The Dr. Hyman Show - Bugs to Brain: How Infectious Diseases May Precipitate Neurodegeneration with Dr. Jay Lombard

Episode Date: September 4, 2019

The gut and brain are strongly interconnected. That’s why in Functional Medicine we always take the gut into account, along with the rest of the body, when trying to understand a brain disease. Unfortunately, conventional medicine likes to look at each part of the body separately, which may be why doctors have a hard time effectively treating neurological diseases like Alzheimer’s, Parkinson’s, and ALS. Knowing that the gut affects the brain and understanding the far-reaching role of the microbiome has led this week’s guest on The Doctor’s Farmacy to approach neurodegenerative conditions with a whole new perspective.  Dr. Jay Lombard is an internationally acclaimed neurologist, author, and keynote speaker specializing in neuroimmunological conditions and medical mysteries. Dr. Lombard integrates biological, psychological, and existential components in his holistic treatment approach. Dr. Lombard’s clinical experience revealed an interesting pattern: one patient with ALS also had small intestine bacterial overgrowth, then another who had ulcerative colitis, another had Crohn’s, and so on. He started seeing the connection between these bacterial imbalances and Clostridium difficile, or C. diff, and the link to neurological symptoms.  This episode of The Doctor’s Farmacy is brought to you by Thrive Market. Thrive Market has made it so easy for me to stay healthy, even with my intense travel schedule. I never let myself get into a food emergency. Instead, I always carry enough food with me when I’m on the go, for at least a full day. I order real, whole foods online from Thrive Market. Right now, Thrive is offering all Doctor’s Farmacy listeners a great deal: you will receive an extra 25% off your first purchase plus a free 30 day membership to Thrive. There’s no minimum amount to buy and no code at checkout. All you have to do is head over to http://thrivemarket.com/farmacy

Coming up on this week's episode of The Doctor's Pharmacy. There's very strong compelling evidence at this point that bacteria are the cause of neurodegenerative diseases. Hey everybody, it's Dr. Mark Hyman. Now before we get started with this week's episode, I want to tell you about a company called Thrive Market that's made it so easy for me to stay healthy even with my crazy travel schedule. In fact, I believe in them so much that I was one of their first investors over five years ago. So here's a little background. I split my time between three different locations, Cleveland, the Berkshires, and New York.

And I'm constantly traveling. Anyone else who travels a lot knows that airport food and rest stop food is horrible. It's junk. It's pretty scary out there actually. I recently drove through Ohio and it was a food wasteland. It's easier to make healthy choices at home for sure, but when you're hungry and you're on the road, it's pretty easy to get in a food emergency. Those french fries and cinnabons well they just seem to call your name i never let myself get in a food emergency i bring enough food with me for at least a whole day sometimes more than a day whole foods real foods that i order online from thrive market they sell all my favorite snacks

condiments cleaning products self-care products pretty much all the stuff in my kitchen or the rest of my house at discounted prices. Now, they don't sell fresh fruits and veggies, but pretty much everything else, including regenerative beef and sustainably harvest fish. I just order a box full of all my favorite stuff, have it delivered to my house or, in fact, wherever I am. And then I stock my pantry and my backpack with all my favorite stuff and I carry it with me and all of it's clean whole food and it's between 25 and 50 percent off the retail price that you get at a place like Whole Foods. They also carry one of my favorite snacks of all time, Hugh Kitchen dark chocolate. Now this is probably the best chocolate in the world. They have all the flavors that you need and that I love. And if you haven't tried this chocolate, it's pretty amazing. They use only the most high quality organic ingredients. They use coconut sugar, which doesn't spike your

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25% off your first purchase, plus a free 30-day membership to Thrive. There's no minimum amount to buy. There's no code at the checkout. All you have to do is head over to thrivemarket.com forward slash pharmacy that's thrivemarket.com forward slash pharmacy that's with an f f a r m a c y i think you're going to love them as much as i do i'm really proud to have them as a sponsor and to be an investor in their company all right let's get back to the episode. Welcome to the doctor's pharmacy. This is Dr. Mark Hyman. That's pharmacy with an F-A-R-M-A-C-Y.

It's a place for conversations that matter. And if you care about your brain, today's conversation will matter to you because it's with Dr. Jay Lombard, who's an extraordinary physician, neurologist, psychiatrist, author, speaker, and friend of mine who i met probably gosh close to 15 years ago i don't even know it seems like a long time ago and you were teaching a course on a functional medicine approach to neurodegenerative disease and sitting and listening to my mind was just completely blown And we're going to go through what we learned then and what we know now, almost a decade plus later, about how to fix and treat very tough brain diseases, things that there really is no good treatment for in conventional medicine, things like ALS and Alzheimer's, Parkinson's,

MS, all these horrible diseases that we really struggle dealing with. So he's integrating a whole series of things that are pretty unusual for a doctor he's written a book called The Mind of God about spirituality, faith, medicine he integrates understanding of the biology of our human being our psychological components

our existential components in a very complete holistic treatment of the person. He's a very unique guy. And he's written a lot about all sorts of things, including the brain wellness program, which was a great book he wrote years ago, which is how I got to meet him. And recently, The Mind of God, which was featured in the New York Times, a great article about you in the New York Times.

Very good. Congratulations. And exploring the difference in the relationship between faith and science. He's appeared on lots of TV radio shows, including Larry King Live. That was a while ago. Yes. CBS News, the Food Network, Dr. Oz. And he's been the chief of neurology at Westchester Square Medical Center, the Bronx Lebanon Hospital,

and clinical assistant professor at New York Presbyterian and Albert Einstein College of Medicine. And he has a practice in Tarrytown, New York, which is fantastic. So welcome, Dr. Lombard. Two disclaimers. I'm not a psychiatrist and I really know nothing about the brain. Oh, wow. Okay. Well, I thought you said you were trained in psychiatry.

I was trained in psychiatry. Yes, I'm not a psychiatrist. So you're not technically a psychiatrist, but you learn enough about psychiatry i was trained in psychiatry yes i'm not a psychiatrist so you're not technically a psychiatrist but you learned enough about psychiatry you know just enough to be dangerous yeah well you know it's often you know psychiatry used to be uh brainless uh and now it's mindless right exactly exactly you try to bring those two things together and i think that's why i tried and failed so we were we were discussing and we've talked over the years about the challenges of dealing with this sort of epidemic of broken brains brain disorders that uh we in medicine really struggle with a typical line for neurologists was adios diagnose and adios you know

you can diagnose the disease but not much we can. We'll see you later and good luck. But now that's all changing. And you're doing pioneering work looking at the relationship between things like inflammation in our gut microbiome and mitochondria and all sorts of stuff that just seems sort of marginal in medicine, but now has come to the center and is allowing us to think about these conditions in a new way and treat patients in a new way and you are at the leading edge of that you you have thought differently about this than almost any neurologist i've met i mean we've had david perlmutter on this show and others but you know this is this is uh your sweet spot is the sort of intersection of all this emerging science, emerging therapies,

and putting them together for patients in a way that really help to make them better. So thank you for that. That's the goal. That's the goal. All right. So just to dig in a little bit, let's start at 30,000 feet. Why have we failed so miserably at addressing these neurodegenerative diseases that are affecting literally millions and

millions of people in the United States and around the world and causing untold suffering to patients and their families. That's a very simple answer. We're treating symptoms, not pathophysiology, which is why I love IFM. Yeah. So functional medicine, yeah, functional medicine is really about treating the cause. Exactly. And not the symptom. Right. And that's what we're good at in medicine is treating symptoms but the disease process continues underneath those symptoms even though the symptoms are suppressed right exactly so it's fine if you have a broken leg and you want to take painkiller you don't care if your leg's still broken you don't want to hurt

right but for these kind of conditions uh we just spent so much money and research in the wrong direction. 100%. So what is really the root of these things? You were sharing with me before we got on the show that Parkinson's and ALS and MS and Alzheimer's, there's so much in common. They're almost the same disease with different manifestations, like the same tree trunk with lots of different branches. Right. That's right. How does that work?

Well, I think that there's been a lot of research recently, really quite frankly, from IFM, which kind of led into— The Institute for Functional Medicine. Right. Yeah. Right. That basically talking about the role of the microbiome in chronic disease.

So I'd be honest with you, I was very skeptical of that whole thing until I saw my first patient with ALS who told me that he had SIBO. Yes. Okay, and I'm like, okay. What is that? Right, I was like, what is SIBO?

You're a neurologist, anything that happens south of the neck, you're like, don't know right so i said to him i go look you SIBO there ALS here he goes no my ALS is being caused by my SIBO and what is SIBO what what well he didn't know i didn't know at the time what SIBO was okay that's i gotta get to the punch line so what is SIBO good question So what is SIBO? Good question. So what is SIBO? But I sort of started thinking like a microbiologist instead of a neurologist, meaning that my patient's telling me he has an infectious disease that's associated with ALS. Since he's one person, instead of trying to divide and conquer that he has SIBO and has ALS,

what if SIBO and ALS were somehow related? That was the first question I started with when addressing this particular patient. Most people don't know what SIBO is. So what is it? What is SIBO? It's small intestinal bacterial overgrowth. So it means bacteria are growing in your small intestine. Oh, you asked me that question.

You want me to answer that question? Yeah, because people don't listen. Who knows what SIBO is, right? Sounds like a new kind of thought. listen. Who knows what SIBO is, right? Sounds like a new kind of law. I thought everyone knows what SIBO is. Isn't that the convenience stores in airports, SIBO or something? Right. No, no.

SIBO means that you've got bacteria growing in your small intestine, where it's not supposed to be. It's supposed to be in the large intestine. And when you eat food, it ferments quickly, and you feel bloated, distended. You get what we call a food baby. And it can cause a whole host of other problems. It's been linked to fibromyalgia, to depression, to heart disease.

I mean, pretty much everything, right? Right. So, okay, so now. So now I'm thinking about, can a bacteria be the cause of ALS? Now this is, at this point, you know, a completely unfounded theory that, you know, people have told me to this day, I'm still crazy for thinking this. Okay. So anyway, I don't think so. Good. So my second patient with ALS had ulcerative colitis and ALS. Oh,

and I said, Oh, this is interesting. So as I looking at ulcerative colitis, I was like, wow, ulcerative colitis looks like it's immune mediated. Not that it's autoimmune, but immune mediated from bacteria. So I'm looking at all this gastroenterology literature about ulcerative colitis and Crohn's. I'm like, oh my God, it's the same bacteria. I got ulcerative colitis from C. diff. Right.

Exactly. Exactly. I almost died from it. And it made my brain not work. Exactly. I almost died from it. And it made my brain not work. Wow. It's just amazing that you're sharing that with me because, you know, I, look, I'm a neurologist. I don't think about ulcerative colitis. I don't think about Crohn's.

I don't think about fecal transplants. I don't think any of that, right? All of a sudden I'm like, okay, I'm thrown into this thing where if I believe that C. Diff is the cause of ALS, I got to kill this disease, man. I got, I got to, I'm like a disease hunter. Like I'm going to, I'm going to nail this disease, right? So what happens? So like the Indiana Jones of medicine, right? You're, you're screwing my patient. I'm going to get you first. And my best friend is like a former FBI agent. So it's like, that's like when they follow serial killers, that's what they do, right? They get all the

evidence and then they kill them or they arrest them at least. That's what they do, right? They get all the evidence, and then they kill them. Or they arrest them, at least. First they hopefully arrest them. Then they try them, and then they kill them. But in C. diff, you've got to kill, not arrest. That's a whole separate conversation. But anyway, so I started putting together how C. diff neuropathologically can produce motor neuron disease because I had to sort of establish what those pathways were

in order to convince my colleagues that they should look into this. So you kind of connect the dots between stuff that goes wrong south of the border there and the gut. To the nervous system. And what happens to your brain. Correct. But they're actually connected, right? There's a whole thing called the second brain, which is your gut.

Yes. And your brain brain, which is your brain. Right. And they're all connected through all kinds of hard wiring. It's one body. Right. We're one body. Isn't that holistic medicine?

The idea that you treat the patient. That's why I joke. I always say I'm a holistic doctor because I take care of people with a whole list of problems. They're all connected. They're all connected. Why? Because you have all those problems, right?

I mean, there's this horrible phrase in medicine. It's called comorbidity. Which means you have multiple chronic diseases. That aren't related. Like, oh, you have multiple chronic diseases that aren't related like oh you have heart failure and diabetes and hypertension and you have kidney failure and you have you know this and that and alzheimer's they're not related they're just happen to be showing up in the same person at the same time oh it's a coincidence right nonsense right they're all connected right just like it was a coincidence i was walking down the street and i saw an old uh doctor who

actually his son was a patient of mine like oh that's not a coincidence. I was walking down the street and I saw an old doctor who actually, his son was a patient of mine. Like, oh, that's not a coincidence. Like, that's to be something of value for that. But yes, it's not a coincidence that these diseases occur in one person because they're interrelated to each other. So I started asking that question. How are these separate conditions? What's the mechanism?

What's the mechanism, right? So here's the mechanism. The mechanism is protein aggregation. That's a fancy word. What does that mean? Protein aggregation means that chronic disease, by definition, whether it's neurological or cardiovascular even, or even cancer, these are where proteins are malformed.

The proteins- The funny-looking proteins. The proteins have weird shapes. They get damaged. They have- Or injured or produced in ways that are funky. And that's a common factor in every neurodegenerative disease, meaning that there are misfolded proteins. Amyloid and L-cell.

Amyloid, tau, alpha-synuclein, all of the different proteins that are associated with their pathology for those diseases. They're all protein misfolding disorders. I said, okay, well, why are they misfolding? Like, what's stopping them from folding properly? And what controls... Yeah, because it's not only the amino acid structure of a protein that matters. It's three-dimensional.

It's the three-dimensional structure of the protein and how that interacts with receptors and how it interacts with other proteins and how it interacts with your cell membranes. Everything. It's a three-dimensional world. Right. It's not two-dimensional. So I started thinking, okay, how it interacts with other proteins, and how it interacts with your cell membranes. All that. Everything, it's a three-dimensional world. Right. It's not two-dimensional.

So I started thinking, okay, what is causing the proteins to misfold? Okay, and I think this is well known, it's not something I discovered, so this is actually well known, that misfolded proteins are caused by microtubule dysfunction. And microtubule dysfunction is caused by other things. There's actually lots of things that cause microtubule dysfunction. And microtubule dysfunction is caused by other things. There's

actually lots of things that cause microtubule dysfunction, but guess what bacteria produces primary microtubule dysfunction as its pathology? C. diff. A hundred percent. But many other bacteria might do that too? I looked for that question and I could not find as strong an evidence of a direct A to Z link between clostridium. Clostridium actually makes a toxin that you can actually test for called rokinase. So rokinase, I said, what does rokinase do?

Well, how is rokinase producing the lethality? The lethality? Is that the right way? That's good enough. Yeah, lethality. Deadliness. Deadliness, right, of cells. And it does it by poisoning microtubule-associated proteins.

What's a microtubule? Microtubule is like the architecture of this house. Think about all of the scaffolds and all of the walls. Everything makes this house. It's all the framing. The framing. It's the framing of the cell. But it's not just the framing of the cell.

It's in charge of all of the export-import, the border control. So it's the trading company. Right. And reproduction. I mean, how cool is it it has that function, right? Yeah. It's all about reproduction for microtubules as well. So it has interface not just with ALS but also cancer.

So if you look at the cancer data, A, these are protein aggregation disorders as well, different proteins, obviously, right? But possibly the same mechanism was causing those misfolded proteins. So I was like, okay, I'm not ready yet for this. I mean, like even this conversation, but I've not begun to look at evidence of C. diff in cancer yet, because right now I have to focus just on neurodegenerative diseases yeah but uh in that case so so so we're at the potential you know issue that you know how do we prove this basically so then what causes besides c diff though there's other things right that cause it right inflammation and well inflammation as a as a result of infection you're saying you're saying there's one cause which is c diff for all neurodegenerative diseases?

In order to prove that hypothesis, two things have to happen going forward. Two things. The first is we have to establish that there is C. diff in the brains of patients with Alzheimer's disease. Guess what? That study's been done. Yeah. It also showed that there was some... Poop for brains. Po poop for brains poop for brains is

that is that like is that a true website or something or i thought rudy made that up for brains well there's another way to say it but but but more importantly clinically clinically i mean look people can say oh it's an epiphenomena right like the brain is you know already decomposing of course you can have the bacteria emerging when the person's dead their argument right maybe it's not that clostridium is causing the disease but it's just it's there for the ride as it eats your brain up after you're dead right that's that's sort of the meaning meaning they find out an autopsy but maybe it's like it doesn't mean that it was there when they were living yeah right so fair enough that what that means is that we have to demonstrate so they ran for the hills as soon as a person died is that it i guess i don't know it's true probably unlikely right exactly yeah but but in fairness to that sort of uh

counter punch what what the medical community would ask for going forward is especially clinically like we make a decision that that we think that this is definitely c difficile what the medical community would ask for going forward is, especially clinically, if we can make a decision that we think that this is definitely C. difficile in, you know, a patient with a disease like Alzheimer's, right? To make that conclusion clinically, you have to have absolute 100% evidence that that bacteria is actually causing that disease. With some, you know yeah obviously not every disease is

gonna you know test positive and not only are is a challenge here that the majority of patients who test for C difficile who have dementia Parkinson's Alzheimer's and what have you have negative tests for C diff in their stool in their stools right and so people that are sort of looking at this picture with me if you will are saying exactly that well it can't be c diff because we're testing c diff in the stool and it's not there i say well guess what it went uptown okay it used to live downtown but it likes uptown more why because a we give them ppis which they love that that alkalinic environment acid blockers acid blockers like pepsi and what do we give them that they love that that alkalinic environment acid blockers acid blockers like pepsid and what

and what do we give them that they love most of all antibiotics c diff loves antibiotics it's actually an antibiotic associated infection exactly that's how i got it i took an antibiotic for my bad tooth and i ended up getting yep c diff yep that's i mean that if that's not a word of warning to all the listeners i don't know what it is yes exactly right c is basically it's called antibiotic associated c diff so i started asking patients with neurodegenerative diseases if they had a prodrome when they first started getting sick and all across the board i mean like symptoms that happened before they got of course well well, you ask questions like that. I want to know what they did as a baby, basically.

Even though they're 70 years old, why ask? I don't know, I've asked my mom that question. But younger patients, you could ask them that question because they're with their parents. And I say to them, I ask them three questions. I go, did you have a lot of antibiotic exposure before you got sick, sick? 100%.

It's like I know the answer before I even ask the question. It's just a question of how many antibiotics they had and what course of antibiotics they had. And the second question that's worthwhile to ask clinically is, do you have trouble actually mounting a fever? So that's a question that I was surprised by the answer that most, I mean, not most, but most, my patients basically have said, no, you know what? I've noticed I really never get a fever. I'm like, oh, okay. Which is not necessarily a good thing. That's right.

It's not a good thing at all. Because the only thing that actually will treat spores, right, is heat. Heat. If you look at. That's why we get a fever, right? That's why we get a fever right which is you get a fever because it's your body's mechanism for killing infections it's it's you know i make a joke with people i say them all the time i said name one disease that that humans have cured cured like oh you know if they and they always mention infectious diseases because that's that's that is

the truth we've cured infectious disease but the only thing that actually cures disease is our endogenous mechanisms. You know, fever actually, fever and sleep basically are the two endogenous mechanisms of holistic medicine. And endogenous means stuff that you do yourself. Your body does itself. Your body's doing it for you. But you have to help the body do that. You can't be staying up late and taking PPIs to watch, you know, Seinfeld episodes. You can't have your, like, pizza followed by your Prilosec and stay up all night watching Game of Thrones.

Correct. Now, in perfect disclosure. Damn, that sounds no fun. I've done all of those, except I actually do eat the pizza when I'm watching those shows. I got to work on myself, basically. Okay? Doctor, treat yourself. Yeah. Right? But anyway, yes. pizza when i'm watching those shows and i just i gotta work on myself basically okay doctor treat yourself yeah right but anyway yes so so this this whole conversation is fascinating to me because

from a functional medicine perspective you know many roads lead to rome in other words just because you know the name of the diagnosis of the disease you have doesn't mean you know what's wrong with you. Exactly. And the truth is there can be a 10 or 20 causes for the same disease. Right. And I think that's probably true even of neurodegenerative diseases like Alzheimer's. So I just want to make sure that we're not saying that every single person with Alzheimer's has C. diff.

Right. Or that that's the cause because it could be something else. Exactly. It could be Lyme disease. 100%. It could be heavy metals. But the that that's the cause because it could be something else. Exactly. It could be Lyme disease. 100%. It could be heavy metals. But the point is,

no, but I think it's sort of like the devil's in the details, if you will, right? Meaning that, yes, I think there's very strong compelling evidence at this point

that bacteria are the cause of neurodegenerative diseases. Not my research. Yeah, we talked about Rudy Tanzi, who's a Harvard scientist, one of the discoverers at this point that bacteria are the cause of neurodegenerative diseases not not my yeah rudy we talked about rudy tansy who's a harvard scientist one of the discoveries of some of the presenilin genes which are the genes that show that people are at risk for early alzheimer's he actually said they were discovering all these microbes in the brain which we thought was impossible and that we had this blood-brain barrier that protects us. And you're saying, and he's saying,

that that barrier is not always 100%. And that stuff can leak through. Not only can you have a leaky gut, but you can have a leaky brain. Look, bacteria, not to scare people, bacteria love the brain. Why? 25% of the body's glucose is used by the brain.

They know where to eat. They go into, you know, Le Pen or whatever that or the fancy restaurant is downtown like everyone else is eating downtown they're getting you know our brains they can bacteria live on ketones 100 but not but not wait that's very important they prefer simple sugars why because they're lazy right they want you know they want instant gratification. So they like sugar better than ketones. But ketones and ketotic diets work for some of these neurodegenerative diseases,

like Alzheimer's and even LS and brain cancer. That's right, that's right. And I think one of the mechanisms, to be honest with you, is that ketones actually improve, firstly, improve mitochondrial function, but they're not a good substrate for bacteria. They're a great substrate for us. Bacteria don't like them because they like eating fast food, basically. Yeah. So feed them sugar and we eat fat. That's right. Okay. So this is just a breakthrough idea. And this isn't just an idea you've actually treated patients

using this approach and seen some really extraordinary things yes so can you share with us you know a little bit about this case you were sharing with me earlier about ALS which is a horrible condition Stephen Hawking had it it was called Lou Gehrig's disease after the baseball player essentially it's where your nervous system is affected by the killing of the neurons in your spinal cord, which makes you basically paralyzed. You get fasciculation, which is twitching.

You eventually can't move your arms and legs. You're in a wheelchair. You can't breathe. You need a respirator. You wouldn't worship on your worst enemy. You would not worship. It's like a slowly getting paralyzed. Yep, that's right.

And never has there been a treatment that has stopped or reversed it. Right. And you're saying that you've seen patients where this has actually happened. So, well, we are in the process of validating that sort of data, yes so yes we need more studies yes we need to do research on multiple patients but even if there's one patient right where you've seen a change it raises the question oh it may it's by the way it's made me go crazy by the way because you know i am so i'm finally glad to be a neurologist you know being a neurologist is like being a nihilist or a masochist.

Diagnose and adios, right? Well, it's worse than that. It's like diagnose and let me not tell the patient that they have ALS. Let me treat them for, you know, like a CIDP picture because they don't want to actually make that diagnosis for people. It's the hardest diagnosis you can make for a patient because everyone knows ALS is incurable disease, right? I mean, it's a hundred percent it's

like not even pancreatic cancer is better well you have a five percent chance of living a pancreatic cancer you have zero chance of living through this disease zero so so based on your hypothesis that it's infectious yes that plays a big role if not is the main role right um you know I personally shared on on this podcast that I went to a place in Mexico called Santa Viva where I and my wife both went through this treatment called hyperthermia, which essentially is where they heat you up to 107 degrees, which sounds crazy and is scary, but actually we did both fine and it killed a lot of infections that we had.

Like Lyme, my wife, her viral loads of a very tough to treat infection called CMV came plummeting down. Yep. She felt much better. I felt much better. And so this is a therapy that is not much used in the United States, but is used widely

in Europe, is used in Mexico and other countries as therapy for some of these types of infectious diseases and even cancer. Right. So how does the theory work behind this with something like ALS? Well, the idea is that, you know, fever is the way of actually denaturing spores. Okay, that's a big sentence. Can you unpack that? Sure. So human cells have their proteins that either fold properly or not fold properly

at a certain temperature, right? Bacteria have their own temperature zone, like their ideal climate. And spores have another ideal climate, right? Meaning that to kill a spore- A spore is like a baby bacteria. A spore is a baby bacteria. And that's what I believe personally is the reason that patients have amyloid accumulation.

That the spores are creating this protective cover against antibiotics that actually is, in fact, the amyloid being produced. The amyloid is like the armor for the bacteria. Yes. They're like the, they're like the bomb shelter. The biofilm is the bomb shelter for these little baby bacteria. Yep. And so how does hyperthermia work to disrupt that? And what is that procedure? Well, so it works, hyperthermia works by,

it's a very narrow window of temperature. Meaning if you give too much temperature, you can actually hurt normal cells as much as, you know, bacterial cells. If you don't give enough temperature, you've done nothing. So it's like Goldilocks. It's like Goldilocks. You got to get it just right you have to get it exactly right okay and that's part of uh the way that the hyperthermia technology uh has been developed is by really understanding that the brain itself can provide feedback on the the tolerability for human cells because brain cells are going to tell the brain hey this is pretty hot in here you don't want to fry your brain right can you turn the thermostat off now so the part of the part of the device actually is to to get the brain temperature uh back into the feedback system

where it's self-regulating so you never reach a point where the temperature is harmful to your own cells and and so you know they often in places where they do this, they'll give, at the peak of the temperature, they'll give antibiotics or antivirals. Right. Does that make sense? To give antivirals?

Or, yeah, to give antimicrobial treatment to patients when they're at the peak of the fever because the idea is that it sort of flushes out the... Oh, I see. Yes, for acute infection, yes.

I would argue that... Like Lyme or... Well, if Lyme is acute, out the... Oh, I see. Yes, for acute infection, yes. I would argue that... Like Lyme or... Well, if Lyme is acute, certainly. I mean, I don't think that... I mean, I think you'd be weary of the issue that by robbing Peter to pay Paul, for instance. Let's say that C. diff is... Let's say, for argument's sake,

say this is a polymicrobial disease, okay? As opposed to a... Like lots of different bugs. Lots of different bugs, as opposed to just one ringleader different bugs lots of different bugs as opposed to just one ring leader that everyone else is following okay so lombard believes it's that that c diff is the ring leader okay and all these other guys lime hsv they're just they're tagging a ride because it's such a great killer that's like okay great we'll take the leftovers no problem here we'll

take the leftovers so my concern is clinically that if we start treating patients, you know, with, you know, bacterial drugs like Rocephin, whatever it is for chronic Lyme. Yes, you're addressing chronic Lyme. I mean, the C. diff gets worse. Yes, exactly. Yeah. Exactly. So the heat alone is enough to disrupt the C. diff? It's, well, we haven't demonstrated that yet, to be quite frank.

But what's been demonstrated is that by applying hypothermia, that we're able to actually see improvement in clinical symptoms of patients with ALS. With people's muscle strength. This is a progressive disease, so it gets worse and worse and worse. Every visit, they're worse. You're seeing patients, it stops or gets better, which never never happened correct right so this is a major breakthrough i think so major breakthrough and and this is not something new this has been around for a long time so where in the world is most of the research being done on hyperthermia for als period i mean it's

most so they're most of the research on hypothermia actually is cancer research. So they call it chemothermia, chemohypothermia. So people can look up a lot of data on how hypothermia affects cancer. But as far as I know, there's zero data until now applying hypothermia for ALS. We will be the first people to actually talk about applying hypothermia for treatment of ALS. What about things like Alzheimer's or Parkinson's or MS? Well, the difference in those diseases are that in Alzheimer's, right, it's very difficult

to induce hyperthermia in a patient with Alzheimer's disease. Why? Because you need to be compliant. The treatment itself is, you know, it's fairly rigorous as you know from your first experience. They put me to sleep. They put you to sleep, right. We don't want to put them to sleep though right because we're concerned about protecting their brain so you know you have a patient who's got you know end-stage alzheimer's

disease for instance i don't see how this is going to be helpful for them but early 100 early early in fact i will talk later not about the case now because i we're really just in the beginnings of of this case uh Uh, but yeah, I think it would be applicable for Alzheimer's disease as well. Have you seen any patients reported or in the literature or anywhere, but you serve as a theory. Yes. It's still a theory and MS. What about MS? Uh, MS there's data on actually, uh, the opposite, right. Which is how do you induce hypothermia, right? Because an MS, it's an inflammatory disease, obviously, right? Which, by the way, I also believe is caused by clostridium, but not C. diff,

where it's especially important to actually identify at that stage that this is bacterial. So I don't know what they're... Yeah, so what is the idea with ms that you you wouldn't want to use hyperthermia that you wouldn't want to use heat because it makes it worse well because remember when you heat up a patient with ms what happens they usually get worse so the the trick is but maybe not enough right maybe it's not enough that's right maybe you haven't reached the threshold to actually you know use the body's fever mechanisms against bacteria. Because there's links to MS and Epstein-Barr virus and other infections.

There's links to Alzheimer's and herpes virus infections. So yes, the whole principle is applicable for all those diseases. But we don't know yet if it is applicable yet until we clinically demonstrate that. But yeah, I think that this is going to be a treatment that's going to be very important for a lot of different diseases, Mark. So there's this whole theory that the body has a mechanism for dealing with this and it has these own proteins that are produced in response to heat. And there are things we learned about in medical school. They're called heat shock proteins.

I learned something very important about heat shock proteins from Dr. Lesler because remember that people are looking at how to induce hypothermia, right? So there's all sorts of research. There's actually even a drug in clinic for ALS that is the mechanism of action is based upon increasing heat shock protein through a pharmaceutical agent. So I was at this lecture, and you know i thought i thought i knew everything basically and i learned that actually you can induce you thought md stood for medical deity is that it medical deity yes i was yes exactly we all got that training yeah the truth is we know close to nothing that's that's

why i said the beginning of this talk i you for inviting me, but I really know nothing. Just disclaimer. But anyway, so yes, actually in MS, the goal is to induce heat shock protein through hypothermia. Hypothermia. So you get people cold. Not people. The brain. The brain.

Right. How do we do that? Chill the brain. Chill the brain. How do you do that? Ice blocks around the head no no um well i'll invite you up and you could you could see for yourself what that looks like all right dunk your head in ice water nope nope nope none of the above okay so we have to be

in mystery here a mystery about what the device looks like i mean yeah it's it's it's basically the same concept as building a hyperthermia device, except remember now that technology itself was developed basically for anesthesiologists. So this was developed at Yale by Dr. Abreu, who's the person who actually discovered a way of measuring brain temperature objectively externally.

Okay, so that's kind of where this whole thing started from to be honest yeah and we don't just stick electrode in your brain you can literally map it out from the outside you can map it out from the outside so the the ability to do that now allows a clinician to not only you know heat the the body to create hyperthermic states but through other types of modalities to actually cool the brain safely externally with the same in the same way meaning that you can actually apply a small device to a region of the of the skin it's periorbital location and you can actually change the temperature of the brain through this what's called the brain thermal tunnel and that also creates heat shock protein 70 and i didn't know that until i was in australia that's amazing so you're hopeful about the future of neurology

sounds like it's the first time i've been hopeful about anything in my life to be honest you that's a big statement yes it's true yeah Well, this is a fundamental shift in our thinking and treatment. Yes. So besides treating, for example, these ALS patients with hyperthermia, there's a whole lot of other things you do. Yes. What are the other things that seem to be effective or that are working? That I do? Yeah. So I'm at the stage of my life where I,

well, I shouldn't say anything political, but I realize that I can sort of, you know, I have to stay in my swim lane. Meaning as a neurologist, you know, I always thought like, okay, I'm only gonna see patients with neurological problems. And I had to get my head around that I'm holding myself back from-

Because there is no such thing as neurology it really isn't right just one human organism that's right and everyone needs this a good motto that that my my friend jennifer told me i should put everyone needs a neurologist right would that be a good tagline everyone needs a neurologist because everyone has a brain that's right right fair enough so anyway so I started thinking about pediatric brain cancer. And I have a very dear friend of mine who I was supposed to meet today, and she lost her son to pediatric, it's called DIPG, which is a brainstem glioma that's inoperable.

It's terrible. Yeah, you can't resect out of the pons. So I started thinking about, you know, okay, well okay, well, if we can do this for ALS, let's think about if we can do this for cancer, basically. But those are very early innings in terms of thinking out what that means. And what happened? Did you try? No, nothing yet.

This is all theoretical at this point. I'm just sharing with you where I'm going with this. But you take a patient with ALS. So if I, with this but you you know you take a patient with ls so if i as a functional medicine doctor would take a patient with us i would look at everything because it's a disease of inflammation it's a disease of oxidative stress it's a disease of of um often challenges with the gut microbiome right right so i would look at everything maybe heavy metals are all. Maybe there's environmental toxins that are triggering it. I rarely think it's just one thing. I would challenge the thing.

I think it's probably Clostridia and. Okay. Right? Right. And so what else do you do for these patients besides, you know, thinking about this kind of innovative treatment? Like what are the things that you would do to help? Well, I'm still thinking about how to eliminate Clostridium, to be with you but but orally fecal transplants well but okay so that that was the

that's the thing that works you know for people who are listening the disease c diff is a terrible infectious disease causes diarrhea and kills 30 000 people a year most antibiotics are not that effective uh and even the ones that work are not really fully effective. Whereas when you do a fecal transplant, basically taking the poop out of a healthy person and putting some of this disease, it literally is like 98% effective on the first try. Right.

My concern is that if these infections are primarily colonized bacteria, even if it's not, let's say it's C. diff, NH pylori, and whatever other bacteria it is, its fecal transplant may not be the way of addressing C. diff in the ileum. Why? Because the good bacteria don't, they're not really good climbers. They're not good rock climbers.

They like hanging out where they're used to hanging out, right? So you put in a transplant of all this healthy bacterium. They like it. They're not going up north. They're perfectly comfortable going down south, which means that the bad guys may never get a look at the good guys in those patients. So I spoke to this with, of course, FMT surgeons because I wanted to ask them this question. There's a lot of data for FMT being looked at right now using oral FMT, basically. Poop pills. Poop pills, right. I asked the question that a good immunologist would ask them, which is, okay, how do we know if you put a good guy in a bad neighborhood whether you got it right and you know what the answer was that we've seen exacerbations in our studies of patients with

ulcerative colitis when we've tried that with autoimmune diseases yeah that's right right so in other words this this it's complicated stuff it's very complicated yep so yeah i remember i had a patient with ms once uh years ago and she reported to me you know and i think as a doctor your job is to listen carefully not to come in with a bunch of preconceived ideas about what you learned in medical school it's true or not true because often it's not true and the this patient had an incredible exacerbation or worsening of her ms symptoms whenever her gut started becoming wacky she started bloating getting distended was uncomfortable and then her MS symptoms would get

worse right and I was like oh this is not a coincidence right this is important data exactly and I knew if I treat her gut I treat her gut and her MS got better like I didn't know what I was doing at the time I just like right I know how to make people's gut healthy empirical doctor right i'm thinking like let's try this because it's not going to hurt you and it could help you so let's see what happens and it's so striking when you start to apply these foundational principles of restoration of health and balance in the system all sorts of things get better yep and and in a way you're you're resetting the equilibrium through things like hyperthermia and those kind of treatments, right? Right.

Because at that stage, look— But you use diet, you use supplements, you use other lifestyle factors, exercise, sleep. Like, what else do you do as a neurologist when you see these complicated patients who have all these diseases? I have a mentor who's now teaching me that. So, because, you know, quite frankly, I'm in sort of that model, you know, of, you know, kill the disease, find the magic bullet and we're done. Yeah. Right. Uh, but I understand a lot of what should be done. Uh, I can tell you the thing that I'm most interested in, uh,

as far as, uh, neuro protection, let's say this yeah if you said to me that there's one molecule that you could be king of metagenics or king of whatever that you would you would promote okay listen up this is important guys one molecule one in your life well no let's not say that either uh because i'd be sort of the magic bullet of course of course but it's toro deoxycholic acid well that's a big word what is that stuff so can you buy it at the gnc or i don't know probably after this podcast i'm sure we will not with my label on it by the way um but yeah so tudka is actually uh something that rutansi studying for als so let's give you know credit where credit's due um and what uh tudker is is

secondary bile acid yeah right so bile acids are the things that help you digest fat but they also where all the toxins come out of your body through your liver right exactly and the other so this is helping you eliminate toxins 100 and the other uh fancy part of the secondary bile acid is that it's attached to taurine, which is my favorite amino acid in neurology. Whenever I give IFM talks, I say, what's your top supplement that you recommend? The taurine. It's always taurine. Which is very relaxing for the brain.

It calms it down, right? Well, it affects aquaporin receptors, right? Which affects sleep. Sleep hygiene is something that I do educate patients on uh so i don't want to think that people i'm not totally holistic because i am you know but about food too food too yeah i think food is bagel and lox bagel and lox at least only in my own diet i don't recognize any patient trust me it's uh no no what are we talking about no uh no i think that the ketogenic diet is a very important augmentation strategy for patients

with neurodegenerative diseases, 100%. So have you used it in patients with these diseases? No, because don't forget, I've only been in practice now for, you know, I only have like four patients at this stage of my life. What do you mean? Weren't you a practicing neurologist forever? I was, but you know, I left and I, you know, I did other things in my life, basically, you know, genomined and things like that. so i'm back clinically really only the last year so i'm i

feel like a student again which is kind of cool right to be like a student but you take very difficult cases i only take the most difficult cases if you're if you have like you're like the sherlock holmes of neurology right and my, my assistants decided on a Sherlock Holmes, you know, icon for my website, but yeah, you like that too? Yeah. You do? Okay. What about Dr. Watson? Dr. Watson. Okay. I like that too. Isn't that, it wasn't this sidekick? Oh, Watson was a sidekick? Yeah. So we'll call it the Watson clinics. People think I discovered DNA. It's perfect. Or what's on. The Watson clinics. That's great. So I think that we're in a real new era in neurology.

And truthfully, I don't want to be sort of, you know, making light of this conversation. As a neurologist, look, I, you know, I chose the wrong profession, to be honest with you, because I'm a very sensitive person. I take every person's problems to heart, too much so, where I've become depressed when people die with these diseases. And that's a depressing place to be because I'm blaming myself. It's not my fault that they're dying, right? But I still blame them. I blame myself.

But you couldn't fix them. I couldn't fix them, correct. And so when you say, are you happy now? I am more than happy, meaning that I finally feel like I have tools to treat patients with these kinds of diseases that will die without treatments, basically. So I'm very, very optimistic

for patients that have these diseases, especially, not that I don't think they're applicable for all stages of these diseases, because I think it's much, much more difficult to reverse a patient with end stage Alzheimer's. And it is right. I mean, it's almost like, you know, it's like, I'm sorry. Somebody needs a new heart. If their heart's all damaged from a heart attack, it's hard to fix that. Yeah, that's right. But, but I'm very,

I'm very optimistic both about, you know, Dale's work on, on sort of, you know, understanding the risk factors and how to intervene before disease, and also what we can do once patients have onset of those diseases as well. So in these conditions, there is a way forward and the hyperthermia concept is fascinating. How far are we from actually being able to do that in America?

It's happening in Europe. It's happening in Mexico at scale. What are the obstacles and opportunities that are ahead in using hyperthermia and neurology and other conditions in America? Well, I think the obstacles, in my opinion, are to establish clinical validity for these conditions. Like, are we doing research on it? Is it happening in America? Research is happening, yes. And doctors and scientists are starting to look at this. Yes, thank God.

So how far are we from actually seeing this in the news or as a treatment in America? Very close. Very close. Yeah. So if you're listening and you know someone with ALS or you know someone with MS or Alzheimer's or Parkinson's, there is hope is what you're saying.

100%. Yeah. Yep. And in functional medicine, we do make a lot of progress. But I think there are things we just don't know. And I think this whole connection between the inflammatory pathways, the microbiome, and the brain is uncharted territory that we're now exploring. Right.

And there are a lot of ways to intervene, including the idea of hyperthermia. There's other therapies, poop pills, maybe. But we have a whole new way of thinking about these conditions. And we always have to, right? Medicine has to be iterative. It can't be static. So let's back up a little bit, because I don't think people really understand

how you get a leaky brain and what that is, and how does that connect to a leaky gut, and what are those things? Right. I was having a conversation earlier today, by the way, so I'm very fresh up on this concept. So leaky gut is both a cause and a consequence of dysbiosis, right? Which is?

The SIBO, which is small intestinal bacterial overgrowth, which is full of bad bacteria that are looking to make things worse, not only in the gut, but also in the bloodstream. So dysbiosis is basically your happy garden in your gut has been taken over by weeds. Exactly right havoc that's right and those weeds and it's crowding out the good stuff and causing all kinds of problems right and those weeds want to grow and guess what prevents them from growing is the mucosal barrier right so like okay well that's the lining in your gut right so they they basically release you know certain protease enzymes that break down

the proteins in our gut so they can actually go into other places looking for their food or if it's a weed analogy to grow beyond just a little pac-man i'm gonna chew up the chewing up all the intestinal lining so they can sneak through and get into the rest of the body that's right that's right that doesn't you know when you have bacteria and nasty proteins in your blood, your body doesn't like that. That's right. And it creates what? Well, it produces inflammation, but it also produces disease. Yeah.

And I'll tell you an interesting story. Which is secondary to the inflammation. Right, right. So one of my interesting stories about ALS is that they asked me, they said, this is like a really crazy hypothesis, right, that somehow clostridium is causing ALS. I said, I realize it's crazy right now, but it won't be crazy for long.

Well, it's like the guy, Dr. Berry from Australia, who decided that H. pylori was the cause of ulcers. And I was advised to do the exact same thing. I was like, I'm sorry, I'm not eating clostridium to get ALS. I'm not that desperate to show that this is the right thing how he did that for h pylori yeah he would i'm sure he would say do not do that but people thought he was crazy because it was like oh this bacteria was around like just like it's around in alzheimer's and als and people thought it was just a secondary thing

it's not the real thing right so they kind of ignored it and they laughed at him when he said just these bacteria are causing ulcers right and he won the noel prize not only that i'm going to prove it to you by drinking a beaker right of these bacteria getting an ulcer curing on the antibiotic and yeah you're right for that he won the nobel prize i'm afraid that they won't give me no prize unless i unless i do it for myself okay here's c diff okay yeah i skipped that can we speed up alzheimer you know, or whatever else? And then I'll prove it's in my bloodstream or through CSF. Whatever biomarker you need to know that I'm infected. No, thank you.

No, thank you. No, that's a little too risky, yeah. That's right. But you can do it in animal models. You can do it in other, right? So, well, there are animal models that actually show this. So I think that's already been established as well, that there are animal models

that if you give them bacterial infections, that you can recapitulate or reproduce, if you will, the pathological changes that occur in neurodegenerative diseases. So that's already there. So how does that connect to the leaky brain? Right, okay. So let me tell you a little-

This was like, in medical school, this was like, this is an inviolable barrier. Like nothing gets through except nutrients- The blood-brain barrier yeah right okay you've got a wall between like you know so if you need to understand actually when i when i lectured ifm i always talk about this to to the practitioners is that leaky gut uh and leaky brain are are synonymous they're they're they're basically the same uh anatomical structures uh that exist both in the brain you know it's endothelial cells that you know barriers it's a barrier right it's and the barrier has exactly the same types of glial cells that regulate what's going in or not

they're sort of the gatekeepers the security guards right, bad bacteria, don't go in here. So what happens is the bacteria actually are smarter than us, quite frankly, meaning that I'll tell you how much smarter they are than us by an anecdote, which is that one of my patients who I presented this theory to said, if you think that this bacteria is causing ALS, why don't you call the CDC? I said, good idea. So I did. Right. She didn't know that I would actually call when she was in the office, right?

But I did. I called the CDC. Great idea. I said, yeah, right, great idea. I called the CDC. Okay, no problem. Ding, ding, ding, ding, ding. You know?

So I end up speaking to someone there. And he was very respectful. And he said to me, you know, I'm going to take this back to my working group. And I'll let you know what they think of your insane hypothesis that that c diff is causing als i said okay great give me a call back like whenever you whenever you feel like it you know there's no time for me it's like and did he call you he called me back and this is what he said he said that the group doesn't feel uh that c diff diff has enough evidence of it being anything other than an enteropathogen.

I said, really? That means it only affects your gut. Only affects the gut. Use all these big words. I keep having to translate. Sorry, that's right. But I said, it only belongs in the gut. Yeah.

And I said, well, how about other Clostridium species? Do you think those are only enteropathogens? And he said, no. I said, well, guess what? Neither is C. diff. It's not only an enteropathogens?" And he said, no. I said, well guess what? Neither is C. diff. It's not only an enteropathogen. And the way that it becomes, the way that it moves from the gut into the bloodstream is through leaky gut. I said, have you seen the leaky gut data? I never heard of leaky gut data. I'm like, okay. So let me ask you one last question before I hang up this phone.

I said, do you not believe that other enteropathogens like E. coli can produce meningitis? Of course they can. I go, well, you're just contradicting yourself. You're saying that an enteropathogen can't produce meningitis. And the same breath you're saying, oh, but of course, E. coli is an enteropathogen that produces meningitis. Which way do you, which, you're the CDC, man. I'm not, I'm just some crazy neurologist. Come on, answer that question. And of course, that was the last time they took any of my phone calls. True. Well, don't confuse me with the facts, right?

Yes. It's tough. Paradigms are tough to break. Very much so. And you spent millions and billions of dollars and decades building up a paradigm. It just turns out to be really false. Right. The paradigm of medicine today, which is siloed, it's segregated, it's not understanding those interconnections. And I think we're in this

convergence right now, which is super exciting, which is the tremendous amount of understanding we're having about systems biology and what we call network medicine, which I also call functional medicine, the emergency of our understanding of the omics revolution, right? The genomics, the metabolomics, the proteomics, and the microbiome, which is blowing the lid off all of our conception of disease. Artificial intelligence,

which enables us to gather all that data, what we call big data, and crunch it in ways that make sense of it where we can't even see. I mean, the average doctor, you know, you look at your blood work, you got 20, 30 other things you look at, fine. What if I gave you a million data points to look at?

Oh, forget it. The doctor is not going to be able to do it, but a computer can do it. And then you get quantified self-metrics where you can measure things that the body's doing. And you put all that together and it's changing the way we're going to be practicing medicine going forward. And we're going to be able to sort of make much more rapid evolution of understanding of things like what you're talking about well i i i agree except that i think ai uh is double-edged sword because my concern with ai is that if doctor let's say ai comes up with the ideal formula for you know treating every disease

let's say it's an ai you. You need HI too. Thank you. Human intelligence. We need human intelligence. The filter, right. It just gives you stuff to think about, and then you have to make your decision. Thank you. Right.

I 100% agree. You know, we don't want computers treating us, but we do want them to help crunch the data and look at patterns that otherwise we can't see. So all you're talking about is that you've noticed a pattern in the literature that connects bacteria to neurodegenerative disease and alias yeah and then you're following that trail right and you noticed it but you know a computer might be able to notice it a lot faster than you you just kind of have the

luck of the insight right but the truth is that that we can actually start to use computers to start to look at all this data map it out read every study connect the dots in ways that we just can't he's saying ai may help me uh confirm that cdiv is the root of of all these absolutely who do i call who do i call ghostbusters watson we call watson so this is really an amazing moment in in medicine where scientists and doctors like you are starting to connect the dots about diseases that were really helpless and for which we felt helpless and now are hopeful. So thank you.

Thank you. So thank you. You've listened to the doctor's pharmacy. This is Dr. Mark Hyman. We've been with Dr. Jay Lombard. You can learn more about his work at drjaylombard.com. That's drjaylombard, L-O-M-B-A-R-D.com. You can learn about his practice in Tarrytown, New York, which I certainly would see him if I

had a neurological problem. And you can also get his book, which is called The Mind of God, Neuroscience, Faith, and Search for the Soul, which we didn't have too much time to talk about, but it's a fantastic book that maps out the connections between purpose and meaning and health which we now know is actually scientifically driving healthy disease in fact there's an article a couple weeks ago in the journal the american medical association said that if you had more purpose in your life you live longer who knew purpose is life yes purpose is life so thank you you've been listening to dr pharmacy if you love this podcast we'd love to have you leave a comment and hear from you. We would also love you

to share it on Facebook and social media, Instagram with your friends and family. And if you subscribe to podcasts, please subscribe to this podcast and listen every week. And we'll see you next week on The Doctor's Pharmacy. Hi, everyone. It's Dr. Mark Hyman. So two quick things. Number one, thanks so much for listening to this week's podcast. It really means a lot to me.

If you love the podcast, I'd really appreciate you sharing with your friends and family. Second, I want to tell you about a brand new newsletter I started called Mark's Picks. Every week, I'm going to send out a list of a few things that I've been using to take my own health to the next level. This could be books, podcasts, research that I found, supplement recommendations, recipes, or even gadgets. I use a few of those. And if you'd like to get access to this free weekly list, all you have to do is visit drhyman.com forward slash pics. That's drhyman.com forward slash pics. I'll only email you once a week, I promise. And I'll never send you anything else besides my own recommendations. So just go to drhyman.com forward slash pics. That's P-I-C-K-S, to sign up free today.

Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice 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.