The Dr. Hyman Show - The Power Of Food To Heal Everything From Autoimmune Disease To Traumatic Brain Injury with Dr. George Papanicolaou

Episode Date: December 18, 2019

One of the reasons Functional Medicine is so transformative is that it recognizes disease does not occur in isolation. If one part of the body is compromised the entire body is thrown out of balance. SIBO, or small intestine bacterial overgrowth, is a great example of this. It rarely occurs on its own, and is often paired with a number of other issues, from neurological symptoms to migraines, arthritis, and more. When we focus on healing the gut in these instances, the entire body shifts for the better. This week on The Doctor’s Farmacy I’m joined by Dr. George Papanicolaou to talk about the Functional Medicine matrix as a framework for healing, as well as his own journey in overcoming a traumatic brain injury.  Dr. Papanicolaou is a graduate of the Philadelphia College of Osteopathic Medicine and is Board Certified in Family Medicine from Abington Memorial Hospital. Over time as the healthcare system made it harder for patients to receive personal care, Dr. Papanicolaou decided a change was needed. He began training in Functional Medicine through the Institute of Functional Medicine. In 2015, he established Cornerstone Personal Health—a practice dedicated entirely to Functional Medicine. In August 2017, I invited Dr. Papanicolaou to join The UltraWellness Center and we’ve been successfully helping people together ever since.  This episode of The Doctor’s Farmacy is brought to you by ButcherBox. Now through December 31, 2019, ButcherBox is offering listeners of the podcast 2 lbs of wild-caught Alaskan sockeye salmon and 4 grass-fed, grass-finished sirloin steaks for free in your first order PLUS $20 off your first box. Just go to ButcherBox.com/farmacy to take advantage of this great deal. Here are more of the details from our interview:  -The 4 principles of osteopathic medicine and what attracted Dr. Papanicolaou to become a DO before he discovered Functional Medicine (6:05) -Why prevention, as thought about it in conventional medicine, is really early detection (11:29) -Treating SIBO and how the Functional Medicine Matrix is used to identify issues and create health (17:19) -Leaky gut, why SIBO is rarely seen in patients by itself, and how to test for it (27:09) -Patient cases in which Dr. Papanicolaou and I have treated gut issues (32:40) -The reason why people get so-called “food babies” (36:29) -The 5 R’s of Functional Medicine (40:10) -Why Functional Medicine uses genetic and toxicity testing not regularly used in conventional medicine (48:33) -Gluten as the trigger for autoimmune disease, how sugar and starch can cause hormonal issues, and Dr. Papanicolaou’s experience treating his teenage daughter’s fatigue (1:00:34) -Dr. Papanicolaou’s personal experience with brain injury and how he healed himself (1:09:24) Learn more about working with Dr. George Papanicolaou at The UltraWellness Center at https://www.ultrawellnesscenter.com/team-member/george-papanicolaou/. 

Coming up on this week's episode of The Doctor's Pharmacy. I'm not interested in finding out if you have early disease. I'm interested in helping you create a disease-free or cancer-free life. Hey everyone, it's Dr. Mark Hyman here. Now, I'm always being asked how to source high-quality meat and seafood. So, I want to share one of my favorite resources with you that I use to get high-quality protein in my own diet. Now, unfortunately, most meat and seafood at the grocery store is not serving our health or the planet for that matter.

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Just go to butcherbox.com forward slash pharmacy. That's F-A-R-M-A-C-Y, butcherbox.com forward slash pharmacy. I promise you'll see why I trust them when it comes to my own diet. Welcome to the doctor's pharmacy. I'm Dr. Mark Hyman and that's pharmacy with an F, F-A-R-M-A-C-Y, a place for conversations that matter. And if you've suffered from any chronic illness or know someone in your family or friend who has a chronic problem that nobody can figure out and fix, this is a conversation that matters for you. And it's because we're here at the Ultra Wellness Center, my practice where we've been doing functional medicine for 15 years with our leading doctors. And our doctor today is Dr. George Pepinicola, who is an extraordinary physician.

He's joined our practice recently, but he's been a doctor for a while now, probably what, 25, 30 years? It's been 22 years. a while now probably what 25 30 years been 22 years 22 years all right yeah he's a graduate of the Philadelphia College of Osteopathic Medicine he's board certified in family medicine he is also certified as a functional medicine practitioner through the Institute for functional medicine he went to the Indian Health Service after graduation he worked on the Navajo reservation for four years the chin Lee comprehensive medical facility and I. He worked on the Navajo Reservation for four years, the Chinle Comprehensive Medical Facility. And I actually also worked on the Hopi Reservation.

So we were kind of neighbors back there. He founded the Cornerstone Family Practice in Rowley, Massachusetts in 2000. His philosophy was centered on personal relationships, treating the whole person, not just the disease, which is really at the center of what we call functional medicine. He called this philosophy whole life wellness. Now, over the time that he had in the healthcare system, he found it harder and harder for patients to receive the kind of personal care within the existing model, which is why he came and joined us at the Ultra Wellness Center a number of years ago.

And we're so excited to have him here. He's been working with our patients, doing a phenomenal job. And welcome, George. Mark, it's a pleasure. Thank you for that introduction. It's always exciting to talk about what we do here at the Ultra Wellness Center and how this model of functional medicine can impact people's lives in so many ways. It's true.

I mean, I think that's the thing I experience here over and over. It's just the miracles that happen every day. You know, people who come from all over the world with chronic diseases, which nobody else can figure out. And, you know, we collectively here probably have 60 plus years of clinical experience in functional medicine. And given that functional medicine has only been around for 25 years, that's a lot of years. And we have an extraordinary experienced team of nutritionists and navigators and doctors and nurse practitioners, PAs. And we are doing things that are not being done in most centers in the world.

So talk about how you came into this journey. You're not an MD. You're a DO. So tell us, what is a DO? And why did you go to DO school? And how is that different than traditional medicine? Sure. So, you know, as we talked about earlier, I'm a, I like, I'm a very curious person. And so I've always looked at my life very curiously. Why am I doing and being where I'm at in medicine

right now? And I think it starts out because I'm just innately a empathetic person. I've always been connected to people. I've always felt deeply for people, particularly dispossessed people, whether it be disease or whether it be socioeconomic. I've always had a draw for people. And I've always been very curious. And I believe in intelligent design. And I believe everything is interconnected. Everything has a plan and a purpose that goes beyond our understanding and is a huge mystery, which always leads me to ask the question, why? And that is one of the key elements that I think I bring to care and we bring to care here at the Ultrawana Centers.

We're always asking why. We're always looking for that answer. Yeah. I mean, functional medicine is about the why, not the what. You know, not what disease you have and what drug do I need, but why is this happening? What's the root cause? What drew me to the osteopathic medical school was the principles that Andrew Taylor Still

had outlined in 1872, I think, right around there. And here are the four principles. They're very interesting. One is that the body is completely integrated and has the ability to regulate and heal itself. That's number one. That's true, right? Absolutely.

The body basically wants to be healthy, right? That's a very profound idea, which is- This is 1872, okay? Then he goes on to say that all the systems of the body are interconnected. Another amazing idea, not what we learn in traditional medical school, that there are all these different parts and we have to treat each part, you need a specialist for every part. Absolutely. And so there's no functional medicine in my mind at that point. But I hear these principles

and they're really resonating with me. So then the third principle is that the structure and function of the body are connected. From membrane to hormone, they're all connected. You cannot disengage the mechanical structure, the biochemical structure from the function of the body. Those are the three top principles. His fourth principle was the one that really made me pause.

And I said, this principle was this. If you do not account for the first three principles when you are designing your treatment plan for a patient, it's irrational. That's fantastic. I mean, that is is really in a way that's what you'd like medicine right which is the body's an interconnected system right that everything works together right and that you can't really heal people from chronic illness unless

you're actually thinking about how everything is connected exactly which is the opposite of how we're training in medical school and you were saying when you're in medical school you basically got a lobotomy and... No, you stole it. I should have told you that. You stole my thunder, man. Well, tell us about what that means. Okay, so in osteopathic medical school, and you experienced it when you went to medical school,

you have your first two years of basic science. But the basic science part was cool because you get to learn about how everything's connected. You do the biochemistry,chemistry the pathology the microbiology the the physics of everything and it and you're excited and then you go into your clinicals and that's where the lobotomy happens it's like all of this interconnectedness that we learned even in osteopathic medical school there is still that disconnect it went down to make the diagnosis treat the disease and quite honestly you know as my career went on in medicine and I started

being driven further and further from that ideal I had when I first went to medical school, I became more disenchanted with the medical system. Yeah. Well, I think that's true. I think we really are in a way disconnected from the basic biology and functional medicine comes back right to the most elemental things we learn in the first years of medical school, how we make energy from food and oxygen, how our immune system works, how our biochemistry works. I mean, biochemistry was that class you took in the first year of medical school. You gutted your way through it. You hope you pass. And then you forgot about all of it. But in a sense, functional medicine brings all that back. So you have to learn about the way in which your body works.

So we're interested in the mechanisms and the causes, not just the name of the disease and the symptoms. And that's really the problem in medicine is we're focused on geography. Where is it in your body? Is it your stomach? Is it your head? But your headache might be caused by something going on

in your microbiome, right? Oh, yeah. We have a lot to talk about. Yeah, so exactly. And then so when you're practicing conventional medicine with my mindset, and I was trying to build this whole life wellness program, I was writing nutrition programs for my patients. I was writing physical fitness programs.

I was helping people periodicize their training, helping them plan for events. And that was really great stuff. but as time went on, Mark, here's something really interesting that warped. One is, is that I was being pushed more and more by insurance companies and health plans to meet these metrics. They were trying to measure quality of care.

And I had to meet these prevention metrics. But the prevention metrics were really measurements of disease once it was out of the box. Right. Did you get all your women to get mammograms? Did you get all your young ladies to have their chlamydia tested? Did they all get their pap smears? We're looking for disease out of the box.

We're not helping people create a cancer-free zone in their body. Right. You know, a woman would ask me, so what do you think about mammograms versus thermography, Dr. Papanikolaou? I would say I'm more interested in- Didn't versus thermography, Dr. Papanikolaou? I would say I'm more interested in- Didn't you invent the Pap test, Papanikolaou? Well, I had a few years to read that up. I was waiting for a good answer.

So, yeah. That was your uncle, right? No, he's not my uncle. But I will tell you- That's the Pap test. Yeah, if you give me a brief aside for this little story, when I had my i had to have surgery at the hospital for special surgery it's right next to cornell yeah so um a

lot of people saw my name i had nurses coming from other floors to come up to see if i was related to george nicholas papaniklau george james papaniklau so my dad told me and don't hold me to this audience but my dad told me that we're like second cousins once removed or something like that. He may or may not be. You get royalties from every path. That was about it. You're stealing all my thunder.

I was going to say, it doesn't really matter how we're related because I get no royalties. That's another one. But the first person or two that asked me, I said, I think we're second cousins once removed, and they left deflated. Oh, I came up all the way here to hear that. So the third person that came in, I said, yeah, he's well see that's very funny so yeah but getting back to her you know what you just said was very profound which is that prevention as we think about it in traditional

medicine is absolutely not prevention exactly early detection exactly do a colonoscopy so you can find a polyp or an early cancer do a pap test you can find early cancer do a mammogram so you can find early cancer how about not getting cancer in the first place and that's what goes back to i was just saying you know about the mammography i would say to them i'm not interested in finding out if you have early disease i'm interested in helping you create a disease free or cancer free life or zone yeah and we talked about hormones a little bit later we'll talk about estrogen and xenoestrogens and how that creates that environment for women that were more likely to get cancer. But that's going back to the point, we need to prevent, not just detect.

Yeah. And I think that's what people get sort of confused about because doctors don't learn how to truly prevent. They learn how to detect. And what functional medicine is, it's really a science of creating health. So when you create health, you don't allow disease to show up, right? If you create a healthy system, which is going back to your osteopathic training, it's what functional medicine is,

you absolutely don't have to worry so much about disease when you create health because the diseases often just go away as a side effect of creating health. You create an inhospitable environment. And we see this over and over again with diabetes and chronic illnesses where you actually figure out how to build and create the body's functional systems and treat the whole system. The diseases just kind of get better without actually treating them. I don't treat disease anymore.

And that's what we do at the Ultra Wellness Center here. We don't treat diseases, we create health, and as a side effect, their symptoms go away and their diseases go away. Yeah, and it's hard work. You know, when I practiced traditional medicine, it got to a point where you weren't required to think necessarily too deeply because you have specialists.

Everything got siloed, right? That's right. We learned that basic science of interconnectedness. We learned all the beauty of the organicity of the body and how it can heal itself. And then we forget it. And then not only do we lobotomize it in terms of our science and thinking, we do it as a system. We break it all up into organ systems and then we're in trouble because now one silo is not talking to the next i would refer

somebody for a rheumatologic problem very bright doctor would see my patient and if it wasn't a rheumatologic problem the patient came back and told me nothing you do for me told me to go back to you i didn't get even an idea of where else i should look or or a collaboration of here's what i did find and here's what you might want to look next but it's not in my purview yeah it was isolated silos so you know developing you know starting to to think about functional medicine it's really hard well before you think about functional medicine it's really hard for a patient when they're sick to get better if nobody's integrating the whole message yeah all the data and so as a family doctor i took a lot of um pride and i put a lot of emphasis

in being that quarterback for my patient and trying to get as much of that information to integrate a good health plan for the patient, hopefully to get them better, then to help them not only be better, but to optimize their performance. And in functional medicine, we do that. And here's the really cool part is we have the time to do it. You don't have the time to do it in conventional medicine.

So you have silos, you have no time, and now you're treating really chronic disease, and you just can't do it. Yeah. So I think that your point you bring up is really important because when we're trained in traditional medicine, the rheumatologists do their thing and they just focus on the autoimmune stuff. The gastroenterologists focus on their lane, the neurologists focus on their lane, and on and on. And people go from doctor to doctor and are super frustrated because they have all these symptoms. When people come in with 10 or 15 different diagnoses, I'm like, is this just a

coincidence? And they're all treated separately. The addicts are treated by the migraine doctor, their rheumatology doctor is treating their joint pain, their gastroenterologist is treating their IBS, and so on and so on. And they're getting different drugs for every different symptom. And instead of going, well, gee, is this just a coincidence? Or is there something linking all these things together? And how do we think differently about them? And that's what functional medicine is. It's a way of thinking differently.

So you mentioned the rheumatology issue, and you mentioned the gut. The microbiome is one of those areas that is blowing apart our traditional concepts, right? So the microbiome is this ecosystem of bugs in our gut. It's trillions of bacteria. It outnumbers our cells by 10 to 1 and outnumbers our DNA by 100 to 1. And it has been linked to everything from autoimmune disease to cancer to heart disease to diabetes to obesity to autism to Alzheimer's. I mean, the list goes on and on. So when you go to the rheumatologist, they autism to alzheimer's i mean right the list goes on and on so when you go to the rheumatologist they don't go how's your poop but we do all right absolutely so so let's talk about the gut in connection to some of these diseases we we treat

something a lot that's called SIBO now when i went to medical school this wasn't even a thing but essentially it means small intestinal bacterial overgrowth which means bad bugs growing in the small intestine where there should be sterile that have an impact on our health so what what are the symptoms how would people know they have it and what kinds of problems are they connected to and let's kind of get deep into what our approach to diagnosing and treating it's going to be sure so you know i just want to be a little cautious here because we're jumping right into talking about a disease. Yeah. Well, it's not a disease. It's a phenomenon. It's a phenomenon.

That actually causes all sorts of other problems. Right. We do have to give things labels, but it is a phenomena that's connected to many different parts of our body. And getting somebody better involves the whole lifestyle spectrum and involves us using something in the functional medicine realm that we call the matrix and the matrix is looking at not diagnoses but conditions yeah let's talk about the matrix yeah tell us more about them yeah what is the matrix yeah how does it differ from traditional diagnosis and so why do we use it for me to tell you about the matrix you have to swallow the red blue or the blue pill. Which one do you want to swallow? I think I'll take the red pill.

Okay, take the red pill. That's the right pill. Okay. So anyhow, now I can tell you about the matrix. So the matrix is basically a construct that we have in our minds where when you start telling me, I have headaches, I have fatigue, I have belching, I have bloating. I have a diagnosis of Hashimoto's thyroiditis. Migraines. Migraines.

Lupus. They don't become the end point. They become part of the narrative of your disease. And we put it together into a story we call the matrix. And so we look at assimilation, which is the gut. We look at energy that takes us from an idea of fatigue. We rattle it down on our brain to, what are the things in the body that control energy?

And so we think about mitochondria, and we think about energy. We think about toxins. How do toxins influence the rest of your wellbeing? We think about our transport system, our blood vessels, our lymph drainage, and the connection between lymph drainage in the brain and your gut, leaky gut, leaky brain, things that we'll talk about.

And we think about the hormonal system, neurotransmitters to adrenals to thyroids. And we place this all in our mind in this matrix, this paradigm of thinking, and then we make the connections. Yeah. We say, okay, what's SIBO? Okay, well, it's gonna be symptoms, bloating, distension, I feel like, I've used the term food baby, there's something always in my gut.

Yeah, when you have a food baby, something and you feel your belly blowed up, that's called SIBO. Right, that is SIBO. You don't feel like you fully evacuate when you have a bowel movement. You're fatigued. You get depressed.

And you can actually feel your depression. And it's related to how your gut feels. I had that food baby. I'm anxious. I feel depressed. It impacts my ability. And it can link to all sorts of other diseases, right? Yeah.

Fatigue. And then when we think about fibromyalgia, we need to think about the gut and what's been impacted there. And we think about Parkinson's. 50% of people with Parkinson's actually have SIBO. Yeah, asthma, autoimmune diseases. And we don't know, we know there's an observational connection there.

We don't know anything about causality, but it's something you have to consider when you're thinking about other diseases. So the fatigue, the brain fog, the potential inflammation and joint pain, all of the gut issues, that's SIBO. Yeah. And a lot of SIBO, we don't know all the causes.

There used to be some standard ideas what the causes were, but now we know that it's hard to determine. So the use of proton pump inhibitors and other acid blockers. It's acid blockers like Prolocec, Prevacid, all that stuff. All that stuff. And then we have stress plays a major role. And so that's some of the cause that's what SIBO can look like. And now how do we address it?

How do we get people back? I'm just going to back up for a second. You mentioned these acid blockers because they're given out like candy. You can buy them in the drugstore. They're over the counter now. And people think they're safe and fine. I remember when I went to medical school, they just came out and we were told by the drug reps these are very strong drugs they completely shut down acid in the stomach you never want to give

them more than six weeks and now people are on them for six decades you know and and what they do is pretty frightening literally they will help your heartburn but the side effects which are not really side effects they're effects we just don't like them, so we call them side effects, are bloating and diarrhea and distension, all the SIBO symptoms. And by the way, they cause osteoporosis and pneumonia and prevent B12 absorption and zinc absorption and mineral and magnesium absorption. So they're not exactly the safest thing to know about. I just have to say this, Mark, is that this is the concern we all have for medicine

when we've been unplugged, and this is the issue, is that we have pharmaceutical companies that provide medications to our patients to support sick lifestyle that perpetuates disease. Yeah, I love those advertisements on TV where they're like, don't worry, eat your sausage and peppers, and don't worry, just take this Premicet or Frelozac, take the purple pill. It's ridiculous.

It is. And so they have, but on the functional medicine side, here's where the hard work is, changing the lifestyle to make it a healthy lifestyle. So people can, you know you know be healthy prevent disease if they do get sick then we help them change lifestyle because that can impact disease more than anything else and then for people who are well or have gotten better we can use lifestyle to optimize their their their their aging and again using a term i've heard you use age young you know and that's that's part of what we do here at the ultra wellness is the whole spectrum prevent treat and then help people optimize and age young yeah my goal is to die

young as late as possible so back to the SIBO thing yeah right it's a you know so once we we make that now how do we make the diagnosis so I always tell people tests are good but there's no perfect test and you know your cognition your doctor's ability to think through problems is the most important thing that they can do for you. Well, that's what we do in functional medicine, right? We think. We are thinking differently. Thinking all the time. My mentor, Sid Baker, who's one of the leading, I think, medical minds of the last century, who's really pioneered a lot of the visionary concepts of functional medicine.

He says, we're in the name it, blame it, and tame it game. You know, we name and blame. who's really pioneered a lot of the visionary concepts of functional medicine. He says, we're in the name it, blame it, and tame it game. We name and blame. We name the disease, then we blame the name for the problem, and then we tame it with the drug. So we say, oh, you're sad and hopeless and helpless. You have depression. That's what's wrong with you.

No, it's just the name of what's wrong with you. It's not the cause. Then we go, oh, I know what you need. You need an antidepressant. And that's like, it just doesn't make sense instead of what we do in functional medicine it's called thinking and linking right we actually think and link everybody you know thinks you treat the same disease with the same treatment and in functional medicine you can have 10 people with migraines or treat everyone differently everybody's different

right people with lupus and everybody's treated differently because you're looking at what the root cause for them is and right I think that's really profound. And I want to get back to the SIBO thing, but I just want to come back to the matrix because that's such a key concept. And you described all these biological networks, assimilation, which is the gut, defense and repair, the immune system, energy, how we make energy, detoxification, our transport system, our circulation, our communication systems, hormones, our transmitters, our structural system. And all those are influenced by our lifestyle,

by our thoughts, our feelings, our relationships, our diet, our exercise, our sleep, all those things. Intrinsic relationship. Yeah. And then they're also influenced by external factors like toxins, allergens, bad bugs, stress, poor diet. Right. And those impact our genes to change the expression. And so we have basically our inputs that are a problem and then our lifestyle, and that causes disturbances in these systems. And no matter what disease you have, we use this model, and every single chronic disease and even many acute disease are caused by disturbances in our biological systems.

And that is what functional medicine is so unique at diagnosing and treating in a totally new way. Absolutely. And so it's that constant work around the matrix. And one of the things that I said earlier is functional medicine is hard medicine. It's hard for the doctor. It's hard for the patient. Yeah, because you think you have to think.

Right, and you're constantly thinking, and as you treat, the environment of the patient changes. So you treat, you begin the treatment plan, and the patient comes back with a particular response. And that response will be based on what is their lifestyle, what part of their lifestyle have they been able to change, because it's a real struggle for people to change lifestyle. That's hard work.

And then, what are their genetics? And how are their genetics, because we use a lot of genetic testing here that help us identify that. And so once they come back and they've responded to our first step of treatment, then we go around the matrix again. And we rebalance and we look,

okay, okay. It's like tailoring, you adjust every time they come in. Every, it's like a fine watch and you're just constantly working the gears, asking questions, having them tell their story again, retell their story. I can't tell you how many times I have sat an hour and a half initial visit only to have the patient come back over over a zoom or a physical visit to the office and i ask them the same questions and all of a sudden they're in a different place and i get a different answer that opens up a whole new realm of thinking about their disease their health and even their goals for their life so every time i go around the matrix i get that person better and better and better so So we don't treat 155,000 diseases. We just work with optimizing our biological systems in the

matrix. That is the key to functional medicine. So that in a way it's very simple, but it's also very unique because each patient's different. And for the patient, some of the changes are hard because we're asking people to change their diet or take different supplements. But the truth is that it's actually, you know, ends so much suffering and helps them so much that people are so excited about it and they do it. And so it's actually, and many times, very easy for patients to change because they see the results so quickly. So let's talk about the SIBO.

Let's get back to SIBO and talk about cases. I think we should share some cases. Give an example of what we're talking about. Because it's sort of abstract. I would say that very rarely do I see SIBO by itself. And why is that? Because, Mark, you've already talked about it. It's the microbiome.

When the microbiome is disordered, as it is in SIBO, and you have these bacteria growing or they shouldn't grow, and so you're now changing how food is processed, you're changing where it's processed, and you're changing the body's ability to absorb it. And what we know about the microbiome is those bacteria actually train our immune system. They're very closely related to our immune system and they they they will they our immune system identifies antigenic material from the bacteria and it the bacteria is able to tell the immune system here's what you need to be worried about here's what you don't need to be

worried about yeah right and so when we alter that gut immunity we can create inflammation and we create inflammation we begin to break down that membrane that's responsible for opening and closing and letting good compounds and good nutrients in and keeping the bad guys out. Yeah. When that breaks down, we have leaky gut. And now all of a sudden, our immune system starts to see proteins that have not been completely processed down to the peptide level that they're accustomed to. And they start making antibodies against commonly eaten foods.

So now this person with SIBO is sensitive to a plethora of foods that they eat every day, which they might not be allergic to those foods, but they're sensitive to them. So now they're not eating. So they're coming with all these symptoms. It gets exacerbated by almost everything they eat sensitive to them. So now they're not eating. So they're coming with all these symptoms. It gets exacerbated by almost everything they eat in their diet.

And because now the disease process- Or they're eating and they don't know what to do, not eat, because everything bothers them. Right, right. And so now they can come in that sick. Now that their immune system's triggered, they have muscle aches. They have joint pains.

They have brain fog, because now they're having- Fatigue. They have fatigue. Their mitochondria are being affected. Their brains are inflamed. They're being affected. So now this person comes in and they may say to me, I have brain fog. I have this, I have that. I get the whole story and I hear the gut. Always start in the gut, right? So now what do we do? When they tell me there's symptoms, we order a test.

It's called a small intestine. Before you do the test, I just want to recap. What you said was so profound, which is that- I like being profound, thank you. No, I mean, it's a total frame shift. So most doctors don't think much about the gut unless you have direct digestive symptoms. And even when you do, they treat it kind of in a very linear way But what you're saying is when those bugs that should be in our large intestine migrate up to the small intestine for various reasons

It causes an imbalance in there and that leads to a breakdown In the barrier which causes this leaky gut and then all these foreign proteins and bacterial components Leak into the system your immune system goes ah that's not me and it starts creating a response and then you get systemic inflammation which is why you get brain fog and muscle aches and fatigue and joint pain all these things skin rashes oh yeah acne whatever and and and people think these are all not connected but they're all they are connected that's why SIBO is such a great topic to start with. Yeah. Because it connects the entire matrix.

So tell us how we test for it. Now let's get into a case. Okay. So testing will be with a breath test. It's called a SIBO breath test. And we starve you for a day. Basically, we want to starve out those bacteria that are living in the small intestine. So they become metabolically inactive.

And then you wake up in the morning and you take some lactulose. Which is like a non-absorbed sugar. Non-absorbed sugar. But before you do that, you breathe into a little balloon and then we put that aside as your baseline test. Then you drink the sugar drink. And now the bacteria are like, we got some food, we're excited, we're starving out,

thought we were doomed. And then they get very metabolically active. And then within 30 minutes or 60 minutes, when they're metabolically active, they start producing the exhaust of their metabolism, hydrogen, and then sometimes methane, and even sometimes sulfur gases. So it's not just the cows that are burping methane? Nope.

Humans? Nope. Yeah, Uncle Art's been belching methane. So if you have SIBO, you're contributing to climate change, is that it? Yep. That was gonna be, when we get to the magic wand question, I'll talk about my wife. Anyhow, so-

There's also other tests, like urine tests. You can look at metabolites. Right, yep. You can look at, yeah, so yeah, we can look at metabolites that will show us markers for dysbiosis in the gut using an organics test. So an organics test is when we look at all the organic acids that are products of your metabolism. And so we're able to tell, we know what should be, you know, in the metabolism appropriately. And we can look at organic acids.

And we do that as a part of our GI work. Which is a test that traditional doctors don't do. They'll do the traditional breath test, but they're not going to do an organic acid test. Organic acid test or something even more advanced called an ion profile that looks at all of your amino acids. And that's important when I do a SIBO workup because if I look at your amino acids and you're depleted, then I know you're really in trouble with your SIBO because you're not getting good nutrition.

You're not absorbing. You're not absorbing. Yeah. And then I can see markers of inflammation on the ion test. Yeah. I can also see the organic acids are really critical because there are things that the bacteria produce that will end up in our urine that indicate to us that, wow, those things are in the urine because you have bacteria overgrowing or don't belong in your gut. And now we find out.

I think you're right. I'm going to jump in with a case that just reminded me of a little girl I saw years ago who was nine years old. And she's a pretty little sweet looking girl who was a monster, like a terror. She would constantly get kicked out of class. She literally couldn't make it home on the bus without the bus driver having to stop 10 times to settle her down. She was violent. She would rip pictures of a part of her family at home she would terrorize

her sister and i'm like what's going on with this girl right and we did a whole workup and we found her organic acid test and we found she had massive levels of overgrowth of bacteria yep and she had overgrowth of yeast which is not called sebo but sefo or small intestinal fun had overgrowth of yeast, which is not called SIBO, but SIFO, or small intestinal fungal overgrowth. And what I did was I gave her an antibiotic and an antifungal. And literally, the girl completely transformed. So you think you're treating a psychiatric disorder with antibiotics and antifungals. How does that make sense?

Well, it makes sense when you understand the connection between the gut and the brain. I mean, this was over 10 years ago. And I remember writing about it in the Ultra Mind Solutions and I was like, wow, you know, the gut is so connected. I had another one with OCD, the same thing. She had high levels of ammonia and she had severe OCD. She wouldn't put anything off the floor. I gave her an antibiotic and literally she became like a neat freak.

It was the weirdest thing. Oh, yeah. Now, so I would, so in those cases um in the cases i've seen SIBO is very commonly related to neuropsychiatric disorders so when i have people with memory loss brain fog adhd just as you've said i've had i've had multiple patients of mine right autism the first thing we do is treat their SIBO change change their diet. And within the first six weeks, we're starting to see significant change in their behaviors with ADHD and in their verbal abilities with autism kids. So I was going to talk about a fibromyalgia case, but I will talk about ADHD. I had actually an anxiety-depression case.

Talk about both of them. Yeah, talk about them all. There's so many cases I could choose from. There is a recent case from a patient from a different part of the world actually came in, and they were having lots of difficulties with their child, very bright siblings, but this particular child was having lots of issues with impulsive behavior, tension in the classroom, moodiness, to the point where the child would speak of not wanting to live anymore. And so I went through all of their symptoms,

and the biggest thing that this child had difficulty with was the bloating and the distention. That was constant. Mom noticed it from almost day one of life. So we did not only the SIBO breath test, but we did something called a GI map test, which will look at, using DNA and PCR technology,

look at all of the bacteria in your gut, the major colonies, the major species, look for candida, and then also look for markers of inflammation. Those two tests on this patient indicated severe disruption of the balance of the microbiome. The patient was put on a brief elemental diet, which is a diet that takes out most foods.

All the foreign proteins. All the foreign proteins and then was put on a autoimmune paleo diet and very difficult to put a kid on a diet which basically starves a lot of the bad bacteria absolutely feeding them with all the starch and sugar and carbs which they love you giving them less of that and we and we combined it with a low FODMAP diet to make sure that the child got all the nutrition they needed. FODMAP is like what?

It's like- So those are long chain sugars that get fermented very quickly by bacteria. And when you eat them and you have small intestinal bacterial overgrowth- You get a very big food baby, like nine months pregnant. Right. You know, and the food baby is this, basically. You're fermenting food where you shouldn't be. Food's meant to be fermented in the large intestine, and that's like Florida, right?

But what's happening with small intestinal bacteria, the bacteria are up in Maine, and the food's coming into Maine. Maine's not ready for gas. So now, all of a sudden, you've got this gas where it doesn't belong geographically, and you feel very uncomfortable. And it starts to impact everything we talked about. Your nutrition, your inflammation, and that translates to impact everything we talked about your nutrition your inflammation and that translate to that gut brain connection the brain gets affected that's

why we see so much benefit when we treat diseases like SIBO and dysbiosis in our patients with neuropsychiatric disorders from ADHD to OCD to anxiety and depression and you've noticed it I know we've talked about even Parkinson's and other disease processes that will stabilize once we start addressing gut issues. So what happened to this kid then? So we had the six-week follow-up, and we had started, it was actually not the six-week

follow-up, but the six-week follow-up, we went over all the testing, and we started the second part of the nutrition plan. Once we started the nutrition plan and I used some natural herbs to get rid of some of that overgrowth. So sort of anti-bacterial herbs. Anti-bacterial herbs that come in different compounds

that we use. At the eight weeks later, that child's behavior, the mood swings were completely gone yeah completely gone the impulsivity was drastically reduced and the teachers were saying he was now paying attention in class and that was just with food no stimulants remarkable no stimulants just herbs like oregano and oregano and time and things like that absolutely yeah powerful stuff yeah and so that's that's the story yeah it's that gut brain connection it's so powerful brought back some bad memories because

we're talking about the food baby uh when i got sick from mercury poisoning almost 30 years ago one of the things mercury does is it interrupts all your enzymes and your function so my gut became very dysfunctional and i remember literally having food babies all the time. I literally almost couldn't eat anything without my stomach blowing up and feeling like someone just pumped my intestines up like a bicycle tire. And at that point in time, we didn't really think about SIBO. We didn't really name it and we weren't really aggressively treating it. I was trying things that I thought would work, but it was really tough. Until I got rid of the mercury, I couldn't get rid of the SIBO. So often there's something underlying it. There's often a root cause. I've seen people with gut issues that maybe were caused by Babesia, for example. It's a tick

infection. Oh, absolutely. So Lyme disease- Which can paralyze the gut. Right. So if I have a SIBO patient that's not getting better, I think two things. One is I think about Lyme disease because if one of the symptoms of Lyme disease and is a trigger to test somebody for Lyme is when they get Bell's palsy. Lyme disease can affect the nervous system. And so Bell's palsy is when you have your facial nerve is paralyzed

and it can be caused by Lyme. The same thing can happen in the gut. You can get a paralysis and a dysfunction of the migrating motor complexes and now the peristalsis of the intestine is declining, the intestine won't move, now these bacteria can stay there and populate. So again, it's all these things that can impact it.

And that's the thing, you know, when you go to a traditional gastroenterologist, you might say, okay, we do the breath test, you have SIBO, take these antibiotics, forget about the yeast stuff, and like I'll see and help cause things. And there's so many times it fails because they're not getting the root cause.

So the root cause may not be SIBO, it might be something that's causing the SIBO, like Lyme or like mercury or something else. And there's something else too, going back to lifestyle. When I can't get a person better with SIBO and I start going around the matrix again, are you sleeping?

Are you exercising? Are you, how's your marriage? How are your relationship? Do you have a toxic relationship? Because the people that I've done everything for, I've given them a bone broth and colostrum and elemental diets, they're not getting better. It's the fifth R, we use the five Rs, right? We use remove, repair, restore, and I can't remember four.

It's remove, replace, re-inoculate, repair. Rebalance. Rebalance. And the rebalance piece, the fifth R, I call it fifth R. It's the fifth R. It's getting people to rebalance their lives. And that is basically, are you dealing with your stress? The people that aren't dealing with their

stress aren't getting their sleep aren't exercising and how would a stress have to do with your intestines ah that we that's another podcast come on yeah give us a nugget here okay so uh stress so stress is probably the the start of all disease. It impacts everything from your hormones in your own body. But stress actually creates some neurochemical changes in your brain. And there's a communication between your brain and your gut microbiome. And your gut, it's called the second brain. It's the second brain. Some people think the gut was the first brain.

Maybe. And that our brain only developed once mitochondria were starting to make energy force and then we're able to convert, use that energy to make a second brain that allowed us to reason and so forth. However, once you have that gut brain connection, stress can actually, we have this vagus nerve.

It's a superhighway from the gut to the brain. And more, there's actually- It's the relaxation nerve. It's the relaxation nerve. And your brain can communicate anxiety and stress to your gut microbiome and actually change the makeup of your gut microbiome. Yeah, and your nervous system. Right, and your nervous system. And it literally paralyzes, stress hormones literally paralyze your gut.

Your sympathetic nervous system and your fight or flight, you don't want to be digesting your food when you're running from a tiger. You want your gut to shut down so you don't have to poop or do anything else. So your gut shuts down. And that's what happens. We live in a state of chronic stress and our gut's not working. It's not working. And then you end up with, now you create that environment for SIBO to develop. Yeah. I just, talking about SIBO, I just remember this patient I had a few weeks ago, was what a striking case. She came in with what we call vestibular migraines,

which is essentially a migraine from hell, where your room is spinning around, you're in bed, you're nauseous, you can't get up, and she had it like 25 days a month. And she was a really smart young woman who wanted to go to graduate school and was basically in bed. And so I started not just asking about her headaches. And she was, she'd seen like 45 doctors and, you know, seen neurologists and everybody.

And she was on this medication. Nothing was working. So I'm like, what else is going on? Well, I bloated all the time and my belly's distended. I, you know, and I could see she was puffy and swollen. She gained a bunch of weight. She was severely depressed. She was anxious. And I'm like, this is not a messed up person. This is a person whose biology is messed up. And I said, well, let's just try to put you on a clean diet, eliminate all the allergic foods. I gave her a non-absorbed antibiotic and an

antifungal, basic nutrients, very simple. And I waited for a test to come back. And she came back in. Now, the first time she came in, she had to leave the door open. She was so anxious. Her system was so in fight or flight. She couldn't even be in the room. She stood up, she's pacing around. I'd never had a patient like that. She came back six weeks later. She looked like a different person. I mean, not only was all the inflammation gone out of her body, all the fluid, not only did she lose 20 pounds, but her gut was normal and she hadn't had a migraine. She was completely better. She maybe had one or two very mild headaches. And when I got her test back, yes, she had SIBO. And I sort of could anticipate based on her history what was going on. that you know that's a case where you know she had been seen doctor after doctor after doctor and these are the kinds

of patients we see here where I often joke because we've been here for about 15 years before that I worked at Kenya Ranch was the medical director and I always joke I was a resort doctor the doctor of last resort and that's the kind of patients we see here. Or I joke I'm a holistic doctor because they take care of people with a holistic patients, a holistic problems. So, and the treatment for this is all the things you mentioned. It's diet. Right. We start with diet.

You know, it's really diet lifestyle. And by the time patients get to me, as I said before, SIBO is just part of the whole complex. Because once you've affected diet, then you're affecting how your hormones are working, your autoimmunity, and so forth. So we always start with diet because we can impact all the systems with a good diet. So diet, we can include a FODMAP diet. It can include elemental diet. It can include autoimmune paleo. And our nutritionists here at the Ultra Wellness Center, we work very closely with. And when a patient is here, after I see them,

I will consult with our nutritionists and we will customize the diet plan for each particular patient that has SIBO. It's not always going to be the same diet. So that's really important you said. So we here at the Ultra Wellness Center work as a team. Absolutely. And tell us a little bit about that. Yeah. So we have a team from the first phone call to your first visit and beyond. Each team is made up of a navigator, a nurse, a nutritionist, and a doc. And we meet every week, multiple times a week, and we discuss cases. And we discuss cases that are coming to our center, cases that we're working on and we're constantly collaborating.

And we're always trying to answer that question. We're always asking why and how. And so our team, from the first visit, the navigator will identify what your needs are. And then you'll get a phone call from our nurse practitioner who will do a collaborative pre-visit a whole hour you'll spend before you even get here going over your case and we'll get all your documentation we'll get a summary from the nurse practitioner i review all of that before the patient even gets here and i'll review that case with my nurse with my nutritionist even before i go in the room to see the patient for the first time so before i even come in the room with the patient i've actually gone over all the data they sent in it's been

reviewed by a nurse practitioner who's actually interviewed the patient i get that summary i talk about the case of my nutritionist i actually begin to create the patient's matrix before they come in for their visit yeah so when i'm sitting there I am now getting them to fill in all the blanks, answer any questions, any pieces of the puzzle that I haven't been able to figure out yet. And an illustration I will use with my patients is I'll say, look, you know, we get patients from all over the world. And they're usually very complex. And they've usually been to many other doctors.

And they bring me this big sack. And they empty it. And it's puzzle pieces. It's the pieces they've collected from all their other medical workups. And we connect the dots. And we put those puzzle pieces down and we try to piece them together. And by the end of that first visit, I can see where the gaps are. I can't tell if it's a lion or a tiger or a bear or an elephant,

but I can start to get a picture. And at that point, we make the decision, here's some more testing we need to do. Here's more information I need to get. And here's some things we're going to try based on what you've tried before and what might be a good starting point for you. It's always nutrition and it's always lifestyle change. Food first. Yeah, food first. I mean, when I started this practice 15 years ago at the Ultra Wellness Center, I think we probably were the first practice where it was mandatory to see a nutritionist if you wanted to get an appointment.

Right. Because if food is medicine, then how do we practice without nutrition? You know, just like imagine taking a prescription pad away from your doctor. Absolutely. I don't even know where my prescription pad is anymore half the time because it's like I barely use drugs because I don't need to. I'll use them if I need to. Right.

But I don't usually need to. That's that's absolutely correct and we're in the same i'm in the same situation i i went from using them a lot to barely using now and you also mentioned testing now people think oh i'll test for the same i my doctor worked me up he did all the tests everything was normal and everything's fine what do you have to say to that? Conventional testing is one thing. It's very one-dimensional. Again, it doesn't look at the root cause of disease. So one thing that we do a lot of is we do genetic testing. We don't do a 23andMe. You get 5,000 genes,

we don't know what 4,900 of them do, right? And we don't know how to make clinical connections. But we use a company that looks at eight very important biologic systems and the most important potential variants. Yeah, things that are common that you can do something about and make a clinical impact. They're actionable. They're're actionable genes what we call single nucleotide polymorphisms just basically when one gene is is is altered in a way that the gene will still be a blueprint to make an enzyme or a protein it just the protein or enzyme that's made is might not be as effective different functionality different functionality um A different functionality. It might do what it's supposed to do really fast. It might do what it's supposed to do really slow. And that will impact how you will function.

So doing that genetic testing allows us to see what your blueprints are. And you have baseline variants that if we alter your lifestyle and alter your nutrition can support those variances so they optimize. And now your body is functioning better. Your immune system is functioning better.

Your ability to stop oxidation improves. Your ability to turn good inflammation on and turn it off when it's done, that can be improved because they can be affected by those blueprints. So genetic testing is a critical part of what I do for all my workups. And then another test that we do is we check for toxins. Yeah, so what you're saying is we're starting to look down through the matrix. We're looking at these biological systems

and dysfunction or imbalances that aren't called diseases through testing that isn't available really in most places or for sure through conventional medicine. And that's where we find the answers, right? You know, I once was doing a study, I mean, a lecture on vitamins, and I had to figure out how many chemical reactions there were because all chemical reactions depend on vitamins and minerals. And there's 37 billion, billion chemical reactions every second in the human body.

That's 21 zeros. Yeah. Okay. How many blood tests you get from your doctor 30 yep you got your chem screen your cbc your cholesterol and and we think oh well that's fine so you're healthy but the truth is those only diseases yeah we could if we want to talk about testing we can just go down that cholesterol route and we can just talk about the debacle that is for our patients you know with the testing that's done it's very one dimensional one layer that doesn't really look at cardiovascular risk at all um so testing that we

do it starts to get into those deeper levels that really impacts the function of the body looking at toxins we live in a toxic world right it's not a matter of you know do you have toxins just how many do you have right you know you know persistent pollutant toxins that will just migrate you know will just camp out in your fat and just leach into your system on alter how your mitochondria work alter how your immune system works yeah great case that i had uh it's a gentleman who has alzheimer's he was seen at a very large institution in boston and he was diagnosed at the age of 56 with you know moderately advanced alzheimer's uh he was diagnosed at the age of 56 with moderately advanced Alzheimer's. He had a basic evaluation with a SPECT scan and he was told he had Alzheimer's. He was given a pill that we know doesn't work

for more than 18 months to stabilize it, right? He was given a- It doesn't work even for me. Yeah, it doesn't even work. I was just trying to be generous. And then- That's not our opinion. This is basically in the major medical journals.

The pills for Alzheimer's just don't work. They just don't work. So then he was given, you know, start behavioral therapy and cognitive therapy. Again, hasn't been proven to do anything to slow the progression or improve cognition at all. So he's, you know, at a major institution, given those two things to do,

he is a very, very active gentleman with a great deal of huge responsibilities in his life. Very dear man. And he comes here for the first visit and he's, you know, he's, you know, you see these issues and so we start talking. And I start testing. So we do the test.

Let's look at the gut. Let's see what there's toxins let's find out about your hormones right let's see if you have any autoimmunity let's do some we do some you know we do specific autoimmune testing to see if your your body is making auto antibodies against brain tissue so why would you do that because Alzheimer's is what it's Alzheimer's is a multifaceted multi-causality disease. It's inflammation of the brain.

It's inflammation of the brain. That's what's driving it. Right. And there's lots of things that can cause an inflammation. So we're going to look for everything that can cause inflammation. And there's also disruption of normal function that might be distant. So what effect does having a low testosterone have on the brain? Testosterone has a big impact on the brain.

It can have an impact on inflammation. It can have an impact on how the pituitary and the hypothalamus are secreting other hormones, how those hormones will work, how your neurotransmitters may work. So here's some of the things we found with this gentleman. He had a mercury of 120. Oh, wow.

Now put it in perspective, like zero is normal. Zero to four. And anything over 10, I worry about. 20 is bad. And like 120 is, you know, a handful of people that you see over the course of decades have 120. Yeah. Yeah.

Very, very few people. Mercury level. Testosterone level. From where? Fish, water, air. But he was a fish eater in his lifetime. And again, he wasn't like an extraordinary fish eater, but if you look at his detox genes, on his genes, he had a lot of variants that made him susceptible to not being able to detoxify as well as he should. So you and I could go eat sushi the whole week.

Not me, I got those same genes. Okay, you got those same genes. That's why I got mercury poisoning. All right, so I could eat it, I don't have an issue with mercury, right? My mercury wasn't high at all. And I love fish, I eat a lot of fish. So jealous.

Okay, well, so, so mercury, his testosterone level was 150. So at his age, his testosterone level should be, you know, 600 on average. 800, 800. 600, 800. Yeah, right. So- 150 is like- Nothing. About what a woman has almost.

Exactly. So he had testosterone as though his mercury was bad. And of course, there was SIBO. And he had dysbiosis. So not only did he have- His gut was all messed up. His gut was all messed up. And then finally on top of it, he tested positive for Lyme disease. So that's another thing that we do here at the Ultra Wellness Center is, you know, you can't practice functional medicine without coming across Lyme disease almost every day. You know, it's stealth infections. Lyme disease and the co-infections that can be found with it, along with other viruses,

are a big part of what impacts people. He had Lyme disease. So he had four strikes against him. And so here's what's really interesting. We've arranged for him to get some really intensive Lyme disease treatment at another clinic in Germany, where they do hyperthermia. Hyperthermia.

Hypothermia, and they give IV antibiotics when you're, by making somebody really warm, you are able to, that's when the bacteria are most susceptible to antibiotics. And so at that really high temperature, about 107 degrees, they're going to put an IV infusion of an antibiotic in and fight the infection i did that i i went to san diego and i had hyperthermia and i had lyme disease and babesia and i had night sweats all the time and i did the treatment and it kind of went away and i've seen this case after case now it's not something that's available in the united states

but it can be very powerful yeah so in his particular case we chose that direction because of the degree of the severity of what he was facing yeah so we wanted to let's just let's just hit this hard hit it fast it was something we really believed in so we arranged for him and i worked with those doctors at the saint george clinic and um then we treated his mercury uh we we started treating his testosterone um using um first getting him to sleep better, working on his nutrition. I always like to work on lifestyle before I start treating directly with hormones. Then we added in some hormones that would benefit his testosterone levels. And at six months, he had stabilized. So he had not worsened. Actually, about the eighth month mark,

when we saw where he was at he was still working and he had he noticed that his memory had not gotten any worse than it had been and so we're continuing to work it's a story that's ongoing but really really exciting because and that's important to say that this is a progressive disease because usually a year later people are a lot worse right i was thrilled that eight months he wasn't worse and where his numbers better right oh oh absolutely testosterone levels were up to like 500 at that point um mercury level was coming down mercury can be hard to come you know bring down it can take a period of time but i do like to remind people he was very excited to know there are

things i can work on see he left a large institution with things to do that weren't gonna work, sort of hopeless. So this is a really important point with functional medicine. Alzheimer's is a diagnosis, it's not the cause. No. And functional medicine helps you figure out what that is. Doesn't mean everybody with Alzheimer's has those things,

although they're common, but you know, tick infections, heavy metals, hormonal issues, gut issues, things you can actually treat. And I think this is such a big difference between functional medicine, what we do here at the Ultra Wellness Center in Lenox, Massachusetts, and what people get when they go to a traditional physician. They're not having somebody pull back the hood

and look underneath and see what's going on. They go, oh, I know what's wrong with you, you have Alzheimer's. No, that's just the name of the problem. Now let's start to figure out what's going on. And that's beautiful. We see everything here. We see autoimmune diseases from Hashimoto's thyroiditis to ulcerative colitis to rheumatoid arthritis. We see Alzheimer's disease, ADHD, autism. We see people with- It doesn't matter what diagnosis you have because we treat the system, not the symptoms or diseases. And when you do that, whatever they have has a chance of seemingly getting better. And that's the point I want to make. We see everybody with everything from every age,

and we end up being able to help them more than the specialist did because we're looking at everything and we're getting to the root cause and so in a course of a week i can see a two-year old or a three-year-old with autism yeah and i can see i can see a uh 62 year old with als right i can see a woman with depression no libido, fibromyalgia, and it's all in my purview. And it's all really exciting. That's a really important point. People say, well, do you treat this, do you treat that?

I'm like, I treat things I've never seen. I never had a patient with vestibular migraines before. I don't know that much about it other than the basics, what I learned in medical school. But I know how to treat the body. I know how to treat the system. I know how to treat the system. I know how to treat a human being and look for the root causes. And when you do that, even if you don't exactly understand the disease, it'll often dramatically

improve or reverse completely. Absolutely. But I like to let people know it's hard work. It's good work. It's really good hard work. Let's never not like take this pill, I'll see you in six months. You have to change your diet,

you have to take care of your lifestyle issues, you have to take things to help reset your system, fix your gut, do the hormones, treat the Lyme, right. Like example I think is a good one is my own daughter. She went, you know, she started having, I have permission from my daughter actually. She said, are you gonna say my name? I said, do you want me to?

She said, yeah. So my daughter, Isabel. So my daughter isabelle um so she started having her period and about you know in the first year of her cycle she was very irregular and she was really getting more and more fatigued so it was around school time it was august you guys were a pediatrician yeah so you know no no because you know my wife goes with her and at the you know my wife is she she's um very attentive to these these health issues and nutrition and so she sat in the visit and she came back and she shook her head george she said i am done i am so done i told him that isabel had fatigue never once asked her what she eats didn't talk about nutrition whatsoever

basically said you know barely asked her about her period other than to know that it was irregular. And really basically said, you know, you just started your period. Give it some time. You're an adolescent. You know, you sleep more. You're going to be fatigued. It's sort of the natural process. So I'm like thinking, nope.

So I wanted to know, I know my daughter's diet is hard as we try in our home. My wife and I eat whole foods. She will tend towards carbs and sugars outside the home and even inside the home. So I had a lot of suspicion from watching her in our house that she was having issues around her diet and nutrition. So the first thing I wanted to do was find out if she was having any food sensitivities. So we did some IgG antibody testing, which looks at food sensitivities, not necessarily food allergies.

So IgE looks at food allergies. Like you've got peanut allergy or shelf-age allergy. Peanut allergy, that's anaphylaxis. You'll know in a minute. You eat it, you turn blue. But IgG is like, you might not know, you might eat red on Monday and on Wednesday you get a headache. Right.

Strawberry on Friday night and Sunday you have red cheeks. That's sensitivity. Now, you can have sensitivities and you never make the connection to food. My daughter had huge sensitivities to gluten. Gluten is a really bad thing. We're going to talk about it in a second. Milk, egg, and then multiple other foods, which goes to that whole leaky gut syndrome. She had a leaky gut. She had a leaky gut. Checked her thyroid. Your TSH should be, in general, if you look at numbers,

4.5 or less. Hers was 5.8. Yeah, because that's like low thyroid. I checked her thyroid antibodies. When the body begins to make antibodies against self-tissue, my daughter had antibodies against her thyroid. Wow. Again. 14 years old, right? And she was told-

And most doctors don't check anybody. They'll just check the TSH, and if it's around normal, they'll just say it's fine. Right. And her CBC, her blood count. We have hemoglobin hematocrit are two numbers you look at to see if you have enough blood. Blood carries oxygen, oxygen is required to make energy, energy gives you energy.

And if you don't have it, you're fatigued. And she was fatigued. These tests were not done. She was anemic. Her hemoglobin was 9.9. Oh, that's really low. It should be 13 to 14. Yeah. That's like down like three pints. Now, these lab tests were available to conventional doctor. So now here's my daughter

with all this going on. So the first thing we're going to do is we're going to change your diet. But here's the key thing, the gluten piece. See, that gluten sensitivity triggers everything. As we know, gluten is what triggers the, can be a trigger for your gut to make something called zonulin. And zonulin is the molecule that opens and closes those gates in that membrane that protect the lumen, your body from what's in the lumen of your gut. In the intestines. Right, in the intestines. So when you're sensitive to gluten

and you start to trigger that, you create this leaky gut, that's when you really open up that door, as we talked about, for autoimmunity and malnutrition. And on top of that, she was having these bleeds. The last thing I checked, Mark, was her hormones. Well, before you jump in, I just want to recap that because that's important.

So gluten basically damages your gut lining, which then causes leaky gut, but it also prevents iron absorption, which is why she was anemic. It also triggers autoimmunity, particularly thyroid autoimmunity. So a lot of people Hashimoto's is caused by gluten. So when you sort of dial back,

you can get to the root cause and see what happens. So, okay. And then on top of that is a quick aside. I checked the hormones. And you can do this ratio between your progesterone and your estrogen. When a woman's irregular like that, you should really check that. Because if you have a relative elevated estrogen compared to progesterone, that's called estrogen dominance. And estrogen dominance can impact your cycle.

It can make it irregular. And it can make it very heavy. It can make it irregular and it can make it very heavy. It can lead to a lot of PMS and depression. And it can last for half the month. Okay, so all this was going on. By the way, 75% of women have PMS. That is not a normal condition. No, it's not. It's because of our diet, our stress, our lifestyle, our gut.

Our food. Food. So many different things drive it. That has hormones in it. We just, the whole issue with hormones in our food. And guess what's the biggest driver of high estrogen levels? Sugar.

Sugar and hormones in our food. And starch. Exactly. So my daughter is a perfect example of the modern diet, despite, believe me, I gotta say this, parents who eat really well have a garden in the backyard and do so and teenagers are temporarily psychotic it's part of the point i want to make and this is this is the point is that she is fortunate to have me as her dad because if she

didn't have me she could have gone a decade or two decades thinking, hmm, that's just me. Only in her 30s, after a baby or before a baby or in a stressful time to just completely break down and all of a sudden have Hashimoto's or rheumatoid or some other immunologic disorder that could have been prevented. And this is what happens. I've seen this over and over in patients that start out and you can track their history. We call it the timeline in functional medicine. We track, okay, this person it the timeline in functional medicine.

We track, okay, this person was born by C-section. Their gut doesn't get developed in the microbiome. They had antibiotics early on because of ear infections. Disrupts their gut microbiome. Maybe they developed some acne, or maybe they got some allergies. And then they get maybe thyroid issues when they're 20. Then they get, when they're 30s,

they start getting autoimmunity, like rheumatoid arthritis. And it's the same frick same freaking story almost every time. All the time. And you can track it back. So the fact that you got your daughter early is a huge thing. And that allows her to then maybe develop normally and not develop these autoimmune diseases

and so forth that we see in so many people. And here's one of the things I want to say about functional medicine. Applying everything that we discover as we ask those questions why we do this advanced testing that you're not going to get at another center is not easy, right? And I know firsthand what it's like to have to change a lifestyle, not only my daughter's, but in my own when I dealt with my brain injury, but with my daughter

having to help her sleep better, create a sleep ritual, help her to learn how to meditate, help her to make good food choices. That is not easy work. And so, you know, at the Ultra Wellness Center, we also have coaches. So we have coaches that will come alongside of you and will hold you accountable, will work with you to help you devise strategies

over a long period of time to change these lifestyles. We know habits don't change for at least three months. How can we anticipate that some of the most critical things that are going to make you healthy are going to happen in two weeks, six weeks, or eight weeks? It could take three years. Yeah. I like to remind people that.

Well, what's fascinating too is that what I see here is that it's not as hard as you might think because when we put people on a regimen and i do this pretty aggressively to get them feeling better fast yeah because i figure if they can have the experience of feeling good even if there's more work to do they're going to do it right in other words in 10 days or two weeks by changing your diet and doing a few simple things, you often see profound differences and it doesn't take forever. So there is work to create sustainable lifestyle change, but if you get people to do an aggressive change quickly, you know, like if you're allergic to five things and you stop one of them, you're not going to feel better. If you stop three of them, you're not going to feel better. You got to stop all

five. And that's why we do the kind of work we do here. We get people to actually quickly shift their biology because we know how to do that with functional medicine. And then they go, oh my God, like this woman who, you know, got rid of her migraines, who's gut normalized, who lost 20 pounds, who had energy back, whose anxiety and depression went away. Like she's going to be motivated to stick to the program. It's not going to be so hard. Yeah. yeah, yeah. So you mentioned something briefly I want to come back to, which is your brain injury. You just sort of slipped that in there.

So tell us what happened. It happened actually while you've been working here. Yeah. And it was kind of a shock for you and for all of us. So tell us about that. Yeah.

So I was doing CrossFit one morning and if anybody knows anything about CrossFit, you'd think, oh, he was doing some crazy thing. He deserved to get injured. No, that's not at all what happened. I just went to do a pull-up. But we have these things called the racks. And so you go to a rack, you go to do a pull-up, but every other station in the rack has another bar that sticks out. It's called a kipping bar. It's a way you can do a pull-up using your momentum. When I went, I was talking to the instructor, I got into the rack, the cage, and I wasn't looking to see which one I was in. I just looked up, saw my bar,

went to do a pull-up and hit my head on the kipping bar. Now I've hit my head a lot worse in my lifetime and I didn't make too much of it. 20 minutes later, I was jumping off and on a box, and I got the worst headache of my life. That was on Thursday before Christmas 2017. And it turned out over that next four days that the headaches would come and go, but get worse and worse and worse. I ended up going to the emergency room that I used to work in when I first came to our community. And the nurse recognized me, and I put my head down at the triage desk.

I couldn't even look up. And I said, Elaine, I have like the worst headache of my life. That's a line in medicine you learned me, what? So here I am in the emergency room that I worked in when I first started practicing medicine. And I hear myself say that. And the words are coming out of my mouth. I'm saying, you have a subarachnoid hemorrhage.

An aneurysm. Well, and it turned out to be, I did not have an aneurysm. So it's just that you banged your head. Well, here's the story. They get the CAT scan. 20 minutes later, I'm in an ambulance. I'm headed down to Beth Israel. And what that means is you have a bleed in your brain.

I have a bleed in my brain. So basically, it was a bleed in the center of my brain. It was leaking out of a blood vessel. And it creates this huge headache. So when you're in an emergency room and somebody tells you, this is the worst headache of my life, the first thing you think of is a subarachnoid hemorrhage that could possibly be an aneurysm.

In my case, it turned out they did a 3D CT angiogram in my brain, which is a really cool thing. They can map out every blood vessel in your brain and you just see these blood vessels and then they rotate it and they can look for aneurysms. And they did it that night and the neurosurgeon came in and said, great news for you, you don't have an aneurysm. Because if you did, that changes everything.

I had what's called a paramecencephalic bleed. So it's right in front of the pons or the midbrain. It's usually very isolated. And here's what he said to me it had nothing to do with you hitting your head really he said they can have their role in the literature he said there's usually spontaneous and it there's no link directly to trauma there's no link to anything but you had to heal your brain after all right so so that's how did you heal your brain so i was told after three days in a neurosurgical intensive care unit,

which is sort of like a, it's a strange place for a person with a brain injury because they're waking up every two hours. Oh my God. You know, to make sure. Are you awake? Are you alive? No, I'm trying to sleep to heal my brain.

So on the third day, my wife. The worst place to go is you want to get better at the hospital. So the day after Christmas, I missed Christmas. I was like, I'll tell you a funny story. I recently had an arrhythmia and I had to go and get treated and i had to stay overnight in the hospital yeah and the bed that i was on was designed to prevent bed sores for people that don't move but it literally went on every half hour like it would like blow up and wake me up and i couldn't sleep so i'm like i actually pulled the plug on the bed so I could sleep but then the bed deflated and it was like

sleeping and have basically a like a depression in the bed it was the worst yeah I remember having my compression stockings on when I had my hip replaced they had the compression stockings on that whole first night and every every like 20 minutes yeah it's a great way to wake up the patient so anyhow you know so much for helping you sleep and regenerate so i leave the icu my wife rescued me the day after christmas and said you're just coming home so i came home and i was told you'll get better with time that was it you'll get better with time so of course i'm here and i'm talking to you and I'm talking to Todd and I'm talking to Liz and I'm doing my own reading and I'm learning and I understood this before my own brain injury,

that number one, I better make sure my gut's in order because I just had inflammatory process in my brain that's gonna affect lymph drainage, it's gonna affect the blood brain barrier which protects my brain. If I have leaky gut, I've got leaky brain. And after trauma, you will have an autoimmune response. And that autoimmune response, if your gut isn't healthy, could be quite dramatic. And now on top of your brain injury, you're having autoimmunity,

which is going to prevent you from healing well. So I started doing some different things. One of the things that you really want to try and do is you want to make sure that you, again, you go to the gut, make sure your gut's healthy and you're eliminating any inflammation that you can have. So I really cleaned up my diet. And when you're sick, you begin to realize, eh, maybe my diet wasn't as good as I thought it was. And I made some significant changes. I went gluten-free. And all of a sudden that bloating i get occasionally that you know some of those gi things i'd been ignoring went away so i went

gluten-free really a big deal i started using really high dose fish oil because there are studies that show higher doses of fish oil can really help in the brain injury brain injury improving neuronal regenesis, membrane. Omega-3s are very important for membrane integrity. So I went up to 10 grams per day. That's like 10 pills almost. Yeah, I was taking a lot of fish oil. The real first inflection point, though, was my sleep.

Brain injuries definitely impact your ability to sleep. So I needed to really find ways to work on my sleep. Brain injuries definitely impact your ability to sleep. So I needed to really find ways to work on my sleep. I tried melatonin, which will trigger your body into the right rhythmic pattern, but it just triggers you to get into sleep and won't necessarily maintain it. I was really having a hard time maintaining sleep. So I started working with a advanced medical provider

who grows organic hemp. And he was able to create a combination of CBD, THC with botanicals specifically to help me sleep. When I started using that, I started to sleep. That was the first time I started to feel like I might get better. Because up to that point i was depressed flat really had to work hard for memory recall everything i did took me so much longer to get done yeah i mean i i was working 24 7 just to keep up with stuff that should have been done in you know six hours so that was the that was the big first inflection point. And I also started taking lithium orotate, which is known to increase BDNF, which is miracle growth for the brain.

So, BDNF helps with neuroregenesis. It also helps your neurons speak to each other. It makes those transactions occur faster and allows more neurons to combine at a junction to talk to each other. So, I started using that. But the next big major inflection point was when I started meditating. I had never meditated. And I came across a book just serendipitously.

I use Amazon Books as a library. And I was just flipping through different things. I'm going to look up some things on Amazon. And I found a book. And I started using this technique. library and i was just flipping through different things and i look up some things on amazon and i found a book um and uh i started using this technique and i started as as can i mention the book sure yeah so it was um uh stress less accomplish more by emily fletcher and i think she's been on my podcast did you write the forward for that i did right so that's what i thought so i i opened the forward i'm like'm like, oh, my heavens.

Mark wrote the foreword for this. It must be a good book. So I started listening. She's my meditation teacher. Yeah. So I started listening to it. And she narrates her own book. It was just amazing.

And she went through the science of meditation and what it actually physically does to the brain. You know, it increases the thickness of the connection between the right and the left brain called the corpus callosum. It increases the size of your hippocampus. Decreases inflammation. Decreases inflammation. It decreases the size of your medulla, giving you more control over your anger and frustration. When I started meditating, that was a huge inflection point. My focus became clear.

My worries, my negative self-talk resolved. I was able to make a huge step forward. And it's not just for people with brain injury. No, it's for everybody. We all sort of have chronic brain injury from chronic stress. So that as a way to actually. So there were things that I could actively do, but the critical pieces were get the sleep, get the nutrition in order, get the sleep in order get the sleep in order and then you know i did things that were known to enhance healing and i will say and i will have to emphasize what you just said meditation isn't just for injury meditation should be taught as part of basic life hygiene for your entire physiology yeah it's it's huge um and then um the then I was able to have enough energy to start exercising.

And so I started running. Running is probably, of all the exercises, increases BDNF, miracle growth for the brain, more than any other exercise. So running is not something I'd done for a long time, but my wife encouraged me to do it. And I've been running and that is just really gives me a lot of mental clarity so great So the truth is you can't heal from brain injury And I think you know our traditional approaches are lacking and right I think it's one of the things we do And if I know now if I know and then what I know now I would have forced myself to exercise earlier because some new research has come out that says with brain injury particularly concussion

Don't wait to start exercising. Actually, when you start exercising sooner in modulated ways, you'll enhance recovery. Fantastic. Well, this has just been the most extraordinary discussion, ranging from brain injury to gut injury. There's so much more we could talk about. There's just so much more. You can't stop. Yeah, we see so many cases here at the Ultrawanna Center that have really been difficult for

people to live through. And we help them navigate to what's going on. We help them diagnose it in the right way. And, you know, George, you're just such a fantastic physician. The work you do here is so important. And any last thoughts on what you want to share with our audience? Yeah. Are you going to ask me that question about if I resolve it today?

Yeah, I basically do. Don't ask me yet, don't ask me yet. I just want to make sure, because it's going to meter my answer. So I would say, you know, working here is an extraordinary experience because we're working with people that have a real vision for helping patients really get to the root cause

and get better. And if we can do that in six weeks, great. But if it takes us three years, we're there for the long run and we're constantly working at it. So just the dedication of the entire center and staff to working towards getting people healthy using a functional medicine model has been an extraordinary experience. And having colleagues that we can talk about cases and help each other answer those why questions and get people better just multiplies my effort exponentially. It's true. We do.

We work together. We review the research. We're always looking at the latest things. We're looking at new diagnostics, new therapeutics. We're going over cases together. It's really a pretty amazing place. It is. And I would be remiss if I didn't say one of the big impacts that we have on patients here is when it comes to food. Food is huge. And it's interesting because throughout my entire career, even before I was fully engaged in the functional medicine model, I would always tell my patients that the path to health is a path that

leads to a 10 by 10 or 20 by 20 raised bed organic garden in your backyard. Grow your own food, grow it without toxins, eat it and then help have your kids help you grow that garden have your kids help you harvest that help your show your kids how to now take that food and prepare whole food meals i was telling my patients that for the last 18 years and so so good so food i think is really critical to our health. And I think if we really, and I've heard you talk about this, and I just, I think if we cook, if we grow our own food and we demand food to be healthier from the makers of food, we can change the world.

Absolutely. We can change the world. Amen to that. Well, thank you, George, for being on the podcast. Dr. George Papanikolaou at the Ultra Wellness Center. Here we are recording right from the center. It's just great to have you. If you want to learn more about our practice, go to ultrawellnesscenter.com.

And if you love this conversation, please share it with your friends and family on social media. Subscribe wherever you get your podcasts. Leave a comment. We'd love to hear from you. And we'll see you next time 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. 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.