The Dr. Hyman Show - A Functional Medicine Approach To Curing Crohn’s And Colitis with Dr. George Papanicolaou

Starting point is 00:00:00 Coming up on this episode of The Doctor's Pharmacy. And if a person has a genetic predisposition to ulcerative colitis or Crohn's, inflammatory bowel disease in general, then they're going to be at high risk for triggering that gene and developing that disease they have a predisposition for. It's our diet, it's our environment, it's the stress. All of those can trigger your genetic predisposition. Hey everybody, it's Dr. Mark. I travel all the time, so at this point I have packing down to a science. I know exactly which grab-and-go food items and personal care products I like to bring, and I always keep them on hand so I'm ready for my next trip. I used to run around before every trip trying to find what I needed, which meant going to different stores, spending too much time packing, and now I use Thrive Market and I get everything in one

Starting point is 00:00:47 place shipped right to my door. Here's a little snapshot of what I like to travel with. Food is, of course, first on my list. I always order some of the Ioba grass-fed biltong jerky, which is so yummy. Royal Hawaiian Orchards Organic Macadamias because it's super full of fat and protein. And I love that they make me feel full and easy to carry and don't go bad. And they're also super handy pouches of Thrive Market brand pitted green olives. I want to splurge and bring a treat. I'll grab some Hugh Chocolate too. And in my toiletry bag, I bring some Schmitz deodorant, some all-terrain herbal armor bug spray, a tin of raw elements SPF 30 natural sunscreen, and a bar of Dr. Bronner's peppermint castile soap. Thrive also carries so many other things that makes packing for a trip easier,

Starting point is 00:01:30 and I'm sure you'll find your own personal favorites. Thrive has two different membership options. I went with a 12-month because it comes down to five bucks a month, and I'm constantly ordering stuff. Plus, it's 30 days risk-free, but you can also sign up for a monthly membership. If you join Thrive Market today, you'll get 25% off your first order and a free gift. Just go to thrivemarket.com forward slash Hyman. That's T-H-R-I-V-E market.com slash Hyman for 25% off plus a free gift. I'm all about finding the easiest ways to eat well with a busy schedule. One shortcut that I've really, really found helpful for making delicious meals come together

Starting point is 00:02:04 fast is having a few high quality condiments and sauces on hand in my kitchen. Now, high quality is really the catch there. So many condiments come loaded with artificial ingredients, tons of sugar, inflammatory oils, yuck. If you think about it, there's nothing sadder than creating a huge, colorful, organic salad only to ruin it by pouring unhealthy ingredients all over it. And that's why I love the products from Primal Kitchen. Primal Kitchen is known for their avocado oil dressings, marinades, mayo, sauces, and other condiments. You won't find canola oil, soy, grains, gluten, refined sugars, or industrial seed oils in any Primal Kitchen products. They have all the traditional dressing favorites like ranch and honey mustard that are made with avocado oil,

Starting point is 00:02:42 along with some elevated flavors like lemon, turmeric, and cilantro lime. And their mayo is incredible and comes in several flavors as well. My favorite is their pesto mayo. I love using it in lettuce wraps with some grilled salmon or chicken for an easy summer meal. Having some options like these makes creating healthy meals at home so much easier. Their line is almost all keto and paleo friendly and Whole30 approved and Dr. Hyman approved. Plus it gives your food so much flavor with ease. Right now, Primal Kitchen is offering my community 20% off. Just go to primalkitchen.com and use the code Dr. Hyman 20. That's Primal Kitchen, P-R-I-M-A-L-K-I-T-C-H-E-N.com with the code Dr. Hyman 20. Now let's get back to this week's episode of The Doctor's Pharmacy.

Starting point is 00:03:32 Welcome to The Doctor's Pharmacy. I'm Dr. Mark Hyman. That's Pharmacy with an F, a place for conversations that matter. And if your digestive system has ever been a problem, especially if you've had some type of inflammatory bowel disease like Crohn's or colitis, this podcast is for you because we're going to discuss a functional medicine approach to inflammatory bowel disease with my friend, my colleague at the Ultra Wellness Center, Dr. George Pepinicolaou, who has been with us for years and is just one of the brightest and most amazing docs I know. And I'm so happy to have him here to talk about this terrible problem, which affects so many people, which I have suffered from, and which is amazingly fixable using functional medicine. Welcome, George. Mark, it's always a pleasure. It's always great

Starting point is 00:04:12 to talk about functional medicine and what we do with functional medicine at the Royal Tumor Center to help people get better and reach their optimal health. Wow. Thanks, George. Well, listen, we're going to get right into it. So inflammatory bowel disease, how common is it? What is it? What symptoms do people get? And tell us about what we know about the disease in terms of a traditional approach from, you know, traditional conventional medicine. What's the approach to this? Because, you know, it just seems like a vexing problem and we just seem to have made some advances, but still, it's not great. Yeah. So, you know, it's very common. There's about 3 million people have it per year in the United States of America.

Starting point is 00:04:56 That is actually up from 2 million in 2000. So there's a very steep increase over the last several decades. And the projections are that it's going to increase at an even more rapid rate over the last several decades. And the projections are that it's going to increase at an even more rapid rate over the next 20 years. So ulcerative colitis, Crohn's disease, which both are the two major inflammatory bowel diseases, are frequent and common and are very, very disruptive to the people that have it. They can really just completely upend their lives. Depending on how quickly you want to get into this, I can get right into it. I'm just thinking of all my patients and their suffering.

Starting point is 00:05:35 I can tell you that when it's uncontrolled, there is a lot of pain. There's a lot of diarrhea. There's an inability to eat. There's fatigue and weakness that keeps people from being able to live. Weight loss. Weight loss. You know, all of those symptoms. Malnutrition can be included in there.

Starting point is 00:05:55 So there's a lot of people that have it. It's a growing problem. And when you have it, it's very disruptive. And even when you are well, you have to work hard at staying well. Yeah, it's a huge problem. And, you know, it's basically an autoimmune disease of the gut. What's amazing to me is in traditional gastroenterology, I've talked to gastroenterologists and they're like, oh, you know, what you eat doesn't really impact it. I'm like, wait a minute, you're putting pounds of some foreign substance in your mouth every day that's going through your gut.

Starting point is 00:06:24 How could that not affect it? It's just so striking to me that there's just this complete almost ignoring of the role of nutrition and food in what's going on with gut disorders. That's just kind of a meta comment because it's such an obvious like duh to me. Yeah, but to make it, to retort with another meta comment, I would say that in our food, yes, but in that food are toxins and in our environment are toxins. And we have medications and we have, you know, we have endocrine disrupting hormones, all of which end up in our gut, in our gut microbiome, and are very disruptive. And if a person has a genetic predisposition to ulcerative colitis or Crohn's, inflammatory bowel disease in general, then they're going to be at high risk for triggering that gene and developing that disease they have a predisposition for. It's our diet, it's our environment. It's the stress. All of those can trigger your genetic

Starting point is 00:07:25 predisposition. And that's why, because you have to ask yourself the question, like, why have we had, you know, such a rapid increase over the last several years? Yeah, what's going on? And, you know, and this is, you know, this is your area that you just, you know, you're you are the leading edge of the medical voice and understanding agriculture and food production in our country and how it is. It is toxic and why it's toxic. going to have healthy soil, we're not going to get the nutrients in our gut soil to grow good bacteria and have a healthy microbiome so that our intestines can stay healthy and do their job for us. Yeah, it's such a big deal. And, you know, from a conventional perspective, the treatments are really to shut down your immune system, right? Oh, yeah. Prednisone, steroids, chemo drugs, TNF alpha blockers, things that increase risk of cancer and infection.

Starting point is 00:08:27 They're pretty extreme drugs, and they can be very helpful, and they can be life-saving, and they can work for people. But the question is, is there an alternative? And do we have to deal with this the same old way we've been doing with it? And then, of course, for a lot of patients who have it, sometimes they need surgery. They have total colectomies for ulcerative colitis where they remove your entire colon or resect whole sections of your bowel with Crohn's disease, which doesn't really even cure the problem. It's just a rough, rough disease. It is rough. And I think you and I can bring people some really good news today that using functional medicine and what we understand about the gut microbiome, what we understand about food as medicine, you can get better and stay better without having to use the kind of drugs that you just mentioned that can lead to cancers down the road. People on immunosuppressive drugs, you know, followed for 20 years or, you know, they're already at very high risk.

Starting point is 00:09:23 They're already at increased risk with inflammatory bowel disease for colon cancer. And then if you put them on an immune-suppressive drug and follow them for 20 years, they have an increased rate of skin cancers by about 40%. And during that period of time, they have increased rates of infection. They have side effects to the medications. They have to come on and off them. They have to try new medications. And by and large, you know, they're moderately effective and sometimes not effective at all for some people. For sure. And I, you know, I think that people suffer a lot from this and

Starting point is 00:10:06 they can manage the disease, but it often doesn't go away or it's not curable. But from a functional medicine perspective, it can be really curable. And I can tell you so many patients that I've had. I mean, I just, actually how I got the job, probably how I got the job at Cleveland Clinic was because I met someone to the CEO whose niece had severe colitis, tried all the medications, wasn't working, was about to have her total entire colon removed at 32 years old. And I said, look, just have her come to me, no promises no it's worth trying before she rips out her entire colon which is irreversible right and i think she was skeptical uh she was from new orleans and probably wasn't the healthiest you know lifestyle down there and she agreed to do what i told her

Starting point is 00:11:00 but she was quite skeptical but i changed her her diet. I reset her gut microbiome. You know, did simple things, simple things. And six weeks I talked to her. She said, I'm perfect. I'm fine. I'm on no medication. And I'm like, what? Literally six weeks. And they were going to take her colon out and she's symptom free and off her medication. And I can tell you story after story like that. Another young kid was 25 years old. Same thing about take his colon out just some simple dietary lifestyle changes and and getting the gut microbiome straight and resetting the gut with the functional medicine for our five-hour program was so key so i think well you know it's it's we we had talked earlier as we were preparing for this and one of the one of the things the first things that happened and you can correct me if I'm wrong, but you met with Dr. Ruggiero, who's a GI doc, a clinical clinic,

Starting point is 00:11:49 and you guys set up a collaborative, you know, to, you know, work with functional medicine and traditional and conventional forms to treat ulcerative colitis, inflammatory bowel diseases. And that, that sounds like a phenomenal partnership. Absolutely. It really is. And I think there's a real openness to understanding there's, there's really room for this, including with everything. It's not either, or yes. How do we, how do we create the best conditions for a patient to get to health?

Starting point is 00:12:18 And I think, you know, I just, in terms of causes, let's sort of dive into that because from a functional medicine perspective, you know, we really look at root causes. And today I was, you know, going through my medical research that I do every day and just sort of looking at what's new and was sort of shocked to see this. Well, not really shocked, I kind of expected it, but I was shocked to see it sort of published so prominently in a medical journal, really, really discussing the way in which food sensitivities, I mean, that's right, food additives and ultra processed food will drive changes in people's gut. So when you look at this data, it was quite interesting.

Starting point is 00:12:55 They looked at mice and people and they basically show that high sugar processed food diet affects the gut in a harmful way. We also know that there's a lot of emulsifiers and additives in food like that. There are thickeners, even things like microbial transglutaminase, which is like a gluten product that's put on purpose in food to make it stick together because gluten makes it glue, makes it stick together. And so we have to sort of think about when we

Starting point is 00:13:22 take care of these patients, what their causes are. So from your experience, George, what are the top things you think about when you're seeing a patient with inflammatory bowel disease? Well, the first thing I think of is disordered microbiome. I just think of, and then I think of all of the components that go into that, from their diet, specifically their lack of foods that are prebiotic and probiotic. I think about the types of foods they eat that would be disruptive to the gut microbiome, like grains that have glyphosate sprayed on them if you're not eating organically. That's where I really begin to dig down, dig deep. I look at stress. You know, I will tell you that it's whenever one of my ulcerative colitis patients or Crohn's patients call suddenly with, you know, an exacerbation that's come on and they're in a panic and they want help. Eight times out of ten 10 stress is triggering, you know, and the role of stress in triggering this

Starting point is 00:14:29 disease and driving it and causing exacerbations and making it even more difficult to get under control. So I think about lifestyle, I think about stress, I think about the role of exercise, because exercise does play a role in controlling inflammatory bowel disease. I mean, stress and exercise have been studies that have shown controlling stress, getting your exercise, and altering your diet, those are three things that can make a big difference. So I think about those when a person's coming to me, that lights up. What the causes are, you know, there's obviously a genetic, you know, predisposition for people. And so we think about that. There's not a lot I can do to change the genetics at this point in medicine. I think about the, again, I go back to the immune system. We know that there's an immune triggering that

Starting point is 00:15:21 goes on. And we know that the gut and the microbiomes, very specifically, is the gateway to the immune system. And that's why I think about it first. Because we need a healthy gut microbiome to have a healthy gut lining or that mucosal lining plays a very important role of providing very concise and precise communication between the gut bacteria and the immune system because the gut bacteria and the immune system work very closely together to make sure that we are protected from outside danger things that aren't us and when that when that microbiome, those bacteria aren't healthy, then that mucosal lining breaks down, and now toxins and bacteria and viruses, heavy metals,

Starting point is 00:16:19 can get back into our system and recirculate, increasing our toxic load, further damaging our immune system, further creating inflammation to trigger or maintain that inflammatory process that we call ulcerative colitis and Crohn's disease. Yeah. I mean, what's great now is that we're learning so much about the microbiome and so much about how to work with it and how to optimize it and what harms it. And I've seen all sorts of cases of Crohn's and colitis. And I'll just share another story of a guy who I saw years ago who had severe colitis, was really losing weight, struggling.

Starting point is 00:16:58 I tried all the normal functional medicine stuff, reset his gut microbiome, the 5R, elimination diet, tried everything, the right supplements, and he just wasn't getting better. And so I went back to the principles, first principles that I learned from Sid Baker, which is what could be bugging this person that needs to be gotten rid of? Is there something else that I'm missing? And what am I missing? Is there something I'm missing? So I went back to the drawing board as my medical detective had on and found out this guy had really high levels of mercury. And it wasn't until I chelate his mercury that he was able to correct his colitis and is now symptom free. I personally had a different cause. I was somebody who

Starting point is 00:17:36 mostly had a healthy gut most of my life. And then I developed mercury poisoning and that messed up my gut. I didn't get colitis, but I had really bad irritable bowel and bacterial overgrowth and all sorts of issues that I cured. But then a few years ago, about five years ago, I got a confluence of events where I ended up having to take an antibiotic for a bad tooth and a root canal. And it was clindamycin. And this antibiotic is known to cause C. difficile, which is a really common intestinal infection that causes death in about 30,000 people a year. And all of a sudden I started getting not just, you know, diarrhea and this and that from it. I started getting really severe pain, nausea. I'm going to the bathroom 20 times a day, bloody bowel movements. It was just, it was miserable. I

Starting point is 00:18:20 literally was in bed five months running back and forth to the bathroom. And it turned out I had developed colitis from the C. difficile. And then it continued even after we cured the infection, the colitis continued. And so I had to really go back to the drawing board to think about what do I do? Because I also had mold exposures and I had all these imbalances, I had low ecromancia. So I learned a lot about, on a personal level, which I really didn't want to learn that way, but I learned about what the symptoms are, what it does and how to actually start to think about fixing it differently. Yeah. And for me, I did a number of things. I used a cocktail of, I call it gut food, which is a cocktail of components that are, I think, uh, not really been put together too often,

Starting point is 00:18:58 including prebiotics, probiotics, polyphenols, and immunoglobulins and things that really helped the body to reset the gut. And I also dealt with the mold that I had in my house. And I also used ozone to help boost my immune system and kill infections. And it was really amazing. Within a very short time, I was able to really recover. And I think a lot of us sort of struggle without really knowing what to do. And even sometimes when you do an elimination diet, if you have colitis, you don't necessarily always get cured because there may be something else going on. And maybe like what I had, maybe there was, you know, C. diff or maybe there was mercury or maybe, you know, there was something else going

Starting point is 00:19:35 on, but you can, you can really help these patients so much. Crohn's is often a little more challenging, but we do a lot of different approaches. So traditional medicine, it's pretty cut and dried. What are the kinds of diagnostics you'd see us using with these patients to figure out what's going on with them? Well, traditionally, first you're going to get their symptoms. I always like to go back to the basics. We've got to remember that doctors are cognitive beings. We are medical detectives. We like to think. So I think you need to make sure that you're listening to the patient's story, hearing all of the symptoms, doing a really good examination and making sure you do that part because that's where you get, you find those predispositions,

Starting point is 00:20:19 you find those triggers and you find those mediators that are so important because that begins to – those are the categories you think in to solve the mystery. Okay. So once we've – I've done that piece and I have a really good idea of what the predispositions are. I have a really good idea of what the potential triggers are because those triggers can give me an idea of how I'm going to help them get better and control it down the road. And some of the mediators and perpetuators, you know, that could be, you know, stress or that could be their diet. Once I have those pieces, then I say, okay, you know what, I'm pretty sure you have ulcerative colitis. You know, how do we, how do we know for sure? We can check inflammatory markers, like something called calprotectin, which will be very elevated in people with inflammatory bowel disease. And then we can also visualize, and it's the gold standard,

Starting point is 00:21:13 is to visualize with the colonoscopy the intestines. And you'll see that with Crohn's disease, it can involve the entire intestinal tract, whereas with colitis, it typically just involves the very end or the distal part of the large intestine, the rectus sigmoid and the first third of the, or the last third of the colon. And that will be, that will visualize it through colonoscopy. So those are, that's the conventional way. And then once they, once they land in my lap after, you know, being frustrated by just not getting better or finding that their diets are really restrictive and they're constantly having symptoms and they're not finding any answers in the places they're looking in the conventional medical world. Then I immediately go into action and I'll look at the complete diagnostic stool analysis

Starting point is 00:22:19 where we will get a full complete picture of your digestive processes. Are you making enough gastric acid, pancreatic acids? Do you have markers of inflammation? Is your detox system in your gut working correctly? Is your immune system responding, over-responding, under-responding? And it will also tell us very specifically the diversity and abundance of your gut microbiome. And so it's one of the, it is the first test that I'll get. But I'll also look for other things. And we should have mentioned this earlier, but I'll look for SIBO, which is small intestinal bacterial overgrowth.

Starting point is 00:23:02 I will look for food sensitivities, particularly to gluten. I'll look for leaky gut. And I'll also look for those cross-reactive foods, foods that act like gluten that can create inflammation if you're sensitive to gluten and then be a trigger for your ulcerative colitis. So those are some of the tests. I'll do an ion profile or a micronutrient. It's a functional evaluation of all the most important biologic processes that your body does. And it allows us to determine which systems are or aren't working. And if

Starting point is 00:23:40 they're not, what nutrients are you missing? Do you have, particularly when it comes to the mitochondria, do you have compounds or toxins that might be impairing those functions? Like with you, you had mercury elevations that probably were impairing your mitochondria, probably impairing your immune system. And on top of the other conditions you had may have, you know, tipped you over and made you more susceptible to the adverse outcome with a antibiotic. So we're looking at all those things. And those are the tests that I look at. And I, you know, I may do, you know, some, well, yeah, I usually will stop there in my first tier. And I usually get most of all the information I need with those tests. Yeah, it's true. I mean, I do look at food sensitivities, look at the gut, look at heavy metals. And those can often be so helpful in figuring out what's really going on with people. And then you end up being able to sort of customize their treatment based on what you find. And, you know, there are some dietary

Starting point is 00:24:48 approaches, but, you know, when you get to, you don't deal with the root causes and figure out what you're doing initially, it's a problem. That's really what we do at the Ultra Wellness Center. We map out what's going on with people at a much deeper level. I mean, look at things that most traditional physicians just don't look at, like who's measuring acromantia levels. Well, we do because we want to know what this particular bacteria does. We want to know what your nutritional status is. We want to know whether your gluten is an issue. We want to know what's going on with your gut.

Starting point is 00:25:10 Is it leaky? I mean, we do all these things. And then we implement a plan. So what are the kind of things we find that work the best? And talk about from a dietary approach and then sort of drill down into the other aspects of our treatment for colitis and Crohn's disease. Right. So the, you know, neck and neck, it's diet and gut microbiome, right? So it's really neck and neck. And I will say, you know, with the gut microbiome, it's very intriguing because there's more and more research being done into the differences between a healthy gut microbiome and the gut microbiome of a person that has inflammatory bowel disease. And there are significant differences. And in a person that has inflammatory bowel disease, one of the key bacteria, as you mentioned earlier, is acromantia. Acromantia plays a role in keeping

Starting point is 00:26:10 the mucosa, the gut lining, the goblet cells really healthy. It breaks down the mucin. And then when it breaks that down, it turns it into short chain fatty acids. And we know that short chain fatty acids are the, you know, that's the honey of the, you know, the colonocyte. It just loves, you know, it's short chain fatty acids and that keeps it really healthy. People who have inflammatory bowel disease tend to have really low levels of acromantia. And it's not uncommon for me to find that they're not even detected when I do the complete diagnostic stool analysis on patients. So replacing acromantia, you know, has been shown to have, you know, an important role in helping the gut mucosa heal. There is a study that I had come across in preparing for this.

Starting point is 00:27:06 It was in the European Journal of Inflammation 2020. And basically in this study, they took bifidobacterium, another strain of bacteria that is found to be really low in patients with inflammatory bowel disease. And they took a specific strain of bifidobacterium lactis, and they combined it with xyloglucan, which is a non-digestible fiber source. So they had a prebiotic and a probiotic together in a patient with ulcerative colitis. And they followed, you know, all of the patients in the study and control groups. And they found that there was at six weeks, the study group had significantly more healing and resolution of their symptom, more healing of the gut mucosa and healing and resolution of their symptoms.

Starting point is 00:28:07 And this is just, they had no other therapy. This is just a prebiotic and a probiotic and that they use. And so using probiotics, you know, to control and to resolve an exacerbation can be really critical. And I think we're learning more and more about how they work. There are other probiotics or other bacterial species that are missing or are in low concentration in patients with inflammatory bowel disease, including lactobacillus GG, sarcomyces boulardii. And when you replace these, you find huge benefits. So I use probiotics pretty quickly in a patient. I also will use, there's a probiotic called VSL number three. A lot of people know about that because it's

Starting point is 00:29:00 frequently used. And it's really powerful. It has all the screens of lacto, bacillus, and bifidobacterium that are low and are also very helpful in healing that gut lining and gut mucosa. And just by using that, I've been able to help people start to feel better and see the symptoms resolve. So as you can tell, the gut microbiome, using probiotics are really a big part of how I'll treat my patients. But there has to be balance about what you can tolerate and where they are in their disease, because the diet then becomes really important. Sometimes I can't give probiotics right away. Sometimes I've got to get this person eating. I've got to get them feeling better before they can actually tolerate the addition of the probiotics.

Starting point is 00:30:00 Absolutely. What I would say, George, is also the diet is such a key thing for most people. And it's not only, you know, eating an anti-inflammatory diet. It's not only getting rid of the food additives, the emulsifiers, and the things like the carrageen and other things that can cause damage to the gut lining. But it's also thinking about how do we reduce all the potential inflammatory factors in the diet and all the potential food allergens. And there's been some interesting research done on what we call an autoimmune paleo diet that's been shown to be effective for Crohn's and colitis in trials. And I think it's

Starting point is 00:30:37 really been overlooked for the most part, but can you talk about what is an autoimmune paleo diet and how does it work for Crohn's and colitis? Yeah. So, you know, as I said earlier, the microbiome is the gateway to the immune system. And we know that there is a strong immune component to inflammatory bowel disease. The autoimmune paleo diet, I got to put my glasses on so I can see you better. And so the autoimmune paleo diet basically is going to eliminate foods from your diet that can trigger your immune system to have that autoimmune response and to create that inflammatory response. And it's going to allow the gut lining to heal. And so there are foods that are thought to really be...

Starting point is 00:31:27 What do they take out? What is an autoimmune paleo diet? What do they take out of the diet? They're going to take out grains, legumes, nuts, seeds, nightshades, eggs, and dairy. All of these have inflammatory components to them. Wow. And so then, you know, yeah. So that's the main things.

Starting point is 00:31:45 So like grains and beans and nuts and seeds and eggs are supposed to be healthy. So, right. So they are, but they have inflammatory components to them. Once you, you know, your, your system begins to break down, then those foods can tend to have, you know, trigger the immune system to have that, you know, an increased autoimmune response. Because what happens with some of those foods is that you develop, the mucosa breaks down, so it can't do its job. Number one, it can't break foods down, so you're not going to get the nutrients that you need.

Starting point is 00:32:17 Number two, that mucosa now, this very finely designed gait system is broken. And these foods, when they're not broken down into the smallest peptides possible, can actually, they don't have to be because the gates are broken. So now you have these larger peptide forms. And these particular foods, their proteins are inflammatory to the immune system when they're larger and the immune system can't recognize them. So the immune system begins to create the autoimmune response and the inflammatory response. So that's why these particular foods are taken out. And it includes alcohol, coffee.

Starting point is 00:32:58 It includes processed oils, corn oil, canola, cottonseed. You want to not have those oils in your diet as well. Absolutely. And so you're getting rid of all that stuff. And what are the kind of results you're seeing with those patients? Well, with the AIP diet, we see very good results. Because a lot of folks, when they've come to us, they've never been told that you can eat a certain way to improve your symptoms.

Starting point is 00:33:33 So when we take these foods away for six to eight to 12 weeks, it gives the intestine and the immune system opportunity to rest. And now you can get healing of the gut because you are still eating very nutritious foods that are healing to the gut. We're able to, once the symptoms begin to be vanquished, they're able to tolerate more foods. We can get more fiber in. we can get more probiotics in and then the healing process really begins and you know by 12 weeks we're seeing you know people with you know all symptoms are gone and they feel great and that's the main eip with with probiotics. That's incredible. I mean, really, when you think about the fact that this is such a debilitating disease, that it's such a difficult challenge for patients, that the drugs

Starting point is 00:34:35 are so potentially toxic and harmful, that so many millions of people suffer from this. And that you're saying, George, is that in functional medicine, we have a map to figure out why. We have a approach to improve the microbiome, to treat them with an anti-inflammatory diet, and to reset the gut microbiome through a whole host of interventions that we call the 5R program in functional medicine. We've talked about that on the podcast before. And we also, you know, tend to look for other things that people don't look for, like heavy metals or infections or other issues. And it's amazing what you'll find and what you see. And it's so gratifying. I mean, of all the conditions, I love it when I get a patient with Crohn's or colitis because it's such a slam dunk. And for me, I had one of those cases that just was not

Starting point is 00:35:22 getting better. And so I always get the cases, whatever it is, and then I have to figure it out. And I figured it out. And I think, you know, there's other treatments that can be helpful. And I used ozone. I used exosomes. There's a lot of different things. But it's quite amazing when you see the potential for this. Yeah.

Starting point is 00:35:39 And I want people to know that, you know, it's, there are, look, you're really sick, you're not feeling well, and you're having bloody mucousy stools, and you're having them 11 times a day, and you're having pain, and you can't eat, you're desperate. And, you know, and then you're going to be told, well, guess what, we're going to put you, we're going to eliminate all the foods that you like. Well, you know what, sometimes, unfortunately, we don't even start an AIP diet because people, when they come, can be so debilitated that they can't tolerate food. diet. You know, an elemental diet is basically a medical food that has all the nutrients that you need, but doesn't require your body, your broken mucosa to break down the proteins and the complex carbohydrates. And so we're able to use the elemental diet to really rest and really get all the symptoms calmed down, then move on to AIP, then add in our probiotics. And then we have other

Starting point is 00:36:47 things that we can do for long-term maintenance of a healthy state. And that is some things that can boost the immune system, modulate the immune system. I commonly will use things like low-dose naltrexone, which modulates the autoimmune response. And I'll use CBD with THC blends that again, can have a modulatory effect on the immune system, decrease inflammation in the gut, increase appetite. And so there are a lot of things that we can do in functional medicine, just as you just pointed out. And those are some of them in a little bit more detail. And I agree with you. I, you know, I'm, you know, you know, that's what we do. You know, there's not a patient that comes to me that even if they're coming for one thing, that we don't end up talking about their gut. It seems like gut issues are

Starting point is 00:37:39 epidemic. Huge, huge, huge. And also, Crohn's disease, I think, are at the apex of the severity of what can happen when you have a poor diet, you have a disordered microbiome, and now you have

Starting point is 00:37:55 an immune barrier that's broken, and now your immune system's, you know, under, you know, under, you know,

Starting point is 00:38:02 siege, and it can't respond appropriately. Yeah, under, you know, under siege and it can't respond appropriately. Yeah. Well, I'm telling you, George, this is one of the areas in functional medicine that I've found over the last 30 years has been such a gratifying area because people really suffer. The traditional approaches are kind of limited and the potential to heal the gut through restoring the microbiome, changing diet and some simple measures is just huge. It's huge. And so I'm excited about having this podcast with you, because I think when we see these interventions in functional medicine working out the way they do, it's just such a life-affirming thing for me as a physician to know that I'm helping someone.

Starting point is 00:38:42 And I've been there. I've had all this. I had 20 bloody painful problems today. I was nauseous and in pain for five months. I was just, it was in bed. Like all I could do is go bed, bath, bed, bath. It was like, it was terrible. And, and now I think, you know, um, we have such a clear roadmap to how to fix this. And there's some other weird things that people are doing, like using worm therapy and other things. Helmets. Helmets. I don't use that that often, but it can be helpful. So there's a lot of tricks in the functional medicine toolkit. And George, you've been really great

Starting point is 00:39:10 helping us understand inflammatory bowel disease. This has been another episode of the House Call with Doctors Pharmacy with Dr. George Papagnacolaou. If you love this podcast, please share with your friends and family on social media. Please leave a comment. How have you dealt with your inflammatory bowel disease? Have you gotten better using a different approach? Subscribe wherever you get your

Starting point is 00:39:28 podcasts and we'll see you next week on The Doctor's Pharmacy. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introduce to you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff

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Starting point is 00:40:49 or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.

The Dr. Hyman Show - A Functional Medicine Approach To Curing Crohn’s And Colitis with Dr. George Papanicolaou

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