Épisodes

  • How to Follow a Low Histamine Diet
    Oct 25 2021
    Histamine is often overlooked as a cause of chronic health problems yet the fix for this issue can be quite straightforward. In this article, I cover the details of histamine and how to follow a low histamine diet. Histamine intolerance (HIT) affects approximately 1% of the population. Approximately 80% of those affected are middle-aged. Histamine intolerance occurs when an individual has more histamine in their system than they can breakdown. Excess systemic concentrations of histamine can result from overproduction, overconsumption, and/or having a reduced ability to clear out histamine from the body. For those with HIT, eating a diet that results in increased histamine can contribute to chronic inflammation due to the ongoing exposure to histamine. This excess histamine often accumulates as a result of decreased diamine oxidase (DAO) activity. The resulting excess histamine contributes to the physical symptoms associated with HIT. Following a low-histamine diet along with supplemental DAO is often recommended to decrease the symptoms associated with HIT. Eating a low-histamine diet involves more than simply eliminating foods that are high in histamine. This article will help to explain the challenges with following a low histamine diet and will highlight the many ways excess histamine can occur in food and in the body. Histamine Synthesis and Degradation Excess histamine concentrations may be exogenously released from food or endogenously produced. Histamine is synthesized by a variety of cells in the body including mast cells, basophils, platelets, histaminergic neurons, and enterochromaffin cells. Endogenous histamine is released in response to a variety of immune and inflammatory related stimuli as well as certain foods, alcohol, or drugs which can activate release. Endogenous histamine supplies are also controlled by genes that code for the enzymes that synthesize and degrade histamine. Genetic polymorphisms in histamine receptors and DAO can decrease the rate of DAO activity, reducing the rate of clearance and increasing systemic histamine concentrations. Exogenous sources of histamine mainly comes from ingested foods. Several factors in food processing and storage can increase the histamine content of certain foods as well. Histamine is normally metabolized by amine oxidases in healthy individuals. These amine oxidases include monoamine oxidase (MAO), DAO, and histamine N-methyltransferase (HNMT), with DAO being the primary enzymes for metabolism of histamine. It is thought that low gastrointestinal levels of DAO contributes to an individual being unable to break down histamine in the intestines, resulting in the increased sensitivity to histamine found in common foods. As excess levels accumulate, intolerance symptoms develop. Symptoms Associated with Histamine Intolerance There is great heterogeneity in the presentation of symptoms in those with HIT, making it difficult to define a clear clinical picture. Histamine intolerance is generally suspected when symptoms appear after the ingestion of histamine containing food. Symptoms may develop immediately or can be delayed as much as three hours following ingestion. Histamine receptors are found ubiquitously throughout the body, making different organ systems susceptible to adverse reactions due to excess histamine concentrations. This results in a wide variety of symptoms that may be exhibited by an individual, contributing to the difficulty in diagnosis. These symptoms include gastrointestinal issues such as abdominal pain, bloating, diarrhea, and constipation. Extraintestinal complaints may affect neurological, respiratory, dermatological, and/or hemodynamic systems. Histamine has vasoactive properties that may result in flushing, headaches, and/or hypertension. Other common symptoms related to HIT include brain fog, fatigue, dizziness, itching, and difficulty swallowing, low blood pressure, nasal congestion, sneezing, and menstrual cramps. Low-Histamine Diet and DAO Supplementation Following a low-histamine diet along with DAO enzyme supplementation is currently the recommended strategy to prevent the symptoms associated with HIT. Sanchez-Perez et al. (2021) reported a >70% efficacy rate among the clinical studies examined in their review of low-histamine diets. They also found that only 32% of the excluded foods in a low histamine diet contained histamine. Foods containing other biogenic amines (BAs), like putrescine, were thought to be responsible for the increased symptoms related to HIT. They state that it is possible that certain foods, while containing no or low levels of histamine, may act as histamine liberators resulting in excess accumulation of histamine. There is also great heterogeneity in the foods recommended for a low-histamine diet. Fermented food products and beverages were consistently recognized as a primary food group to be avoided. Decreasing the amount of histamine in the diet has been shown to decrease ...
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    18 min
  • Can Birth Control Pills Cause Hypothyroidism?
    Jul 19 2021
    The National Institutes of Health (NIH) states that five out of every 100 Americans over the age of 12 have hypothyroidism. The prevalence of this disease increases with age.(1) This makes hypothyroidism the most common disease arising from a hormonal insufficiency.(2) Gender is an influencing factor, as women are three to seven times more likely to develop hypothyroidism than men.(1) Known risk factors that increase the likelihood of developing this disease include having a family history of hypothyroidism and pregnancy.(1) Recent research by the British Medical Journal (2021) suggests that taking birth control pills, or oral contraceptives (OCs), may also increase the odds of developing hypothyroidism.(3) Birth Control Pills Statistics Oral contraceptives are a widely used form of birth control by women. Many individuals turn to these medications for reasons other than birth control such as relief from symptoms such as abnormal uterine bleeding, endometriosis, hormonal and menstrual irregularities, etc.(3)Approximately 6 million women in the US, aged 15-49, take oral contraceptives (OCs) each year.(4) The National Survey of Family Growth (2015-2017) reported that OCs are the second most common method of contraception used by women between the ages of 15-49.(4) The use of OCs is higher among younger populations and decreases with age. Approximately 90% of women taking birth control pills are < 40 years old and 54% are under the age of 20.(1)Therefore, an association between the use of OCs and the risk of hypothyroidism could potentially affect a significant number of individuals. These individuals, when presented with other options for contraception and/or better monitoring of thyroid function, may be able to avoid the increased risk of morbidity and mortality associated with hypothyroidism. Birth Control Pills and Risk of Hypothyroidism The British Medical Journey (2021) recently stated that women with a history of taking OCs for more than 10 years have greater odds of developing hypothyroidism (OR, 3.837; 95% CI 1.402-10.500; p=0.0090). Their finding was the result of a retrospective, cross-sectional study derived from information gathered in the National Health and Nutrition Examination Survey (NHANES) 2007-2012. This large epidemiological survey included a total of 30,442 participants. Of this number, 5116 females met the inclusion criteria for participation in the study. These individuals were divided into two groups: those with a history of OC usage (n=3034) and those that had never used OCs (n=2082). Approximately 16% (830) of the combined individuals were identified as hypothyroid. Hypothyroidism was more frequently diagnosed in those with a history of taking OCs (17.7% vs 14.1%). The state of being hypothyroid was defined as either those taking levothyroxine, regardless of thyroid stimulating hormone (TSH) or those with a TSH >5.6 mIU/L.(3) Women should therefore consider the long-term health effects of OCs and the increased odds of developing hypothyroidism associated with their use. This study had several strengths, including the large population surveyed, and the strict criteria used to control for confounders. Limitations were also inherent in this type of study. One of the main limitations is the lack of data to differentiate between the types of OCs used, including their chemical composition. Knowing the types of contraceptives used, i.e.: combined contraceptives containing estrogen and progestin versus progestin only contraceptives, may have provided different outcomes. Other limitations included possible recall bias due to the use of self-reported data from individuals, which can often be incorrect. These factors may have skewed the results obtained. It is also important to recognize a cross-sectional, retrospective analysis can only demonstrate an association between the OCs and hypothyroidism and cannot establish causation.(3) According to the National Institute for Health (NIH), hypothyroidism can be mild and present with few symptoms.(1) Common hypothyroid symptoms include constipation, weight gain, fatigue, lethargy, cold intolerance, change in voice, and dry skin.(1),(2) Other symptoms may include depression, anterior neck pain, dizziness, wheezing, hair loss, difficulty swallowing, restlessness, palpitations, shortness of breath, and mood lability.(5) The presentation of these symptoms decreases as an individual ages, making symptomatology an unreliable diagnostic tool for individuals over 60.(5) For this population, tiredness and respiratory issues are the prevalent symptoms that may signal the onset of hypothyroidism.(5) The non-specific nature of these symptoms contributes to the difficulty of reaching a definitive diagnosis. Including the prior use of OCs in a patients’ history may help identify those with increased odds of developing this disease.(3) Oral Contraceptives Increase Thyroxine-binding Globulin The estrogenic effect of OCs has been shown to increase various ...
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    20 min
  • Beat Autoimmune Disease with Palmer Kippola
    May 26 2021
    In this episode of Functional Medicine Research, I interview Palmer Kippola on how to beat autoimmune disease and her new book "Beat Autoimmune: The 6 Keys to Reverse Your Condition and Reclaim Your Health". We had a great talk walking through her F.I.G.H.T.S. protocol which includes food, infections, gut health, hormones, toxins, and stress. Our focus in this interview was on practical strategies for those with autoimmune disease to implement right away into their lives. Palmer has dealt with autoimmune disease herself, so she offers a unique perspective. Full Transcript on How to Beat Autoimmune Disease with Palmer Kippola Dr. Hedberg: Greetings everyone, and welcome to "Functional Medicine Research." I'm Dr. Hedberg, and I'm looking forward to my conversation today with Palmer Kippola. She's a best-selling author, speaker, and functional medicine certified health coach who specializes in helping people reverse and prevent autoimmune conditions. She developed a framework called F.I.G.H.T.S, which stands for food, infections, gut health, hormone balance, toxins, and stress to help others beat autoimmune conditions based on her two-decade battle to overcome multiple sclerosis. Her book is "Beat Autoimmune: The 6 Keys to Reverse Your Condition and Reclaim Your Health," with a foreword by Mark Hyman. And as she shares the science stories and strategies to help people heal and thrive, today she provides total health transformation programs for people who seek to heal from any autoimmune condition by addressing the root causes head-on with functional lab testing and comprehensive mind-body strategies. She also serves a growing community of people in a guided online membership program called Beat Autoimmune Academy. Palmer, welcome to the show. Palmer: Thank you so much, Dr. Hedberg. It's such a pleasure to be here. Dr. Hedberg: Right. So, as I mentioned in the bio, you dealt with multiple sclerosis. So, I'm sure there's a story there. So, why don't you walk us through your healing journey, what that was like, and that whole process? Palmer: Sure, sure. I do need to take you back in time a little bit because I was diagnosed at 19. Let me tell you the story. I was a happy, healthy, well-adjusted 19-year-old, by all accounts. I was home for summer after my freshman year of college, and I was working as a hostess in a restaurant. And one day I woke up and the soles of my feet were tingling, like that feeling you have when you've slept on a limb too long, when the blood flows back, it gets all tingling. But this particular morning, the blood wasn't flowing back. But I thought it'll just go away, so I went off to work. And the tingling just continued to creep up my legs like a vine. It got to my knees and by that time, I knew something was really wrong. So, I called my parents who called the family doctor who said, "Get her over to the neurologist at UCLA today." And we did. That's where we were that afternoon. And this particular neurologist had me do really simple heel-toe walking across her floor and tapped my reflexes. And after about five or six minutes, pronounced that she was 99% certain that I had MS, multiple sclerosis. And if she was right, there was nothing I could do except take medication. And we were absolutely shocked. Remember, this was in the mid-80s, so there was no guidebook, there was nothing. We had never heard of MS. And we just left that office completely confused, devastated, and with very little hope. But I was sent home and that night, my mom lay in bed with me and she was holding me and I was crying and she was crying and it turned out that all of the parts of my body that had been tingling, which by the time I got to the neurologist's office, it had reached right under my collarbone, so all the way up, full body. And then by the time we got into bed that night, all my body went completely numb from the neck down and I would stay numb for a full six weeks. So, an absolutely terrifying first experience, not having any information, not having any idea how this came on, or what my future was gonna look like. But that summer, the Olympics were on TV and I was really grateful because that's about all I could do is lie on the couch and watch the Olympics. And I do have to say that I'm so grateful that my parents were so supportive and rocks and I had friends that came by and brought gifts, like, you know, 19-year-old friends do, books and watch movies with me. But this one family friend who was into things metaphysical came and asked me a question, which at the time I didn't think was a gift, but it turned out to be the guiding light for the rest of my life because she asked me the question, "Palmer, why do you think you've got the MS?" And I was incensed like, "How dare you? What do you mean why do I think I got this? Are you accusing me of doing something that brought this on?" So, I lay there like a dog with a bone just chewing on that question. And it did come to me in a flash of insight...
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    48 min
  • How to Increase Stomach Acid Naturally
    May 10 2021
    Functional medicine practitioners often take a “Foods First” approach, recommending dietary modifications to improve health. However, for those with low stomach acid, diet alone may not be enough to ensure adequate nutrition. Low stomach acid can impair digestive ability, causing nutritional deficiencies even in those individuals consuming an optimal diet. This article will focus on the main digestive chemical associated with the stomach, hydrochloric acid. The causes of low stomach acid and the associated symptoms will be covered. In addition, natural treatment options for low stomach acid, such as betaine HCL and herbal bitters will be discussed. What is Digestion? Digestion is the process of breaking food down into particles small enough so that the nutrients in the food can be absorbed and then transported throughout the body. Digestion begins in the mouth with the mechanical process of chewing along with salivary enzymes that begin the digestive process. This process is continued as the food passes into the stomach, activating the release of hydrochloric acid. The bolus of food then passes to the small intestines where the majority of digestion takes place. The useful nutrients are digested and absorbed and the waste products are sent through the large intestines for evacuation as feces. Why Does the Stomach Contain Hydrochloric Acid? The stomach is a naturally acidic environment, especially following a meal, with a normal pH value of <3. Low stomach acid (hypochlorhydria) is observed with a rise in pH >3 and an absence of stomach acid (achlorhydria) is obtained with a pH > 7.1 This acidity comes from the hydrochloric acid that is secreted by the parietal cells in the lining of the stomach. Healthy stomach acid levels serve as an immune system barrier, providing a first line of defense against unwanted bacterial or microbial invaders that enter the stomach. Hydrochloric acid is also necessary for the digestion of proteins. Proteins are a conglomeration of amino acids folded together into different shapes. Stomach acid serves to denature (unfold) the proteins and expose the bonds that hold the amino acids together. These bonds can then be cleaved by pepsin, which breaks the protein down into smaller, easier to digest, amino acids. The formation of pepsin from pepsinogen is dependent on sufficient stomach acid levels as well. Hydrochloric acid is also responsible for deactivating the enzymes of salivary amylase as it enters the stomach and for stimulating the release of cholecystokinin in the small intestines. Both processes are essential for healthy digestive function. Certain vitamins and minerals depend on hydrochloric acid to liberate them from their carriers, such as vitamin B12 and calcium. Having low stomach acid levels can impair all of these functions. What causes low stomach acid levels? Factors that contribute to low stomach acid include: Chronic stressAgingPoor dietInfectionsMedication use Stress—Stress impairs digestion. Chronic stress may decrease the production of hydrochloric acid in the stomach due to associated nutrient deficiencies.2 Stress also causes the vagus nerve to lose its proper tone. The vagus nerve is a major part of the parasympathetic nervous system, and it is deeply involved in stomach acid production. With chronic stress it loses its ability to fire properly which disrupts normal stomach acid production. Aging—Low levels of stomach acid following a meal are more common with aging. Studies that compared stomach acid levels in young individuals (mean age 25) versus older individuals (mean age 75) found that older individuals experienced low levels of stomach acid following a meal for a greater length of time than their younger counterparts. It took 89 minutes for the elderly participants versus 42 minutes for the younger participants to regain normal stomach acid levels (pH 3.0) following a “standard meal”.1, 3, 4 These studies help support the existence of “functional low stomach acid levels” in the elderly following meals. Poor Diet—Eating a diet comprised of highly refined sugars and carbohydrates, alcohol, and/or smoking may result in nutritional deficiencies of B vitamins or zinc, both necessary for the production of hydrochloric acid in the stomach. Infections—Healthy stomach acidity provides a barrier for the immune system's first line of defense against invading substances. Low stomach acid results in an impaired immune response and an increased susceptibility to viral and/or bacterial infection and to bacterial/microbial overgrowth. Common conditions associated with low stomach acid include Helicobacter pylori, small intestinal bacterial overgrowth (SIBO), and Clostridium difficile.1 Medications—Medications, such as antacids, proton-pump inhibitors (PPIs), and H2-receptor antagonists (H2-RAs), are another widespread cause of low stomach acid. These medications are used to decrease the symptoms of gastroesophageal reflux disease (GERD) and...
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    22 min
  • Are Oxalates Damaging Your Thyroid?
    Apr 26 2021
    In this episode of Functional Medicine Research, I interview Sally Norton in a discussion about how oxalates affect your thyroid and your health. We covered what oxalates are and how they can damage the body. We also discussed how oxalates affect gut health, liver health, thyroid health as well as all the symptoms and associated conditions connected to oxalates. If you're really struggling to get well, but your diet appears to be healthy, oxalates may be the missing link. Full Transcript on Oxalates and Thyroid Health Dr. Hedberg: Well, welcome everyone to "Functional Medicine Research." I'm Dr. Hedberg, and I'm really looking forward to my conversation today with Sally Norton. Sally is a consultant writer, educator, and speaker with over 30 years in the health promotion and wellness field. Sally specializes in helping people improve their health with an oxalate-avoiding diet. Sally holds a nutrition degree from Cornell University and a Master's of Public Health degree from the University of North Carolina at Chapel Hill. She worked in the field of medical education at UNC Medical Schools Program on Integrative Medicine and as a research grant writer and research administrator at the Virginia Commonwealth University School of Medicine. Despite a healthy lifestyle, she struggled for over 30 years with seemingly unanswerable health challenges, including chronic pain and fatigue. When she finally discovered the cause and turned her health around, she committed to teaching and reaching out to others stuck in similar frustrating situations. Sally, welcome to the show. Sally: Thank you. It's great to be here. Dr. Hedberg: Yeah, I'm looking forward to this and we were kind of discussing this early on. Oxalates is something that I've always kept my eye on for the last 17 years and I was really looking forward to this conversation. So why don't we lay a little bit of bedrock for the listeners? And if you could just talk about what are oxalates, and do we know why plants actually have oxalates? Sally: Yes. Plants are a major producer of oxalate and obviously, it's also ubiquitous in nature itself. Soil is loaded with it. Even apparently sea spray produces some oxalate and polluted air produces oxalates, so, in really heavily polluted cities, the air has got oxalate in it too. So oxalate is this really minuscule molecule that its parent compound is called oxalic acid. And acids ionize and become charged particles because they drop off the acidic protein and so they become these negatively charged ions that attract positively charged things and oxalates can have a one negative or two negative. It is a tiny, tiny little compound. It has four oxygens, which is a heavy load of oxygen on just two little carbon molecules. So it's very oxygen-heavy, which is probably partly why it's such a pro-oxidant molecule, you know. Oxidation is very bad for tissues, membranes, mitochondria, and it is a great mitochondrial poison, membrane destroyer, and troublemaker. And it's not just the oxygen, though. It's much more about this reactivity that the charge creates where it bonds with minerals and becomes salts. And so, salt is a chemical term for things that can dissolve, but when it...because it can have two negative charges, it will also hook up with minerals that won't dissolve well. So calcium, for example, is a two positive charge mineral. With that double-positive and double-negative marriage between the two, you create an insoluble oxalate, which is the backbone of oxalate you see in nature because calcium is everywhere in soils and in nature, and plants are having to manage their calcium. And one of the ways they do that...because too much calcium can be toxic to the plant. So one of the ways they do that is they make oxalic acid. Often they make vitamin C first, very similar compounds, and vitamin C naturally degrades just hanging around into oxalic acid and oxalates. So plants will create vitamin C and they'll create oxalic acid so they can manage their calcium and store it away like a pantry. And in a siege, you need to store that calcium because calcium can be an enzyme co-factor and promote the germination process. So you store it, you deep-six it in these crystals in your seeds, and then when you germinate as a seed, you liberate off the oxalic acid in the calcium and you get your enzymes going. And in the meantime, those lovely crystals of calcium oxalate in the seed coat protects the seed from degeneration and from predators, and from deterioration, so it helps preserve the seed. But the oxalate has many other uses for plants, and plants deliberately construct special shapes of crystals. They lay out this kind of protein matrix and then the crystals nucleate and create these crazy shapes, including a double-pointed toothpick, super fine invisible toothpicks made in bundles of like 200 or more. And the plants literally use them as poison arrows to disturb the mucous membranes of predators and so on and it can kill ...
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    54 min
  • Dr. Theodore Belfor on Cranial Facial Development
    Apr 12 2021
    In this episode of Functional Medicine Research, I interview Dr. Theodore Belfor in a discussion on cranial facial development and airway resistance. If you have read James Nestor's new book "Breath" then you are aware of Dr. Belfor's work. We talked about the causes of abnormal cranial development and how this causes airway resistance and a number of health problems including sleep apnea, insomnia, IBS, bruxism, and more. Our cranial bones don't form properly when we aren't breastfed and eat a modern diet of processed foods. Dr. Belfor's oral appliances help to correct these abnormal developments to restore proper facial bone structure and improve the airway. Full Transcript with Dr. Theodore Belfor Dr. Hedberg: Well, welcome everyone to "Functional Medicine Research." I'm Dr. Hedberg, very, very excited today to have Dr. Theodore Belfor on the podcast. I first heard about Dr. Belfor in James Nestor's new book called "Breath." And we're gonna be talking about all of that today on the show. And Dr. Belfor, he's a graduate of New York University College of Dentistry, and a senior certified instructor for the International Association for orthodontics. In the 1960s, Dr. Belfor was sent to Vietnam to work as the sole brigade dentist for 4000 soldiers of the 196 Light Infantry from the jungles of Vietnam to Park Avenue in Manhattan. Upon his return, he opened his own private dental office in New York City, and has been in private practice for more than 40 years. And Dr. Belfor specializes in the treatment of the cranial facial system, and that's what we're going to be diving into today. So, Dr. Belfor, welcome to the show. Dr. Belfor: Well, thank you for having me. It's my pleasure. Dr. Hedberg: Excellent. So, why don't we start by talking about how this all began, and go back to, you know, what happened that changed the cranial bones, the cranial structure, our skulls, that led to this epidemic of airway issues, breathing issues, and all of the health issues that come with that? Dr. Belfor: Well, how we develop, how we grow and develop is based on how we breathe, how we swallow, and how we chew. So, just looking at how we chew, according to the U.S. Department of Agriculture today, in the U.S., 63% of our diet is processed and refined foods. So, without the proper stimulation to the body, we are not fully expressing our genes, we're not developing to our full potential. Because of that, particularly when our jaws do not grow forward enough, the retrusion of those jaws helps to push the tongue backwards into the airway and down the throat, so now we have compromised sleep and breathing. Dr. Hedberg: So, it's a combination of things. I know Dr. Nestor talks about it in his...or James Nestor talks about in his book, the changes in diet, soft food, not enough hard foods, not breastfeeding. Can you talk a little bit more about these changes in our society and some of these predisposing factors that can cause an abnormal airway? Dr. Belfor: Well, for me, the enlightenment came, when almost 20 years ago, I was treating performing artists who couldn't wear braces and they wanted straighter teeth, and I used an appliance and had a unilateral bite block, which basically, in essence replaces the missing hard food in our diet. And guess what? The actors, performers were coming in, and their makeup artist was telling them that their faces are changing, and the singers were coming in and saying they were reaching higher notes. So, that's what set me on the path. You see, the concept in dentistry is to balance the bite all the time. And it's kind of an anathema to have, when you bite down, to hit on one side. However, if I give you a stick of gum to chew, nobody on the planet is going to chew on both sides at the same time. We chew on one side then we chew on the other. And apparently from the research, many articles that have been written, the latest one in August 2018, the Journal of Orthodontics and Dentofacial Orthopedics the concept, they used a mammal, a pig, and they sent cyclical signaling to just two cranial sutures. And the result was that that changed...it reached all the cranial sutures, it created strain on the sutures, and that's the key word, because we chew on one side, we create strain at the suture level. And the result was a widening and mineralization of the sutures. So, in other words, there's your direct example of how we're chewing works. And, by the way, chewing is basically a communication that the body uses for development. The body works this way. There's only certain things the body understands. So, chewing is really a reciprocal pressure, alternating pressure. And that reciprocal, alternating pressure and strain is what helps to generate the growth. So, our breathing is reciprocal, cyclical, alternating pressure. And from a lot of articles which are written, when we breathe correctly, as we're developing, that air goes into all of the spaces in our skull, and that helps to stimulate the ...
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    32 min
  • COVID-19 Mental Health Crises
    Mar 29 2021
    In this episode of Functional Medicine Research, I interview Dr. Ron Parks in a discussion about COVID-19 and the mental health crises. Dr. Parks has written a new book "COVID-19 and Mental Health Crises" which we discuss as well as a variety of other topics that can help those afflicted by this pandemic. The mental health aspects of COVID-19 are often overlooked with more of a focus on the physical aspects of the illness, medications, vaccines etc. As usual in the United States, mental health is pushed to the back of the bus with little to no dialogue or support for those who need psychological support. Dr. Parks provides a voice for those in need with his excellent new book. Full Transcript on COVID-19 Mental Health Crises Dr. Hedberg: Well, welcome, everyone, to Functional Medicine Research. I'm Dr. Hedberg. Very excited today to have my good friend and colleague, Dr. Ron Parks, on the show. And we're gonna be talking about his new book. And Dr. Parks is a respected physician, teacher, book author, writer, and mentor, with an integrative and holistic perspective. He especially trained in internal medicine, nutrition, preventive medicine, and board-certified in psychiatry. Currently, Dr. Parks is the medical director and psychiatrist for The Center for Spiritual Emergence and Katharos Sanctuary in Asheville, North Carolina. He has an MD from the University of Maryland and a master's degree in public health and health service research from the University of California at Los Angeles. He has completed specialty training and internal medicine at George Washington University, preventive medicine at UCLA, and psychiatry at the University of Maryland. Dr. Parks is a former assistant professor at the Albany and University of Miami Medical School, chief of internal medicine at the Homestead Air Force Base Hospital in Florida, former director of the Center for Preventive and Nutritional Healthcare in Baltimore, Maryland, and founder of the MacroHealth Medicine, a comprehensive and holistic consultative and treatment service, formerly in Asheville, North Carolina. Dr. Parks, welcome to the show. Dr. Parks: Well, thank you, Nik. Thank you for having me. Dr. Hedberg: Yeah. I'm looking forward to this. So, you've written a new book, it's called "COVID-19 and Mental Health Crises." So, we're gonna dig into that. But before we do that, can you just talk a little bit about how you got into integrative functional medicine and psychiatry? Dr. Parks: Well, that's a good question. Actually, it started when I was very young. I think I write a little bit about this in the book. I came down one summer as a kid with polio. And it was very upsetting, of course. And I compared it to the current COVID crisis. Back then there was no treatment and everybody had been waiting 10 years, 8 to 10 years for a vaccine. But here I was, a young, healthy, athletic kid that suddenly was running high fevers and a stiff neck. So, I ended up in the hospital at a children's ward. And back then the only treatment they had was more of a natural treatment called the Sister Kenny treatment. It was like a heat treatment. They wrap you in warm towels. And so that was my first exposure to, you know, what I would call functional medicine or holistic medicine. Though I had a sweat through it, but luckily, I didn't end up with the paralytic form of it, but sometimes I do think I have some of the long...they're talking about with a new virus, the long hauler syndrome. But with polio, there were some aftermaths there, and I think maybe some of the weakness I had some time in the legs and things like that might be from that. But anyway, that got me started on the path of interest in broader treatment programs. But a lot of it came, though, from my being formally, formally trained in internal medicine, where everything was about labels and diagnosis. And I remember in training, I got yelled at by the pathology teacher because I looked at a slide and I said, "I know what this is. It's such and such." He said, "The secret and the art is you spend time looking at that, you get the full picture, you let it sink into you before you tell me what it is." So, maybe he was seeing, you know, or trying to lead me in the right direction. But after working in more traditional medicine and you've seen my credentials, I mean, I would see some of the most rigorous formal training. I just finally decided to get out of it. And actually, you know what, Nik? This is very, very interesting. I always keep up to date, you know, and I start my morning with doing some review of some current stuff. And I came across an article about burnout syndrome they call with COVID-19, and how that's affected many academics and professional people because it's so changed their lives, that it's caused them to relook at themselves. And this article just snapped something in my head and I realized in writing this book and in telling some personal stories in there, I missed the most important one. ...
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    48 min
  • GI-MAP Stool Test Interpretation
    Mar 15 2021
    In this episode of Functional Medicine Research, I interview Tom Fabian, PhD in a detailed discussion about the GI-MAP stool test interpretation. We covered virtually every aspect of the GI-MAP stool test including what the test results mean and how to use them in clinical practice. Dr. Fabian has tremendous knowledge of the gut microbiome and the intricacies of the GI-MAP stool test markers. This is a vital interivew to listen to if you're utilizing the GI-MAP stool test in your practice. Full transcript of the GI-MAP Stool Test Interpretation interview with Dr. Tom Fabian: Dr. Hedberg: Well, welcome, everyone to Functional Medicine Research. I'm Dr. Hedberg, and I'm looking forward today to my conversation with Dr. Thomas Fabian. He is a PhD., and he's a clinical laboratory consultant, translational science expert, functional nutrition practitioner, educator, and speaker. He is a former biomedical research scientist and deep expertise in the role of the human microbiome and health, chronic disease and aging. As a leading expert in translational applications of microbiome research and functional medicine and integrative health settings, Tom's primary focus is on providing educational resources and consulting services for practitioners and scientific advisory and consulting services for clinical testing laboratories. Dr. Fabian, welcome to the show. Dr. Fabian: Thanks so much, Nik. It's great to be here today, and I'm looking forward to the conversation. Dr. Hedberg: Excellent. So, we're gonna be talking about the diagnostic solutions, lab, GI-MAP test, and we're gonna cover interpretation, you know, what these markers mean. And so, for all the practitioners listening, they'll have a strong idea of how to approach this test and how to use these things clinically. So, why don't we start with...take it from the top in the pathogen section? And I wanted to ask you specifically about C-diff. There's toxin A and toxin B Clostridium difficile markers on this test. And what is your interpretation of this if it's positive and the patient is symptomatic, and then you treat them, and then they're no longer symptomatic, but the toxin still shows up on the stool test? Can you elaborate a little bit on that type of presentation? Dr. Fabian: Sure. No, I haven't personally seen that particular scenario but, in general, it's important to keep in mind a lot of people can be carriers of C-diff. So, the majority of the time that we see it detected positive, whether it's low levels or high levels, typically, patients don't have the classic symptoms. So, that suggests that they're probably just a carrier. And there's, sort of, kind of, a gray area in between where there still may be some effects of C-diff. Of course, that's one of the purposes of looking at the markers on GI-MAP like calprotectin, zonulin, etc. to see if there seems to be any evidence that may be have an impact, even if there aren't symptoms. So, we're also learning a lot more from research about factors that can control or influence the ability of various pathogens to thrive and also whether or not they can cause infection or if they have their, you know, typical pathogenic effects. So, that's essentially factors that influence virulence. So, one of the first things I want to mention is all the microbial markers on GI-MAP are assessed based on detection of DNA. So, when you're looking at DNA, you're looking at detection of the organisms or the genes but not necessarily whether the genes are being expressed. And that's definitely true for toxins. So, lots of research has been coming out in research years in terms of, again, as I mentioned, things that regulate toxins, and it's very specific. So, pathogens tend to only express those toxins under very specific conditions when conditions are favorable for them. So, for example, if you've detected C-diff and it really syncs up with what's going on with the patient, symptomatically, and you decide to treat, and then on a retest, symptoms are better, but the C-diff is still detected, that's telling you that it's still there. But you may have improved the gut environment to the point where they're not expressing their toxins at that point. So, they may just at that point become carriers. Dr. Hedberg: Yeah, that just makes me think about, you know, some of these patients because we can't or I can't necessarily say that it's the C-diff, you know, that was causing the symptoms because then these other patients, they had other pathogens and dysbiosis and other issues. And so, that could have also been the reason why they were symptomatic. Dr. Fabian: Absolutely. Dr. Hedberg: Yeah. So, that can make it difficult to really get a clear picture of what exactly is causing the symptoms if there's multiple issues there. So, that makes sense. And, you know, for the practitioners listening, so when it says less than DL, that's less than the detectable limit. Correct? Dr. Fabian: Correct. Yeah. Dr. Hedberg: And then, if we see...
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