would recur.

Now, what I see is that these kids tend to fall into three different categories.

>>   What are those?

One is you find it, you treat it and it’s gone. And you never have to worry about it again. That’s optimal. It unfortunately is a minority. The other end of the spectrum is I have kids who are still on antibiotics years later, like more than two years later. And this is kind of like the rheumatic valvular heart disease, where you got to stay on antibiotics. Every time I try to take them off, they relapse. And I’ve got a couple of great examples of kids who are actually in special ed classes because they had to have an IEP, an Individualized Educational Program, because they had such challenges in their behavior and learning deficits. But within a couple of weeks of getting on antibiotics, they were mainstream, they were at the top of their class, their social abilities dramatically improve. But then every time I try to take them off of antibiotics, they relapse.

>>   That sounds really challenging.

Yeah. So nobody wants to keep kids on antibiotics long term, but we’d much rather have them on antibiotics and be normal functioning kids than to be relapsing. And then we, I get kids who get better and then we can take them off the antibiotics…and what happens is they go back to school and there’ll be a strep outbreak and they’ll get exposed and then they’ll relapse. And they might need a round of antibiotics once, twice, three times a year, but they don’t have to be on it continuously.

>>    Now, before we get into some of the other options that we may have besides antibiotics, I wanted to backtrack a little bit and talk about diagnosing it. How do we look for it?

There’s a couple of simple blood tests. One is called an ASO titer or “Antistreptolysin O”. It’s the antibody that we make to a particular protein on the strep. And if that’s elevated, then you can be sure that somebody has had an active strep infection recently, if it’s negative or borderline, there’s a secondary test called anti-dnase-B test, which is an enzyme that the strep makes. So it’s a bit more direct test. And sometimes that’s positive, even when the ASO titer is not positive and those are pretty definitive for it. Then every once in a while I get somebody who’s kind of a borderline case that we’ll just give a trial of antibiotics. So you can always do a clinical trial and see if they respond.

>>    So it sounds like casting a little bit of a broader net here than there just being a PANDAS test that you either are positive or negative for?

Well, you got to think about it. You got to take these kids who, especially if they have a sudden onset of obsessive compulsive disorder, anxiety, ADD, Tourette’s, seizures…..I had one patient who had trichotillomania, which means that her symptom was, she pulled her hair out and ate it. And that was her form of OCD. So this can show up in different ways. I have another patient who had narcolepsy, which means they fall asleep suddenly during the day and we’re on medications for that. And this turned out to be what it was, it was the brain inflammation from PANDAS. So this can show up in different ways….you just have to be suspicious. But these aren’t expensive tests. These tests are like $20, $30 each to do. You just have to think about doing them.

>>    Which leads me into the next question: Are there specific characteristics that might make some people more susceptible to having or developing PANDAS?

Yeah. What I’ve seen is if you’re low in iron. We’ve got to have iron to make our blood cells, obviously. But we also have to have iron to run our immune cells. So our white blood cells basically take iron and vitamin C and make hydrogen peroxide. And that’s how we kill off infections. So if you’re chronically low in iron and you don’t even have to be low enough to have anemia, you can have a normal blood count, you don’t get anemia until there’s one lab test called a ferritin is less than about eight, but anything less than 50 can actually inhibit your immune system and your energy and your thyroid and how your brain works. But especially your white blood cells use the iron environments to make hydrogen peroxide. And if you’re low in iron you’re shooting blanks, so you can’t suppress these infections. So we got to get that up. And the other thing that I’ve seen is kids who are growing up in restored or not restored Victorian homes with a lot of lead dust and mold, because all these old 1920 bungalows and Victorian homes in Asheville have these basements that are unfinished or crawl spaces that are moldy and they’ve got lead. And a that’s a common thing I’ve seen is kids living in old houses that have mold or lead exposures.

>>    And of course, if a parent is suspicious and they’re thinking about, “well, I don’t know if my child has low iron levels or not…” talk about an iron supplement because you don’t just want to start doing that, right? Just on your own, taking an iron supplement?

Well, there’s problems with iron overload too. About 10% of the population has genes for hanging onto too much iron. So you want to measure iron directly. And this is one of those things that doctors just don’t do routinely. They’d measure your blood count and chemistry profile, maybe they measure your thyroid, but they don’t think to measure your iron. And I think iron is essential. It has a very narrow therapeutic window, meaning it’s easy to be too low. It’s easy to be too high. Too much iron is really toxic to us. And especially with the COVID-19 too much iron is very toxic to us. People who have high iron have been shown to have the worst outcomes from that pandemic.

>>    So in this case, it would be worth having a child’s iron checked before deciding whether or not to give them supplements?

Right. And I like to check two tests. One is a direct iron that has the percent saturation, and the other is a test called a ferritin, which is a carrier protein for iron in our bloodstream.

>>    Okay. Now, it’s a pediatric disorder, but can adults develop pandas as well?

Yeah. I’ve diagnosed several adults with PANDAS, then it’s called PANS.

>>    Do the symptoms vary at all? Or is it about the same? 

It’s about the same. Yup, about the same. But especially….may be more sensitive to just the emotional dysregulation. Like you’ve been pretty good, but all of a sudden, for some reason you’re having rages or anxiety or panic attacks and you never did before, certainly tics and OCD, you know, is a big red flag for that.

>>    Now what’s the likelihood that if someone has had strep before at all that they could develop PANDAS?

I don’t really know the likelihood, but again, it’s not so much about whether they had strep, but whether they have symptoms of brain inflammation. And then whether they’ve had step or not, you go looking for it and that’s why people aren’t catching it, because they’ve just not thought to think about it yet. The primary care physicians and pediatricians, and unfortunately, like we talk about a lot in our podcast is, why is that? Well it’s because doctors are in a paradigm box that is basically defined by what makes Big Pharma a bunch of money. So if there’s not some new wonder drug out with a huge profit margin, then doctors aren’t taught to look for the problem.

>>    And now we can loop back around, I think, to what else do we, Asheville Integrative Medicine, what else can we do to help with PANDAS that’s outside of the (paradigm) box?

What I’ve noticed is that most family practice and pediatricians are extremely reluctant to give more than 10 days of antibiotics. Even if they diagnose PANDAS, the kid get 10 days of antibiotics, and I found that you got to start with 6 to 12 weeks of antibiotics to get this under control. You’re talking about a much longer course, and you’ve got to think like doctors thought back 50 – 60 years ago with the rheumatic valvular heart disease. They did not give just 10 days of antibiotics for that. They would give penicillin shots for months or years for that. And that’s the way we’ve got to think about it. Because there’s a reason that these people were not suppressing their strep…whether that’s nutritional deficiency or lead toxicity or mold exposure or genetics, and we do go looking for the mold exposure and the lead toxicity and the nutritional deficiencies in our clinic. So that’s the other thing is that we do the other doctors don’t do, but just being willing to give longer courses of antibiotics and educate parents about that.

There’s some wonderful books out there. The best one I know of is written by a mother who’s 12 year old, you know…suddenly his life turned upside down and this book is called “Childhood Interrupted” and the author is, Beth Alison Maloney. And I always respect research done by parents because nobody is more motivated to get a kid well then than a parent, especially a mother who sees their normal, healthy kid suddenly take a regression.

>>    You don’t want to see them struggle.

You don’t want to see that. One time I was at an autism conference and a lady stood up to speak and she goes, “you know, you don’t have to be (and she was a parent of two autistic children) …don’t have to be a rocket scientist to learn and educate about this stuff, but I happen to be a rocket scientist (and she was!), and she was teaching about the biochemistry of autism, and this is one of those things that can kind of show up as a mild autism…what used to be called Asperger’s…is another way it can actually show up.

Okay. Some other books. There’s one called, “PANDAS and PANS In The School Setting.”

And then that author is, Patricia Rice Doran. I haven’t read that book, but it looks good. And then there’s one written for the kids themselves, for younger kids to understand what may be happening. It’s called “In A Pickle Over PANDAS.” And of course, PANDAS is hard to research because when you type it in, all you see as the pictures of the black and white bears, you have to type out the whole thing. You can’t just type in “pandas” when you want to research it. So other things that we can do is either IV vitamin C or hyperbaric oxygen therapy. And we found the hyperbaric oxygen…I don’t like to do IV vitamin C in kids….

>>   Right, for obvious reasons!

Yeah. So the hyperbarics is good. You can put them into a chamber, and we have a chamber (in the clinic). Actually, we have three chambers. One stays here, it’s called “The Pod”, and you can get in there with your kid. Of course you have to come here to do that. So it makes it a little bit more expensive and a little bit less convenient. And then we have two different chambers that go home. And one of them is big enough that a parent can get in with their child.

>>    Of course. We always want to make sure that children can communicate well and express themselves. And if not, if that’s a struggle, we need the parents to get in with them. It’s very important. 

Right. And then with the take home chamber, you do one treatment here and then you take it home, it’s portable, and you set up a home and usually do it an hour, twice a day. We usually do that for two or three weeks. And so in two weeks you can get 28 treatments in which is a great start. And you can see how much of a difference that makes.

>>    How does the hyperbarics actually affect the PANDAS or the brain inflammation?

The “hyper” means that you’re increasing the pressure, and we’re going up to 1.3 atmospheres of pressure, which means it feels like you’re under about 10 feet of water, the amount of pressure your ears feel under 10 feet of water. And that’s called a dive, because this was originally used to treat the bends from deep sea divers coming up too fast. And that pressure then pushes the oxygen into our bloodstream, not just onto the red blood cells, cause just breathing oxygen puts oxygen onto your red blood cell, but that doesn’t work. That doesn’t do anything for the immune system. Because the red blood cells don’t leave the bloodstream. But your plasma of your bloodstream does exchange with the interstitial fluid around your cells of your brain, and so that actually delivers more oxygen to the cells and especially the sub cellular energy generators called mitochondria in your brain and your immune cells. And our cells love that oxygen, but infections don’t, They don’t like that oxygen a bit. So it both improves our immune system and suppresses the infection and we see it can be wonders, and I’ve got some kids who have done well, and as a way to not be on chronic antibiotics, they actually end up with a hyperbaric chamber of their own in their own home and do that maybe three times a week…an hour three times a week for long-term maintenance to keep their infection suppressed.

>>    I have to say nothing makes me smile bigger and sometimes tear up a little bit then to have parents of a child we’re treating, calling me up (because usually I talk to people about hyperbarics anyway) to say, “Oh my goodness, my child’s been using it for a week and we’re already seeing this happening!” 

Right. And we’ve had that just this week!

>>   It’s amazing. Absolutely amazing. Now, aside from these things, are there any type of anti-inflammatory nutritional recommendations we might be likely to make for this?

Well, you know, that’s part of what we’re doing in the clinic anyway, is doing kind of a full workup for people. A part of that would be if, if they have signs of allergies or gut disruption or rashes, we might test for food allergies, and we can either do avoidance or we can do oral drop desensitization for food allergies. I know this was a big deal on my own daughter, who’s almost five years old now, and she had pretty bad eczema and turned out to be very sensitive to eggs, wheat and dairy. And we had her off of those for a while and gave her the oral drop therapy. And now she’s back on all those and no rashes and tolerating fine, but anything like that can cause more inflammation throughout the entire body, including the brain. So that’s what we might look at it. We might look for other infections too like mono. Strep and mono tend to go together and really support each other. So we’ll test for reactivated Epstein BARR virus, which even little kids can have, even though they haven’t been dating, but you know, aunt Mary or grandma Elizabeth come in and give big smooches, “gimme a big smooch here, baby!”. So you know, little kids can definitely get mono.

>>    And then for ongoing, more lifelong care perspective, what are some ways to hopefully manage PANDAS? 

Well, I think you want to decrease re-exposure. I think re-exposure is huge. And I have seen that both in kids going back to school and then there’s strep moving around and may get a relapse or even within a family. I have several families where there’s two kids in the family with PANDAS and they both always relapse at the same time. So I’ve got to imagine they’re exposing each other. And then avoiding the stressors that caused the relapse, and that’s a lot about air quality. I’m really convinced that the air you’re breathing, you know, it needs to, it needs to be good quality air and you can’t have a bunch of mold toxins in it. And that seems to be the big challenge. How good is your house? How well is your house built? How well do you keep it dry during the summer? All the way down to getting your ductwork cleaned out every five to seven years, if you have forced air.

>>    So what can someone do if they might suspect that they do have poor air quality that’s contributing? Are there things you can do to help clean up your air?

Well, you can use your nose and if you don’t have a good nose, you can get a friend with a good nose and just use your sniffer and sniff around. I mean, if you’ve got poor air quality, if you open a basement door and you get hit in the face by dank, musty smell, you got a problem and you’ve got to get that remediated. Otherwise there are professionals out there. I don’t have one to say on air right now, but there’s professionals who do evaluations of air quality.

>>    Would air filters help at all? 

Air filters can help. Yeah. Especially in the bedroom. Now in order to filter the air or dehumidify the air, you have to have a house closed up. I had a patient yesterday who had their windows open and doesn’t have air conditioning in their house, but they were trying to filter their air and dehumidify. And it’s like, well, you’re just running electricity. You’re not really doing anything. You have to be able to close the windows to filter the air, unfortunately.

>>    And the last question I have for today since PANDAS is an autoimmune issue, does having that make one more likely to develop other autoimmune issues going through life?

Well, I have two answers for that. One is, I don’t know. And I doubt it’s actually been studied because PANDAS hasn’t been around long enough for somebody to run that study. The second answer is yes, because every autoimmune disease ever studied pretty much triples the risk of you getting another autoimmune disease. So if you’re tending towards autoimmune disease, you’re tending towards auto immune disease and you want to reverse the causes of that. You know, one of the big things we do besides looking at food allergies specifically is just have people go on a gluten free diet. Because gluten is such a big deal has been so closely tied to, for example, thyroid autoimmune disease of Hashimoto’s that it’s a worth a gluten free lifestyle when people are trending towards autoimmune.

>>    I can testify to that from personal experience.

Give us your testimony!

>>    Well, I was diagnosed with Hashimoto’s about 14 months ago here at the clinic. And the first suggestion given to me was to go gluten, dairy, and soy free. And of course that’s big, that’s a big deal to just radically change your diet like that. But I did do it and I committed to it. Because I’m here, I really believe in what we do and I want to walk the walk and talk the talk. So I eliminated all those things from my diet. Six months later, my antibodies were down significantly and now it’s been 14 months and my auto-immune indicating antibodies are now down 50% from when I was first diagnosed. So in just over a year, I’m halfway back to normal just from changing my diet, which is unbelievable. I couldn’t be happier.

Right. So your immune system is calming down. And I mean, that’s the whole strategy, is figuring out why are people getting autoimmune disease!?… and then reverse that. And our general list includes food allergies, in particular gluten sensitivity, toxicities, especially heavy metals and molds, but they can be other chemical toxicities…nutritional deficiencies, hormonal imbalances, sources of stress, etc. We’re always looking at those fundamentals and trying to clean them up  

>>    And it’s worth doing, it really is!

That’s right. But if you have a child or even an adult family member, who’s got ADD, OCD, Tourette’s, anxiety, separation anxiety, trichotillomania, narcolepsy…all these different things, then definitely get your iron levels tested and get your strep blood levels tested your antibody reactions to strep tested with the ASO titer.

So that’s this week’s, ask Dr. Jim Bob! Thank you very much for helping out, Joy.

>>   Thanks, Dr. Jim Bob. I learned a lot. I hope you all did too. And please send me emails at info@docbiddle.com because we want to know what you want to know for upcoming podcasts.

All right. Take care of yourself and each other.

Welcome to AIM For Health: Root Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

Hello everybody. I’m Dr. James Robert Biddle at Asheville Integrative Medicine. Today’s the 9th of July, 2020…and, what are we going to talk about today, Joy?

>>    So we have had a lot of great feedback from people who listened to a podcast we did recently on stress and the mind-body connection and stress management, and people want to know even more. So today we’re going to do a follow-up and talk about some things that we didn’t go over the first time in regards to stress… going over things pertaining to supplements, breathing, and other things we can do to help reduce our stress.

Yeah. Last time we talked mostly about behavioral things like eating, exercise, resting, grounding..

>>     Meditating….

Yeah.  All right. Well, number one on my hit parade is always magnesium.

>>   Yes. Supplements. 

Yes, supplements we’re going to talk about, and the number one supplement for me is magnesium, and funny (interesting)….when we get to diabetes, it’s magnesium (we need), heart disease….it’s magnesium, depression….it’s magnesium. Why? Because magnesium is our most important nutritional mineral. It runs over 400 known enzymes in our body.

>>   That’s incredible.

And two thirds of Americans are deficient in it.

>>    Why are we deficient in magnesium? 

Because we don’t get it in our diet enough. You get magnesium from eating a real food, not processed food, especially your vegetables, and Americans just don’t eat their vegetables. Or, they’re over-cooked or over-processed, and then every time you eat sugar, you waste magnesium.

>>    Right. Sugar, alcohol…there’s other things we’re doing that’s kind of sabotaging our magnesium supply. 

Exactly. So our original native diets had huge amounts of magnesium and potassium in them. And now instead we get actually more calcium and sodium in our diets and less magnesium and potassium. So we’re always, in our practice, trying to increase our magnesium and potassium intake.

>>    What are some foods that have magnesium in them? 

Well, greens! Greens have chlorophyll, which is interestingly almost identical to our hemoglobin except in the center of the chlorophyll, rather than having an iron, which makes our blood red, it has the magnesium, which makes the plant screen.

>>   Hmm! Fascinating.

Yes. And also Vulcans, if you have green blood.

>>   Hahaha! Live long and prosper.

Yeah. It’s shown that you’ve got to get about 300 milligrams a day of magnesium to do things like stabilize your blood sugar and control your blood pressure and make your neurotransmitters to help with anxiety and depression.  The downside to magnesium is if you take too much of it, you’ll get loose stools. Magnesium moves your bowels. And here’s an interesting paradox. The more deficient you are in magnesium, the less you’re going to tolerate before you get loose stools, because your ability to absorb magnesium is indeed a magnesium dependent enzyme in itself in your small intestine. So if you’re very deficient in magnesium, even small doses, it will give you the runs….which means if you get the runs with just a hundred milligrams of magnesium, you know you’re very, very deficient. And the way to get around that is to get a powdered magnesium and put it into your drinking water bottle and sip small amounts throughout the day. So you don’t get a big load all at once. You can absorb it easier and then gradually increase it.

Otherwise you can do topical magnesium creams, which I’m not real wild about because they tend to irritate the skin, and I’m not certain they actually work real well. I mean, they work for relieving muscle soreness locally, but as far as raising your body level….? Or we can give the intramuscular shots or IV magnesium, but you know, that’s inconvenient and expensive.

>>    Right! So if you’re not sure if you’re magnesium deficient and you want to start, but you also don’t want to be running to the bathroom. Maybe start that on a weekend when you’re not at work,

Just start low and work up. Start with a hundred milligrams a day, then a hundred milligrams twice a day, and then 200 milligrams in the morning and a hundred in the evening. And then if you can get to 200 milligrams twice a day, that’s a good dose for almost everybody. Now, the other time you should not take magnesium is if you have kidney failure.

>>   Why is that?

Because we get rid of extra magnesium through our kidneys and when your kidneys get down to about 30% functioning or less, then you start to retain magnesium and potassium. You have to watch your intake on those, but if you have that issue, you should know it.

>>   Yes. Most likely.

Most of us have good kidneys. So that’s the fundamental nutrient. Otherwise we get into a lot of kind of fun nutrients.

>>   Fun nutrients?!

Yeah, which is your favorite?

>> I have to say my favorite fun nutrient for stress relief is actually the Kava Kava, which is next on our list.

What do you know about kava kava?

>>   I know that you have to be careful with the kava, because you want to make sure it is produced from the root of the plant so that it does not become liver toxic as opposed to the leaves and the stems.

Exactly.

>>   So I get my kava kava from here, cause that’s something we pay attention to with the supplement store. And I know that it can be great. It’s kind of fast acting. So if you’re having some anxiety, or maybe you really have, the (mental) hamster will go on before bed and you can’t stop thinking all those thoughts, that a little dropper of that will help relax me.

Good. Yes. All that’s true. And the way kava works…it’s the one natural thing I know of that hits the benzodiazepine receptors. So it’s basically nature’s valium because it hits those same receptors. It’s used in Polynesia in their rituals. Historically I understand, I’ve never visited to research this myself, they ferment big vats of it and get a relaxingly into a trance with it.

>>   And it’s not habit forming.

It’s not habit forming. No. You’re not going to get hooked on it. I find that the capsules don’t work very well, that you really want a liquid. And you do not want an alcohol based liquid because that will rip your mouth up. It’s way too strong and harsh. What you want is a glycerin based liquid.

>>   Yes. And I can say from experience, the glycerin based one we have here is one that I actually enjoy the taste of.

I enjoy the taste. And like you said, it works really quickly. I can put it on my tongue. It is nice for going to bed, it’s nice for in the middle of the night if you wake up and you’re, like you said, your hamster wheel or your mind starts worrying about things, then it can calm that down. But it won’t interfere with driving or meetings. You can take it before meetings and other stressful family situations.

>>   Or even with melatonin, if it’s your bedtime.

Yes, even with melatonin. It mixes well with everything, you just need to get a good company so they don’t use the stems and the leaves because they have liver toxic alkaloids, you can only use the root. So that’s kava. The next one we can talk about is CBD oil. CBD oil is all over the place. People are hearing a lot about it since it was legalized last year to be sold across state lines. And it’s the non psychoactive component of hemp, which is related to the marijuana plant. The CBD, I gotta say, it works miracles for some people and for other people, it’s like a placebo, it has almost no effect. And I’m not sure exactly why that is, but it’s really worth a try.

It’s used for anxiety. It’s used for pain and it’s used for insomnia. And if you have either of those, it’s really worth giving it a good try. The cost has come down to about a fourth of what it was about two years ago. You can now get a good 20 to 30 milligrams in a dosage and get a bottle that will last you two months for $30. Whereas it used to be a hundred dollars for 10 milligrams for a month.

>>    Right. Also non habit forming. And there’s other things that are good about it too.

Now, if you are in a profession that you get drug tested randomly…it is possible that you can get a positive test on your THC or marijuana assay. So you do have to be careful about that. But otherwise it’s worth a good try. Next we can talk about GABA, which is Gamma Amino Butyric Acid, and that’s an actual neurotransmitter. Supposedly GABA does not cross the blood brain barrier. Did you know that?

>>   I did not know that!

Yeh, supposedly if you are a perfectly healthy person with an intact blood-brain barrier, GABA won’t get from your intestines into your brain. I think none of my patients must be perfectly healthy with an intact blood brain barrier because it seems to work for people anyway. So GABA is another one of those that’s good if you have your mind racing around round circles with excessive thoughts and worries. It kind of slows down how fast your neurons are all firing.

>>    And just to make sure that we’re explaining everything and people are able to keep up well, what is a neurotransmitter? How does that work? 

Neurotransmitters are how one neuron in your head talks to the next neuron and sends signals. So there’s activating neurotransmitters that are really the same stuff that our adrenal glands put out, the epinephrin in the norepinephrine are also neurotransmitters, and then there’s feel good neurotransmitters like serotonin and dopamine. And then GABA is the ultimate calming neurotransmitter. It calms everything down. And so thats very good. There’s also your basic nutrients, for example, that are involved in the neurotransmitter production, like magnesium.

One of the reasons the magnesium is so important is because when you are deficient in magnesium you can’t make your neurotransmitters. So really, if we lived in a world where our medical profession was not completely controlled by Big Pharma, what makes them money, every time your doctor prescribed an antidepressant or an anti-anxiety medication, they would also prescribe you magnesium to help it work.

>>   To help it work!

But the only reason they don’t is because magnesium cannot be patented.

>>   There’s no money in it.

There’s no money in it for anybody. And so doctors aren’t trained to do that, which is a darn shame.

>>   Yes, it is.

Or you could use harsher words.  So the next would be tryptophan…talking about that. Tryptophan is the direct precursor for serotonin, which is one of our feel good neurotransmitters. And then tyrosine is the direct precursor for dopamine, which is our kind of other feel good neurotransmitters, especially people who have had history of addiction problems. They’re usually low in dopamine. For example, even when developers, software developers are looking at things like Facebook algorithms and TikTok and gaming, they actually hooked people up to brainwave machines and other devices, and they measure your responses, including your dopamine response. Because that’s….the better you can get people to feel that dopamine rush, the more addictive their apps are going to be for you to keep coming back to. Isn’t that wild!?

>>   It’s a little too wild for me.

Yeah.  So, tryptophan with the serotonin tends to be very calming and helps you to go to sleep. So most people take tryptophan at bedtime. It comes in 500 milligrams…usually I take one, two, or even up to three of them at a time. But you’ve got to be careful because you can’t take tryptophan if you’re taking a prescription antidepressant like SSRI’s, the selective serotonin re-uptake inhibitors, like Prozac and such.

>>   Why is that?

Because you can get a kind of overdose in your brain of tryptophan all built up at once…of serotonin…and that’s called serotonin syndrome, and that can be uncomfortable. I just pushed my dosage up once to see what this was like. It took me 6,000 milligrams of a tryptophan to get to serotonin syndrome.  And it felt like I had the heebie-jeebies. I couldn’t go to sleep. I laid there kind of a with my arms and feet wanting to move….that’s called akathisia. You just kinda lay there feeling like you’re having the heebie-jeebies.

Now when you’re on a prescription medication and then you take that much tryptophan, you can actually get into a very serious, dangerous situation where your pulse and blood pressure yet control. So you gotta watch those combinations. But the tyrosine is much safer and that’s more activating. So usually take that in the morning. Both are best on an empty stomach because amino acids kind of disappear into food. They’re both amino acids. The tyrosine also helps your thyroid because a molecule of thyroid hormone is basically four tyrosine’s with four iodine’s on it. And then you activate that from T4 into T3, by knocking off one of the iodine’s.

So when you take tyrosine in the morning, not only do you help your energy by helping your dopamine and your attitude, but you also help your energy by helping your thyroid functioning.

>>   That is really good to know.

That’s really good to know. And so that’s again about 500, a thousand, maybe 1500 milligrams in the morning. Now we can actually measure neurotransmitters. We can measure your dopamine, your serotonin, your epinephrine, and your norepinephrine and your GABA, and we measure that in your urine. And realistically, what we’re measuring is more what you’re making in your gut than your brain. You know, that guts often called the second brain, right? And you have your gut feelings, but from biochemical and genetic point of view, your patterns are going to be the same. So what’s coming out your urine is going to tell us what your body is needing, and what you have too much of and not enough of. So that can then guide us in what supplements to give you to calm down your anxiety or to help lessen your depression and even what prescription medications you should take. But in order to get accurate neurotransmitter testing in your urine, you have to be off of prescription medications at the time you can’t be taking an SSRI or something like that.

>>    For how long would you have to be off of that? If anyone’s interested in doing the neurotransmitter testing?

I’ve been thinking several weeks. So you can kind of reestablish your balance. Ideally more than six weeks because you’re going to have a dampening effect that’s going to take time to recover from. So we’re still seeing the effects of that. All right, the next one I talk about is L-Theanine. And L-Theanine is an amino acid that’s in green tea. So both green tea and coffee have caffeine.

>>   Yes they do.

But coffee kind of jacks you up and makes you hyper and then dumps you on your butt when you crash, and green tea kind of lifts you up, but it lets you down really easy and you don’t get as anxious, and you stay calmer on green tea. And L-Theanine is a lot of the reason why. Because it has this thing that calms down your brain and they take L-Theanine out of that and put it into capsules. So it’s usually a hundred milligrams in a capsule, sometimes 200 milligrams. And L-Theanine has been shown to take your brainwaves into the brainwaves of meditation, which are the calmer brainwaves.

>>    So even though green tea is giving you caffeine, which will give you that boost, and sometimes that little energy rush, it actually can have a calming effect too.

Exactly. Because it’s balanced out.

>>   Now I’m about to say something that some would consider heresy. Does that mean that green tea is better for us than coffee? 

Well, since my wife is French and Dutch, I would never go quite that far, because we love our coffee. But you know, I’ve been studying coffee for a long time. I keep a file folder now in the computer on studies on coffee. And I started off really kind of prejudice against coffee, because I watched my mother get fibrocystic breast disease from drinking coffee, and watched her get much better when she stopped it. And I’ve watched many, many men get prostate issues from coffee. Because just like it makes the breast tissue kind of get fibrocystic, it makes the prostate tissue get fibrocystic and enlarged, because BPH symptoms four guys. But on the other hand, there’s many, many studies showing that coffee has lots of positive health effects. It’s one of our major antioxidant foods that we eat.  Not because it’s such a great antioxidant, because we drink so much of it, so there’s many good things about coffee.

>>   I am glad to hear that.

Yeah, but green tea will definitely keep you calmer than coffee. You’ve gotta admit that, right?!

>>   Okay. That’s good to know!

And I want to get back to making the neurotransmitters, besides needing magnesium as a cofactor, you have to have B6, but when you take B6 as a supplement, there’s impurities in it that can actually cause neuropathy. So when you take B6, you should always take the activated B6 called pyridoxal-5 phosphate or P5P. You should never take plain B6, and P5P is about two to three times more potent. So 50 to a 100 milligrams of P5P is equivalent to 200, 300 milligrams of regular B6. So you don’t need a whole lot of it, but you do need a little bit of it. And we’ve actually reformulated our multivitamin to make sure that we only have the activated B6 in there.

>>   Right. And we do have just P5P in the supplement stores if anyone’s interested. 

Exactly. And then we get into some herbal things. Ans a lot of these, interestingly, are also about the adrenal glands…about calming and supporting the adrenal glands. And you would think that, Oh, if I’m going to support my adrenal glands, I’ll be making more adrenal hormones, and that’ll make me more anxious, but that’s not the way it goes necessarily. That’s when your nervous system is tweaking your adrenal glands and giving it that fight or flight response, but healthy adrenal glands actually are part of us staying calm. So these herbs include Holy Basil, which is also called Tulsi, and Milky Oats. Also, shizandra and ashwagandha. And I’m not an herbalist, so you can talk to your favorite herbalist about how they think all these work biochemically, but I know that they all support the adrenal glands, and by supporting the adrenal glands we actually seem to help people call them down.

The next one also with the adrenal glands is called Phosphatidylserine. It’s not an herb, it’s a phospholipid. It is part of our neurons…the cell membrane of our nerves has this in it and it makes those cell membranes calmer, when it builds up in them, and also calms down the adrenal glands. And, the adrenal glands are like one big nerve ending that’s designed to release those now as hormones into the bloodstream, rather than just talking to another nerve ending. So the phosphatidylserine helps both calm your brain down and your adrenal glands down. So that’s usually a hundred milligrams taking one, two, maybe three of them at bedtime…is usually when we give that, so that also helps people sleep.

>>    Question about the adrenal glands and these options. If you know, or even if you don’t know or suspect that you might have adrenal fatigue, because we know that that is a real thing,  then is that something that’s okay…to try these herbs? 

Yeah, absolutely. They’re supportive. And of course, why do you have adrenal fatigue? It’s because of decades of unmanaged stress of one type or another, whether that’s emotional stress, physiological stress, usually both. So managing the stress. So let’s talk more about managing stress. We talked a lot last time, but we didn’t talk so much about breathing and what’s cool about breathing is that when you don’t think about it, you still breathe.

>>    Right. Autonomic function!

Autonomic function. But when you think about it, you can change your breath. So that makes it a somatic function. The two main parts of our nervous system, the autonomic and the somatic. So it’s one of those places that links the somatic to the autonomic or the voluntary to the involuntary, which means it’s a way that we can voluntarily affect our involuntary nervous system. So by influencing our breathing, we can calm down our fight or flight response. And basically what we got to do is we got to activate our parasympathetic, which is mostly operated through our vagus nerve.

>>   And where’s the vagus nerve?

Well, the vagus nerve is the 10th cranial nerve. So it comes out of our brainstem in our upper neck, lower brain. And it travels down our neck and innervates all of our intestinal organs, including our esophagus, our heart, our blood vessels, our entire intestines, our liver, pancreas, spleen, everything in there. And basically when you are in fear or anger, some sort of a fight or flight, it shuts the blood down to all the digestive type things that you don’t need right now to survive the tiger, and increases the stimulation to the thing that you do need like tightening your blood vessels and making your heart beat faster and things like that.

>>   Getting ready to run.

Right. So when you’re chronically in that state you’re going to have poor digestion and low stomach acid and all the things we talked about before. So in order to heal and especially calm down your adrenal glands, you want to keep activating the parasympathetic relaxation response of your vagus nerve, and one of the ways you can do that is by breathing. And my favorite breath is a deep rhythmic breath called the ocean wave breath. And when you sit and look at the ocean with its waves going in and out, you’ll notice that it never stops.

>>    No it’s continuous.

It’s continuous. So the wave comes in, the wave goes out, but there’s not a place where it is frozen, but when we get into a fight or flight response, our breathing freezes. So to do this breath, what you want to do is…you don’t want to put efforting into it, but you want to just start off by observing how you’re currently breathing, and then just let your breath go gently in and out, but as soon as you get to the top, then it starts going out again, like the wave. And as soon as you get to the bottom, it starts to come in again, like the wave, but you don’t really push where it is at the top and the bottom. You just kind of let it be, but make sure it doesn’t freeze. And that’s the simplest, I think most easy way to get into a relaxing breath mode.

>>    And with the breaths, do we want to be looking at short breaths, deep breaths? Could you talk a little bit about that? 

Well you want deeper, but you want to do that very gently without stressing yourself. If you work on it, then you’re actually not going into the relaxation, you’re going into the excitatory phases. You can get a lot more sophisticated, where if your exhales are slightly longer than your inhales, that’s relaxing, but again, not if you’re working at it. So you’ve got to find that balance. So I think that for people who are just getting into this, simply observing it and doing the ocean wave where you’re not trying too hard to control it, except you’re just making sure you’re not frozen at any point. And you just keep it moving in and out.

>>    And does positioning matter. Is it ideal to be sitting up, laying down, standing up?

You can do it in all those. I don’t think the position matters that much. No. Whatever’s comfortable. And the last thing we’re going to talk about is neurofeedback. And we’re big fans of EEG biofeedback. This is where people use machines to actually give you a look at what your brainwaves are doing and identify where you’re too jacked up and where you’re too ramped down, or suppressed. And then they can have a feedback technology that helps to even all of that out. And I don’t know this intimately, but I know there’s basically two types of feedback technology. One is when you’re an active participant, and the other is when you’re a passive participant and the machine does it with your brain. And the active participant is usually… you’re watching a video, and when your brain’s not doing what they want it to the video kind of fades out and isn’t as clear. And then when your brain does what they want it to, then the video is more clear. So it’s work, but it’s not work that the way you think of work.]

>>    Right. It sounds like it’s kind of refocusing the brain a bit. Training it to refocus!

Training it to refocus and to wake up the parts that are damped down and such. So there’s three places in Asheville that can do this. And it usually looks like doing a half hour to an hour at a time, usually going once a week, usually starting with 10 to 20 visits, and then maybe backing off to maintenance of a once a month to every six weeks after. So the first one is Dr. Yonce at Asheville Brain Training. The next is Dr. Michael Trayford, and Denise Trayford, and Diana Tyler at Apex Brain Center. And then Sean Jarman is a licensed professional counselor at Jumpstart Counseling and Neurofeedback. So we’ve had good reports on all of their interactions with clients. And if you’re not able to get your own nervous system calm down enough, then getting some help like that can really change your life.

>>    It is always good to have those options.

That’s right. So you have the options of these supplements…. magnesium, kava, GABA, CBD oil, L-theanine, tryptophan, tyrosine, P5P. Oh, we didn’t talk about a inositol.

>>  Oh no, we missed that one.

Yeah. And inositol is an alcohol sugar, kind of like a B vitamin. It’s also a component of our  nerve membranes, the membranes of our neurons. You can’t overdose on that. It tastes wonderful. It’s a white powder that tastes like sugar. It is very calming. I get good effects with it. I take it myself, I put it into my smoothies. And interestingly it’s been shown through regular medical studies to help with obsessive-compulsive disorder, and to help with polycystic ovarian syndrome. In PCOS, the ovaries aren’t getting the signal from the pituitary, the hormonal signals of LH, it doesn’t receive it very well, but by softening those cell membranes, they work better and receive that signal better so that the PCOS symptoms lessen dramatically.

>>   That’s a great to know.

It’s just great to know. That’s also very calming. And then the phosphatidylserine and the adrenal herbs. Alright, those are things that you can do with supplements, and a few other behavioral things to lessen anxiety and stress. Any parting thoughts?

>>    Yes, of course! If you have questions about what’s going to be the best avenue for you, how to put this all together, if you want a little more structured advice, give me a call, especially if you’re interested in establishing care, because this is all part of the care that we do here and that we are happy to help people with every day.

And if you have other questions for ask Dr. Jim Bob, then just to email them to info@docbiddle.com and we’ll talk to you next week.

>>    All right. Take care. 

Welcome to AIM For Health: Root Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

Hello! Welcome to our podcast. I’m Dr. James Robert Biddle, aka: ask Dr. Jim Bob, and today’s the 2nd of July, 2020, and I have our new patient coordinator, Joy Lambert here to help me. Hi Joy.

>>   Hello, Dr. Jim Bob. Hello everyone!

What are we going to talk about today?

>>    We had someone call in and they wanted to know more about the practice and they said they’d been listening to the podcast.  I asked what they’d like to hear about, and they would love to learn more about how what we eat affects our energy levels. How different foods, or what goes on with digestion….how can we eat some things and we feel really good…and other things might make us feel heavy groggy…..what’s that all about? 

Right. Well, I guess first we got to talk about digestion.

>>   Yes. What is digestion?

There’s four main phases to digestion. I mean, once you find it and catch it, that’s the first place (we start) Hunter-gatherer, right?

>>   Haha, right. Procuring it!

Then you got to chew it and break it down into smaller particles and mix it with your saliva. And saliva actually has enzymes in it that breaks starches into sugars. So a lot of people are very proud. They’ll say, I’ve cut out sugars and I’ll ask them what they’re eating. And there’ll be like, well, I had a banana or this and that, you know, or bread or potatoes, pasta. And guess what? By the time those things hit your stomach, they are sugar. And so you can get a very good blood sugar rush, even though you think you’re eating complex carbohydrates. So that’s the first phase.

>>   Is Chewing?

It’s chewing and saliva.

>>   And the more you chew the better. That’s what we’ve heard. That’s not just a myth. You actually are supposed to chew your food up really well. 

It’s not just for the fancy ladies and finishing school. You’re supposed to chew each bite 30 times. You really should chew your food well, and one of the greatest meditation practices that I ever heard about, from a tradition in the country of India, is to put your fork down after you take a bite, and chew consciously…and be aware of the food going all the way down your esophagus and hitting your stomach before you pick up the fork to take your next bite. Which is very different from the way most of us are taught to eat, especially in medical school and residency.

>>   You’re just shoveling it in.

You just shovel it in, so you can run on to do the next task. So conscious eating is a whole different ball game. It could help a lot of people, especially who have esophageal swallowing dysmotility problems.

>>   Well, and if you’re slowing down and chewing and eating deliberately like that, that gives you more time to enjoy dinner conversation or lunch conversation. 

It does. And it also activates your relaxation response and turns off your fight or flight response. And that turns on your vagus nerve, which then actually helps you to make stomach acid and the protective layer of mucus that protects your stomach from your own acid, and helps your pancreas to make bicarbonate and digestive enzymes. So if you’re eating in as even a subconscious anxious state of mind, or in a hurry, you’re shunting all your blood to your muscles and your brain and not to your gut. And so you’re not really digesting efficiently.

>>   Wow.

Yeah. So it goes even deeper than that.

>>    I did not know that. Thank you!

So the next phase is in your stomach and your stomach makes mostly stomach acid.

>>   And what is that acid?

It’s hydrochloric acid. The stomach is supposed to have a pH of 1- 2, which is extremely acidic, kind of like put a penny in the bottle of Coke and watch it dissolve over a few weeks. That type of acidic! And as you grow older, you’ll lose that opportunity to make acid. And so by the time you’re 70, there’s a 70% chance you’re low in stomach acid – and who gets told to take acid blockers all the time?

>>   Who?

Older people! But you know, they’re not low in acid. You know, they’re not high in acid. I mean, maybe if you’re a 30 or 40 year old executive with high stress or something like that, you’re high in stomach acid, but most people did not have too much stomach acid. And in fact, what they have is not enough mucus to protect their stomach lining from their own acid.

>>    So they feel the effects of the acid, which is why the acid blockers are recommended, but that’s not what’s needed?

That’s right. It does relieve your symptoms, but then you get malabsorption of your nutrients, many of which require acid to be absorbed, especially all your minerals and your B12. And so that’s why these acid blockers have been associated with an increased risk of dementia and kidney failure and a whole list of other problems long term.

>>    Now I don’t want to get too far off topic potentially…

Good, because I love to!

>>  Haha…are there things we can do to actually help retain mucosal lining of the stomach so that we don’t feel that? 

Yeah, again, the best thing you can do is to get into the relaxation mode when you eat and throughout your day to not be constantly cranked up into anxiety and a fight or flight response. But beyond that, you can take things that are kind of emulsant…things that are kind of slimy and slippery that help this. So things like licorice, if you have high blood pressure, you can’t take that. So you take DGL, which is deglycyrrhizinated licorice…the glycyrrhizin raises your blood pressure…so this is just the part that coats the stomach lining. Other are the extract of marshmallow, and I’m not talking about the candy!

>>   No! Marshmallow root!

Exactly right. Also Slippery Elm Bark.

>>   And that actually feels very slippery. I’ve had it in tea. It’s thick, viscous.

Very slippery…also Okra. Okra is very slippery. So any of those…ground flax seeds even. Have you ever soaked flax seeds and see slippery they are!?

>> Chia pudding (too)!

Chia pudding. Yes, all those things that have that kind of slimy slippery stuff is all coating to your stomach and helpful there.  And to get to make more acid is to use Apple cider vinegar before you eat. And if you use the liquid, you always want to dilute it a little bit with water and you drink it just before you eat…or five minutes before you eat. We also have it in capsules. I was even surprised (to see that) I didn’t know we could put Apple Cider Vinegar in capsules! But it’s a dried powder and it certainly smells like Apple Cider Vinegar. And you take that about 10 or 15 minutes before you eat so the capsule can dissolve, and that kind of primes the pump to get you to make stomach acid again.

And if you’re really low, you can actually take capsules of hydrochloric acid called betaine HCL. So there are usually 650 milligrams per capsule. The average healthy stomach would make 10 capsules worth to digest a meal. Now we usually give people one to three capsules per meal to augment their own stomach acid. You gotta get a little bit careful…if you’re really thin in mucus, you can burn your stomach lining with that, but it can be very helpful for people who are poor digesters. And if you don’t have enough stomach acid, you don’t break down your proteins enough and then those incompletely digested polypeptides…they go across the leaky gut in your small intestine. That’s how you get food allergies.  (*leaky gut syndrome)

So food allergies have been increasing dramatically over the last few decades. And a lot of that, I think his gut disruption from stress and from toxicities like glyphosate or Roundup, and from gluten sensitivity, all that kind of goes together. So stomach is the second part. And then the third part is your pancreas. Your pancreas….after your food comes out of the stomach, into the small intestine…your pancreas releases enzymes and bicarbonate to neutralize the stomach acid and to further digest the food. And then your gallbladder releases bile to emulsify the fats so that you can (emulsification means basically like what you do with soap. It makes the fats into water soluble compounds) so they can then be absorbed.  And the last part of digestion is then reabsorption of water in your colon. So all most of the nutrients are absorbed in the small intestine. And then when it empties from your small intestine into your large intestine, it’s still liquid. But then hopefully by the time it comes out, it’s at least formed or semiformed. And most of that is reabsorbing the water. And unfortunately, when you’re reabsorbing the water, you also tend to reabsorb a lot of toxins. So this is where a lot of fiber (is good)….

>>    Right? Cause we’ve talked about that before. You don’t want that to just stay in your body for too long.

Because then you reabsorb it and your liver has to do all the work of excreting it again. So you want fiber. So you poop out the toxins rather than reabsorb them. And so that your good gut bacteria have something to ferment…because your good gut bacteria, fermenting fiber is what makes these really healthy short chain fatty acids like butyrate. Butyrate is what gives butter it’s smell and that’s what heals and nurtures the stomach…the intestinal lining of the stomach. So we need to have a lot of fiber because that’s what supports our good gut bacteria and binds our toxins. So that’s kind of how we get there. Now, when your food is actually that absorbed, it’s got to be in very small particles you know…and it gets absorbed across the small intestinal membrane and goes through your liver, and then gets distributed to your body. And the way we actually make that energy…which is one of the questions you had…

>>   Right, how does the food actually turn into usable energy? 

Yeah. That’s in our mitochondria at the cellular level. Our mitochondria takes these molecules of food, (carbohydrates and fats) and breaks them down to create ATP.

>>   What’s ATP?

ATP is the currency of energy. It’s what your cell uses to move a muscle or to grow a hair or anything is going to do to create proteins, it uses ATP to achieve that. And so I’m not going to try to get into the complexities of the biochemistry of exactly how that works.

>>   That might be another podcast, haha!

That’s even beyond me to really….I understand it….but I don’t understand it well enough to teach it, but that’s cellular respiration and that’s why we need the oxygen and why we release carbon dioxide because we are breaking down those foods and creating energy out of them. And then releasing…we need the oxygen basically to burn it, and then release the carbon dioxide, just like a fire does.

>>    So if it’s the mitochondria…and there’s mitochondria in every cell in the body?

Yes.

>>   If it’s the mitochondria that’s converting our food into energy, is all food equal in that regards, in terms of its potential to give us energy?

Well kind of, except for fats are denser…proteins and carbs have four calories of energy per gram of food. Whereas fat has nine calories per gram. And that’s why people who are trying to lose weight will often choose to limit fats because you’re getting less calories. But when you talk about wanting to burn energy, it’s much more efficient to burn fats for energy than to burn carbs for energy. Because you’re getting more energy per gram. So one of the things I say is that burning carbs for energy is like burning rolled up newspaper in your fireplace and burning fats for energy is like burning well-seasoned Oak in your fireplace.

>>   Big difference!

Yeah. It gives a good, strong, slow burn. It’s much more stable. And I think really the point is, is when you primarily eat carbs, you’re inducing enzymes at the cellular level to burn those carbs, to process them.  And when you switch over to eating more healthy fats and burning fats, then you have to change over your enzymes…and that takes like two or three weeks assuming you’re not severely insulin resistant. If you’re really insulin resistant can take a lot longer. They studied this actually in Canadian troops, marching them, and then they changed their diet….and for the first few weeks they really sucked wind when they changed from a high carb to a high fat diet. But after three weeks, they got much, much better because they shifted their enzymes and were then able to use the fats at the cellar level efficiently, once they flipped over their enzymes. So fats are actually much better to burn for energy.

>>    And if you’re burning fat for energy, does that then promote fat burning – as it pertains to weight loss? 

Exactly! That’s what we teach in our nutrition classes. You want to actually eat fat to burn fat. And this is kind of at the cellular level, how that mechanism happens. But first you have to reverse insulin resistance, because insulin tells the body to store fat, store fat, store fat. Make cholesterol, raise your cholesterol, and store fat. So if you’re insulin resistant, then you’re storing fat rather than burning fat. And, of course, why are you insulin resistant? Because you’ve been eating sugar and carbs.

>>   Right. The spikes.

That’s right. So you’ve got to make that switch over. And that can be hard on people. And sometimes it can take months. I mean, if you’re really overweight and insulin resistant and diabetic, it can take months to make that conversion. And people sometimes don’t feel so good when they’re making that conversion because now they’re not able to access energy very well for awhile. So I understand that it’s tough for people sometimes to make that conversion. This also kind of ties into the energy of ups and downs. Why do some people get reactive hypoglycemia? Why did they get this blood sugar drop and other people don’t?

>>    Right. That’s a good question. Why do they?

Why thank you! Well, you know what goes up must come down. And how high it goes up correlates to how far it comes down. They’re getting the blood sugar drops because they’re getting the blood sugar highs. And when you convert over to eating more from carbs to fats, then you stop getting the blood sugar highs. So you’ve stopped getting the blood sugar lows. The other thing that exacerbates this is adrenal weakness. If you tend to have weak adrenal glands, that makes it harder because when you have a blood sugar drop your adrenals kick in with that kind of cortisol and epinephrine response to bring your blood sugar back up. So if you have weak adrenal glands, it won’t kick in as well. And then your blood sugar will stay down enough for you to have a reactive hypoglycemia.

>>   So talking about a cortisol response reminds me of another question. Does that have anything to do with the phenomenon of “hangry”? You’ve heard of hangry?

Sure!

>>   And we tell people, please eat your breakfast before you come in for a nice long visit so you’re not hangry, but what is hangry? Is that part of it? If we’re triggering a cortisol response in order to digest?

Partly. But it’s also combined with the low blood sugar, you know, people can’t think if their blood sugar is too low.

>>   That is real!

Especially if they’re used to burning carbs for energy. If you’re used to burning fat for energy, you hardly ever get hangry because your body is that adapted to burning fat, and even the thinnest of us have enough fat to run several marathons. So if we can access our stored fat, and your enzymes are induced to burning fat, you will almost never get hangry.

>>   Really!?

Yeah. And that, that brings us….I see another question I had written down…is it better to eat six times a day…

>>   Grazing.

Grazing, yes. Or is it better to do intermittent fasting where you eat once or twice a day? And then you go 18 hours without eating.  And I’ve got to say in the short run, when I find people who are having the blood sugar rollercoaster…and in my old nutrition lecture, I used to teach to eat six times a day…to stabilize your blood sugar. But what I’m teaching them to eat is low carb, adequate protein, and high fiber and high healthy fat. And so that ends up stabilizing their blood sugar and then gradually they can shift over into spacing out their meals. And I do think it’s much healthier these days to do the intermittent fasting because once you’re able to stabilize your blood sugar, then you can start to start to go longer and longer between meals. And you can go the 16, 18 hours without getting hangry….once you’re burning fats for energy, and then that induces your body to burn more and more fat, and it also reduces cancer risk by breaking down abnormal proteins, which are what leads to cancer.

So in the short run, frequent eating. In the long run, less carbs, more healthy fat, adequate protein, lots of fiber, lots of fiber in your diet. And then you shift over to the intermittent fasting for longer term health. It doesn’t have to be every day, but at least two days a week, you try to go 16 to 18 hours between meals. Now, most people, when they do that, they find it easier to skip breakfast. But here’s the problem with that. If you’re skipping breakfast, that means you’re eating later at night and you’re going to bed with food on your stomach, and that’s not so good way better to go to bed with an empty stomach.

>>    Well, and doesn’t breakfast jumpstart the metabolism for the day…?

It does kind of, but all these people would say, Oh, I don’t like breakfast. I’m never hungry in the morning. Well guess what, not being hungry in the morning and having the urge to snack at night is a classic sign of leptin resistance, which is basically a cousin of the insulin resistance, but especially for leptin, which is a hormone, I don’t completely understand, but you can look it up on our favorite medical site of “Wikipedia” and read about leptin. But people who are leptin and insulin resistant, won’t want to eat breakfast in the morning. They’re not hungry, but when they fix that, then you’ll wake up and you’ll actually be able to eat breakfast within an hour of getting up. So it’s much healthier to eat breakfast, let’s say at 8:00 AM, and then lunch at one or 2:00 PM, and then to be fasting from 2:00 PM to 8:00 AM. And so, you know, that is your 18 hours, right there. It’s much better than eating lunch and dinner. Much better for your metabolism.

>>    So my gears are turning as I’m processing all of this. Am I correct then in understanding that it’s not…this isn’t a matter of whether or not you have food in your stomach…if you’re going to have higher or lower energy levels. It’s really about getting your whole body working as a machine where it’s burning your fats, it’s processing to maintain your energy levels.

That’s right.

>>   Okay.

Well, there is one other part to that and that is that if you have weak digestion, meaning low stomach acid or low ability to make enzymes, then after you eat you’re going to be like a snake that just ate a whole Guinea Pig or whatever it is…you’re going to be sluggish and tired. Because it takes so much energy to eat a big heavy meal. It takes a lot more energy.

>>    And that was another question I had. It’s the whole phenomenon…some people call it the food coma or the itis, or, you know, you just have to take a nap. Why do we get tired after a big meal? 

Yeah. And some of that’s just how much energy it takes to digest your food. And I think part of that’s natural. And some of it can sometimes be food allergies. If you have certain foods you’re allergic to, that could be a problem or sensitive to, and other ways besides just allergy. Yeah, so I think there’s some naturalness, but if it’s excessive…if you’re really getting knocked out…then you might want to experiment with, is it the type of food you’re eating? Is it the balance of food? Is it too much food all at once? Or are you having food allergy reactions?

>>    Well, since you’re mentioning food allergies, you want to talk about that for a little bit?

Sure.

>>   Because you know, sometimes people think that, well, if I don’t have an immediate reaction, if I’m not having signs of anaphylaxis, then I don’t have food allergies. How do we know what’s actually happening? Can you have delayed reactions? Can you be reacting to foods and not even be consciously aware of it? 

Sure. And I get to use my own daughter as an example of that. In conventional medicine, food allergies are generally just the immediate reactions, and those are measured in the bloodstream by an IgE antibody. And you usually know if you have it because you eat shrimp and your lips swell up, or you eat peanuts and you can’t breathe…something like that. And it shows up on skin testing. The delayed reactors are an IgG antibody reaction and they’re usually delayed by 6 to 48 hours. They don’t show up on skin testing because of that, and because of that, the regular allergists don’t believe in them. And the whole medical profession doesn’t really believe in them. We find they’re about 95% of the problem are for people with food allergies.

>>    So what is a delayed food allergy reaction? 

It can be almost anything. For my daughter it was eczema. For many people it’s migraines, for some people is just fatigue, or pain, for some people it’s irritable bowel syndrome, it shows up in the gut. It could be brain fog. It could be a tendency towards auto immune disease. For example, the reactivity to dairy and wheat can show up as Hashimoto’s thyroiditis as a cross-reactivity. There’s a very strong correlation between the wheat sensitivity and Hasimoto’s, and that’s not an IgE reaction.

>>    I can speak from experience on that. I’ve been diagnosed with Hashimoto’s and one of the first things recommended from Kamila, our nurse practitioner, was to change my diet. I stopped eating dair,y whea,t and soy. And five months later, my antibody numbers dropped by about 40%.

And that’s basically most of what you do.

>>   Showing that my body was reacting to those foods. Whereas prior I never thought about it. I never realized or felt that I was having a reaction, but yet here it was setting something up that I don’t want to perpetuate. So I was begrudgingly happy to make those dietary changes.

Exactly. And being able to avoid foods like that is great. And why not? What I run into is people who have a lot of food allergy reactions, and then avoiding those is not only challenging, but sometimes doesn’t work, and sometimes it can backfire. So the way to make a food allergy worse is to avoid it for about three weeks and then get exposed…and avoid it for three weeks and then get exposed. And pretty soon you’re cranking up into anaphylaxis with it. And how do they desensitize kids with peanut allergy now? They take a microscopic amount of peanut dust and put it under their times. Then they gradually increase that until about a year later, they’re taking a tablespoon of peanut butter a day. And as long as they do that, they can tolerate peanut butter and peanuts and peanut butter. But if they stopped doing it in a few months they’re anaphylactic again. So that’s inducing tolerance. That’s just like taking a ragweed pollen and injecting into your arm every week for desensitization. And that’s what we do with the foods is we put the proteins of the foods into a dropper bottle and squirt it under your tongue two to three times a day. And that’s what I did for my daughter. And after about a year of that, no more eczema. That’s fantastic. And also, you know, asthma is a lot easier to control. I can’t say no more asthma, but a lot less. Also treating for inhalants.

>>   Yes, and it’s not painful. She can do it herself. It doesn’t taste bad.

No, it tastes good. Actually. Luckily it’s in glycerin, so it tastes very good. So we can do that for foods and we can do it also for the inhalants, like ragweed and dust and mold and things like that. So those are parallel programs. We can do all the testing by blood testing. So we don’t have to do skin testing anymore.

>>    Right. And the blood testing, not only does it look at immediate and delayed reactions, but just so everyone out there listening knows that blood testing will also rank – not just are you reactive or are you not – but it’s on a 1 – 5 five scale of how reactive are you?

Yeah. Then we can start you at where you need to be treated, and then gradually move the treatment up. Whereas with the skin testing, they usually just start everything at the lowest level and move it all together, which isn’t the most efficient way to treat. And again, with the shots, people have the risk of reacting to the shots – and sometimes having an anaphylactic reaction. So a few people across United States die every year from that. And with the drops, nobody’s ever been shown to be injured by the drops under the tongue, your nose can get a little itchy, back of your throat can get a little itchy, but that’s about the worst that ever happens. So, you know, I have been profoundly moved with how positively oral drop desensitization has changed our practice over the last 15 years. And I’m not sure how I’d practice without it anymore. It’s just a great tool. And then of course, when we have people with food allergies we’re looking at, how do we support the digestion so they don’t develop more food allergies in the future?

>>   Right.

To break that cycle.

All right. Well, what else did we need to talk about…specifically to food and energy levels? Did we cover it?

>>    We’ve gone through most of the questions. Oh, what about the resources our body needs to digest food, and does that pertain to our energy levels…like our gut flora, or our hydration level, or hormones or things like that?

Well, you do have to be hydrated because you have to have water to make your stomach acid and your bicarb and all that. So dehydration is not so good. I think being relaxed is probably the single most important part of digesting well…is to manage your own stress levels. And last week we talked about different things to manage your stress. I think in the future, we’re going to do one specifically about stress and anxiety and the types of supplements we can take for that.

>> Yes!

Besides the behavioral changes, I think the gut flora has a much more to do with the health of your intestines. And what’s interesting…we all love probiotics. I prescribe probiotics, and we try to avoid antibiotics when we can. Because we all have an intuitive knowing that that changes our gut flora. However, in the studies on the microbiome, they’ve shown the only thing that actually changes the microbiome of adults is how well you eat and how well you exercise. So how well you eat means not eating a bunch of pesticides that kill off your gut flora. And eating plenty of fiber that your gut flora can ferment and metabolize. And exercise all types of exercise. That’s what really affects your microbiome. So, it comes back to eat your vegetables and your ground flax seeds.

>>   And keep moving!

Keep moving. That’s right. I think that’s it. I think maybe we’ll leave it at that for today.

>>    Yeah. We’ve gone through all the questions. Thank you, sir.

You’re welcome. If you have questions, send them in to info@docbiddle.com. We’ll talk to you next week.

>>    Thank you. Bye bye.

Welcome to AIM For Health, Root-Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition now onto the show.

Hi, this is Dr. James Biddle and we are doing a show today called ask Dr. Jim Bob, and we’re Asheville Integrative Medicine. Today is the 24th of June, 2020. And I have our new patient coordinator, Joy Lambert to help us out. Hi joy.

>>    Hello Dr. Jim Bob!

What are we talking about today?

>>   So we had a client in the office last week, commenting on how much she enjoys listening to the podcast. And she asked us if we would be willing to talk about stress and the mind body connection?

Absolutely. It is very useful. Please do send your questions in and we are happy to tackle them.

>>   We want to know what you want to know.

And obviously this is a huge topic, as most of them are, so we have to pick out the biggest part and here’s the thing. Our brains are so big and so efficient that we can no longer tell the difference between what we think and imagine, versus what is happening in physical reality. So it used to be, when you look at your animals, like your cat or your dog, they’re pretty much in the present moment, right? Unless they’ve developed some really bad neurosis, but you know, when a fireworks are going off, your dog is very, very frightened. But they’re not still frightened two weeks later.

>>  No, they’ve forgotten about it.

Right, they don’t think about it. But we think about it. We have great memories and we run that over and over in our head. And for us the fireworks are still going off, and they can go off 80 years later. So we’ve got to diffuse that, and there are many ways to do that. That’s deep work. What we like for people to do themselves…we like EFT, “Emotional Freedom Technique” also called tapping.

>>   Tell me about that.

When you tap …you use your body. I like mind body therapies. So you’re using your acupuncture points and your acupuncture meridians, and you’re tapping on them at the same time, you’re doing affirmations such as, “I deeply and completely accept myself. Even though I have this issue, I deeply and completely accept myself.” And meanwhile, I’m tapping on these acupuncture points above my eyebrows and next to my eyes and on my face.  And that’s a way you can work on stuff yourself. Now, if you have actual PTSD, you can possibly trigger yourself too much trying to work by yourself. So then you want to work with a therapist and the best therapy for that is called E M D R.

>>   And what does that stand for?

Eye Movement, Desensitization and Reprogramming. And that was developed originally on Vietnam Vets who were hospitalized for years with PTSD. And they wake up in the night with these terrible nightmares. That would be the same nightmare and never finish. And it comes from the knowledge that when we dream and process our eyes flitter back and forth side to side.

>>   The rapid eye movement.

Yes, REM sleep. And that’s how we process things. And so they would have these vets go through the story of their dream while they’re doing this rapid eye movement with a therapist.

And when they would get to the right place and actually get a process, then the next night the vets would go back and have that nightmare again, but it would finish and then it’d be done and then we wouldn’t have anymore. And now they can be discharged after 20 years in the psych ward.

>>   What a relief.

What a relief, right!? So this is a way to help your body process old traumas. And this is what we like to refer people out for when they really have deep seated trauma, especially childhood trauma or some big trauma. Luckily most of us don’t have that bad of traumas so we can work on stuff ourselves…but that’s one of the best ways to do it. The other thing about realizing that most of the psychological stress that we experience is our own doing…

>>  Yes! You get stuck in that repetitive loop of thought. 

Right, and you think you’re powerless about that. Like, Oh, I can’t control my thoughts. And it is true. You can’t control where your thoughts flit to, but it’s also true you can control where your thoughts dwell. This is one of those powerful places where you have this point, I call the point of choice where when you recognize, when you get into the observer, and you know, it has been well-published that one of the greatest skills in life is called metacognition, and metacognition is the ability to watch yourself, to watch yourself think. And if you can develop the skill of metacognition, your whole life can change in a positive direction, because you watch what you are doing and what you were thinking. And when you develop that skill, you then develop a point of choice where you can say, do I want to continue thinking about that old trauma?

Because right now there’s a million things I can turn my attention to, right? I can listen to the air filter running. I can feel my hand on the desk. I can look at your beautiful hair, right? I can feel the breath coming in and out of me, I can look at a picture of my daughter. And I can choose where to turn my attention now and turn it away from that thing that is creating me repeated trauma by, by playing that story over and over again. Now I’m not in favor of people avoiding emotions. I believe that we should feel our emotions, but I don’t believe that just feeling the same old emotion over and over again is helpful. It just runs the groove deeper on that record player.

>>   It makes you feel stuck.

It not only makes you feel stuck. It gets you stuck. You are stuck, but you can unstick yourself by point of choice, by will. And I think one of the best ways to do that is called a gratitude journal. So when you find yourself stuck, you just grab a sheet of paper and you start writing down 10 things you’re grateful for in your life. I have enough food to eat. I’m safe, nobody’s chasing with a machete, right? I have a warm house. I have air conditioning and I have a car. I’ve got a beautiful family. I’ve got…whatever it is you have you just write those down and start to dwell on those rather than dwelling on that bad thing.  And then if you keep doing that, and maybe you do the same things over and over again, but maybe you start to find new things. You realize that you have tens of thousands of things you can be grateful for. 

>>   All the time, in every moment.

And if you dwell on those, then your stress will decrease. And it’s not just a distraction, although it is a distraction, but it’s actually a rewiring of your circuitry so that you stop running that same groove of anxiety and if you’re stuck too much in the past, then that’s depression. If you’re worried that the past is going to repeat itself into the future, that’s where the anxiety comes up. So the fact that our bodies don’t know the difference between whether the tiger is chasing us or whether we’re just thinking about the tiger chasing us – that’s the root cause of most of our stress today. And most of us are in 24/7 stress. Cause we keep it jacked up by being on social media or watching the news or problems and not being in the present moment.

>>   Yeah, that is very true. I like that perspective of observing your thoughts instead of reacting to them, because then you can take a moment and decide how you do want to consciously react to it instead of letting it just take over and control you.

Exactly. And that moment is the whole thing, you know, we all have that initial reaction. It’s hard to retrain that, but it’s that moment after that initial reaction, when we decide, am I going to stick with that and act out on that? Or am I going to take a breath and choose a different reaction!?

>>   I’ve heard of meditations where you treat your thoughts like a visualization, like clouds or waves…where you’re observing it and you see it, but you’re actually separating yourself from it so that you can kind of be still in that space and really figure out what’s going on. 

Exactly. And many people get confused about meditation because they think, “I’m still having thoughts therefore I’m not doing it right.” And that’s not it. You just don’t want to get on that train and follow it down. You don’t lasso a cloud and go off on the horizon with it.

>>   No, you just watch it drift by.

Right, and then it goes away and then you have a moment of stillness and then another thought comes and you watch it drift by….and you’ll learn a lot about yourself that way. And this is one of the ways to develop metacognition, and strengthen that muscle.

>>   The screensaver on my computer here is a field of clouds to help remind me of that. Whenever I get stuck in my thoughts.

There you go.

>>   So I have some specific questions (from listeners) about stress. We’ll dig into that and how our bodies are reacting. So we’ve been talking about emotional stress and thoughts and kind of getting stuck in those grooves. I want to talk a little bit more and get your perspective on physical stress. And then of course, which comes first, the chicken or the egg!?

Well, our emotional stress can definitely turn into physical stress, right? Because you know, our body is going to respond to our brain. Our adrenal glands are actually big nerve clusters. They’re just the end of nerves that have enlarged, and so they’re producing a lot of the same things that our nerves produce, but they’re producing so much that it travels through the bloodstream now. So then it becomes an endocrine organ and producing hormones. But it doesn’t matter if it’s a physical stressor or emotional, mental stress, the result is the same on your body..

Then there’s stressors TO your body, like I’m cold, I’m hot, I’m exercising, I’m working, I’ve got an injury…which are primarily physical and they may have a secondary mental component to it. And one of these questions is, is all stress bad? Well, obviously it’s not. We have to have stress in order to grow…and grow stronger. Now I don’t agree with that old saying whatever doesn’t kill you makes you stronger. My brother lost his leg. It’s not growing back. That didn’t make him stronger. You know, there are wounds that leave scars that make things weaker. But there are stressors that do make us stronger and their stressors and what we call the hormetic zone. H O R M E T I C and our nurse practitioner, Kamila Fiore just wrote an article about the hermetic zone. And we use this in terms of foods and herbs.

For example, broccoli has toxins in it that amp up our detox system and our liver, which is why broccoli reduces cancer and other problems. It makes us stronger. If you were to take those same toxins and overdose on them, it could actually harm you, potentially, if you get more than you can process.d So what you want as the hormetic zone, and exercise is something we talk a lot about to be in the hormetic zone because the most important part of exercise, from our point of view is recovery. If you exercise beyond what you can recover from, then you turn exercise into work. So in exercise, you stress yourself and then you rest, you regrow, you rebuild, you get stronger, and then you stress yourself again. In work, you stress yourself and then you stress yourself, and then you stress yourself…..and pretty soon you’re old, tired and worn out.

>>   Exactly! You’ve got to recover.

So we don’t want to make exercise into work. You got to have recovery and how much you stress yourself and how much you recover. That balance is a little bit different for everybody, but you got to find your point where you can actually recover and get stronger. And that’s your hormetic zone. And it could be very different between people.

>>   Now talking about exercise makes me think, of course, of muscles. And a lot of people have a very direct correlation between how their muscles feel and their stress levels. Why is it that when we get stressed our muscles tense up and we get knots, because that’s a real physical manifestation that a lot of people experience?

Right, well, I imagine that’s just your nervous system sending those signals. The muscle tension, like your shoulders, you know, climb up to your ears and somebody comes up and before we were all physically distanced here, someone might come up behind you and put their hands on your shoulders and start to rub those muscles on the top of your shoulders, your trapezius. And you go, ahhhh, and your shoulders drop down and you realize your whole body has been holding tension. You were really kind of subconscious about.  And so our daily kind of stress, many of us hold it in our muscles that way, which is something I learned about when I went through massage school.

>>   It’s amazing what a difference that can make, just letting your muscles relax, and how that affects the frame of mind. So another question we have is can one form of stress, such as emotional versus physical, make another form of stress worse. Can your emotional stress make your physical stress worse, or can they have a synergistic effect that would just make everything worse?

Definitely synergistic. You’ve heard of ACEs – Adverse Childhood Event Score. It’s a form you fill out and basically how rough was your childhood? How many different traumas did you have during your childhood? And that score has been shown to directly correlate to how long your diagnosis list is of medical problems in adulthood. So the more traumatic stresses you have in youth, the more illnesses you’re going to have as an adult that shows how much that chronic thing is. And the thing about our thoughts is, nobody knows this for sure, but it’s estimated that 90% – 95% of our thoughts are subconscious thoughts. So we can see 5% to 10% of our thoughts, but then this subconscious belief system going on, even though we can’t see. And part of what meditation does is allow some of that to rise up from subconscious, to conscious, to be seen and dealt with.

And there’s a PhD named Bruce Lipton who wrote a book called, The Biology Of Belief, who talks about this, how our subconscious belief patterns actually affect a lot of what’s going on in our body over decades.

>>   So it sounds like you’re thinking that the ACEs score, the higher your score, the more trauma you experienced in your youth, that your adult outcome is not necessarily a function of actual physical trauma one may have experienced, but more of the emotional, psychological repercussions as we age.

Right! I mean, you could have a childhood that had zero actual physical trauma and you could still have a terrible ACEs score from the psychological trauma.

>>   And that would set you up for medical problems down the road?

Absolutely. It’s been shown. Now, I don’t believe that’s fixed. I believe that we can get in there and untie that knot to some extent, I have never seen it be completely undone. You know we do have some amount of fate in that…of what we’ve experienced is still our history. But you can see people who have had identical kind of upbringings and ACEs scores, and one ends up with terrible chronic fatigue and fibromyalgia, perhaps heroin addiction, or whatever it is. And the other one unravels that some and is able to live a functional life, even though that still comes up in dealing with themselves and their interpersonal relationships.

>>   It sounds like there’s always a lot of healing we can do.

There’s always a lot of healing we can do. Yeah.

>>   Which leads me to my next question for you. So just how amazing are our bodies in our ability to recover from stress?

They are pretty amazing. And, I’ve got to say that there are things we’re stuck with.

And I talked a lot about the adrenal glands, and I’ll notice that once people have adrenal fatigue, I’ve never seen anybody ever get completely back to normal. I’ve got adrenal fatigue, I got a high ACEs score. And then I went through medical school and residency and working in the emergency room, lots of stressors. Years of stress on my adrenal glands, as well as the subconscious belief stories that were being perpetuated. Because it’s not like medical school is a place to do personal healing. You come out worse than you go in. So my adrenals are fatigued and I’ve been treating them for 25 years now. And they’re better. I don’t pass out when I stand up now, but they’re not normal. I don’t think they’ll ever be normal. So there’s ongoing support that’s needed to continue that healing. So, healing is a relative term.

>>   But that is something that we can teach people how to do, how to support those functions so that they can have more control themselves.

That’s right. 

>>   Positive control, not neurotic control!

Positive influence….I wouldn’t say it’s control. You can influence the system quite a bit by your current choices and by the current supports that you have for your health.

>>    And another question regarding stress and how we react to it, “does comfort eating, drinking, smoking, all the things that people do, kind of the creature comforts…does that actually help our stress? Does that actually comfort our body in any way?

Well, I got to get back to the hormetic zone. I think it can. And my evidence for that is alcohol and heart disease. Because nobody knows exactly how it works, but if you’re a Teetotaler, you actually have more heart attacks and more deaths from heart disease than if you have an average of about four to six drinks a week. Now, if you get up to about above 12 drinks a week, you’re back to break even. And if you get above about 20 drinks a week, then you’re going to have more problems. And alcohol is definitely bad for some things like any alcohol at all, increased over time, increases the risk of breast cancer and prostate cancer, right? But since even women, for example, are six times more likely to die from heart disease than breast cancer. The stats work out then a little bit of alcohol can be very good. And the only theory I’ve ever heard for why that is, is as a stress reliever, because we know that stress increases heart attacks. When are most heart attacks? First thing, Monday morning, I mean does your body know that it’s Monday? I mean, we just created the calendar. We made all that up, you know, on Monday is no different than any other day, except for the fact that you had to get up and go to work and you don’t want to.

>>   And a lot of people have trouble falling asleep on a Sunday evening, specifically.

That’s right.

>>   Because you start thinking about what will the week bring and what’s going to happen and am I prepared?

And so there’s those stressors. So a little bit of alcohol for example has been shown to have definite health benefits. And you got to say that that’s one of the stress relievers, and perhaps some drinking and eating and different things….and sometimes those come with a social context. So the social context is one of the best stress relievers. And that’s one of the challenges right now. And we’re trying to not say social distancing, but physical distancing. We want people to stay socially connected. However, you can do it, whether that’s a meeting outside and having a drink for happy hour, but sitting outside six feet away from each other, but you’re still able to connect emotionally. It’s very important to do that. So I do think those things, but obviously if you go overboard with stress eating, with stress drinking with smoking things that are legal in some States, but not here, then you’re going to get past your hormetic zone, it’s going to be detrimental. So all things in moderation, this is a saying I like.

>>   And try not to judge yourself for it. If you do indulge from time to time because that probably doesn’t help stress either.

No, the judgment is a stress in and of itself.  So what are the fundamentals of managing stress?

Well, some of what you’re just talking about, you got to eat in a balanced way and especially eating the way that your blood sugar is stabilized. You want to eat in a way that you get all your nutrients. We see people who end up getting blood sugar roller coasters, and that’s a real stress, especially on the adrenal glands because when your blood sugar goes up, what goes up must come down, and then it crashes. And when it crashes your adrenal glands kick in or the fight or flight response of its own, and you get that shaky, wired, nervous feeling, and then you got to go eat something more and the blood sugar rollercoaster continues. So you want to stay off of that. You want to eat in a solid way.

>>   One thing you’ve taught me with regards to that I do keep in mind.  And it’s easy to remember if you’re going to have some sweets, pair it with a little protein, right?

Yeh, and fat and fiber. So a banana by itself is just all sugar, but a banana with almond butter on it….then you have fat fiber and protein and more nutrients. And that really changes the equation. The next is sleep, getting adequate sleep. And of course the biggest thing interrupting sleep these days is people being on their devices late at night and not being able to start their melatonin cycles on time. I’ve heard it said that an hour of sleep before midnight is worth two hours after midnight. So the old Benjamin Franklin early to bed early to rise makes it makes the person healthy, wealthy, and wise. So, you know, get to sleep by 10:00, 10:30 or 11pm at the latest. And don’t be looking at screens for an hour before your bed.

Don’t have your phone right next to your bed, put it across the room to charge to get away from it….to decrease your EMF’s and you know, sleep hygiene is way important. We talked about that with almost every patient…and having your room very dark, decreasing your EMF’s and having a regular schedule. So you can only change your sleep schedule by an hour a day. So if you’ve got to get up, at seven o’clock on Monday morning, then you want to get up at eight o’clock on Sunday morning, nine o’clock on a Saturday morning. Cause if you sleep in later than that, you’re going to really be stressing your body when you do get up earlier.

>>   Well, another thing to think about with the EMF’s at night and the screen time is not only do you have the blue light, but what are you looking at right before you go to bed? Do you want to be watching the news? Do you want to be looking at everyone’s opinions on social media? That’s just compounding the stress factor of things to think about.

Right! Because you’re probably going to change some reason opinion on social media, right? You’re going to make that comment that just changes somebody’s life changes their opinion.

>>   Right, ha ha ha….that’s why I got away from social media.

And then exercise… a lot of people can’t go to the gym right now, but you got to find a way to keep active and getting outside, which kind of combines with nature. If you can get out and just go for a walk, get a touch of nature. In Japan, I understand they have this tradition called forest bathing…where you just you’re in the forest for a certain amount of time. And you’re bathing in the energies of the forest. And luckily we’re blessed to have lots of forest around here and you can get out and still find some nature. So those are really the fundamentals.

You to sleep right, you eat right, you get exercise, and you get out in nature. And then you journal and especially gratitude journal. Now also if you have some bad thoughts…if you have some adverse emotions and thoughts running circles in your brain, journaling those can also be very useful. I can find if I just roll over, grab my journal and write them down, then I don’t have to feel like I have to continue to try to problem solve them. And then I can let go of them and go to sleep.

>>   You got it out!

And then you might follow that up with some things like, “okay, so that’s what I’m worried about. Now, what am I grateful for?” And then you can lay there and count sheep and count your blessings. Sheep are your blessings.

So do we have any more questions about stress?

>>   That covers it for now…because as you said, it’s kind of a tip of the iceberg subject, right? So I think this is a great start.

Alright….but if you all have questions about anything and we like to make these questions more widely applicable, not just like, how should I change my blood pressure medicine? But if you have a question, like, for example, what causes blood pressure, what are the three main reversible causes of blood pressure? We’d love to tackle those types of topics, just send them in. And where would they send those to?

>>   They’re going to be emailing those to: info@docbiddle.com, which is my email address here, the practice. So I’d love to get those questions and use them for upcoming podcasts.

If you want to see more about what we do, just go to docbiddle.com and we’ll talk to you next week.

Welcome to AIM for health: Root Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

Hey, I’m Dr. Biddle and today is the 3rd of June, 2020. And then I have our new patient coordinator, Joy Lambert to help us out today. Hi joy.

>>    Hello! It’s good to be back.

Yes! So we have people sending in questions. What do we have today?

>>  So a question that came across my desk today is people are wanting to know, is there a connection between sluggish bowel habits and hypothyroid? 

Absolutely.

Are we done? Should we go home?

>>   Well, no! What’s the connection?

What’s the connection…..!? Well, if you’ve got sluggish thyroid, you’ve got sluggish bowels and why is that word, metabolism.

>>  Well, what is metabolism?

It’s basically how well you turn food into usable energy in your body at the cellular level. And what drives the metabolism!? The thyroid. So your thyroid gland of course makes thyroid hormone. And that travels through your bloodstream and tells all your cells to be active. You know, and it’s almost easier to say what happens when you lack thyroid hormone, because that shows you then what thyroid hormone does. So if you have somebody whose thyroid just shuts down completely, and they’re not diagnosed after a few months, they’ll have all kinds of interesting things.

They’ll of course have mental dullness, they’ll have a weight gain, they’ll have fluid retention and this very weird stuff called non-pitting edema, meaning that when you press on it, it does not make it a little bump. It just doesn’t really give at all. It’s called myxedema, and it’s not so much fluid it’s more like a fatty fluid under there….very interesting…from the lack of the metabolism going on…and they get the dry hair and hair loss and dry skin and dry nails and coarse facial features. And of course, constipated. Everything just kind of stops moving because every cell in your body now doesn’t have the cellular energy production, energy production of ATP, which is kind of our little dollar bill currency of energy that we turned food into to actually do things in our cells.

And so every cell in your body is not doing what it’s supposed to do. A couple of fascinating things about that…..I had one patient go to another practitioner who’s not really licensed. And you know what…they did muscle testing and said, Oh, this thyroid hormone is not good for you, you should stop it.  And so six months later she was in the intensive cardiac intensive care unit with a pericardial tamponade.

There’s a sack around your heart called the pericardium. And there’s a little thin layer of fluid to lubricate it so that your heart can beat and have a smooth surface to meet on inside there. But that can fill up with fluid and then push on your heart so tight that your heart can’t then relax to fill up with fluid anymore. And she almost died from not taking her thyroid hormone. So that’s kind of the extreme case when I was in residency. In my actual medical school inpatient psychiatric rotation, I met a young man in his twenties with myxedema madness. He had temporary psychosis from a complete lack of thyroid hormone. He had hypothyroidism and had not been diagnosed. And that made him crazy. I mean, literally by the definition of crazy, he could not understand conscious reality and what was going on. He was seeing and hearing things.

So that’s all the wild stuff that profound hypothyroidism can cause, but usually what’s happening is people are going to their doctor and they have hypothyroidism and they’re given a certain medication, but it doesn’t work quite right. Or they’re given a lack there of. They’re not diagnosed with hypothyroidism and they’re given a lab test and told, Oh, your lab tests are normal, go home and stop whining at me. And, but in fact, they do have a functional hypothyroidism going on.

>>  So is the hypothyroidism defined by T4…or T3? Or you mentioned ATP?

Well, no, the energy action is actually TSH.  If you’re going to define hypothyroidism, it’s that your pituitary hormone or TSH goes high, trying to drive your thyroid gland. So normally it’s like 0.4 to 5.0, and if it goes higher than that, then you get an official diagnosis of hypothyroidism and then sometimes your T3 and T4 are low. And sometimes they’re not so low, and we’ve talked about this before, it’s that conversion of T4, your thyroid gland makes T4, and it has to be converted into T3 at the cellular level in order to really turn on your metabolism. And if people have anything wrong with them medically, they won’t do that perfect perfectly and “anything wrong” could mean you’re post-menopausal and you’re not on female hormones. It could mean you’re stressed. You know, there’s a lot that can go wrong with people. And of course in my medical practice, people are coming here because they’ve seen other doctors and not gotten the answers they want.

So the majority of my patient population has something going on that could mess up their metabolism or thyroid. So just giving them the usual medication of Synthroid or T4 and making their lab tests normal does not necessarily fix it. And then we check that up by checking their temperatures. And then sometimes you can check their T3, the reverse T3, but the problem is it doesn’t really happen in the bloodstream. It happens at the cellular level. So we like to have temperatures really tell the answer. And then what we do differently is rather than giving the Synthroid or T4, which is Levothyroxin, we’ll give natural thyroid like Armour or Nature Thyroid. And that is 25% of the T3 is still 75% T4, but at least it’s 25% better. If that’s still not good enough, then we’ll just give T3. And that’s through contacting pharmacies as a sustained release T3, or it’s from big pharma as Cytomel or Liothyronine.

Either way, now you’re half T3 and you can’t go down that weird pathway to reverse T3 and plug everything up. But I also want to point out that hypothyroidism is not the only thing that clogs-up or creates sluggish bowels.

>>  What else causes sluggish bowels?

Well, there’s a whole lot of possibilities. So one of the things, a simple straightforward thing, is you’re not eating enough fiber. The average American gets about 15 grams of fiber a day and they should be getting 50. So what constitutes what you would consider to be the right kind of fiber? Well, any dietary fiber is the right kind of fiber and you want a variety, but it’s fruits and vegetables and beans and nuts and seeds. And as a supplement, I like ground flax seeds for extra fiber because they have great nutritional value and they change how you get rid of toxins and they change how you metabolize your gender hormones.

So they decrease the risk of breast cancer, colon cancer, prostate cancer, diabetes, and heart disease, all those things for pennies a day for grinding up some flax seeds and throwing it into your smoothie or oatmeal or something like that. It’s easy to get those in and just basically your prebiotic or your probiotic. It’s what your probiotic eats and ferments in order to make great things that give you a good gut health, which brings us to the next common cause of constipation. And that’s not good bowel flora, your microbiome is off and what’s been shown to actually control your microbiome is your diet. Are you eating enough fiber? Are you exercising?

So how does exercise regulate your gut for? A lack of activity is another being cause of constipation. Not only does it help your microbiome through some mechanism or another, but it just gets everything moving. I mean, you just get up and move and that’s going to help your gut regulate and move.

>>  And when it comes to your gut flora, I’ve heard you say this before, but just so that everyone gets this benefit, when it comes to your actual stool, it’s not all just the food we’ve eaten, right?

There is a relationship with the gut flora. My understanding is about half  of what comes out as your poop is the dead bodies of the good bacteria in your gut. It’s your gut bacteria multiplying and then dying. And that makes up a large percentage of our bowel movements. So you have to have those good bacteria. And we’ve been trying out a new type of probiotic called a spore biotic, (I’ve tried many types of probiotics…I personally never saw a difference, but I tried this and I actually saw a change in my bowel movements. They even got even better.) Other people that aren’t starting to report at the same thing, and the difference is the regular probiotics are alive. And so they can be killed by your stomach acid by sitting on the shelf by many things, the Spore Biotics are not alive. They’re the “seed”…. They are the heat resistant, drought resistant spore of the probiotic. And they go in past your stomach acid and seed into your small intestine and your large intestine. They have been shown to establish there better and to reverse leaky gut syndrome and food allergies. So we really like the Spore Biotics. It may not pan out, but it seems good from where I sit right now.

Dehydration, people not drinking enough water through the day, can also cause constipation.

>>   And since we’re getting into hot weather now, when it comes to drinking enough, what’s enough water?

I suspect that the science around this is not as good people say with such confidence, like you should drink six glasses of six ounces of water a day. Well, you know what, if you’re a hundred pounds or 250 pounds…..there’s a difference.

>>   I’ve heard a general rule of half your body weight. And then that in ounces would be a reasonable target.

>>    Yeah. I like to use looking at your urine. Your urine should be diluted and not concentrated. You know, when you’re getting dehydrated, your urine is getting really dark. Now, when you take the multivitamins and stuff, you have B2 which makes it fluorescent yellow. But otherwise, your urine should be fairly pale. And if it’s getting to where it’s getting really dark yellow or brown, you are dehydrated, then that’s a sign you need to start drinking more.

If you’ve noticed you haven’t peed for three hours and you just squeeze out a couple tablespoons, you got a problem. You know, you’ve got to keep those kidneys flushing well.

>>   If you’re dehydrated, then doesn’t your body absorb more moisture out of your stool as you’re digesting, which would make your stools harder and more compact and therefore make you more likely to be constipated?

That’s right. And that kind of brings us back to the root thing of why do we poop in the first place? And, what are they supposed to be like? So we proved to get rid of this stuff, the dead bodies of the bacteria we put to get rid of toxins, and poop to get rid of the stuff that we’re not using by our cells. The part of food that we are saying, okay, thank you very much…you become part of me and YOU don’t become part of me. And then we poop out the part that’s not become part of us. It is liquid when it moves from your small intestine to your large intestine. At that point, your stool is still liquid really. And the largest role of your large of your bowel of your colon is to reabsorb water.

And as it reabsorbs water, it also happens to reabsorb toxins. And that’s another reason why fiber is so important… the fiber binds onto toxins and helps you poop out toxins rather than continuously reabsorbing them up through the liver. This is called entro-hepatic-circulation, where your liver works all day long to conjugate and excrete things like the bad estrogen that causes breast cancer. But then in your bowel, if you don’t have enough fiber to hang on to, now you have bacteria that unconjugated them and you reabsorb them right back up to your liver again. And you’ve got to do all that work all over again. Now you are toxifying yourself just by not pooping enough.

>>   And so how often should you poop?

Well, how often do you eat? You know, most people eat two, three, four times a day, and I think they should poop two, three, four times a day.  You want to keep it moving and it should be formed or loosely formed, it should no float and it shouldn’t be difficult to get rid of. You shouldn’t have time to read in the bathroom. You should be able to sit down, take care of your business, clean up, and move along. If you’re not doing that yet then there’s things you can do to get there.

I’m amazed at how many people think that pooping three times a week is fine. And it may be average for Americans, but it’s not fine.

>>   No, that just sounds terribly uncomfortable.

They are full of it and they’re getting toxic.  So other things that can cause constipation that I’ve found is food allergies can cause constipation. Food allergies in our experience cause gut paralysis and in women that tends to show up more as constipation, in men it tends to show up more as acid reflux.  It certainly crosses both ways, but what happens is if your things aren’t moving down, then they kind of back up and you get the acid reflux or you get the constipation. One of the biggest food allergens, I think, especially for women, is being allergic to their own candida or yeast growing in their gut.

>>   So you’re saying I could be allergic to myself?

Well, you can be allergic to what’s growing in your gut, which also relates to how good is your microbiome. Because if you have a stronger probiotics in your gut, you’re going to have less yeast. And how good is your diet? Because if you have less sugar and more fiber, you have less yeast. And how well balanced are your hormones? We all hear about women who go through their menstrual cycles and in part of the month, usually the PMs phase, they get constipated when their hormones change.

And part of what happens when the hormones change is it makes the terrain more hospitable for yeast growing.

>>   Candida is yeast, just to make sure everyone understands that.

Yes, it’s a type of yeast that grows in our gut and everybody has it. You can’t eradicate it, but it supposed to be in balance, like staph on your skin. We all have staph on our skin. You can’t get rid of it. It’s always there, but you should not be having staph infections on your skin.  The same is true for yeast. You know, in our mouth, the overgrows is thrush, obviously vaginally, you can get vaginal yeast infections, but in our gut it’s candida. And it’s one of those things that conventional doctors have not been very open-minded to, but it’s been known in the alternative world for over 40 years that this yeast overgrowth is a very common problem.

Part of what’s making that worse and food allergies worse is the amount of toxins we’re exposed to like, like glyphosphate or Roundup in our diet, right? And even heavy metals like mercury really disrupt the gut lining and cause leaky gut syndrome. And then we get more food allergies from the immune system, seeing undigested particles of food going across the gut wall. And then that snowballs and you get yeast overgrowth, you become allergic to that and all of a sudden your constipated. There’s so many things that go into this, it can be a lot! So it’s not just that you have, if you’re constipated, you have a sluggish thyroid, that’s just one thing that can make you constipated.

So when we’re looking down the constipation protocol we want to look at all those different things. And then once we make sure we’ve cleaned those things up, or even before, we can certainly give people things to help the constipation.  And my favorite is magnesium.

>>  Tell me about that. How does that work?

Well, magnesium relaxes your muscles. And if you take more magnesium than you can absorb in your small intestine, the rest hits your colon and moves on through, and if you overdose the magnesium, you can get a roaring diarrhea. And that’s what magnesium oxide does. There’s basically three different categories of magnesium: that which absorbs very poorly, so it’s used to cleanse the bowel like magnesium oxide, and that which absorbs really well, so it’s used to raise the blood levels like magnesium chelates that are hooked on to an amino acid to help them absorb better, so they get better blood levels and less effect on your bowels. And then middle of the road is magnesium citrate. It both raises blood levels well and can help move your bowels if you’re constipated.

We mentioned the ground flax seeds and more water and probiotics and eating more fruits and vegetables. And then there is an Ayurvedic preparation called Triphala. It’s kind of the concept of prunes, but it’s three fruits and it’s not addictive. You can use it the rest of your life. It helps actually helps tone the bowel and it’s put into capsules. And we find it’s one of the gentle ways to keep people regular who have had long-term chronic constipation problems.  And then of course fixing the thyroid.

>>   Now, when you’re talking about magnesium, that if you take enough of it more than your body can absorb, it can have a laxative effect. Doesn’t vitamin C do the same thing?

It does. The dosages for magnesium is about 200mg for most people….around 200 to 250 milligrams per dose that will do that. If you get up to 300 or 400 per dose, you know, then you can spread it out and you can have a dose in the morning and dose in the evening. And so you can get more into your body without the laxative effect. And then for vitamin C, it’s around 2000 milligrams per dose for most people, but there’s a wide degree of individual sensitivity. But again, if you spread it out, you can get a thousand milligrams, three to four times a day, and most people will be fine.  But most people, when they get above about 6,000 to 8,000 milligrams a day, they’ll start to get gassy bloating diarrhea…whereas the magnesium  stool is more slick, surprising diarrhea. That’s a tough decision where it catches you off guard. And if you do both together then it can really get shocked by what’s going on, but you won’t be constipated anymore.

The best idea to titrate is to find your bowel tolerance and to get just a little bit too much action. And then you back off and find your sustainable dose, where you’re helping your body out by getting blood levels of magnesium and vitamin C so you’re pooping regularly, but you’re not having accidents.

>>   Anything else we should cover about constipation? Now that we know that there’s all these different reasons why it could be happening, what’s a good place to start in terms of what do I do next?

Well, you drink more, you move more, you eat more of the right foods. You add ground flax seeds. You make sure you get your thyroid tested. And if your lab tests are normal, but you’re still suspicious, you take your temperatures, not first thing in the morning, cause everybody’s cold. You want to take your temperatures in the middle of the day, like between 11:00 AM and 3:00 PM. And we actually prefer the old glass thermometers under the tongue for 7 to 10 minutes for accuracy. The other ones are okay, but they have too much variability. If you do them three times in a row, you notice you get three different numbers, and it should be about 98.0 or better on the average. And if you’re constantly less than 98.0, then you’ve probably got a thyroid conversion issue.

Even if you don’t have a thyroid production problem, the lab test tells you if you are making enough thyroid hormone. And then your temperature should tell you if you are using it the right way. And you know, I gotta say, if it’s a newer problem you should make sure you don’t have a serious medical condition. Cause a large colon polyp, colon cancer, these very serious things. We are fans of screening to make sure you’re not missing a bad thing.

>>   A thought along those lines is about hemorrhoids. Would hemorrhoids cause constipation or just constipation lead to hemorrhoids or is it something different altogether?

Constipation leads to hemorrhoids for sure. And as people who live long-term with constipation, and haven’t really learned how to poop properly by relaxing, this can be common. We often teach people about the Squatty potty. If you put your body in a position of squatting by raising your feet and knees then that relaxes the anal sphincter muscle and it lets everything out better and people really should not have to push regularly to poop. And if every day you’re pushing to poop it causes hemorrhoids. The other thing that contributes to hemorrhoids is things like weightlifting or working-out in pregnancy and such.

**We hope you enjoyed this episode. If you have questions you’d like explored in an audio podcast with Dr. Biddle, please use the contact form here to send them to us. Take care!

All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

Hello, I’m Dr. Biddle and we’re going to talk about the thyroid gland today and problems with the thyroid that are often missed by conventional medical doctors. And to help me out, I have Robyn Paulete, who is our educational outreach coordinator.

And we’re of course talking on the phone because this is done during the COVID-19 stay at home and stay safe orders. So I hope this technically works out okay for y’all listening at home. The first thing I want to do is just introduce the thyroid gland. So the thyroid gland sits right above your chest right at the bottom of your neck, in the front. It moves up and down when you swallow. If it’s enlarged it’s called a goiter, and you may have at some point seen somebody with a goiter there. The thyroid makes a hormone called “thyroid hormone”….. actually, it makes a couple of hormones.

A thyroid hormone is more complicated than just one hormone, which is the the root of our conversation today. Thyroid makes the thyroid hormone called T4 or thyroxin. And what does thyroid hormone do? It keeps you alive! It helps your to create energy at the cellular level. So if you don’t have enough thyroid hormone, or if you don’t make the right types of thyroid hormone, then you’re going to feel a lack of energy. And that shows up throughout the body.

It shows up as fatigue, weight gain, mental dullness, sluggishness, especially in your bowels. A lot of times constipation…if it shows up as swelling and bloating it’s called myxedema. It’s fluid between your tissues and it can even show up as psychosis. When I was in my residency doing my psychiatric rotation on an inpatient, I got to see a young man who had an acute hypothyroidism that was undiagnosed, and he had what’s called myxedema madness, which is a psychosis from a lack of thyroid hormone.

I had one other kind of alternative practitioner take one of my patients off of thyroid hormone and six months later she was in the cardiac intensive care unit with pericardial tamponade, which means she had fluid between the sack around her heart and it was filling up with fluid so her heart couldn’t beat. So you can’t just stop your thyroid hormone treatment if you need it. Everybody needs thyroid hormone. You can’t live without it.

>>    I’m curious about how come there are so many undiagnosed thyroid disorders. If this hormone is so important, and it seems like we’re deficient in it, wouldn’t the symptoms be pretty obvious? Tell me more about how there are so many undiagnosed thyroid disorders? 

Well, that kind of goes upon what are your diagnostic criteria?  I have a medical license in North Carolina and I am very interested in keeping my medical license in North Carolina. I don’t want to lose it. And so everything I do in my practice, I run through a filter in my brain that says, can I defend this in court? Can I defend this scientifically? And if I can’t, then I don’t do it in my practice. And so when I do diagnoses of actual hypothyroidism, I use the conventional criteria, which means you have an elevated TSH. And TSH is the pituitary hormone that we make called Thyroid Stimulating Hormone. And it’s the hormone that goes from your brain and your pituitary to your thyroid gland through the bloodstream and tells your thyroid gland to make thyroid hormone. And if your thyroid gland is sucking wind and not doing well, then your TSH goes up pushing on the gas, telling your thyroid gland to make more thyroid hormone.

Now, if you’re hyper thyroid, then your TSH will be suppressed because it’s a negative feedback loop. It’ll be trying to put on the brakes and say, hey, don’t make so much. So the diagnostic criteria is you’d have a TSH over the lab reference range, which varies from lab to lab. It’s somewhere around 4.5 to 6.2. So that’s the conventional criteria for hypothyroidism. But many, many people have what is often called subclinical hypothyroidism, which means you have symptoms and your symptoms are consistent with thyroid dysfunction. And from our criteria, it looks like your thyroid glands not working. But we can’t really diagnose you hypothyroid because your lab tests aren’t out of range yet.

>>    That makes sense. And that seems to happen often. Is that true?

It does happen often. I get people all the time. They say everything I read says that I had the symptoms of hypothyroidism, but my doctor tells me my labs are normal. So how can that happen?

>>    Yes. How can that happen? 

Well, the first way that can happen is the lab tests aren’t sensitive enough, so they don’t diagnose hypothyroidism until you have a TSH over about five. We want a TSH less than three. So anytime the TSH is greater than three, I’m suspicious that your thyroid gland is sluggish. If you have a goiter or nodules on your thyroid gland, then those are signs that your thyroid gland is missing something that it needs or is poisoned in some way and it’s slipping.

The analogy I would use would be when your transmission in your car starts to go out and you push on the gas. Your engine revs, but nothing happens. The power doesn’t get to the wheels and your transmission slips. And that’s what it feels like with your metabolism when your thyroid gland isn’t working quite right.

So the next way you can have a problem is that you make enough thyroid hormone but it’s not the right type. And this is one of the things I’m most excited about over the last 25 years in studying thyroid health….and that is most missed by conventional doctors, especially endocrinologists. Endocrinologists really for some reason don’t like this concept. But I’m gonna explain it to you. The psychiatrists and the OB-GYN’s get it because it’s all through their literature. And that is this: The conversion of T4 to T3. So T4 is the main hormone that the thyroid is producing, right? And then it needs to convert it to another hormone.

But that conversion doesn’t actually happen in the thyroid gland. So your thyroid gland mostly makes T4 or thyroxin, but that’s not an active hormone in the body. It’s a precursor hormone. And then in your liver and in your bloodstream or in your cells actually throughout your body, your cells convert the T4 into T3, also called triiodothyronine.

And that is what actually turns on your metabolism. So basically a molecule of thyroid hormone has four amino acids called tyrosine, four of them in a ring. And then off of each one of those is an iodine. So there’s four iodines. And if you knock off the proper iodine, then you get this active hormone called T3. But if you knock off the wrong iodine, you get an inactive hormone called reverse T3.

And the knocking off, that’s the process of the conversion from one to the other.

And that conversion doesn’t just kind of happen randomly. It has a specific enzyme that does that called five prime deiodinase.  I know it’s a mouthful. If you knock off the wrong one, you get this inactive hormone called reverse T3, which actually clogs up your receptors. The thyroid homone works by going through the cell membrane into the nucleus of the cell and actually has nuclear receptors.

But the reverse T3 clog up the receptors and then it can’t even receive the signal of T3. So then people will get stuck in this pattern of having a reverse T3 rather than T3. And they’ll have all the symptoms of hypothyroidism that I already described. But especially, what I didn’t say yet, is low body temperatures. And we check temperatures generally with an old fashioned glass oral thermometer under the tongue for seven to 10 minutes. It takes more than five minutes.

You got to learn how to shake it down or you put it in a sock and spin it to get it down and you do it in the middle of the day because we want to know how hot you get at your hottest.

We don’t care how cold you are when you first wake up. That’s fine if you’re trying to get pregnant or not get pregnant, if you’re trying to track when you’re ovulating. But if you want to know whether your thyroid’s working, you want to know, do you get up to your 98.2 to 98.6 that you’re like you’re supposed to in the middle of the day or 37.0 Celsius!?

And this is indicative of how well the conversion from T4 to T3 is. If we have a normal TSH we know you’re making enough thyroid hormone. The next question is, can you use it? Are you actually able to use it?

>>    Okay, so I was going to ask you that. It seems like there’s two parts to this. There’s the TSH and the creation of T4 that could be one potential problem, or lead into hypothyroidism, or it could be a conversion of the T4 to T3. Am I understanding that correct?

Exactly. In the first part, you know when it gets bad enough will eventually be recognized by your physicians. And then what they’re going to give you is T4 replacement, called Synthroid.

>>  Okay. So they’re not even going to consider that maybe the issue is in the conversion?

Never. They’ll never consider that. The only time they consider that is in the intensive care unit. There’s a process that’s also associated with ICU psychosis and other things. But when you’re ill, your body shuts down your thyroid conversion. And that’s called euthyroid sick syndrome. But that comes back to the question of, why do we have this alternative pathway? Why would we ever make reverse T3?

Well, in our evolution, it’s a way to survive. So let’s say you break your leg and you can’t get any food or you’re starving to death. What you do, your body shuts down your metabolism to burn less calories and live till spring or live until your leg heals and you can go find some food. So it’s a way of surviving, but we get stuck there and the reasons we get stuck there in our modern culture is what fascinates me and what I’ve really been looking at for the last 25 years with our thyroid.

It comes down to three basic categories. Well maybe four, maybe five! But the first is a lack of the proper nutrients. We don’t get the proper nutrients. And for this, this includes of course iodine, tyrosine, and also zinc, selenium, iron, and certain other vitamins like B6. So half of Americans, for example, are low in zinc. I don’t know how many are low in selenium, but quite a few. Iodine for sure. We used to give iodine in the salt to get rid of goiters at one point in the middle of the United States, in the Northern part of the Midwest. You know, up to three fourths of people had goiters because of lack of iodine. And that’s why we put iodine into the salt. But now people are eating all this fancy sea salt without iodine. And so we’re seeing this resurgence of goiters over the last 10, 15 years.

So the first thing is nutrient deficiencies. And in integrative medicine we measure these. We can measure all these and figure out what you need and give it to you. The second category is toxicities, especially heavy metals like mercury, lead, cadmium, arsenic. All of these, but especially mercury poisons the thyroid gland. And these are more prevalent than people realize, especially if you like your sushi, and even more especially if you eat tuna.

There’s a series of patient studies right out of conventional medicine from, for example, San Francisco who would go out and eat sushi two or three times a week. And by conventional blood testing, they showed really toxic in mercury from the tuna. Other things show that, for example, dental assistants who had exposure to amalgam fillings. Back in the day, there’s not as much amalgam and there’s not as much mercury in fillings anymore. But when I started the practice over 20 years ago, more than half of the fillings put in in the United States were still mercury fillings and the dental assistants have the highest rate of thyroid disorders and infertility and miscarriage. It’s really, really sad.

So we can measure all these toxicities and we can help get rid of them. The other category of toxicities besides the heavy metals is all the pesticides and plastics and petrochemicals. So for example, glyphosate, which is commonly marketed as Roundup and other pesticides can inhibit these enzymes too. So we can measure those actually in your urine and see if you’re getting excessive exposure. And of course your lifestyle for that is to eat organically and avoid those things, right? And then it’s your other hormone balance. You know, if your other hormones are out of whack, then your thyroid can’t convert.

So, you have the adrenals making cortisol and DHEA, your gonads making either to testosterone for men or estrogen and progesterone for women, and then your thyroid….they’re all playing together as a concert. And if you go to a concert and the violin’s dropout or the the bass drum is four times louder than it should be, then the concert is not going to sound good. It’s not going to all go together. So if your other hormones are not in balance, then this will all go awry, which is why in my observation, the vast majority of postmenopausal women who are not on bio-identical female hormone replacement therapy have some degree of this conversion disorder, which by the way has a name, it’s called Wilson’s Syndrome, named after Dr. Dennis Wilson. And he has a website you can go to. It’s a wilsonsyndrome.com.

>>    Okay. So just to recap, it’s the conversion from T4 to T3 that is often sabotaged by really three primary things, and that’s nutrient deficiencies, heavy metal toxicities and petrochemicals, and then the other hormone balance in the body!?

Yes, and the fourth big category would be chronic infections, and we talk more about that when we get into the autoimmune conditions like Hashimoto’s, but the chronic infections…and the most commonly known one is Reactivated Mono or Epstein BARR virus, but there’s a lot of different chronic infections and autoimmune diseases that can throw off the thyroid if you’re generally sick in any way. If you’re chronically ill, you’re going to have this problem converting your thyroid because there’s going to be something wrong. And a large percentage of Americans are chronically ill.

>> And is there hope for these people who are suffering with this? The conversion issues and the sabotages that are leading to it?

There is hope! And the hope falls in two broad camps. One is if you need thyroid hormone, if you are hypothyroid, then the type of thyroid hormone we give you can be changed. And the second is if you don’t need thyroid hormone, then fixing all these other things and temporarily supporting you with the right type of thyroid hormone can help. So if you’re hypothyroid, then most likely you’re taking Synthroid or levothyroxine….it’s that T4. And the reason is because the makers of Synthroid had the greatest marketing coup ever in modern history.

For 60 years they have brainwashed all doctors and especially endocrinologists that you’ve got to give T4 because other types of thyroid hormone don’t work right and are unstable. Now, we CAN give T3, it comes over the counter from a prescription pharmacy, but mass made by big pharma as a Cytomel. And that works really well.  And you have to take it usually twice a day, which is the big downside because it is a very short live molecule. So you’ve got to take it in the morning, and take it again in the afternoon, generally, if you’re on higher doses. You can also get it from a compounding pharmacy called sustained release T3 or SRT3, and that sometimes you can take just once in the morning.

>>    Okay. So it seems like typically conventional medicine likes to go the route of just giving the body more T4. Right? But the Integrative Medicine approach is really looking at the problem may not be needing more T4 but converting it….so giving the body T3 instead?

Right. And what happens, how you feel when what you need is T3, but instead of they give you more T4 trying to make you feel better, is you’ll feel better for a few weeks and then you’ll be back to where you started having all those symptoms of hypothyroidism…the weight gain and sluggishness and fluid retention and things like that. But now you’re also going to feel wired. You’ll be wired and tired. It’s not good at all. It’s kind of like drinking too much caffeine…but you’re still sleep deprived, right? You’re just getting too much T4 and not enough. T3.

>>    So hypothyroid seems like a really great example of the value of investigative integrative medicine and the focus on root cause, because as you named those four primary sabotages to T4 T3 conversion, it seems like addressing those as the root cause of the thyroid issue… when you get in there and address those, people tend to see a turnaround?

Absolutely. It’s going to be a little bit different for everybody and it takes some time to turn those things around. Now, by giving you some T3, you can feel better right away, and if you need to be on thyroid hormone the rest of your life anyway, if you’re already in that situation, then we can just give you T3 for the rest of your life and that’ll be good. But you know what? If you have these problems, if you have nutrient deficiencies, heavy metal toxicities, and other types of toxicities, hormonal imbalances or chronic infections, they’re going to start to show up as other problems in your health too. So we like to go after those anyway because then your overall health is going to get better and it’s going to be good for your risk of, for example, vascular disease or cancer or dementia or physical frailty, which are the main ways that we age, and do “not well” at the end of the line.

>>    Right. So important. That really helped me understand more about what’s happening in my thyroid and where things get clogged in the process of having my body function optimally, that conversion piece, especially.

Yeah. We’ve got to get the right type of hormone if you need it. And that’s shown by a very simple test, just taking your temperatures. You know, why? Why can’t we do blood tests for this? So I see people and I have done it measuring the blood levels of T3 and reverse T3and T4 and sometimes that will show, but often it doesn’t. And that’s because this conversion happens at the cellular level.

That’s why we do the temperatures test and go from there. That way we’re going to give the right type of thyroid hormone that really works for you. And that will drive some doctors really loony when they see us do that. And then we’re going to work on balancing your other hormones, your gender hormones, your adrenal hormones….work on suppressing chronic infections if you have them, we can identify those  and measure your nutrients and replace those and then measure your heavy metal toxicities and other types of disease and help you detoxify them.

>>    Amazing. You make it sound so simple. So that’s very refreshing.

Well, the devil’s in the details all the time, isn’t it?

>>    Indeed it is. 

All right. Well I hope this helps you understand thyroid better.

>>  Yes! Was there anything, for our listeners, that I didn’t think to ask that you feel like might help wrap this up….understanding why we have thyroid issues in the first place, and that it’s not necessarily what conventional medicine is telling us and treating us with…but that it’s something else that is the root cause?

Well, I’m always go back to nature’s balance, right? In a perfectly healthy person, their thyroid is gonna keep working right. If your thyroid is not working right there is some reason…but we may not have figured it out yet. Doctors may not have figured out why that is and unfortunately in the conventional medical model, they’re not very curious about why that is. For example, one in four women after menopause go hypothyroid. Well that pretty much tells you there’s a relationship with thyroid functioning to female hormones, right? Cause that doesn’t happen for guys at age 50. So you know, in Integrative Medicine we have that curiosity, that Sherlock Holmes mentality of like, “what went wrong, why, why aren’t you perfectly healthy and how can we restore that!?”

>>  Right. That makes sense…that that’s the direction to look…that hose are the questions to ask. 

Audio transcription below:

Dr. B>  Hey, I’m Dr. Biddle and we’re going to talk about allergies today. I have our new patient coordinator, Joy Lambert here to help me out.

Joy > Yes, hi. How are you?

Dr. B> Good. I have not succumb to the Corona virus!

Joy> Excellent. Myself included. So far, so good. Let’s hope it stays that way. But you know, something else happening during this time also. Right now, amidst the pandemic, the trees and plants are blooming.

Dr. B> It’s beautiful. I have three Oak trees in my yard and everything is covered with green, so I have to clean off the outdoor furniture a lot.

Joy>  It’s always nice to see the return of green. But that means allergies too, which brings us to today’s topic. Allergies and the pollen season. It’s happening. I thought we could start by talking about what IS an allergy, exactly?

Dr. B>  An allergy is an inappropriate immune response to something that is otherwise harmless. So if you do not have a ragweed allergy, you can throw a blanket down in a field and have a wonderful picnic. And if you have a terrible ragweed allergy, that can put you in the hospital with a severe asthma attack, or at least make you miserable with watery eyes and runny nose and sneezing and brain fog and fatigue.

And I know when I have allergies flaring up, I feel really antisocial. I don’t want to be around anybody and I want to talk to anybody. I felt irritable. I feel stupid. A “histamine brain” is a real thing. It makes your brain feel all inflamed.

Joy> So what do you mean by histamine brain? What is a histamine reaction? Isn’t that the reaction of the allergy?

Dr. B>   Well, histamine is a chemical we make in our body and it causes tiny blood vessels and our membranes, like those in your nose, to become more permeable so that they leak fluid which we call, snot. That’s our body’s way of trying to get rid of that stuff that we’re reacting to. Try to wash it away. Dilution is the solution! Try to flush it out. And we release that histamine when our white blood cells deep granulate, especially ones called eosinophils.

When our antibodies, called IgE antibodies but sometimes IgG antibodies, hook onto something that they’ve decided is alien, dangerous like ragweed, then they get our white blood cells to release all this histamine and it starts to cycle.

Joy> Well, what creates these allergies in the first place? Why do we react to some things but not others?

Dr. B> Well, there’s two levels to that. Some molecules are shaped such that they’re more irritating to our immune systems. This is why you get more people who are allergic to ragweed than are allergic to Rose pollen…even though Rose fever was the original word for hay fever, ragweed pollen shapes are reliably irritating.

But let’s also look at food allergies. More people become allergic to eggs and wheat and dairy and nuts, then they do to broccoli and sweet potatoes. And that has to do with the shapes of the proteins and how irritating they are to our immune system. But in the bigger picture of allergies, they were really unheard of in the medical literature before the industrial revolution.

If you look at the ancient Greek in Romans, Indian Ayurvedic texts, ancient Chinese medicine, there’s really not a mention of allergies and I believe that’s because the origin of allergies is from a growing toxicity load. The first place that Rose fever was first identified was in the belt buckle of the industrial revolution, in Liverpool, England, where they were burning massive amounts of coal for shipyard building and things like that.

Factory production and coal is kind of our Pandora’s box. Inside the coal is all this lead and arsenic and mercury and cadmium and other toxic metals, especially mercury. When there was great rain forests upon the earth and giant beasts called dinosaurs roamed the earth for hundreds of millions of years, there was a lot more volcanic activity, and the atmosphere of the earth contained a lot more toxic metals. So these reptiles were not as susceptible to toxic metals as we are, because they evolved with them.

Over hundreds of millions of years, a lot of those toxic metals were captured by the forests and then buried in the crust of the earth. And we have come along and dug them up and we’re burning them. And burning coal is the leading source of putting mercury into our environment.

Joy>  I had no idea! That’s shocking.

Dr. B.> Yeah. The mercury goes up into the atmosphere from the smoke stacks of the coal burning power plants and gets distributed across the world. So, you know, on a bad day when it’s not the coronavirus shutting down factories, you can actually have pollution coming into the West coast United States from China burning coal. It travels a long way. But all that mercury deposits into the Pacific ocean…in the silt and then the microorganisms eat it…and then the tiny fish eat that and the medium sized fish eat those. And the larger fish eat that. And then we eat the tuna.

Joy> And so that’s where mercury in big fish comes from, is from the toxins that were released from burning coal, which trapped the mercury in the first place?

Dr. B> Exactly. And then it concentrates up the food chain. So a large fish like a tuna is going to have a lot of mercury. Cause once it gets in the fish, they don’t get rid of it, they just store it. For us, the half life of mercury is 25 to 50 years, which means 50 years later you still have half of what you started with under your own ability to detoxify it depending on how good you are at that.

Joy> So was it our exposure to plants absorbing toxins that creates the allergy or is it an association if we’re exposed to a toxin around a certain plant or other substances?

Dr. B>  Well, micro plants, like algae and plankton…they are picking all these toxins up from the silt of wetlands and such. But like I said, a large fish will have bio-concentrated mercury from the equivalent of tens of thousands of small fish. So it really gets to a substantial level and where that fish is swimming around, for example, an oil drilling rig in the Gulf that uses mercury to extract oil, then it’s going to have it even more. You can have one fish that’s extremely higher in mercury than all of its cousins. It’s been well shown, and this is also true for the other heavy metals, but I like to focus on mercury cause a lot of research has been done.

Mercury irritates our immune system. It does a lot of bad things to us. But one of the things it does is it confuses and irritates our immune system. It’s been shown to dramatically increase our allergies. This is even true in heart disease. So if you’re higher in mercury, not only do you oxidize your cholesterol more, and cholesterol is bad for heart disease, but you become more likely to make antibodies against your own oxidized cholesterol. And that increases the inflammatory reaction in the artery wall that causes the plaque formation of heart disease. So heavy metals are one of the strongest risk factors for heart disease. In some ways it’s almost an autoimmune phenomenon of a having this reaction going on in your own blood vessels. And that same sort of irritation to our immune systems then makes us allergic to other things.

Allergy rates have been going up at about 5% per year. That’s a lot…for decades! So, I mean, it’s great for business if you’re an allergist. Sure. But it’s horrible for the community. And you know, when we were kids, you’d never heard much about peanut allergy, right!? And when you went on planes they gave you peanuts, right? But now you have all these peanut free, nut free snacks…and that’s just one thing. Then there’s the growing rate of gluten sensitivity. And our theory about that is the glyphosate in RoundUp (weed killer) that get’s into the foods we eat and the water we drink, is causing gut irritation and leaky gut syndrome.

Our immune system starts to see these molecules that they don’t usually see and starts to attack them. So there’s this relationship between inhalant allergies, like mold and pollen, dog and cat hair…and then the food allergies. They’re all going up and they drive each other.

Joy> Getting back to focusing on the inhalant allergies, since all the flowers are starting to bloom now, do you have any thoughts as to why environmental allergies seem to manifest with the stuffy, congested, snotty kind of head cold symptoms as opposed to things like the hives or the throat swelling that one may experience, say with a peanut allergy or something like that?

Dr. B> Just the route of exposure. I mean, they’re right up your nose and your sinuses,  they’re in your mouth from breathing the air, but you’re not swallowing it so much. You’re not eating pine pollen.  You sneeze it out.

So with inhalant or seasonal allergies, are they just annoying in general and not something to be concerned about or is there something going on, on a deeper level that is potentially hurting us?

Dr. B> Now, that’s a great question. It’s just annoying for the individual, for most people. However, if you go on to develop asthma, which has a strong correlation with allergies, that can be life threatening or at least take you out of the game, literally, like if you’re playing soccer and your asthma comes on, you pull out of the game.

You know, my four year old girl has had a type of asthma called reactive airways disease where she gets asthma only when she’s sick with a virus or something. So normally she doesn’t have asthma. But when she’s sick she does. And this is really common. I had that when I was a young child also, and I grew out of it. But it’s really scary when you’re up in the middle of the night with a kid wheezing and you have to give them a nebulizer and the question, should I take this kid to the ER or not?

It’s a scary thing. People die from it. When I was in the ER doctor, one of our nurses had an asthma attack and died right there in the ER, even though they had all the help right there. So I take asthma extremely seriously. When I see my own kid wheezing, I get pretty darn nervous.

With food allergies, they can show up as a wider variety of things. So like you said, it could show up as gut irritation. It can show up as eczema. It could show up as inhalant allergies. It could look like you got stuffy nose after you eat food you’re allergic to, it can show up as an autoimmune disease. We think food allergies are a big trigger for things like lupus and thyroiditis, Hashimoto’s, you know, things like that.

And there’s a lot of evidence to support this, so I would say the food allergies have a much more diverse presentation and it can be almost anything…like a great mimicker. And then inhalant allergies are usually a much more straight forward, with the upper respiratory symptoms.

Joy> And so what can we do about it?

Dr. B> What can we do with the inhaled allergies? You certainly want to restrict your exposure, but you have to go outside sometimes. Sure. You want to live in a clean space. You know, it’s nice to run air filters. It’s nice to make sure you don’t have mold. Here in Western North Carolina, we live in a temperate rainforest. There is a lot of mold…a lot of houses that are over 20 years old have pretty bad mold problems.

I see plenty of patients who are living in houses that are a hundred years old and then they come in with both mold and lead from all the leaded paint…they never got cleaned up all the way. Cleaning up your environment is just one thing. There are other simple things. For example, vitamin C at a thousand milligrams twice a day will decrease the histamine response by 38%. So that gets you to a third of the way there. Just with something really simple it has really significant.  And then we use other natural anti-histamines like quercetin and butterbur. There’s a whole list of nutrients that we give people to help with their allergies. But the best thing we can do is to desensitize… to train the body to say, “Hey, these are good fellows, don’t attack them.”

In conventional medicine they do skin testing. They take extracts of the different pollens and dust mites, and cat and dog and horse hair, and put it in a little injection under your skin and see if you react. Sometimes people call that a scratch test. And we used to do that. It works pretty well. Every once in a while somebody has a reaction and can go into anaphylaxis where they start to shut down in the airway, and their lips swell up and they can’t breathe. And so that’s very scary just from the testing.

So a few people a year across the country die from the testing. And the way that conventional allergists treat the allergies is take the extracts that you reacted to and put them into a shot in your arm usually once a week, sometimes twice a week.  And then over time, they stretch it out to every other week and then even once a month. But that’s usually a three to five year process, maybe seven years. And it is also risky because whenever they raise the dosage to get to the next treatment level, you can again react with the antibiotic reaction.

You have to go to the doctor’s office for the shots just in case you react. It’s relatively expensive. Something like $50 a week.  But who wants to get a shot with a needle every week, every month? Especially if you treat young kids…that’s not attractive, and even the skin testing is not attractive. So we switched to blood testing for the inhalant allergies, and also for the food allergies.

I can use myself as an example. I’ve struggled with allergies. I’ve been through the protocol several times and it’s helped. And then I’m good for a few years, until I had to go through it again. I’ve tested myself both ways and I found that the blood tests I thought were more accurate in two different ways. They’re more sensitive and they’re more specific. When you’re doing a skin test, you look at the little wheel of reactive size, and you use a judgment call about like how big the reaction is. Is that three millimeters or five millimeters or seven millimeters? You’re measuring it, but you know, is it just the fact that you stuck a needle in your arm, you can swell up.

So with the blood test, we found that it actually really nailed down what I was really allergic to and how allergic I was, and then we’d take those same proteins of the inhalants. And of course, my big one is ragweed. So I’m not having that much of a problem in the spring. I have a terrible problem in the fall. And we put them into a little bottle and you squirt it under your tongue two or three times a day. It’s what they call a serum of the proteins of the pollens and such or pet dander or things like that. And then you squirt it under your tongue to desensitize yourself.

There’s cells under your tongue called antigen presenting cells and they present the serum to your immune system and say, “these are good guys, leave them alone. They’re part of the family. It’s okay. You don’t have to react to them and not dangerous.” We’re basically inducing tolerance and nobody really knows exactly how that happens at the molecular level. It has to do with the cytokines and leukotriene, and turning some on and turning some off. But the fact is it works, and people have been using drops for at least 50 years now. The company we use is Allergy Choices up in Lacrosse, Wisconsin. Sometimes oral drop desensitization is called the Lacrosse technique, which has been going for over 40 years. It’s a long time. They’ve been figuring out how to do it right, both on the testing and on the treatment side.

My four year old, she not only has asthma, but she also has had terrible eczema, which is more related to foods like eggs, wheat, and dairy but her big obvious culprit is fish. She’s been on both the inhalant drops and the food drops now. And not only are her lungs a lot better, but her skin is no longer rashing-up. And that’s wonderful. Sometimes we restrict the most allergic foods for a while, but now we’re able to add them back in and with food allergies, I’ve never been a big fan of food allergy avoidance because what I’ve learned is just avoiding the foods you’re allergic to gets rid of your symptoms, but it does not get rid of the food allergy.

The way to make a food allergy worse is you avoid it for three weeks and then get a little exposure, then you avoid it for three weeks and then get a little exposure…and that actually cranks up your allergy. It makes it worse. And of course the way to make it less reactive is to squirt it under your tongue two or three times a day. So you have this low level tolerance building exposure, just like getting the shot in the arm once a week.

They’re about equally effective, but the drops into the tongue are always safe. Nobody’s ever had an anaphylactic response from them. I mean, sometimes you can get a little itchy in the back of your throat or something like that, but nobody’s ever died from it. It’s much less expensive too. It’s more like $70 a month rather than $50 a week. That’s a significant perk. There’s a blood draw, yes, but there’s no skin testing and there’s no shots and it’s convenient not to drive to the doctor’s office all the time. You can do it from your home.

Oral drops are regional, so I don’t try to test people who are living in Florida or Louisiana. They need to go to a doctor who’s local to them. We have a bioregional panel for the Southern Appalachia here for all the things that are in this region. And since the drops are made into a glycerin base, even children don’t mind the taste of it because it’s a little sweet. They actually look forward to it. My daughter does her own drops. That way she proves she’s a big girl. So I’m really happy with the drops. I can hardly imagine practicing medicine now without that as a tool because it’s been such a great tool for both the inhalants and the foods. And for myself, I’ve had really positive results with the inhaled allergy drops.

Joy>  So with the drops, how long would one expect to be on them?

Dr. B> Three to five years generally. But, just like with the shots, about 20% of people you don’t see a great response with. There’s always non-responders in any program. And it’s about the same…not everybody gets a response. But 80% of people get a response…in our experience, about a fourth to a third of people get great responses, and after about three years they’re done and happily go on their way. The middle group of people, they get to five years and then they’re better, but then when they try to stop the drops, maybe they relapse and so we might retest and do another round.

Joy> And for those where it is effective to some level, how long should they expect to wait before they notice a difference?

Dr. B> Well, that varies too. I’ve seen people have responses within a few weeks, but in general, I tell them to expect something like six to nine months before we can really expect results. So it’s a process, but a process worth starting. You’re really calming down the immune system. And again, when we talk about autoimmune diseases, the three big things we look at, and I’m sure we’re going to talk about autoimmune diseases in a whole other podcast sometime, are toxins like heavy metals, we look at chronic infections like Epstein BARR virus, (which is mono or walking pneumonia or things like that that had been shown to cause autoimmune diseases including things like Hashimoto’s thyroiditis), and then we look at the allergy reactions. Because if your immune system is re-attacking a lot of foods or inhalants, it’s now over-reactive and that over-reactivity tends to bleed over into also attacking your own cells.

And so the autoimmunity, where you can attack any part of your body….it’s where your immune system can get confused and attack anything…and it’s really pretty amazing that it doesn’t happen more often. The immune system is smart, it knows what to attack and what not to attack generally. So what the drops do is give the immune system more intelligence and you can calm an over active immune system down by giving steroids like prednisone, right? But then you’re also taking away your ability to fight off infections or your ability to fight off cancer.

If you think about the immune system, and we’re just doing a podcast so we don’t have a visual aid, but if you make a graph and make it into four quadrants, and on the top is your immune systems too reactive and the bottom is not reactive enough and on one side it’s reactive against yourself in those sites you’re active against other things.

Then if you’re too reactive against yourself, you have autoimmune disease. If you’re too reactive against other things, you have allergies. If you’re not reactive enough against yourself, you get infections, you get cancer. And if you’re not reactive enough against other things, you get infections. And all that conventional medicine knows how to do is basically turn that down by suppressing the immune system with steroids. And what we want to do is slide it all towards the center. So it’s just the right amount of reactive, but it’s intelligent enough to attack what it needs to and leave alone the rest.

It is not dangerous. It’s a really delicate balancing act, right? And so in doing that, we’re also looking at cleaning up the toxicities, cleaning up the diet, cleaning up the lifestyle, cutting up the stinking thinking, right?  Because our thought patterns and our stress management play a role in inflammation too. So now we’re back to the five pillars of health, of balancing the hormones, the nutrition, the exercise and stress management….all those things to get people into a good state of health so they’re not having either allergies or autoimmune attacks and it makes a difference, a huge difference. It’s a really rewarding way to practice versus just throwing medications at people that are just band-aid’s.  The band-aid on the problem will inhibit their immune system so down the stream they have worsening problems rather than gradually getting better. And that’s what I love to see is people gradually getting better.