Kyle Kingsbury Podcast - #96 Dr. Michael Ruscio

Episode Date: July 15, 2019

Michael Ruscio, DC is a doctor, clinical researcher and best-selling author whose practical ideas on healing chronic illness have made him an influential voice in functional and alternative medicine. His research has been published in peer-reviewed medical journals and he speaks at integrative medical conferences across the globe. He stops by the show to discuss his new book, his FODMAP diet approach and ways to improve gut health.   Connect with Michael   Dr. Michael’s Website - https://drruscio.com/ Dr. Ruscio Radio - Facebook - https://bit.ly/2LruBmt YouTube - https://bit.ly/2VAo6WX Twitter - https://twitter.com/DrRuscio Instagram - https://bit.ly/2GE0reD   Show Notes Low FOBMAP Diet - https://bit.ly/2IOBpgk Dr. Michael Ruscio’s New Book - https://bit.ly/2V1FR1P Dr. Mike T Nelson - https://bit.ly/2vpQYCz   Felix Gray Blue Blocker Sunglasses (Free Shipping/ 30 days risk-free, returns and exchanges) felixgrayglasses.com/kyle  https://bit.ly/2J0BhJA   Organifi - Gold  https://www.organifishop.com/ (Use Promo Code Kyle for 10% Off)    Get 10% off all foods and supplements at Onnit by going to https://www.onnit.com/kyle/   Whoop www.whoop.com (code Kyle at checkout to save $30 off new subscriptions)    Connect with Kyle Kingsbury on: Twitter | https://bit.ly/2DrhtKn Instagram | https://bit.ly/2DxeDrk    Subscribe to the Kyle Kingsbury Podcast Itunes | https://apple.co/2P0GEJu Stitcher | https://bit.ly/2DzUSyp Spotify | https://spoti.fi/2ybfVTY IHeartRadio | https://ihr.fm/2Ib3HCg Google Play Music | https://bit.ly/2HPdhKY      

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or exchanges, that's 30 days. You get an entire month to try it out. If they don't fit, if you don't like the look, you can return it at no charge and exchange it risk-free. That's felixgreyglasses.com slash Kyle. What's up, y'all? We got my boy, Dr. Michael Ruscio back on the show. It's been, shit, I bet, I guess about 18 months since we've had him on. He's written a book. I think we talked about the first time he was out, he was working on it, but it's out now. It's absolutely incredible. He gives some very practical tips on how to fix gut health and really optimize everything. And some of the symptoms you may be experiencing that are gut related that have nothing to do with the gut. So what does that mean? Well,

if you are experiencing brain fog and fatigue and a mid-afternoon lull, that may be a gut issue. And there's some very practical ways you can enhance cognitive function by healing the gut. We dive into all this and more on the podcast. Thanks for tuning in. All right. I got my snooze in a fresh one. Second podcast of the day. So I hopefully still have the bandwidth for you. The juice. Yeah. Dr. Michael Ruscio has returned. I'm back. Fuck yeah. So good to have you here. Good to be here, man. It's always good to see you. Talk about what you've been up to lately. You have a book that just came out, or not long ago, not just came out, but came out

pretty damn recently. I want you to dive into that for our listeners, but I also want to really get down to the meat and potatoes of what you've been talking about here at Paleo FX, because I've missed pretty much everything that I'd want to go listen to this this go around just been running around like a crazy man and it's hard to squeeze it all in even if you dedicate all your time to the conference what is there five six stages going at once so it's it's impossible to get it all in but yeah the book's been going great the uh the book healthy gut healthy you i spent three years writing that

just to try to give people a responsible narrative on gut health. There's so much disinformation on the internet. And so I spent some time fact-checking and also correlating with what I'm doing in the clinic to really make sure that I gave someone a responsible book. And when I say responsible, what do I mean by that? If you handle the conversation, as one one example around gluten the wrong way, you will inculcate someone into being

fearful around that food and they may not need to be. Now that can be a very helpful dietary restriction for some people, but if we don't handle the conversation correct and we come in, everyone's got to be gluten-free because this one study in rats showed that a boatload of gluten injected into a rat's belly caused inflammation. Man, that's not the kind of way we should be looking at this evidence and then drawing recommendations from it. So I wanted to go through the important keystone topics in gut health in a responsible way. And after that narrative, okay, now that we've given you this responsible take on these different points, how do we twist that into a self-help protocol so you can apply all this stuff?

So now that you've successfully gotten the download on diet and probiotics and all these other things, how do you most effectively apply that? Is it just here, take a boatload of stuff and go on a crazy restrictive diet? Or is there kind of this stepwise process where, okay, let's start here and see how you do. And for some people, simple cases, step one, you're done. You're healthy. All your symptoms are gone. Great. Home run. And then for the most progressed people at the other end of the spectrum with severe, let's say inflammatory bowel disease or IBS, they're going to have to go through more steps as they should. If you sprained your ankle and you're doing rehab compared to a guy who sprained his ankle towards ACL and just had his hip replaced, what's going to be a more challenging rehab case,

right? So it would be logical to assume that the level of care that you need to go through is connected to the amount of dysfunction that you're presenting with. So since the book's been out, it's been amazing. I mean, the results that we are seeing, We just interviewed this, this gal, a dual doctorate, ND, PhD, cardiovascular rehab researcher, super smart lady, didn't understand how impactful gut health was for mental health, suffering with lifelong anxiety, semi-debilitating, right? Where she would, I believe the story she told was she'd have a hard time bringing her kids to whatever sport they were doing, like dance or soccer. And I believe she even was she'd have a hard time bringing her kids to whatever sport they were doing, like dance or soccer. And I believe she even said she'd have to pull over sometimes because she would get so angst in the traffic.

So this anxiety was really debilitating for her. And she had to change her diet. She found that a low FODMAP diet was really helpful for her, like cathartically helpful. That led to about an 80% jump in her improvements. And then she also added on top of that as kind of our step two, a well-rounded probiotic protocol. And that pretty much got her the rest of the way there. So this lifeline anxiety that doctors were trying to give her meds for, and she wasn't really happy about, because if you look at the side effects of some

of those, it's decreased libido, it's depression, it's lethargy, ironically, lethargy. So that was just one cool case. And there have been a ton. And it's really cool to see, hey, I wanted to write this all down so people wouldn't need me. And it's worked. Yeah. And how can you scale it to the masses, right? You have your own practice and you work very closely with a fraction of the population, but now you can take this out to many, many, many people and affect change positively everywhere. Explain what a low FODMAP diet is. I think we talked about the last time, but I think it's important to rehash. Yeah. So the low FODMAP diet stands for fermentable oligosaccharides, monosaccharides, and polyols and disaccharides and polyols. What does that mean? It's this word soup, but

essentially it's the structure of carbohydrates. And some carbohydrates are harder to break down for our intestinal system. And we really require bacteria to help us with that breakdown. That can be a problem for some people. If you have in your gut right now a bacterial overgrowth, then eating lots of foods that feed bacteria can make that overgrowth worse. And what's so paradoxical about the low FODMAP diet, many people listening to this probably are paleo-like in how they eat. Lots of vegetables, generally a good thing. But for people who have these imbalances in their gut, lots of vegetables and certain types of specifically high FODMAP vegetables may actually make their gut worse. So it's the ultimate paradox, right? You're going on a healthier diet, yet you can see someone actually have a worsening of their symptoms.

So things like broccoli, cauliflower, avocado, all pretty healthy foods foods i think we would all conclude but again ironically some people if they reduce significantly the amount of those that they're eating this is kind of like everyone's like yeah i don't have to eat broccoli yay that's what you're telling finally i told you mom i was right um they'll actually see massive improvements like this one gal her main symptomatic manifestation wasn't so much of gastrointestinal. It was more so neurological with the anxiety, but we do know there's this profound gut brain connection. And we do know something like a low FODMAP diet can reduce leaky gut, can reduce immune activation in the gut. So the low FODMAP diet, what you can do with that is you can nuance your paleo diet. And we have a handout floating around out there. It's just called a paleo low FODMAP diet. So we stay compliant with the paleo principles, but we also give you a list of

here's the vegetables that are in the red. Not to say you can't ever have any, but you want to try to kind of spread these out in your diet. And here's the ones that are in the green that you want to try to more so focus on. And for some people they do that. And within one or two weeks, they go, wow, my guts never felt so good. Or I'd never been sleeping so well. I've never had such clear cognition. So that's a low FODMAP diet. Let's go break that down a little further as far as like, you mentioned a few of the common ones that have the fermentable fibers.

What would be some other items on that red list and some good items on the green list? So you're putting me on the spot here to try to list these all off the top of your head. Leafy greens tend to be lower in FODMAP. So things like spinach and spring mix are going to be safe. Carrots will be safe. Many of the brassica and cruciferous family, like youruliflowers your broccolis your asparagus your brussel sprouts not kale okay um because that's a leafy green but it's also cruciferous right it's not it's on the curveball yeah yeah um and there's certain fruits and i don't have

all the fruits committed to memory um i believe apples are high fodmap and also berries uh but but again if you just search michaelcio and low FODMAP, you'll be able to find the list. I'm going to have the homies on the team find that and we'll link to it in the show notes. That way it takes one step less for people listening in. But it's certainly, it's worth the trial. If you're someone listening to this

and you feel like your health is not where you'd like it to be, it doesn't, you don't have to have gut symptoms. You could have only, so you could have gut inflammation that's only manifesting outside of the gut. That's a paradox. Like this gal I just mentioned, she didn't have much in the way of gut symptoms, but she had a lot of anxiety that was being driven by her gut. But her gut, it was inflamed, but it was silent inflammation. So you can give the low FODMAP diet a trial, and you only need one to two weeks to be able to say, yeah, this seems like it's helping, or I feel no different at all. So if you feel no different at

all after one or two weeks, move on to something else. That's what's nice about this. You don't have to do this huge, long six months trial. It's one, two weeks. If it's helping ride that wave until you hit your peak level of improvement. And if it's not helping, then there's other things that you can think about so you guys introduced probiotics in stage two and some other things that go along with that protocol kind of break that down what it looks like and what are your some of your favorite products that go yeah so here's here's something that's disconcerting when you when you look in in the kind of healthcare industry it seems like everyone's trying to one-up each other with

their probiotic recommendations. And it's this weird perversion where whenever there's a new study finding a new outcome with the probiotic, constipation, now there's a clinical trial showing probiotics can improve constipation. Now there's a clinical trial showing that probiotics can improve mood. Now there's a probiotic showing that probiotics can lower cholesterol. It seems like the supplement companies all are scrambling to make a formula and proclaim, this is the best probiotic because it does X, Y, or Z. And the problem with that is it's like looking at a probiotic like a drug, meaning this drug does this one thing, right? Blocks the cyclotoxin in the enzyme and lowers cholesterol like a statin. It's not how probiotics work, right? Probiotics help to heal the gut. And because a problem in

the gut for a different individual could manifest in a litany of different ways, right? If we both, if we had this experiment where right now we injected inflammatory proteins into your gut and inflammatory proteins into my gut, there's a good chance we'd walk away with different symptoms, right? You may feel it squarely in the gut. I know for myself, when my gut's inflamed, I don't feel it in my gut. I feel it more so in my head, right? And we see that documented in the celiac disease literature. Some celiac don't have any gut symptoms, even though their intestines are super inflamed.

They only have these, what's known as extra as extra intestinal manifestations which in many cases are neurological so what's i think challenging for the consumer is they're saying what's the best probiotic they go on the internet and there's just a long list of all these different claims and you're going well do i want the probiotic that's good for this or good for that? And that's really a misread. What that is, is you're getting lost in all the marketing hyperbole. If you zoom way out and you look at the literature and how it's evolved with probiotics

over the past five years, there's this cool narrative that emerges, which is, geez, this one formula was the first formula to show that a probiotic could help constipation. But then six months later, a different probiotic also showed it can improve constipation. And then another six months, a different probiotic showed it could also improve constipation. So maybe the probiotics are just treating you in a fundamental way and it's not highly strain

specific. So when you understand that, then you look at all the probiotics and you say, well, are there some commonalities in all these different probiotics out there? Could we organize them into a few different categories? And that's what I talk about in the group. I introduced this category system that you see published in some of the literature where you can organize most probiotics into three categories. Technically four, but one you can't get in the US. So for conversational sake, three. And again, I lay this out in the book. It's category one, category two, category three. Your category one formula is going to be lactobacillus and bifidobacterium-based. So people have likely heard of, oh yeah, lactobacillus acidophilus, bifidobacterium infantis, what have

you. So that's your category one. Your category two is Saccharomyces boulardii it's a healthy fungus and then category three people probably also heard of your your soil based your spore forming have you guys talked about this in the past script assist yeah like no i want you to dive into that for sure okay um so those are your three categories and and and if people are looking for like an easy on-ramp protocol, it's cool if I share your URL. Yeah, yeah, yeah. Please do. I'll promote for sure.

We try to just break that section out of the book and summarize it in like a one-page PDF. So if you go to drruscio.com slash probiotic, D-R-R-U-S-C-I-O.com slash probiotic, we just put this protocol in a one-page PDF. And we actually, we gave you a nuance. If you're a really sensitive person, if you notice you're really reactive to supplements, then we give you a, okay, start these one at a time. And if you're not someone who's historically really sensitive, you start all three at the same time. And we give you the dose and just how to apply these. But here's what's cool about this. Some patients come into the clinic

and they say, well, yeah, I've taken a probiotic and I've never felt any differently. And I even feel like they've bloated me a little bit. And I go through their history and I took lacto-5, then I took this bifidotin, then I took this natrin, you know, gut trinity. And when you look at them, they're all category one. So someone's concluded probiotics don't work for me because I've taken a bunch of different probiotics. Well, yeah, but you've taken the same category of probiotic every time. And I'll have them then try a category two and a category three. And they go, wow, this is great. I've never seen these kinds of results before. And it's like, well, yeah, because now you're applying these in the more correct and efficient fashion.

But back to your other question about the soil-based probiotics, these are interesting in the sense that they're organisms that are more so found in the soil. And they actually are one of the few probiotics that have more of a tendency to colonize you. Most probiotics actually don't colonize you. A handful of strains do. And it seems like some of the soil-based or spore-forming probiotics do colonize you. And I think they were underappreciated up until somewhat recently. And now we're seeing more and more evidence being published with them.

The lactobacillus and bifidobacterium-based probiotics, they were vastly the most popular. They were the most well-researched. And you saw most of the studies being published with them. The lactobacillus and bifidobacterium-based probiotics, they were vastly the most popular. They were the most well-researched, and you saw most of the studies being published with those, but they don't work for all people. And now we're seeing there's about, at last check, there was about 14 clinical trials published with soil-based probiotics, all showing various levels of effect. So it's definitely something to include in your program. But you also want to be careful that if you go into the paleo community, that type of probiotic is the craze, and then the other two aren't mentioned as much. So if you're someone who you need a category one and a category two, the paleo community may misdirect you only to look at a category three. So that's why I make it simple. Here's the three categories, try them all.

If you're sensitive, try them one at a time so you can suss out any reaction. And there are literally patients who come in and upon lab testing, they have small intestinal bacterial overgrowth and a fungal overgrowth. We put them on this probiotic protocol and a month later, their symptoms are gone. No shit. So, I mean, it's, and we've written up these case studies and we've published them in our clinician's newsletter. You'd be amazed at how well a well-rounded probiotic protocol can work. Even in treating things like, wow, I've got SIBO. Okay. Yeah. There's been a meta-analysis showing that probiotics can clear SIBO out of your gut. So you can do a lot with

a little. All right, guys, I want to take a quick moment to tell you about an amazing product from Organifi and it's called Pure. It's lion's mane and baobab infused and it's truly something that's going to tackle both brains in our body, the gut and the brain. And it works on the brain through lion's mane and some other factors here that are going to increase things like BDNF, which is brain derived neurotrophic factor. And that's basically the growth hormone of the brain. So we can increase that through running and a lot of different activities. But if we can increase that with a supplement, it's just going to be good for our bodies. In addition to that, it helps with gut health,

which is incredibly important. But digestion, all these things factoring in, it's an all-in-one product that can help you feel better, take dumps better, and think better all at once. Pure by Organifi. Go to Organifi.com. That's O-R-G-A-N-I-F-I.com and use code word Kyle at checkout for 20% off. That's impressive. I had no idea. I think our buddy Sal from Mind Pump had to go on

antibiotics to get rid of it and then go back to repopulating because the antibiotics killed everything. But obviously that's pretty, in Western medicine, we obviously have a very barbaric way of treating illness at times. One size fits all approach, just old school thinking there. That's really cool. I didn't realize that about small intestinal bacterial overgrowth. How many people do you see that come in with that? Because it seems to be like a growing thing where people are like really getting messed up by it and not necessarily knowing where to go and how to treat it. No, I mean, you're dead on in saying not knowing how to treat it because there's this canard circulating that if you have small intestinal bacterial overgrowth, you shouldn't use probiotics.

And that couldn't be further from the truth. There's two pieces of evidence that support that claim, and they're really poor level data, whereas we have four clinical trials showing that we can actually five. The fifth actually found that, and this is just beautiful support for my point, in people who had IBS, irritable bowel syndrome, plus SIBO, probiotics worked better than someone who had IBS without SIBO. You follow? So two groups, IBS plus or minus SIBO, the group that had SIBO actually responded better to the probiotics. And this is likely because probiotics are actually antimicrobial. They release antimicrobial peptides. So it's a real travesty when a patient sees a clinician and they go, oh, you have SIBO, you should not use a probiotic. It's not a guarantee that a probiotic is going to help all SIBO cases, but it would be foolish not to try that. Yeah. Yeah. Yeah. Dang, that makes a lot of sense.

Well, I'm sorry. And to your question, it is fairly common, but over-diagnosis of SIBO is also a problem. And this is where I would really caution people about, especially the Quintron machine, the report it spits out, and it kind of gives you this algorithmic computer-based interpretation, that software hasn't been updated. So you will see more people diagnosed as quote-unquote positive by the test than who are actually positive. And so it's important. I would really caution people against doing their own lab work because it's easy to fumble that

and then think you have a condition when you don't. So just be careful. What are the best ways to go about finding out if that's the case? If you maybe you go, I'm sure a lot of people who listen to the show are into more functional medicine, alternative medicine, things like that. And they kind of can sort their own health. But if you feel like you might have some type of gut issue or you're feeling chronic brain

frog and fatigue, what are some of the best tests that you think are out there to kind of self diagnose what's going on? Well, there's a two part answer to that question. I would firstly not recommend doing any testing. Honestly, I wouldn't. And I don't mean this in a self promotional way, but going through my book or our quick start protocol, you will almost for certain achieve better results in less time than if you got a test and then try to treat those test results. Now, why is that? When we test something like SIBO via a breath test and all sorts of imbalances via a stool test, we're only getting a small slice of what could be wrong in the gut. There are many other things that we're finding in research studies now that you can't do in

clinical practice. So there's a bunch of other stuff we know happens in the gut that you can't test on these tests. So these tests only give you a small slice of what could be happening in your gut. So then if you're only getting a small slice of the gut story from your testing, how helpful is that going to be in informing your gut care? Whereas if you have an approach that really tries to restore a healthy gut ecology and treat the gut in a more holistic and global fashion, like we do in the book protocol and with our quick start guide, then you're very likely to get much better results. So it's one of the things that I think functional medicine is doing a really

bad job at is making this promise that with this new and progressive and more detailed testing, we can find the cause and provide the solution to all your health ailments. It's a massive problem. There is a time and a place for testing, yes. But I really would recommend just going through a good gut program because you can get really far with that. And even as a clinician who sees more chronic cases, I do way less testing now than I did like three years ago. Because you get all these lab results and you kind of end up working someone through the same algorithm. Start with diet, you know, diet trial one, diet trial two, try these couple of nuanced diets, see how that goes. Then step two, like there is in the book, escalate to probiotics. And that, you know, so those two steps will address SIBO, candida, they'll help with H. pylori, they'll help with, you Laurie. They'll help with all these things. So it kind of doesn't matter what assortment of those you have. A good hierarchical protocol will navigate you through how to restore your gut ecology in light of any kind of lab findings. But for testing,

a SIBO breath test is a good place to start. And then a good stool test. Doctor's Data has a good stool test. Diagnostic Solutions has a good stool test. But I would 1000% not order a stool test. Doctors Data has a good stool test. Diagnostic Solutions has a good stool test. But I would 1000% not order a stool test as a consumer because that's not going to help you treat yourself any better in the vast majority of cases. And with that money that you spend, you could go through a probiotic protocol plus add in a bunch of other gut supports and likely fix your problem almost by the time you've got the lab results back. You could be done fixing the problem. Oh yeah. So obviously we got step one, eliminate some of the problematic things. So removing and taking away the things that are an

issue, adding in some good bugs and bacteria. What are some of the other ways that we can influence a healthy gut that maybe go outside of supplements and food? Yeah, that's a great question. And a lot of this comes back to healthy inputs to the human organism. So we know that sleep has a favorable impact, of course, on your gut. We know that exercise does. Some interesting studies have actually taken people who are sedentary, tracked their microbiota

over time, had them start exercising, and by doing nothing other than exercising, the microbiota got healthier. Wow. Because you are the host that houses and harbors these bacteria. So if you're a healthier host, you're going to grow healthier bacteria. If you have sick soil, you're not going to have good stuff growing in the soil, right? But if you have really healthy cultivated soil, then you're going to have a much better harvest. So it's a really crucial concept. Sun exposure and vitamin D, there's some evidence showing that. Flying has been shown to be bad for

your gut or circadian shifts have been trying to be bad for your gut. So those are a few inputs that I'm sure you guys have harped on those lifestyle basics, but you definitely want to get those in place. And all those definitely have a positive impact on your gut health because they make you healthier. And again, you're the soil from which these bacteria grow. What are some of the, I've been speaking on some panels and a lot of them have had to do with mitigating the effects of travel. There's a lot of people here at Paleo FX this weekend flew in for the event. What are some of the ways that you mitigate the damage to the gut and even just the brain fog and sleepiness that can happen from travel? I like to take probiotics while I travel. I take a low dose of probiotics pretty much every day. I take all three of the ones that I've formulated.

Our three are lactobifidoblend, saccharomyces boulardii, and soil-based. I named them according to the categories to make it easier for people. And probiotics have been really helpful. And then the other thing that I found to be really helpful, I use this cocktail of nutrients to help to support gut health. It has things like glutamine and aloe. It's called gut rebuild nutrients.

And that combined with probiotics has been really helpful for me. From a lifestyle perspective, I've learned to gear down a little bit. I used to come into these hot, trying to do everything I can do. I'm sitting in every seminar and I'm emailing in the back on my computer at the same time, I'm trying to listen and take notes. And I just learned when I travel, I try to offset by having a little bit more downtime. Yeah. And I think there's a lot to be said for just offsetting the stress of flying a little bit. Yeah. Finding time in the day is something that I talked about on one of the panels was like, you can, you can get dialed in on any workout and diet routine, but if you're not taking

time for yourself to unplug and unwind and just have a break, uh, you're really missing the boat, you know, because you're, you start to accumulate stress, even good stress, but it just accumulates over time. And that's so important that people find that, whatever it is, whether it's a 10-minute walk, five minutes of breath work, sitting in a park somewhere. But just trickling that in throughout the day can be really important. I never really, I guess I do think about that personally when I'm traveling, but I haven't thought of that in terms of like as a travel hack, how important that would be. Yeah, it took me a little while to figure that out.

And I kind of realized that I would always be so beat after a conference. And then I figured out, well, I'm not doing anything to offset the travel. All right. And just, it makes sense. You have to look at these things as what are deposits into your health bank account and what are withdrawals out of your health bank account. And you have to try to keep a, you know keep a positive balance. And so, yeah, that's definitely been helpful. It took me a while. It took me years to figure that out. But that's why on Friday, I didn't get to the conference until about one o'clock. I slept in, took some time in the morning instead of getting up and trying to be, you know, Johnny on the spot and get everything done. Yeah.

Criminal in another concept we were talking about. Cause you know, I think Keith and Michelle Norris put on the event. Keith said he had only been on four hours of sleep and he's one of the moderators and obviously it's his show. So it's go, go, go. There's not a lot of time for himself, but you know, what I brought up was the fact that that was a testament to his he had filled his cup before this event started he knows how

to take care of himself so when the event starts he's not paying for it on credit he actually has enough to spare so that if he's on four hours of sleep he can still show up and be awesome at the event yep um and i think obviously that goes into a lot of this lifestyle stuff. But I remember when I first met you two years ago, we had a really fun night, had a little bit of alcohol, definitely ate some bad food by all of our standards. And that kind of, it's just making me think of that right now.

Like our ability to have a cheat meal or to have a little extra booze or any of those things is really dependent upon what we've put into the bank leading up to that event. Right. I mean, it's such a great point you make also from the perspective of being okay with having those indulgences. And I was telling you, I was up really late last night with one of my buddies here who lives in town. And we always get into these really deep kind of philosophical conversations. And we have a few beers and, and what have you. That's definitely

a big withdrawal, but it's so worth it. The point of a bank account is not to just put a bunch of money in there and be like Scrooge McDuck swimming in your pool of golden coins. You want to buy stuff with it. You want to purchase these enjoyable experiences. And it's not to say every enjoyable experience is going to be one that's also bad for your health, but there are definitely a fair amount that are not good for your health. And I think it's a great point that we should be okay with making some of those, you know, big, big time purchases. Yeah. Yeah. Talk a little bit about how, I mean, you're, you've, you've really figured out what's best for you in terms of the diet, how to remove stuff, how, what your supplement protocol looks like. Obviously, the last time I had you on

the show, you're a fucking very svelte man. You're put together well. Most guys and most people, for that matter, if they have doctor in front of their name, are not as physically fit as you. They certainly don't carry as much muscle. I think last time we were talking a little bit about your training and how you're training with training with weight training you're getting into soccer and different sprint work for high intensity intervals yep um how has that changed in the last year has it changed at all or is it pretty much sticking to the protocol it's changed a lot actually i i decided that i wanted to invest a little bit in myself and so my background is one of my backgrounds is in exercise science, but now I've been focusing on gut and autoimmunity and thyroid conditions, but chiefly gut and those different autoimmune

and thyroid conditions that tie out of the gut for 10 years now, pretty, pretty heavily. And so I'm not up to date on all the exercise stuff. I mean, I have a clue because I have friends like you who really know what they're doing and we talk. And so I'm not totally removed, but I said, what if I started working with a guy like myself, but instead of he was focused on the gut,

he was focused on exercise. And that's Mike Nelson, who we're talking about. Yeah, he's going to come on tomorrow. Thanks for setting that up. You will love a conversation with Mike. I've always had nothing but great things to say about Mike

when he's been on my podcast. He's been on three times. And what I really enjoy about Mike is he's progressive, but he's not a zealot where some people just, whatever's new and novel, they just fall right in. Mike is progressive, but he's also circumspect and cautious and he's very evidence based and he reviews the literature and he thinks through things rationally and objectively. And I said, you know what? I think he'd be a good guy for me to train with because he's not just one of these guys who's got good genetics and has got a big opinion and a small amount of education, which is like the worst combination, right? He's a humble, smart, very precise guy. And so I've been training with him now for about six months and holy cow,

I was like, hey, i want to gain a little bit of muscle i gained about 10 pounds i was like maybe a little less muscle let's make it dense now on the soccer field i was just drilling the crap out of people and i wasn't meaning to but i was just so i gained a ton of muscle and i think there were some major oversights in my in my programming um and i mean for him it's like for me looking at someone's gut health they go yeah my gut's never really that good i look at what they're doing it's like yeah you know this is wrong that's wrong this is wrong and boom in three months they're like oh my god i can't believe you helped me i feel so much better

so when you flip that into the exercise realm and you got a guy who's been doing this for 10 years all day every day he's gonna look at my programming and be like, oh yeah, this is why you have a little bit of bilateral knee pain because your hamstrings and glutes and back work is not nearly as strong as your front, you know, anterior chain work. So he dialed those few things in and it's been totally worth the investment to work with him. And yeah, I mean, it's been, it's been cool to see my body change, um, quite quickly, but I think, you know, again, that's what a good professional

in an area, just like a good accountant, you know, they'll, they should be able to fix your financial situation, uh, you know, willing that you'll follow their advice or whatever. So, uh, that's what's changed. And one of the cool things he's been doing in my programming is this kind of progressive overload where week one, I'll do two sets and week two will be three sets, then four sets, then five sets, then six sets, then five sets, then kind of we'll reset. And that ramp up, I don't know how long we're doing that for, but I've responded really well to that ramp up. And he's also found that that gradual ramp up is crucial so as to prevent load and volume spikes. And he's finding, I understand, I don't want to speak on his behalf too much, but that it's the load and volume spikes that are really where injury occurs.

So if I miss a training day on a week, he won't skip up a level. I got you. And he's, and that's one of the things that I really took away from, which is not just like pulling into this overload, this like hit training to try to gain some mass, but rather slowly progressing up to it. And I haven't, I haven't been injured the entire time we've been training together, except for one time when I was visiting my parents, I was in a crappy gym. I was dead lifting. They had these crappy floor panels that had bounce and I lost tension because of the bounce.

Do you know what I'm talking about? I re-caught it. When I caught it, I tweaked my back. So that really wasn't on Mike. It was more so on the equipment. So yeah, that's been something that's been different and it's been a lot of fun. That's awesome.

Are those primarily compound movements like deadlift, squat, bench, pulls, those kind of things? A lot of those standard movements. like deadlift, squat, bench, pulls, those kind of things? Yeah, a lot of those standard movements. That was another refreshing thing, which was it wasn't these exotic movements where I'm standing on a BOSU ball with one hand and doing a press, which is all fine and good. I guess if that's for the needs of whatever you're doing. But it was just a better application of a lot of those fundamental movements. One thing that was different, I probably was doing, I wasn't doing enough back work from standing. And so essentially all my back work was done standing.

And I think that was very helpful. Because just having to do my back work now, bent over and standing in various positions, was way more engaging for my like my lower posterior chain hamstrings and glutes and i think that had a big impact it did have a big impact on my start speed on the soccer field obviously oh yeah yeah and then i had a little bit of like bilateral knee ache and i think that was because i was quad dominant and i didn't have to do like this hamstring glute specific protocol it was more so let's just have you standing up while you're doing all this back work and that's just going to engage these muscles that posterior chain engage the base of your body yeah that makes a ton of sense so

just some small tweaks and i saw a lot of response that's super cool well i mean i'm definitely you're giving me a lot to talk about with him tomorrow and i certainly had just listening to him on the panel we were speaking on talking about the psoas and breathing properly it was like all right we get some good info here oh good good you had a chance yeah yeah yeah we met each other yesterday and he was like hey kyle uh dr michael russo was telling me about you and i was like oh you're mike t nelson dude we got to do this so we're're going to jump on tomorrow, but I know you wanted to discuss, uh, discuss, discuss Hashimoto's. Oh yes. Um, that's a big one. And it's, and it's, you know, I don't think if you've, if you haven't heard of it, that's fine. Probably someone in your family has. And, and outside of that, I think thyroid health in general is a big one, but dive into

that a bit and how, how all of this pertains to the autoimmune issues. What a juicy can of worms for us to be opening up here. So the high level summary is, if you're working, and this is going to be self-deprecating in a way, or it's going to open me up to some criticism, but if you're working with an integrative provider, it doesn't matter what their credential, if they're an MD, a DO, an ND, a DC, a PhD, if you're working with an integrative provider, I'd be very cautious and I would maybe want to get a second opinion regarding if you actually have a thyroid condition or not. It's getting really out of hand, this incorrect and over-diagnosis of hypothyroidism, where people are being put on medication for a disease that they don't actually have.

I know that sounds like a lofty claim for me to make, but here's some of the story. So starting about two years ago, as I've been looking more into these kind of finer points, I started saying, gosh, there's this whole belief system in functional medicine that the conventional lab ranges are too wide. You've probably heard this before, right? And so in functional medicine, we want to be more precise and we want these more narrowed ranges. And these narrowed ranges will help us find people who have diseases that otherwise may not. And it'll help the patient who's complaining of symptoms, and this will provide the answer for them. So the promise is good. But when you look into,

is there any data? When a group of researchers test a hypothesis, is it actually true? It turns out it's really not true. For the vast majority of cases, there is a little bit of nuance, but functional medicine is incorrectly diagnosing people was the conclusion I came to about two years ago. And I started looking at this in the clinic and I'd say, you know, Sarah, I know that you were diagnosed as hypothyroid three years ago, and you've been on levothyroxine now for about three years, but something here doesn't really add up. You've been on the medication. You've never seen your symptoms improve.

You've changed the dosage a little bit. You've tried some other forms of medication. And the other doctor you've been working with, they sound like they're kind of hammer nail syndrome, right? So why don't you send me the labs from that diagnosis right before you went on thyroid medication? And I can simply check and look at your levels and we'll know if you're hypothyroid or if you're not. And what do you know? That patient was not actually hypothyroid. And I said, yeah, Sarah, I'm not sure what happened here. Maybe your doc had a bad day,

but good news, you're not hypothyroid. And then I saw another case like that. And then I saw another case like that. All the while, I started doing work to improve their guts. And in a few months, their symptoms are gone. Fast forward six months after that initial catharsis, there's a study published in Greece looking at 299 patients who had this kind of ambiguous hypothyroid diagnosis and they rechecked them. 60% of them were not hypothyroid. I've been writing about this in our clinician's newsletter. Other doctors now who read the newsletter are finding this in their practices, taking people off the medication, undiagnosing them with hypothyroidism, fixing

their guts, and getting these patients well. And they're even sending case studies, and now we're publishing other doctors' case studies in our newsletter. That's how bad this is and how simple it is to identify and fix it. So the bottom line here kind of is, if you look at the lab ranges, to be hypothyroid, you have to have high TSH paired with low T4. TSH is the hormone that goes from the brain to the thyroid. That signals from the brain to the thyroid, TSH. And then the thyroid gland spits out T4. So those are the two hormones that you assess. Now the criticism is, but we have to look at the other hormones, like your T3 and your reverse T3.

So this is what happens once the hormones are made and they're out in circulation. T4 becomes T3? T4 becomes T3. Now, the challenge with this and why this is wrong in terms of diagnosing hypothyroidism is if you have low levels of T3, it doesn't mean anything is wrong with your thyroid gland. It's like a guy making plenty of testosterone, but he's super inflamed. So he has high estrogen. It doesn't mean his gonads are broken, right? It means the gonads are making hormone, but it's being converted downstream into stuff you don't want it to be. So this is what can happen when someone is inflamed or stressed. They can

have these downstream perturbations in T3 and reverse T3 and some of these other things. And providers will look at that and they will say, well, those aren't normal. So you're hypothyroid. They don't distinguish. Your thyroid gland's actually okay, but there's some downstream stuff here that's not optimal. So maybe we can give you a little bit of the thyroid hormone support and that might help in a supportive way, right? And these patients oftentimes do not respond to medication, but they stay on it because they go, well, the doctor said they have hypothyroid. So if you have hypothyroid, you got to take the medication.

Until the end of time. Yeah, but it's really getting out of hand. So the thing that I think functional medicine has been trying to do is say, Sarah, I get that you're not feeling well, and maybe this is why. I think it's a laudable goal, which is trying to help people feel better. But there hasn't been the cross-referencing with the scientific literature to see if the hypothesis actually holds water. And it turns out when you actually do fact check, you see that these patients don't need thyroid medication and giving them thyroid

medication is not a good idea for most. And it's really about fixing what's causing the problem. So if someone has an inflamed gut, that can definitely cause these perturbations downstream with the thyroid hormone. Also, some of those perturbations aren't a bad thing. So I said inflammation and stress, right? But there are healthy stressors. If you go on a lower carb diet, that can be a healthy stress. And now you don't want to go too far, right? So there's a balance.

But there was one diet showing that people who went on a paleo diet saw less body fat, more energy and improved moods all while their T3 levels changed in a negative direction. So what was happening? There was some metabolic stress and the body was adapting to that stress by skewing some of the thyroid hormone, but that was happening in the context of the person getting healthier. So that's why I have to be really careful with

just looking at these things in terms of, well, if this happens, it should be bad. We have to say, well, if this happens, it should be bad. So let's test this and let's see what happens when we test a hypothesis in humans. That hasn't been done, right? The inference has been drawn, but the assessment of how it affects individuals hasn't been, well, actually it has been it's, it's really getting out of hand. And I just, I want to voice this because I think you're going to see some major litigation. I wouldn't be surprised within five years if there's not some big time lawsuits. In fact, someone said jokingly last night, I should start, I should find like a legal group and do like a commercial.

Have you been diagnosed with thyroid? I mean, I would never do that. Get the, get that guy. I don't know how far you've gone around in Austin, but there's this guy who has a motorcycle. He's got like a Harley Davidson and dreadlocks. He's like the local injury law guy.

He'd be fucking great. But I wouldn't be surprised if there's some manager litigation at some point because it's not good to put people on a medication who don't need it. And cardiovascular side effects can be one of the side effects documented if you're not careful in how you do that. If some of these thyroid hormone levels get too high. So yeah, this is something that I want to make people aware of. And this will probably be the next book that I write. I don't have any plans to start it soon

because I have many things on my plate. But yeah, I feel bad for people who have a thyroid problem right now because there's a confusing landscape and it is really kind of getting out of hand. And it breaks my heart when someone has been on a medication for a few years and they never really felt much better from it, but they keep taking it because they've been told that that is what's wrong with them. And their gut in some of these cases have been totally missed. So a few things there with thyroid that I think are really important for you to be aware of. All right, guys, one more quick one.

I want to tell you again about Whoop. It is my favorite self-quantification device. It's a strap that goes around your wrist. It connects through Bluetooth to your phone and tells you all sorts of interesting things. My favorite, of course, is managing sleep. So again, we can look deeply into the sleep here. It can tell me exactly how many sleep cycles I've had in a night, how much REM sleep, how much deep sleep. That allows me to fine tune which supplements are actually working. So if I try a new supplement

at night to help me sleep, do I actually get more REM sleep? Do I actually get more deep sleep? What is my quality of sleep? All of that is easier to figure out with the app. In addition to that, they use machine learning to determine exactly what's going on. So if I share my bed with my son and I do that often enough because he's four years old, typically I'll have 12% less REM sleep. This is important to know. Also, the recovery aspect is absolutely phenomenal because it tells you how hard to push the next day. And through that, measuring your resting heart rate average through the night and your HRV average through the night, you can really get a clearer picture on how to recover better. You don't want to be under-recovered over time. That leads to injury and pain, and you want to dial that in. Day strain is a 24-hour cycle look at exactly how hard you're pushing throughout the day.

All these things are factored into it. If I was to drink a gallon of coffee and go for a run, my heart rate might be through the roof. That's going to increase my day strain. Other factors like stress that will make my nervous system shoot through the roof will also increase my day strain. Other factors like stress that will make my nervous system shoot through the roof will also increase my day strain. It's one of the coolest, most unique ways we can take a look at exactly how hard we're working on a day-to-day basis and then see how we recover from that afterwards. Check it out at whoop.com and use code word Kyle at checkout to receive $30 off your subscription. That's whoop.com and code word Kyle at checkout.

Yeah. I want to dive in a couple of things here before we wrap up. But I remember going on a very long-term ketogenic diet and seeing my T3 go down and I forget which functional med doc I had looking at it. They were like, how do you feel? And I was like, I feel great. I'm losing weight, but I'm gaining muscle. I'm getting stronger. Energy's great. Cognitive function has never been better. And they're like, okay, you're fine. You don't need to put you on anything, right? But that was something where I was thinking of that correlation in hindsight as like,

yeah, I do remember looking at blood work and having a concern over that. But now that makes perfect sense. I know you discuss this in your book, but do you feel like when people have Hashimoto's or some thyroid issue that a lot of this can be fixed when you fix the gut? So, yeah, there's a few ways to answer that question because we have to kind of specify a few points. Hashimoto's, so there's Hashimoto's, there's hypothyroid, and there's symptoms. Those are kind of the three things that we're talking about here. Symptoms, 1,000%. Absolutely. Many of the symptoms that people attribute to hypothyroid, fatigue, thinning hair, constipation,

depression, those are incredibly nonspecific. those definitely can be caused by problems in the gut also. Hashimoto's, there is some preliminary evidence showing that improving one's gut health, most namely through treating either H. pylori in one Italian study, and there's also a case series treating things like blasto, have shown improvements in either thyroid autoimmunity or hypothyroidism in and of itself. So there is some data there. It's in its nascency, but it is there. And there is also a lot of association data tying together problems in the gut and thyroid problems. There was one Polish study that found that those with small intestinal bacterial overgrowth were more prone to have Hashimoto's. Now we haven't gotten so far as to say treating the small intestinal bacterial overgrowth will improve the Hashimoto's, but I think it's a fairly safe posit to say that that

at least is going to be neutral and at best is going to be beneficial for the host, of course. And there's a bit of association data associating H. pylori to Hashimoto's. And then that one treatment study in Italy showing that treating H. pylori can decrease Hashimoto's. So yes, I mean, certainly when it comes to symptoms, when it comes to Hashimoto's. Now, if someone has overt hypothyroidism, can that be reversed by improving someone's gut health? Probably not. Because once you become overtly hypothyroid, you can see some regeneration and some improvement, but it depends on how progressed that damage is. Because what happens in hypothyroidism is the gland becomes inflamed and then the healthy tissue gets replaced with scar

tissue and so it depends on how much of your gland picture in your head there's like a lemon and that lemon is a gland a hormonal gland and it secretes hormone now if all of that lemon is healthy tissue all of that tissue is secreting hormone but if some of that lemon is healthy tissue, all of that tissue is secreting hormone. But if some of that lemon starts turning brown and decaying and becomes inflamed and scarred, then only the healthy region of the lemon is secreting hormone. Now, there's a point at which if enough of that gland, if enough of that lemon is rotted, that even the healthy tissue present won't have enough output capacity to make enough hormone to fuel your body. Does that make sense? Yeah.

So it just depends on how far you've gone in terms of degradation. And you can look at your levels of TSH and T4 to kind of predict this. If your TSH levels, the cutoff is about 4.5, you don't want to be above that. If your TSH levels were 11, 15, it's not too bad. If your levels were 125, then it's more likely that you won't be able to reverse enough of the damage to get back to the point where you're not on thyroid medication. I got you. Well, Dan, we covered a lot here. I want to link to your book in the show notes. Is there anything else you want to mention? Just one thing really quick I should mention

because I feel like it's really salient, I think, to this audience, because I'm assuming, and correct me if I'm wrong, but you probably have a lot of paleo-like and moderate to lower carb dieters. I think so, yeah. I mean, I beat that drum a little bit. Okay.

So this is something that I've struggled with personally, and I just had a reminder of this, which is when you eat paleo, lower carb, there's this tendency to gravitate into more foods that are high in histamine. And these are foods like your jerkies, your kombuchas, your kimchis, your spinaches, your avocados, anything fermented or preserved can be high in histamine. So again, cheese, spinach, avocado, jerky, tuna, nuts, all these are high histamine foods. And if you search my name in high histamine, you can find another dietary list and we'll get you a link for that. But people vary in their genetic ability to clear histamine out of their system and histamine is an immune signaling molecule and it functions as a neurotransmitter and if too much histamine builds up in someone's system they can start having

things like fatigue joint pain insomnia depression excuse brain fog. And about three weeks ago, I was saying, what the heck is wrong with me? I was starting to have this midday fog, no matter what I did, and fatigue, even though everything else was dialed. And I had learned this lesson maybe three or four years ago that I had to be somewhat bridled with how much dietary histamine I eat, because I kind of drifted into this. I call it the lazy man paleo diet, right? Spinach, avocado, tuna, jerky. Starting the same foods like every other meal. They're all so easy, cheese and nuts.

And I had to bridle that because I was getting this brain fog and fatigue from over consuming histamine rich foods. And it happened to me again about three weeks ago. And, but it took me a few days of feeling really poor, really poorly to figure out and say, ah, yeah, I've been eating a ton of these nut bars. I've been eating a lot more cheese. I've been getting a lot more lazy and having more jerky and such. And then I pulled back on those histamine foods and then I just kind of tried to spread them out a little bit more in my diet and all that stuff went away. And I would say in the

clinic, outside of your paleo diet and a low FODMAP diet, the low histamine diet is the most impactful dietary modification that people can make. So if people are saying, God, I got these weird symptoms, some joint stuff or some neurological stuff or some fatigue or insomnia, because it can manifest kind of diversely. You may want to do a one week trial on a low histamine diet. Only takes a week, right? For many people, it only takes a couple of days. For me, it was like two days and I was feeling better. And just try a low histamine diet. And if you see those symptoms markedly improve, don't freak out. It just means you want to be cognizant of high histamine food and try to space

them out in your diet a little bit. That's a simple thing that I think it may be somewhat prevalent in your audience. And I feel like it would be good just to mention that for them. That's prevalent for me too. So thanks for dropping that. It makes a shift of a sense. Well, dude, it's been great having you on. Where can people follow you online? DrRuscio.com. D-R-R-U-S-C-I-O.com. You have the website and the podcast and the book and videos and all that good stuff you can plug in there. Tell me your podcast name again. It's DrRuscio Radio. That's right. That's right. Excellent podcast for people that want to dive into this further. And he just goes down the list of pretty much every major ailment and autoimmune to gut issues and how you can help solve that.

Thanks for joining us, brother. Yeah. Thank you, man. I appreciate it. Yeah. Thank you guys for listening to the Kyle Kingsbury podcast with my man, Dr. Michael Ruscio. Amazing guest. The guy we'll have on every year if we can. He's always glued to the latest cutting edge science and because he's a clinician and working on people, he's on the front lines. Really cool dude and has a wealth of knowledge.

Thank you guys for listening and I appreciate you all.