The Dr. Hyman Show - The Key To Healing Long-COVID With Functional Medicine with Dr. Leo Galland

Episode Date: November 3, 2021

This episode is brought to you by ButcherBox, Athletic Greens, and Joovv. The amount of information we hear about COVID on a daily basis can be pretty overwhelming. I feel that this episode of The Doctor’s Farmacy is one of the most important ones I’ve done on this topic because it’s an incredible resource for understanding how to prevent and treat COVID using a comprehensive systems approach. It’s about how to heal on the cellular level. My guest is someone who has had an immense impact on my own health and my career in Functional Medicine.  Dr. Leo Galland is one of the most incredible resources on COVID and long-COVID syndrome. He is a board-certified internist, practicing in New York City, is recognized as a world leader in Functional Medicine, and a pioneer in the study of intestinal permeability and the gut microbiome as they impact immune function and systemic health. Since the onset of the pandemic, Dr. Galland has devoted most of his time to research on COVID-19 and to the education of other health practitioners in understanding the complex biology of the disease.  This episode is brought to you by ButcherBox, Athletic Greens, and Joovv. New members to ButcherBox can get a free turkey with their first box at butcherbox.com/farmacy. Athletic Greens is offering my listeners 10 free travel packs of AG1 when you make your first purchase at athleticgreens.com/hyman. For a limited time, Joovv is offering $50 off your first order with the code FARMACY at Joovv.com/FARMACY. Some exclusions apply. Here are more of the details from our interview (audio version / Apple Subscriber version):  What is “long-COVID” and what symptoms are most associated with it? (8:51 / 4:51)  Upwards of 30% of individuals who have contracted COVID-19 may develop long-COVID (15:28 / 12:25) The groups most at risk for developing long-COVID (29:28 / 24:36) The COVID, gut, and heart health connection (33:07 / 28:21) Eating to protect against and recover from COVID and long-COVID (42:59/ 38:09) Supplements and probiotics to protect against and recover from COVID and long-COVID (46:29 / 40:28) Restoring mitochondrial function after COVID-19 infection (55:20 / 50:21)  Chronic fatigue, POTS, and COVID-19 infection (1:01:55 / 57:03) Are the Covid vaccines protective against long-COVID? (1:10:33 / 1:05:46) Dr. Galland’s perspective on COVID vaccines (1:12:35 / 1:07:44) Learn more about Dr. Galland at https://drgalland.com/ and follow him on Facebook @leogallandmd and on Twitter @leogallandmd. Mentioned in this episode: Dr. Galland’s The Gut Microbiome in Covid-19 Tundrex.co IFM.org

Coming up on this episode of The Doctor's Pharmacy. The bottom line is a 40% increase in the consumption of vegetables created a 72% decrease in the likelihood that someone would have moderate or severe COVID. Hey everyone, it's Dr. Hyman. One of today's episode sponsors is ButcherBox. Now one part of my life that I'm consistently grateful for is good food. It helps me take care of my health, and preparing tasty meals is one of my favorite ways to show love for people in my life. I love all the flavors of fall,

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their problems to get worse and worse and receive a diagnosis of disease before taking any kind of action. This is not the path to health. We can live longer, healthier, happier lives if we just prevent imbalances in our bodies in the first place. And nutrition is a key part of this. Many of us don't get the optimal amounts of key nutrients through diet alone,

even with a whole foods diet. And then when you add in all the stressors we're up against, like work demands, toxins, lack of sleep, we're even more likely to have a nutrient deficiency. So one of the things I use every day to optimize my intake of vitamins, minerals, phytonutrients, pre and probiotics is AG1 from Athletic Greens. It's a comprehensive superfood powder with a special blend of high quality whole food ingredients that work together to fill the nutritional gaps in your diet. It's specifically designed to support energy and focus, aid with gut health and digestion,

and support a healthy immune system, which we all need right now. I've made AG1 part of my daily ritual because I feel better knowing I have a little extra nutritional insurance to complement my healthy diet. It also gives me a nice energy boost without feeling overstimulated. I like to think of it as a huge leafy green salad shrunk down into a simple glass of water I can take anywhere. Right now, you can get 10 free travel packs of AG1 when you make your first purchase. Just go to athleticgreens.com forward slash Hyman. That's A-T-H-L-E-T-I-C-G-R-E-E-N-S dot com slash Hyman. Now, let's get back to this week's episode of The Doctor's Pharmacy. Welcome to The Doctor's Pharmacy. I'm Dr. Mark Hyman, and that is Pharmacy with an F,

a place for conversations that matter. And if you're concerned about COVID, especially what's been called long COVID or post-COVID syndrome, you better listen up because we're going to have a deep conversation with my mentor, my friend, and one of the most profound medical thinkers of the 20th and 21st century, Dr. Leo Gallant. He's a board-certified internist. He practices in New York City. He's a world leader in functional medicine. He's a pioneer in the study of gut and intestinal permeability in the microbiome. And since the pandemic started in 2020, he devoted most of his time, and Leo's 79 years old, so I'm sorry if I'm speaking out of school, but he really has not stopped. Ever since I've known him, and I met

him when I was 36, and I'll tell you that story in a minute, he has literally been looking at the forefront of medicine and seeing what's ahead before anybody else sees it. And he's done the same thing with COVID. All of his research around COVID and educating practitioners about understanding the biology of COVID and understanding how to look at what the real issues are that are underlying it around how to prevent it, how to treat it, are on his website, drgallin.com. He's created a whole series of videos on lung COVID syndrome for the general public and also for doctors and health professionals. He's graduated from Harvard University, NYU Medical School. He received the Linus Pauling Award from the Institute for Functional Medicine for developing the foundational principles of

functional medicine and many, many, many other awards. He's one of the top doctors, in my view, in the world. And I think his contributions will be felt for generations to come. So welcome, Leo. Mark, thank you so much. It's so good to be seeing you today. Yeah, so Leo, so for those listening, Leo and I met, gosh, 25 plus years ago. I was a fledgling doctor at Canyon Ranch. He came to give a lecture about what then was functional medicine in the earliest stages. He'd written a book called The Four Pillars of Healing, which later the name was

changed to Power Healing. And it changed my life. At the time, I was sick with chronic fatigue syndrome. I was desperate to get better. I didn't have answers from the traditional medical system. And I basically begged Leo to let me come to his office in New York City and sit at his feet and watch what he did and learn. And I remember going down to New York City and being in his office. And it was one of those sort of classic New York City offices where there's not a lot of space, but it had very tall ceilings. And literally from the floor to the very top of the ceiling were books and papers and articles. It looked like kind of Einstein's laboratory in some way. And I saw how he was with patients. I saw the thoughtfulness that he used to ask the questions to get to the root of their problem.

And I learned about a totally different way of, one, treating patients, but also understanding medicine. And his contributions, I think, are largely unrecognized in my view. And I think that those of us within the field know who he is. But for the general public, I think, you know, Leo needs to be understood as one of the biggest paradigm shifters in health care in the 20th and 21st century. And I encourage you to check out his work. Go learn more about Leo. And we're going to get into, and you'll see why as we have this conversation, but the whole idea about the gut and the microbiome and leaky gut, all these ideas that now are just everybody's talking about. He was the OG guy talking about this way back when, and 30 years ago, when everybody thought he was crazy

and everybody thought I was crazy because I was saying what he was saying. I really didn't come up with anything new. I just have learned at the feet of the masters and Leo is one of those masters. So Leo, thank you so much for how you've impacted my life and the life of literally millions of people through the work of all the functional medicine practitioners that have come after you and applied the things that you discovered through your incredible, inquisitive, curious mind that was open to seeing what was in front of you, not what you learned in medical school. So thank you.

Mark, thanks for that. Very generous. Okay. All right. So with that said, let's get into it. Now, there's a billion things we could talk about. And literally, we could talk about the gut. We could talk about all the things you've done over your career. But I mean, I want to talk about your work now on COVID because one of the

scariest aspects for me is not the fact that you could get COVID. And yes, we're seeing death rates of 1%. You can argue this or that. Most people survive COVID. But what's really scary is that the post-COVID phenomena that's happening is at a massive scale. I mean, I've seen data anywhere between 20% to 50% of everybody who gets COVID afterwards doesn't get back to normal. They have what we call long hauler or post-COVID syndrome, where they may not even have had a bad case of it, or they could have had a severe case of it, but they're having this huge aftermath of symptoms where they have headaches

and brain fog and muscle aches and all kinds of physical symptoms that are really impacting their life. It's almost like chronic fatigue syndrome. So can you talk about, you know, how we're beginning to understand long COVID, what the definition of it is, are there criteria established, what are we seeing? I mean, let's get into like what it does. And we're going to go through not only just the disaster that it is, but actually the fact that with functional medicine and an approach that Leo and I are going to talk about, there's a way out. And I've treated many of these patients. I

know you have too. And I've seen these patients see traditional doctors, get traditional care, and just not get better. And when they learn how to use a model of systems thinking and functional medicine, they can get better. So start with the definition of what is long COVID, is there criteria, and what's it doing to the body? Well, the criteria are pretty broad, and it's not well-defined at this point. And there probably is not one syndrome. The name that's being that was assigned by the CDC is post-acute sequelae of SARS-CoV-2 infection. They call it BASC or PASC and the implication there is that it's anything that happens to you after you've had COVID probably looking at a period of, say, 90 days after the infection. Originally, it was 30 days, then it became 60 days.

Now it's 90 days. So the question is, how has your health 90 days later been impacted by having had this infection? And I think there are several different things going on. Someone who is really sick, who is in the ICU, who might have been intubated, we expect that it's going to take that person some time to regain their health. And some part of it might just be the post-critical illness syndrome. But there are people with pretty mild to minimal disease who weren't very sick, sometimes even asymptomatic, who were showing

late sequelae that have a really broad range of findings. And it goes beyond chronic fatigue, ME, that kind of CFS syndrome. Yes, there are people, probably the most common is the chronic fatigue, maybe with some brain fog, possibly muscle pain. Then there's the whole respiratory complex, people who get winded easily, have a chronic cough, and that may actually represent some persisting lung damage from the COVID. But then there are these other phenomena. People who have had COVID-19 are more likely over the next three months to be diagnosed with high blood pressure or diabetes. Diabetic ketoacidosis has occurred late after COVID-19. And that may be due to direct damage to the pancreas from the COVID. That is people who suddenly go into, who look like they have type 1 juvenile onset diabetes.

The type 2 diabetes probably involves another mechanism. It's similar to what causes the high blood pressure. And then there's the impact of COVID-19 on the brain. And this is in many ways the scariest from my perspective and also pretty well studied. It is mostly in the UK. So studies have been done in the UK. They have this thing called the Biobank database and they had about 40,000 people who had had MRIs of their brain

shortly before COVID-19, before the pandemic and before they got sick. And so the researchers offered many, about a thousand of those people the opportunity to have a repeat MRI of the brain, let's say 18 months into the pandemic or a year into the pandemic. Now about half of those patients had tested positive for COVID-19 at one point and the other half had not. And they found that the people, and they called, you know, they control them for age and sex and the interval between the scans. And what they found was that people who had had COVID-19, independently of whether they thought they had long COVID or not, had changes in the MRI that were not found in people who had not had COVID. These are changes over the period of maybe a year. And there was an actual loss

of brain cells, gray matter, in certain parts of the brain that are especially associated with higher cognitive functions. Now, some of these are part of the brain circuits that are involved in smell and taste. And so one of the authors of this thought that because loss of smell is such an important symptom with COVID-19, and it appears to be due to actual damage to the olfactory nerve, which regulates the sense of smell. That the entry of the virus directly into the brain through the nose was one likely mechanism for these brain changes, brain damage. But there was real brain damage there now they did another study in the uk which was different they they did um cognitive function tests what's called

neuropsychiatric testing in a large group thousands and thousands of people um it was done online and they controlled not only for age and sex, but ethnicity, underlying premorbid conditions, level of education. And they had thousands of people who had tested positive for COVID-19, thousands in higher cognitive functions that really correlate pretty well with the changes seen in the MRIs. So I think these are significant changes. They're not like, oh, here's a random abnormal lab finding. So that is really a very scary scenario to be seeing. As to how often this occurs, I mean, it's hard to say. I would say it probably is roughly 30%, although there are some studies showing a smaller percentage. Now, in my own practice, I mean, I really try to, if I haven't seen someone in a while and they've

had COVID, I will follow up with them, especially to inquire about their cognitive functioning until I'm certain this person is fully required. The incidence of long-haul COVID is much lower. I mean, it's not nowhere near, I mean, it's two or 3%, something like that. You don't think it's 20 to 30%? No, no. The patients that I've treated that have been on my protocol since the beginning, since they got COVID. I mean, people consult me after being sick, but people who have been on my protocol since the beginning, since they first got COVID, even if they weren't on the preventive protocol, the incidence of-

They do okay. They do much better. By the average population, I remember one study I saw early on, it was just an analysis of hospitalized patients, which is a more severe subgroup, but there was about 180 patients or something. And at 60 days, 87% had significant symptoms, headache, brain fog, muscle aches, you know, all the lingering symptoms at 60 days. And I think, you know, what you're describing, Leo, about how it affects the brain and other things, pancreas, diabetes, the name is wrong. You know, SARS means severe acute respiratory syndrome. And the mistake of that name is respiratory,

because what it seems like is that COVID is a systemic disease that affects every part of the body through the endothelium, through the blood vessels. And we've had William Lee talk about this on the podcast. He's a blood vessel specialist, essentially. And it's just been fascinating to see how every organ, your heart, your brain, your lungs, your pancreas, and your kidneys, and your intestinal tract, and your, I mean, just everything, your skin, all is affected by the virus. And the question I would have for you is, is the virus sort of a lingering virus that goes stealth, or is this just the consequences of a train wreck that happened and lack of the ability of the body to recover and heal? That's a really good question, Mark. And I don't think

it's been resolved. What we do know is that the virus can persist in the GI tract for months after the acute respiratory infection. And whether how alive is it? What is it doing there? We don't quite we don't know that yet. There is a group that attempted to answer that question by looking at white blood cells and looking for persistence of the viral RNA. This virus is made of RNA. And out of about, I think it was 30 patients with long COVID, they only found that in one patient, persistence of viral RNA, but they found persistence of spike protein in about 72, 73%. So their theory was that long COVID was associated with difficulty clearing the remnants of the virus from the tissues. Now, that's a phenomenon that has been described

in rheumatology, especially. And other viruses. With viruses and other infections, where the infection seems to be gone, but there's all this debris of the infecting organism itself that is in tissues and that is promoting inflammation. Now, that's one possible theory. Another finding, and this is very recent, actually two really significant recent findings, I think, in this regard. A group at the University of Arkansas identified autoantibodies to ACE2 in about 80% of people with COVID-19, including those who are in recovery with long COVID. Now, ACE2 is a vital enzyme that has become famous because it is the receptor that this virus uses to enter cells. And in my own work, I've really focused on the importance of ACE2 in acute COVID and also in long COVID, because so much of what happens with both acute COVID

and with long COVID looks like a deficiency of ACE2. This vital enzyme is destroyed by the virus. The thing that was a little puzzling to me, but this work at the University of Arkansas really offers an explanation, is why do some people not seem to get very sick with COVID-19, but then they go on to have a pretty profound long-haul syndrome. Yeah. So that's the thing people need to realize. It's not just the old and the people with comorbid conditions that are having this. It's young people who are healthy. I mean, 30-year-olds who are robust and running five miles a day and eating healthy, and then boom, their life is over. Right. Right lot of i i've seen a number of

young you know let's say middle-aged and young people who were impacted by long well i'm middle age i'm about the middle i'm at 62 i'm about the middle all right um that's young to me. I'm going for 125 maybe. So the development of these autoantibodies follows the development of the protective spike protein antibodies. So that would explain why someone might not be so sick initially, but then these autoantibodies wind up being created. And that's when they get the ACE2 deficiency. It's not when the virus first enters the cells and destroys it, which happens with people who get really acutely ill. So this is a phenomenon that happens in medicine often, where you'll have an inciting agent, a virus, a heavy metal, whatever, a toxin, that your body creates

an autoimmune response to, and that creates an autoimmune disease. Almost what you're saying is post-COVID is maybe like an autoimmune response to the virus. And so once you get rid of the virus, you've got this autoimmune response that was really your body trying to deal with the virus, but actually it turns on itself. That's definitely true for some percentage of people who've had COVID-19. And these autoantibodies are very common with this infection. And some of them may lead to devastating acute disease. That is, there are autoantibodies that inactivate the main antiviral defense system in

the body, which is alpha interferon. And that's associated with a kind of disastrous outcome with the acute infection. This particular autoantibody doesn't occur right away. It probably takes two, three weeks. It may increase over time. And so it's probably more likely to contribute to the late symptoms. And then there are other immune abnormalities that have been described by researchers in the function of different classes of lymphocytes. And each of these leads to speculation about, well, what's the best way to treat this? And then there's some work that was done by a lab in California where they identified abnormalities of cytokines, which are proteins that are involved in regulating immune responses. And they correlated that basically with deficits in the function of cells called monocytes that circulate in the blood.

So what we're going to see over the next year or two or five years is that we will begin to unravel the extreme complexity of this disease. And it is the researchers who look at this say this is so much more complex than other infectious diseases. I mean, what it feels like is we're trying to fly the jumbo jet as we're building it. And every day we're learning something new. And the things that you're talking about, you know, the effect of sort of autoantibodies, the persistent spike proteins, the effects on the lung, the effects on the brain, the effects on just muscle and fatigue. These are debilitating symptoms for a lot of people. And there's a range of how it affects people from more mild to more severe. But I mean, what percent of people do you think

are getting long COVID? I mean, clearly, if they're following a functional medicine protocol before and during and after, and that's my experience too the same as you is that that's really minimal but for the average person what what do you think the risk is of getting well what does the data show the controlled studies are showing something like 30 risk i mean that's wow that is devastating because I mean, with the hundreds of billions of people impacted by acute COVID-19, you know, hundreds of millions, and many more that haven't actually had a diagnosis made who probably have been infected, the potential for long-term health effects is huge.

I mean, I, I, I, Cleveland Clinic and comparing notes to my other colleagues at other institutions and all over the world. And I, I, what I'm shocked at is that this post post COVID clinics are just overwhelmed. They don't know. And they don't know what to do. The doctors are just like trying their don't know, and they don't know what to do. The doctors are just like trying their best or having a multidisciplinary approach and they're trying to figure it out, but it's just not clear what they need to do. And it's horrible because

they're really recognizing it's a problem, thank God, but they're not actually equipped to deal with it because they don't have a framework for understanding the system's nature of this problem. And they're in a reductionist paradigm. So they're medicating symptoms, but they're not figuring out how to reset the immune system, how to deal with the autoimmunity. I mean, it's quite sad to me because when I know your work and what I've seen with functional medicine, there is a way out. It's not like a terminal problem, which it becomes for so many people if they don't have the right information. And that's really why I wanted you on the podcast, because there's work being done by folks like you and others that is showing that if you are coherent and thinking about how to restore function, how to restore health and how to work with the gut and immune system and all the other aspects that we do, that people can actually get better. Yeah, absolutely. People can get better.

And it's possible that even with if there is any condition that proves the need for a functional medicine approach, it's long COVID. And you're totally right when you say that the long COVID clinics are overwhelmed and don't really have a comprehensive framework for addressing the problem. Hey, everyone. It's Dr. Mark. Now, I keep hearing my friends and patients say they're dreading the darker, colder winter months. It can be a tough time of year for me too, but there is one tool I use every day to feel my best despite the shorter days. It's the Juve red light therapy devices. Juve doesn't replace natural sunlight, but it does deliver similar wavelengths of light called red and near infraredinfrared. Thousands

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And basically it was women over the age of 50. People with a history of asthma, which is kind of interesting because asthmatics are not necessarily at higher risk for acute COVID, but they are at higher risk for long COVID. And I've actually seen a couple of people in whom, with pretty quiescent intermittent asthma in whom having COVID-19 brings out their asthma and it becomes more chronic and problematic. And people who initially have five or more symptoms of their acute COVID-19, those have been identified as the highest risk group. I mean, you know, what's really staggering here in America is that, you know, we're seeing 5% of the population of the world having 25% of the cases and deaths. And, you know, to date, there's 44 plus million cases.

That's a lot of cases. And yet it's probably an underreporting. Maybe it's double that. Maybe it's 80 million who had it. And you're talking about 30% of 80 million. That's like 24 million people. That's like more people that that's you know that's like more that's more people than have heart disease or diabetes well i don't think we're seeing the end of this either if you go back to

the 1918 flu pandemic there were neurologic consequences of that which actually were described in this book and film called awakeningsings, which the film starred Robin Williams and Robert De Niro. Yes, yes. It was written by Oliver Sacks. And it was about these late Parkinson disease-like symptoms after COVID-19. Well, the incidence of new cases of that peaked five years after the pandemic in 1923 and were observed for 10 years until 1929. So we are not necessarily seeing the full impact of COVID-19 on health care and on the health of people.

No, I mean, just in terms of productivity, disability, burden on the healthcare system. I mean, we're worried about what's happening now. Right. How many new cases of diabetes are there going to be over the next few years because of the metabolic effects of COVID-19? Yeah. And the brain studies you mentioned from the UK about the cognitive function

and the research on long-term cognitive decline, is this a risk faster now for dementia? Is it a risk factor for depression, for, you know, who knows what? I mean, what do you think? The risk of Alzheimer's is something, I mean, it's not just people like us that are talking about that. It's the, I mean, in the conventional medical and neurologic communities, there is a lot of concern about an increase in Alzheimer's disease and other forms of dementia lying ahead because of COVID-19. We're not going to get, we're not going to stay on this depressing note. I promise everybody, we're going to get into the good stuff in a minute, but I want to go through a little bit more about the, the, the impact of the, the gut and the cognitive function and how it's

all connected because a lot, you know, a lot of your work from the beginning and how I really began to understand functional medicine was through your work on the gut. And you really, in the world of functional medicine, were the pioneer that helped us understand leaky gut, the microbiome, before it was even called the microbiome. And I really would love to hear your perspective on how COVID affects the gut and how long COVID affects the gut and how that may even affect our cognitive function. Right. So even before that, there's a question of how the gut affects COVID. Oh, okay. Yes. Studies done in hospitalized patients have looked at the relationship between the bacteria growing

in the gut and the severity of COVID-19 in people who are hospitalized. And there is a definite effect because there are types of species of bacteria that have anti-inflammatory effects in the body. There are species of bacteria that impact the function of the brain. And then there are other species that are pro-inflammatory and have negative impacts on immune function and brain function. And so the absence of some of the keystone species that really support the healthy function of the gut in people who have, who are admitted to hospital with COVID-19, that will lead to a worse outcome and a higher risk of death.

Whereas the, whereas high numbers of these are protective. And similarly, the, some of the very inflammatory immune modulating species may actually increase negative outcomes. So we start with that. Well, so basically what you're saying is that the health of your microbiome, if there are bad bugs in there, we call them dysbiosis. I think maybe, I don't know if you call them dysbiosis. I think maybe, I don't know if you came up with that term. I think you might have actually. It's a European term, but somebody told me about 30 years ago, I was the first American that they Yeah, now it's all in the medical literature. And it's like, I'm like, oh God, nobody used to

laugh at us for that term, right? And if someone has this imbalanced flora with bad bugs that are inflammatory, what I hear you saying is that because the microbiome regulates our immune system and there's these inflammatory microbes in there, that if you get COVID and your gut isn't healthy, you're in worse shape than if you had a healthy gut. Yeah, that appears to be the case. And it certainly makes sense. And the converse is too, right? The converse is true. If you have all the good bugs, then you may not get as sick. Right. Yes. That has to be studied in a more systematic fashion, but that's what we see from people who are in the hospital. It's amazing.

In addition to that, there is the impact of COVID-19 on the gut. And that's complicated. Before you get into that, I just want to tell a little anecdote about a similar story that I heard, not related to COVID, but there's a phenomena that's being described called newborn gut deficiency syndrome, which essentially is the result of antibiotics that have destroyed a particular strain of bacteria called Bifidobacterium infantis, which is critically important for development and regulation of the infant immune system in the gut. And the milk, the breast milk, contains 15% of its calories, is a food that the body, human body, can't digest. It feeds this particular bacteria. And since most women in the world have taken

antibiotics, they don't have this bacteria because it's very sensitive. And then these kids without it get allergies, asthma, autoimmunity, inflammatory diseases as a consequence of not having this protective bacteria. So it's a very similar story, different diseases, but I just wanted to say this is not a new idea, that this is well-researched data on how imbalances in the gut flora, lack of the good stuff or too much of the bad stuff in there can cause significant consequences for our health. And we're seeing that with COVID. So sorry to interrupt, but go on the next point you're making about how COVID itself affects the gut. Right. So, so if you take people who've had COVID and, and look at what happens to the organisms in their gut, there are a few things that we see, and they're not surprising actually,

because they've been described in, you know, they act, that actually is one of the areas in which chronic fatigue syndrome and long COVID has a lot in common. There is not only, there's a loss of diversity of microbes, there is a loss of these beneficial bacteria, there is an expansion of pro-inflammatory bacteria, and there's an expansion of yeast. And yeast and other fungi actually become more diverse in the GI tract after COVID-19. In addition, the loss of some of these beneficial bacteria may create this condition called leaky gut, which is an increase in the permeability of the intestine. We know about the intestines as organisms that are necessary for digestion and absorption of nutrients, but they have this very important barrier function. And it is a breakdown of the barrier that causes the increase in permeability that's now known as leaky gut. I mean, 30 years ago, gastroenterologists would say to patients of mine, there is no such thing.

Now, I mean, the term is used in the New England Journal of Medicine. I don't happen to like it, but it is pretty wild to see that. And the leaky gut of COVID-19 has been associated with an increased incidence of heart disease in COVID-19. So there's a gut heart connection with COVID. So one of the things I try to do in preparing people for COVID, in treating COVID, and definitely in working with long COVID is to improve the balance of gut bacteria. And, you know, that can be done with diet, probiotics, and prebiotics. It's really the foundation of functional medicine. It's really the place we start. And, you know, one of the things that reminded me of when you're talking about this

is a particular bacteria, and I wonder if there's any data on this in COVID, it's one that protects the barrier and creates a mucus layer that's really important. And it's got a big fancy name called acromantia mucinophilia, but it's a particular bacteria that we now come to understand that is highly important in regulating immunity, protecting the gut from leaky gut, and is involved in metabolic health and autoimmunity and cancer. Is there any data on low acromantia and COVID or do we know yet? Or maybe it was too early? Yeah, it is too early. I haven't, I've looked for it. I haven't seen the acromantia. I bet you. The particular organism, and it has an even harder name and less familiar,

that has turned up, which is a friend of acromantia and but an even bigger friend of bifidobacteria is something called fecal bacterium prausnitzi and yeah it's a polish bacteria it's a polish bacteria right and it um it is a major producer uh that's that it is a like acrom, it is one of these keystone bacterial species that supports the whole community. And what the F. prausnitzi does is it is a major producer of a short-chain fatty acid called butyrate. Butyrate does two important things. Well, it does several important things. It nourishes the lining of the large intestine. 70% of the energy that is used by the lining cells of the large intestine is generated from butyrate, not from sugar, for example, or glucose. Butyrate is the substrate

that it uses. But butyrate is readily absorbed into the body. It passes throughout your whole system. It has anti-inflammatory effects and it gets into the brain. And in the brain, butyrate has a genetic effect or an epigenetic effect. It allows the activation of a gene that produces a protein called bdnf or brain derived neuroprotective factor that is essential for nerve cells recovering from injury. So a lack of butyrate will impair the brain's ability to recover from inflammation, infection, or injury. Whereas an abundance of butyrate will activate this gene that produces BDNF. And there are a lot of animal studies that have shown this connection. And I'm certain that it applies to humans as well. So this is just amazing, Leo.

I understand every word you said. I'm not sure everybody else did. So I'm just going to do a little translation. And this is just mind-blowing when you start to think about the interconnections of every system of our body. So you've got this special bacteria that when it eats your food, its byproduct is this molecule called butyrate, which is basically not only giving energy to your colon, but it's absorbed, goes to your brain, and turns on miracle grow. So that all your brain cells have more connections,

you make new brain cells and more connections. You make new brain cells and more connections and repairs the brain. So then the question is, well, what makes that bacteria grow? What do you have to feed it? How do you get it? How does that link up to your diet? And so all of a sudden you begin to sort of see these patterns of connection of how we begin to influence our health in a totally different way. So for example, for acromantia, that particular bug loves polyphenols. It loves cranberry and pomegranate and green tea. That's what it likes to eat. And you feed it that, it'll grow. What about your Polish bacteria? What is it like, sauerkraut and bratwurst? I'm like, what do you... Actually, well, sauerkraut well first of all our craft is a great source of lactobacillus bacteria

but the the um the f-prosinitzy really it it likes prebiotic um uh starches basically like like what like um uh well like beans, for example. Yeah. Vegetables. It likes vegetables. And there's a whole host of prebiotic foods like asparagus and artichokes. Right. Plantain and Jerusalem artichokes.

All these foods that we can include in our diet. Avocado enhances its growth. And it produces butyrate, which is then food for the bifidobacteria. Wow. So, I mean, the level of connections is astonishing when you look at these things. And so it's definitely working with diet and the microbiome is a key part of all stages of dealing with the pandemic. Okay. Okay. So we stages of dealing with the pandemic. Okay. So, okay. So we kind of, thank you for that.

We covered as much as I think we can in this moment of what long COVID is, what the symptoms are, how it works in your body and what it causes. Now let's get to the good news, which is what you've discovered about how we can use functional medicine, diet, lifestyle, supplements, medications to actually help to one, prevent it, and then to help you with when you have COVID and to make sure you don't get long COVID or if you have long COVID, how to resolve it. So dive into what you've really learned about this. I know you've got these courses on your website. Everybody should go look at it, drgallon.com. This is a teaser. I mean, you've got hours and hours of content of Leo explaining this if you want to get really nerdy about it.

But I really would love you to sort of summarize what have you learned in the last two years about how to deal with post-COVID and COVID itself with a functional medicine approach? So from the dietary perspective, from a preventive perspective, you can do this. A high polyphenol, high fiber diet has the best impact on the gut microbiome and general body inflammation to prepare you for encountering this virus and to help you recover from it. Then there are a number of supplements that are really important. And the supplements that I focus on are those that enhance your body's ability to generate ACE2, the vital enzyme that is destroyed by this infection. And number one is vitamin D. Sometimes high doses are needed number two are actually supplements of polyphenols and the two that have been the most studied and

that are really mainstays in my treatment are curcumin which is found in the spice turmeric um and it's probably the most studied anti-inflammatory natural product that there is. And resveratrol, which is found in a number of vegetables. It's best known as being found in red wine or red grapes and has been studied for its anti-aging and anti-inflammatory effects. So it's a combination of like an Indian and an Italian diet, basically. Yeah, right, right.

Curries and red wine. Yes. And, yeah, and so vitamin D, curcumin, and resveratrol are, they're foundational for the approach that I take. And that is pre, during, and post, right? Yeah, at all stages of this. In fact, curcumin has been studied. There are two studies, one from Iran and one from India,

where people who are hospitalized with COVID-19 were given curcumin, and it had a major impact on how they did in the hospital. I mean, it rivaled any study of any other treatment in terms of its impact on mortality or the need for mechanical... Curcumin, curcumin. Curcumin. And what were the doses? Oh, you know, it depends on the form. Roughly the equivalent of about a thousand milligrams a day. With a highly absorbed nano curcumin, they got away with less, but I aim for a thousand milligrams, is quercetin. I use that in the early

stages for prevention. It's been shown to be effective there. Again, it doses roughly 1,000 milligrams a day. Now, quercetin has been shown to be helpful in preventing the development of COVID in people who are exposed to the virus. That's probably through a separate mechanism where it blocks the ability of the virus to attach to your cells. Beyond that, quercetin has major anti-inflammatory effects and also can inhibit blood clotting, and blood clots are one of the complications of COVID-19. So that group of polyphenols I found very helpful at all stages of this syndrome. So eat curry, drink red wine, and have like a bunch of orange peels and onions. Onions, right. Onions and apples. Right. And I mean, the whole the dietary pattern, I think, is important, especially from the preventive perspective. Yeah. The. The next thing is there are certain probiotics that may be helpful in better balancing gut bacteria. When someone has had COVID-19, there is a probiotic that's not well

known that actually was developed in Russia and the Ukraine about 40 or 50 years ago that I found really useful, especially for those with gastrointestinal symptoms, which is a lot of people with long COVID. And it's available over the internet under the name Tundrex, T-U-N-D-R-E-X. It actually is a soil derived organism that secretes alpha interferon. This virus is very sensitive to the impact of alpha interferon, which really kills it.

And one of the things that the virus does to enable itself to establish infection is to find ways to turn off your alpha interferon response. So explain what alpha interferon is for those who don't know. Right. Alpha interferon is a protein. It's a cytokine produced by cells of your immune system. When you're exposed to a virus, part of the early antiviral response is the production of alpha interferon. In fact, people who produce alpha interferon in their nose are much less susceptible to getting sick with COVID-19. What this virus does is it finds ways to turn off your ability to produce alpha interferon. Ah. And that is one of the reasons it can establish itself so effectively. And the function that I use

Tundrax for is it secretes its own alpha interferon. And so my goal with that is to have it stimulate the immune response in your gut and eliminate any traces of the virus that happened to be in the GI tract. This is a Russian probiotic. Can you get it in America? It's available. It's been available for several months now, maybe a year through a website, Tundrex, T-U-N-D-R-E-X dot C-O, not dot com. I've been working with it for the past few years. We will put that on the show notes for everybody listening, so don't worry. Okay.

Yeah, I've been using it mostly to help people recover from parasitic infection. So it's a soil microorganism from Siberian soil. Yes. Backed by decades of research and is now available here, which is amazing. Yeah, I find that to be very helpful in recovery from the GI symptoms of COVID-19, and I will probably use it more widely because I want to deal with this potential of viral persistence in the GI tract. And it's called bacillus subtilis, right? That's the name of the bacteria.

It's a particular strain of bacillus subtilis. I think this is incredible. So we've got an anti-inflammatory diet with polyphenols and fiber. We have curcumin, resveratrol, vitamin D, quercetin, and bacillus subtilis. Keep going. And once you don't use the Tundrax indefinitely, it's a fairly short course, maybe 10 days or so. Oh, wow. Other probiotics that help to restore the Polish probiotic fecal bacteria, and those that are commercially available. There's a strain of bifidobacteria called BB536. There's a different soil-based organism called Bacillus coagulans.

And I talk about these on my website in a document called The Gut Microbiome and COVID-19. So we're going to link to that in the show notes, The Gut Microbiome and COVID-19 from Dr. Leo Gallin's website. But I just want you to just keep going because it's a lot. These have been shown in controlled clinical studies to be anti-inflammatory and encourage the growth of F. prausnitzi. Then we need to look at some other manifestations because the complexity of this infection doesn't stop with what it does to ACE2 and how destroying ACE2 creates blood clots, it's clear that 90% of what you're seeing in COVID-19 or in long COVID matches up with ACE2 deficiency. But one of the effects of ACE2 deficit is that the mitochondria take a hit. So mitochondria are these microscopic powerhouses that generate like 87% of the ATP that your body needs for energy. And the mitochondria are damaged, especially those lining the blood vessels, are damaged by COVID-19. And so part of my protocol, especially if there is fatigue or heart problems, is mitochondrial repair. Let's get them up and running again. And merely restoring ACE2 may not

be enough to do that. How do you do that? Well, the single supplement that's been the most studied in mitochondrial function is coenzyme Q10. And there, the doses that are needed are somewhere between 200 to 400 milligrams a day. It depends on the form of coenzyme Q10. But low doses won't work. You need a high dose and coq is very safe i have not seen any side effects with it what's a high dose um um oh let's say 400 milligrams a day is a dose that has been that was shown to help prevent migraine headaches migraine without side effects and migraine is a mitochondrial disorder.

So I usually have people spread it out a hundred milligrams, three or four times a day with food. So that's, that's one step. The other thing is that their vitamin B3, niacin, you might ordinarily. Yeah. Is this why we're seeing benefits from NAD, from nicotinamide diuriboside, which is a sort of a derivative of niacin in COVID? Yes, I think we're seeing benefits because of the direct effect of that on mitochondrial function. So there are different forms of niacin that I use, and it might be NAD. I also use nicotinamide mononucleotide, NMN, which has been helpful. Those are actually my favorites. Niacin itself can cause an unpleasant flushing, although some people like it. Some people happen to like that flush. It's a dingley all over, Shelley.

Right, yeah. Now, the niacin probably works better when combined with an amino acid called NAC, N-acetylcysteine, which is an antioxidant, which also protects mitochondrial function. Glutathione protects mitochondrial function, and that's a major endogenously manufactured antioxidants. So when you take NAC, it helps you make more glutathione. Right. NAC helps you make more glutathione. And there may be a role for carnitine, which is an endogenously made substance of peptide, dipeptide-native amino acids. But I would say coenzyme Q10 and niacin and NAC are the main factors for restoring mitochondrial function. NAC, according to animal studies, also helps with the production of BDNF, brain-derived neurotrophic factor. So especially if there are cognitive issues or neurologic issues,

I want more BDNF. And butyrate being made by healthy gut bacteria, niacin can be helpful with that. And omega-3 fats may also play a role in the regeneration of nerve cells, EPA and DHA. And the data tend to indicate you need a fairly high dose for cognitive enhancement, roughly 2,400 milligrams of EPA plus DHA per day, which should be taken with food. The benefits of EPA and DHA on cognitive function are enhanced by another antioxidant called alpha lipoic acid. And there the dose needed is about 600 milligrams a day. So those are most of the natural products. So those are the natural products you use for prevention, treatment, and post-COVID. Yeah. Actually, if we take the omega-3s, there's studies from critical care units

where people receiving omega-3s have a much better outcome than people who don't. So that was a really extraordinary sort of description of the mechanisms and why these products, which are natural, can help to both prevent, treat, and help you recover from post-COVID. And just to summarize quickly, it was resveratrol, curcumin, quercetin, vitamin D, N-acetylcysteine, lipoic acid, carnitine, niacin, or derivatives like NMN or NAD, and then all the probiotics, like the one that comes from the Siberian soil, other others that can be helpful as well, plus upgrading your diet with polyphenols and prebiotic fibers. These are foundational ideas

that are safe, they're effective. The cost is there for sure if you're taking a lot of supplements, but if someone's suffering from long COVID or from COVID, the cost of not doing it is far greater, I think, in terms of our long-term health outcomes. What else have you found is effective in helping these people recover? Well, it's really important, especially in the people who have chronic fatigue. It's really important to look at this, at how their autonomic nervous system is regulating pulse and blood pressure, and to look for this phenomenon called POTS, P-O-T-S, which stands for positional orthostatic tachycardia syndrome. And what that means is when you stand up, your heart races much faster than it should. And I have a link to a way to determine that,

but it's pretty simple. You lie down for a few minutes and you check your heart rate, and then you stand up and you lean against a wall. So you're kind of resting, standing, your shoulders are against the wall, and you check your heart rate and blood pressure if you can. But anybody can check their pulse. And if you have one of those pulse oximeters that people were using and buying at the onset of the pandemic to check their oxygen, you can do that. And you don't have to check it yourself but and you just look at what happens to your heart rate as you stand for ten minutes if you can't stand for ten minutes you're then you probably have this and and I have a whole description of how to interpret that and about it in the video, the long COVID video.

That may require medication and a graduated exercise program. But vitamin B1, thiamine, also can be helpful for POTS. So that is something else that might be added to the mix. Yeah. So, you know, I have come across, because I'm constantly getting patients with long COVID and with COVID itself and looking for ways that are a little out of the box. Everything you just said would be hard to argue with, really, and is safe and is and it is really reasonably

priced in the scheme of things. But there are a number of modalities out there that I've seen people use that I personally use myself. Plus I've also seen practitioners use, and I've sent patients to practitioners who do these modalities. And I'm just going to list them. And I'd love you to sort of riff on what you think and how they can impact post-COVID particularly, and even COVID. Hyperbaric oxygen, ozone, exosomes, peptides, and even things like, you know, plasmapheresis, ozondialysis. And those are things that I think are a little out of the box, but I've seen remarkable recoveries using a combination of these various therapies.

What's your thoughts on these things? Well, I think if you, I mean, they are expensive and can be invasive. So I would certainly reserve them for people who are not responding to other measures now um hyperbaric oxygen and ozone both are oxidative therapies and may stimulate killing responses um you know i've i've had kind of mixed responses in general with those in my practice. I've referred patients for many years

for them. So far, there hasn't been anyone with long COVID that I felt a need to do that with. And I had one patient who consulted me and then went for hyperbaric oxygen and was not helped by it. But a series of one is not enough to make a judgment. Yeah. Plasma for recess might be helpful in removing autoantibodies. And that's something I would consider sort of as a late, not necessarily a last resort, but a late resort. I haven't worked much with exosomes. They're interesting, and stem cell therapy is potentially interesting. There's been some work with ACE2-producing stem cells.

Wow. But it just hasn't gone very far as yet. And peptides. So I use peptides a lot in, or a moderate amount, I would say, the peptides that I've used, first of all, they probably have to be given by injection. I don't think the oral peptides are going to do it. So they need to be given by injection. It's kind of easy. It's like, like you know use an insulin syringe but you would have to learn how to do it and i would go i would look at the thymus and peptides thymus and alpha one and thymus and beta four four i've seen some very good responses to those yeah in other conditions so this is a very hopeful message i mean it's really depressing that there's so many people who've had COVID, and thankfully, 99% of them haven't died. But if 30% are permanently ill, we need a different way of thinking about this. And what you just presented, Lito, was a really extraordinary

map of how to restore function using functional medicine. And just to kind of summarize, you talked about optimizing nutritional status, let's say vitamin D and omega-3 fats. You talked about how do we upregulate and optimize immune function, including making more interferon alpha, which is your natural antiviral systems through various phytochemicals and plant compounds that can upregulate those systems. You've talked about the gut and how we need to restore the microbiome and butyrate production and how that works with the brain. You've talked about mitochondria as a factor that we have to restore energy production in the cells. This is functional medicine, the gut, the immune system,

the mitochondria, nutrition. You didn't talk so much about toxins, which they don't necessarily play a role here, but this is, and you've talked about even hormonal dysregulation with, you know, POTS and osteoautonomia and neurotransmitter dysfunction. These are things from a functional medicine perspective that many of us in the field have a lot of experience with. And what you've done is applied the science to the mechanisms, the underlying biology of what goes wrong with people who've had COVID and with post-COVID or long COVID. That's just brilliant. And I think for people listening, they should really have hope and understand that even though this is a scary time and a scary disease,

that if you apply these methods, that they do make a difference. Now, yes, we need large trials. Yes, we need more money to study this. But, you know, I was speaking with my friend, Darius Mazzafarian, who's the Dean of Tufts School of Nutrition Science and Policy, one of the most published and respected scientists with NIH grants and just really one of the leading lights in the world of nutrition science and science in general. And he said, we saw that in our school, we had nutritional immunologists and we were studying these phytochemicals, and we're studying these nutrients and their regulatory factors on the immune system and

how to deal with COVID. We tried to get a study going. We couldn't get five cents from the NIH from anybody to study this. We saw this right at the beginning, you know, where there's literally billions of dollars being given to vaccine makers to actually make vaccines or new fancy drugs that are unfortunately not showing that much effect, I mean, marginal effect. So I think you're hitting on something that is accessible to everybody, that's doable by most people. It's not extraordinary measures. And that, you know, if some people get stuck, there's the stuff in our

back pocket that we may want to try like hyperbarics and ozone. I've seen great results. I want to talk a bit about vaccines because I heard this, I don't really know how strong the data is, but it seems to me that if people have been vaccinated, and I'm not going to get into all the risks of vaccination and the controversies, if people have been vaccinated, it seems to prevent them from getting long COVID. Is there data to support that? Does that make sense? There's a little bit of data and the prevention might be 50%. So having been vaccinated may give you a 50% reduction in the risk of long COVID. And which would be one reason to consider it. But, you know, as I said, my experience has been that if you use these functional medicine measures from the time, hopefully before the diagnosis, but from the time of diagnosis, the risk of long COVID is markedly reduced down to two to three percent. And Leo, if people haven't been vaccinated and they have long COVID, does getting a vaccine help?

That's a really important question. Maybe 10% of people actually feel better after the vaccine. or had reports from people that I've spoken to directly of some very dramatic changes occurring, usually within a week after the second shot. But I also have seen people who got much worse after being vaccinated. And so that is people who had long COVID. So it's not an easy decision to make. So, Leo, you can take the fifth on this one if you want. But I love we have a few minutes left. I love your perspective on vaccines and COVID. And if you're willing to share, have you had one?

What do you think about where we're at with and all the controversies about the risks versus the benefits? Sure. Yeah, I'm happy to talk about that. I mean, I've been vaccinated and probably would be due for a booster. I've been postponing it because I'm trying to figure out when do I want to be sick for a few days. But the, and I read on a daily basis the responsible anti-vaccine literature. And plus I have also- That sounds like an axymoron according to traditional science. Well, no, there is- Like responsible anti-vaccine literature.

Yeah, explain that. There is a little bit. There is a little bit. Explain that. And so, or let's just say anti-vaccine literature from sources that I consider reputable. Yeah, I understand. And then I pursue that information that is I don't ever take what anybody tells me if they cite a study. I want to go and read that study myself. And and I would say that most of the anti-vaccine literature is full of holes.

It doesn't really hold up when you go in and you really look at it. There are some very real and legitimate concerns, but in fact, they don't materialize now, except for a few. And there are some real concerns that need to be, and they need to be taken very seriously. You know, the risk of myocarditis in young men, for example. Maybe they should only get one dose of an mRNA vaccine and not two doses. And that's what bodies of scientists are now saying in Europe. Right, right. And so this blanket embrace of vaccines, I think, is very dangerous. And there needs to be a constant analysis. And that's the way that science works. You're constantly looking at the facts and recalculating, you know.

Yeah. I think I would say that the vaccines are indisputably beneficial in decreasing the rate of death and the severity and the need for hospitalization from COVID-19, it is equally indisputable that they are not going to rid the world of this virus and they are not going to create so-called herd immunity and the end of the pandemic. And so a public health policy that relies solely on vaccination, and that's a big mistake. And that unfortunately has been the public health policy in this country. Yeah. I mean, I think that's the challenge is that, you know, what you said was very important. Science is about asking questions. And in some areas of medicine, you're not allowed to ask questions.

Vaccines are one of those areas. And it's the most bizarre thing to me. You know, the science is settled. Science is never settled. It's the point of science is to question and to create hypotheses and challenge your thinking. And it's a nuanced field. And the problem with the messaging, in my view, around vaccines was that it works. It's safe. Well, neither of those are true. It sort of works, and it's sort of safe. And it's nuanced, and it's different for different populations at different times and ages. are in an unfortunate situation where if you even bring up a question,

you're immediately thrown into this camp of being like a terrorist. You're an anti-vaxxer. It's equivalent to being a terrorist. And I personally have had the vaccine. I had the J&J vaccine because I was in a hurry and I didn't have time for two vaccines and I just was able to get it. But I also, I think we need to be honest, scientifically honest. And I think the public can handle the truth and we shouldn't be paternalistic in the way we message. Yes, we need to be simple and clear so people understand what to do. But I think what's

happened now is that people are so confused because all of a sudden it's like, vaccine is going to save us. Like, oh, nope, just kidding. You know, like, oh, like all these other problems are coming out. And like any medical treatment, it's got risks. We just, you know, everybody's been taking aspirin forever. I don't take aspirin. I read the literature for years and it highly concerned me that, you know, 16,000 people a year die from GI bleeding and stroke from taking aspirin. And if your cardiovascular risk factors are low, which mine are, the benefits don't outweigh the risks. And now a study came out showing that, you know, people over 60, even if they're high risk, should not take aspirin, which was given to everybody and it was considered malpractice

not to give aspirin, even though there was data because of what the medical orthodoxy was saying. And I feel like with vaccines, we're sort of in the same boat. We really need to take an honest view. They're not good or bad. They're just another treatment that have benefits and have risks. And you have to calculate those personally and make decisions about what feels good or not to you. But I think, you know, I also think and I would love to ask you this question, but I don't have enough personal or experience or patient experience to really determine this.

But I have a few is if people have side effects from the vaccines. Does this approach that we just talked about also help them recover? Well, I'm seeing a lot of people with vaccine injuries, you know, who are coming in to see me. And yes, I think it can be, I think the approach that we've just talked about can be really helpful with vaccine injuries. I think a lot of the vaccine problems are, in fact, related to the nature another, spike protein into the cells of your muscles, which then actually spreads, gets to lymph nodes, may circulate. And I think it's very irresponsible of the conventional medical community to act as if, oh, the spike protein, it's no big deal. It's been modified. It can affect you. I think that there are effects of the spike protein on immune responses

that are very similar when you look at the vaccine or when you look at COVID-19. And that's a theory, and I'm basing it on indirect information. But it would be a reason why treatment approaches that can work for COVID-19 or for long COVID may be applicable to vaccine injuries. Yeah, I completely agree. So thank you, Leo. You've done so much work to learn about this and share with everybody and with the general community out there with the functional medicine community and the Institute for Functional Medicine has a task force on COVID and has really been producing content and a lot of you have been helpful with that as well. with post-COVID, I encourage people to check out that resource, ifm.org, and check out your website, Dr. Leo Galland, sorry, drgalland.com, that's just D-R-G-A-L-L-A-N-D.com. It is a treasure trove of information. You are not a radical, you are a thoughtful, scientifically oriented doc who has asked hard questions, who's challenged orthodoxy. And I really deeply respect your ability to sift through all the noise and look at what science

says and come up with things that are common sense, that are reasonable, that mechanistically sound, and that can really help people. And I'm just going to confess personally, I, well, if it's confession or whatever, I, since this all started, I wrote an article probably in March of 2020, as soon as this came out and I wrote pretty much everything you said to take and do, I wrote, I wrote down because there was evidence there that all those things work. And personally, I take almost everything you had just described described i don't take some of those siberian probiotics but i'm probably going to get them now but i basically

i take almost everything you're talking about i take curcumin i take coq10 i take a lipoic acid i take nac i take vitamin d i take fish oil i take probiotics i take mitochondrial support. I do the things that I know that are going to strengthen my system. I take quercetin because I know that I don't want to get COVID. If I get it, I don't want it to be bad. And I don't want to get post-COVID. And if I would, look, I'm good. So I think that I feel very hopeful that if people listen to this podcast and that they can digest the first part, which was pretty heavy, that the second part, we really unpacked a way of living.

And we didn't talk about the importance of deep nutrition and exercise and stress reduction and sleep. Those are sort of self-evident ways to help your body. But if people can understand that, you know, they don't have to feel helpless and wait for some new great new discovery of a drug, that there's so much that you can be empowered to do right now to make yourself COVID resilient, to help yourself recover from COVID and to prevent and treat post COVID syndrome. I mean, that's a miracle. So yeah, I, you know, Mark, I would just like to talk about one of what I think is one of the most remarkable studies that was published along those lines. And this was this was a study that came out of Johns Hopkins, Harvard, Columbia, Stanford,

you know, top researchers. They looked at a group of health professionals, mostly doctors and mostly men, and they categorized them as people who had recovered from mild COVID or people who had had moderate to severe COVID. But they were all people who had survived COVID. And they then did a dietary analysis of what their diets had been like during the year before they got COVID. Yeah. And I went in and looked at the data and, and there, you have to really look at the data itself. The bottom line is a 40% increase in the consumption of vegetables created a 72% decrease in the likelihood that someone would have moderate or severe COVID versus mild

or minimal COVID. Now, if there was a drug that did that, just imagine what the headline is. Yeah. 40% increase in your veggies, 70% decrease in severe COVID. The other study was on vitamin D. I don't know if you saw it, but I think it's in in pre-publication but it was released and it showed that if your vitamin d level was over 50 nanograms per deciliter which is probably maybe i don't know five percent of the population that your risk of death from covet was zero like does that make sense like that just there's no drug that can do that no vaccine that can do that and literally we should be giving free vitamin D to every man, but it's perfectly okay to advocate vaccines for everybody. That's right.

Although when President Trump got COVID, in the New York Times, they reported they were giving him vitamin D and zinc and all this stuff. All the things that, yeah. That's what we're talking about. Well, Leo, thank you for your work. Thank you for being such a tireless, dedicated servant of the truth and science, for bringing functional medicine and helping birth it into the world. Without you, I wouldn't be where I am or doing what I'm doing. I think you are just an incredible mensch. And thank you for, I mean, listen, you're 79 years

old. You could be golfing all day and sailing in the caribbean and you know but you're spending eight hours a day with patients you're doing all the work you need to do so thank you thank you thank you and uh for those of you listening this podcast if you love what you're hearing uh and you have anybody who knows how to cope with which is probably a hundred percent of the people share this podcast with everyone you know. It is one of the most important podcasts I feel like I've done to tell the story. Leave a comment. Talk to us about what you've learned about how you can recover from COVID and post-COVID. Subscribe wherever you get your 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 introducing 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 from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use

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That's drhyman.com forward slash picsICS, P-I-C-K-S, and sign up for the newsletter. And I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. 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

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