Why I order Chicken at Chipotle

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I have been traveling all week to fill in for another doctor and there happens to be a Chipotle down the road from the office.  Hallelujah! I am pretty good about packing food to take so I don’t get hangry, but Chipotle can be a nice place to grab food, sit down, and eat outside.  Now to get to the point.  Why would I order chicken at Chipotle when I very rarely eat chicken at home?  There are a couple things I like to consider when eating out:

  1. What basic food options are available?
  2. What is the meat quality?

When eating out, I am always looking for basics, whole foods, simple ingredients.  You can’t get everything perfect at a fast food restaurant, but that doesn’t mean I dive into a McDonald’s cheeseburger by any stretch of the imagination.  Chipotle has veggies, meat, healthy fats, in-house prepared additions, and tries their best to pick non-GMO, higher quality sourcing options.  So, as far as basic food options, I can get a filling, whole food meal.  That takes care of WHERE will I eat.

The second concern now that I am WHERE I’m going eat, is WHAT am I going to order?  I am not afraid of fat by any stretch of the imagination, and healthy fats are abundant in my diet, including the fat from grassfed meat, skin from chicken and salmon, rendered fats for cooking, etc.  However, when I am dining out, unless it specifically says that the cow products are grassfed, I try to order chicken.  Chicken is much higher in omega-6 fatty acids than grassfed cows even if it is pastured and fed appropriately.  Grassfed cows actually have tons of omega 3 fatty acids, which are healthy, anti-inflammatory, and much more effective than supplementation.  However, if the cow has eaten grains, you can chuck those omega 3’s out the window.  Now we are looking at 2 foods that are both heavier on the omega 6 fatty acid side of the equation.  So, we will call it a tie.

Now that I have established neither option has eaten appropriately, I look for the leaner option and that is typically chicken.  Why would I care about the leaner option?  Because adipose tissue (aka fat, marbling) tends to be a storehouse for toxins that have not been mobilized and excreted.  This means, if the animal ate what it wasn’t supposed to, it’s fat products are far from healthy.  It is no longer a meat product with abundant health benefits.  It is now sort of inflammatory, potentially toxic, and should be looked at for it’s macronutrient value alone (protein).   Chicken in the US has gradually made it’s way toward white meat, meaning that it’s fairly lean.  Even if the chicken isn’t pastured, I am not getting much of the toxic load associated because I am not ingesting it’s fat, like skin, dark meat, and schmaltz.  If I eat a leaner meat, it’s choosing the better of two inappropriately fed animals in my opinion.

I make sure to bridge the nutrient gap with healthy plant fats like avocado.  I will order lettuce, chicken, fajita veggies, mild salsa, and a heaping dose of housemade guac.  You may also notice that I don’t even really have a drink sitting around.  I will discuss drinking water during meals at a later time, but for now, weigh your chicken vs beef options when choosing fast food.  If the chicken were breaded, I would choose the beef.  It’s all about priorities.

Gluten’s Part in Leaky Gut and the Autoimmune Cascade (Part IV)

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If you have been following along, we have now established how an autoimmune disease starts, what gut permeability is, how stomach acid may be a problem, and now we can start talking about what causes it in our lifestyle that we can control!  On one hand, I am oversimplifying this part of the discussion so that I can focus on the aspects that you can actually have control over.  I am skipping over some of the things out of our control like certain genetic attributes, environmental exposures, and infections that may have been just bad luck in terms of wrong place, wrong time.  However, even those factors can be overcome most of the time with proper care.  So, lets get to it!

Gluten: Yes, I am starting with our beloved friend, gluten.  Why?  Because this is the most controversial topic that flies around and it’s simply hard for most people to understand how on Earth, eating a bagel and some bread can cause such a problem as serious as autoimmunity….especially if their physicians haven’t said a word about it, or may have even discounted the connection when a patient asks.  If I could have everyone start with A SINGLE change, this would be it.  Antibody production against gluten has been reported to affect as much as 30 percent of the population!  The mechanism by which it contributes to leaky gut has to do with zonulin.  Zonulin is a protein sent into the gut by that single layer of cells called enterocytes and regulates the opening and closing of the tight junctions (shout out to all my AP101 students!  remember those tight junctions I tested you over?!) that hold the cells together.  They are kind of like the pegs that allow legos to fit together in a flush manor.  Gluten has the ability to increase zonulin and therefore increase the amount of time those tight junctions are open, allowing undigested proteins, bacteria, and toxins to cross over inappropriately.

There are also pathways where a enzyme known as transglutaminase is affected.  Transglutaminase is an enzyme that is important in protein modification as they are produced in the cell.  (I promise to not start talking about transcription and translation!) This enzyme activity is increased in the lining of the intestines when we consume gluten.  Increase of this enzyme’s activity increases the likelihood of antibody production against gluten.  The bigger issue is that if antibodies are produced against this enzyme, we can’t perform tissue healing like we normally would. So, let’s say you have tissue damage and one of your body’s ways of helping heal it is to send transglutaminase to the site, but because of increased gluten ingestion, you have created antibodies against it.  Now you are sending this enzyme to all these sick parts and your immune system is going “OMG, what is he doing here?!  Produce more antibodies!  We are gonna need ’em to eradicate him!”   When you start eating a gluten free diet, you decrease the antibody formation against transglutaminase and you decrease zonulin activity, which allows those junctions to stay shut.

*This part is my opinion although is a topic of discussion.  Why now and not before?  Wheat has changed in various ways.  We have changed it from Einkorn wheat to dwarf wheat in order to increase crop yields and increase gluten levels for desired texture of baked goods.  We also now have an issue with Round Up Ready seeds causing damage to our DNA by damaging the microorganisms living in our gut.  We are also not preparing wheat products like we originally did.  We no longer, soak, sprout, or ferment grains.  We NEED to do that in order to get nutrients out of the bran.  Anyway, I don’t know what the largest contributing factor is, and it may just be a combo; but I do know, that many patients do extremely well without these products in their diet.

According to Dr. Peter Osborne (who is an expert on gluten sensitivity), there are 140 autoimmune diseases that science has identified and the ONLY SCIENTIFIC agreement for the cause has to do with gluten and its many mechanisms by which is can cause this cascade of events.  I chose not to focus on a few of the other pathways that I usually do in a health talk like lectins and their contribution.  However, know that there are even more reasons that gluten can cause changes to the intestinal wall!

I’m going to stop there and do another article on more causes because this could get overwhelming.  So, what can you do TODAY?  Try to cut out all of the wheat products in your diet and see how you feel.  No bread, pasta, pizza, donuts, beer, etc.  When you think about it, you may be consuming these things multiple times a day!  If it’s contributing to your issues, you can also understand just how damaging it may be to consume them so regularly.  This alone, will not likely cure anything, but it may give you a huge step in the direction of feeling BETTER.  Most people with autoimmune diseases are willing to entertain the idea that something can make them feel better, and you can only gain other health benefits in addition if you cut out all those junk foods often containing wheat.  Check out my blog recipes for more ideas, but there are so many options out there!  Don’t get overwhelmed.  Just start.

Heartburn and Autoimmunity (Part III)

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I can’t count how many patients I’ve worked with over the years that have heartburn.  Most take some type of buffering agent to neutralize the acid such as Tums.  However, for the more severe cases, they will be prescribed a Proton Pump Inhibitor.  This is such a huge deal that I make my physiology students look this up and write an entire paper on how they work!  You do NOT want to inhibit the function of your cell membrane’s proton pump!  Most people can get on board that shutting down a system in the body may not be a good idea, but they don’t know the alternative options available.  That’s where understanding exactly why stomach acid is getting in the wrong place is imperative to fixing the problem for good.  That topic may be for another time, but for now, we are going to make the general statement that most cases of heartburn are actually cases of NOT ENOUGH stomach acid.  Therefore, taking meds to decrease the production even further drives us into a hole that is tough to get out of.  If you just trust me on that statement for the time being, we can look into why decreased stomach acid may play a role in the development of an autoimmune disease.

The stomach is the first stop in the tube after you swallow your food.  It has been designed to have a very acidic environment by the production of HCl.  The reason we need such an acidic pH (around 2), is because that acidity will start the breakdown of your food, kill many bacterial organisms that we do not want making it into the small intestines because they could make us ill, and is needed for vitamin and mineral absorption.  This acid is specifically important in the breakdown of proteins into their legos, amino acids.  (Remember how we need to first breakdown all of our food into it’s smallest components in order to absorb it.)  If this stomach acid plays so many crucial roles, you can imagine the domino of effects that may occur if there is not enough of it around.

When you aren’t producing enough stomach acid, the pancreas and liver aren’t getting the signal to release digestive enzymes and bile, which will mean your food will further lack breakdown.  If these stages of breakdown don’t occur, you can end up with nutritional deficiencies because you aren’t able to absorb things in such large forms.  I see this a lot with Crohn’s patients; men especially can be so skinny because they simply aren’t able to get nutrition absorbed! So, now we have undigested food in the small intestine, which creates the perfect environment for opportunistic bacteria and yeast to grow out of control.  If you have heard the term SIBO (Small intestinal bacterial overgrowth), you know how this can be troublesome for patients who are “eating perfectly” because that specific case requires  therapeutic protocols to actually fix it.  Until the overgrowth is addressed, you won’t digest anything appropriately no matter how perfect your diet.

Low stomach acid specifically impairs the digestive process and creates the perfect environment for bacterial imbalance in the gut.  Remember me talking about how you have 10 times the amount of bacteria in your gut then cells in your body?!  It’s crucial to have abundant good bacteria, and minimize opportunistic microorganisms.  Without balance, we have something called dysbiosis.  Dysbiosis is at the root of so many health conditions including autoimmune diseases because of the risk of infections, nutrient malabsorption, and the impaired integrity of the intestinal wall.  We don’t want an environment where the wall can be leaky, we have bad bacteria hanging around, and large protein structures on top of it.  If those things cross over the wall of enterocytes and  come in contact with the immune cells on the other side, we have just triggered an immune system response to our food.  All of this being a domino effect of NOT HAVING ADEQUATE STOMACH ACID!  That Nexium or Prilosec isn’t helping matters.

I want to throw out a couple things that can be common in patients.  One is H. Pylori.  This organism can overgrown in patients with low stomach acid and the infection NEEDS to be addressed before you can move forward.  The test I use cost about $100 and is worth every penny.  The other thing is that patients don’t often need stomach acid reducing meds, they need supplements that encourage the production of more!  When your body produces enough stomach acid, it’s the signal to the esophageal sphincter to close.  The reason you feel burning in the esophagus is typically because that “door” between the stomach and the esophagus hasn’t closed adequately.  Stomach acid in the esophagus doesn’t feel good and if left alone chronically, it can cause Barrett’s esophagus and cancer.  No good.

You can increase stomach acid by taking HCL/pepsin supplementation with meals, eat digestive bitters, drink a glass of water with lemon juice or apple cider vinegar in it 20 minutes before a meal, or indulge in a little kombucha.  I would also suggest a good probiotic to patients in this situation because you need to rebalance the microbiome.  I have links to ones I like in the “store” along the top bar.  It will send you to the products through Amazon. While these are great tips, I want to caution people from taking this upon themselves because if HCl is taken in conjunction with asprin, Advil, corticosteriods, etc, it can actually cause serious damage to the gut lining and cause ulcers.  Also, if a pathogen is present such as H. Pylori or SIBO, then more steps have to be taken to address that.  Moral of the story is that if you are taking meds to lower stomach acid, you most definitely have an underlying issue that is not being addressed.  You are simply masking the symptom of acid getting into the esophagus.  I would encourage you to ask why it would get there in the first place?  That is not normal.  Stomach acid was created for proper digestion and nutrient absorption, so any substances that would try to increase the pH to be more alkaline, is going to have a detrimental effect.

If you have an autoimmune disease that you are taking an immunosuppressant for, can you imagine the environment we are setting up for disaster if you have stomach acid issues that are allow bacteria to overgrow AND the meds you take are shutting down your immune system?!  Oh my.

I want your heart to be on fire, but just not due to low stomach acid.  Love you guys!

Intestinal Permeability and Autoimmune Disease (Part II)

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I have written several articles about our bodies being hotels for bacteria, and when the bacteria levels are balanced and the microorganisms are happy, we are healthy.  These bacteria make up so much of our immune system, its hard for me to fathom why we haven’t placed more focus on their role in studying disease.  It’s gaining traction, and therefore most people have heard the buzz phrase “leaky gut” thrown around somewhere.  In this article, we are going to discuss what it actually is, and how it has to do with autoimmunity.

Let’s start with the basics.  From your mouth to your anus, you have one long tube with stops along the way.  The mucosal barrier that keeps food in the tube, and not in your tissue, it technically ON THE OUTSIDE!  I know it sounds crazy, but that tube running down the middle of your body is an exterior surface. It’s comprised of a single layer of cells; that’s it!  Pretty amazing if you think about how food goes in one and end and comes out the other.  After food goes in your mouth, it has stops along the way and one of them is in the small intestines.  The small intestines is where most of your nutrients are absorbed into the body. The way nutrients get into the body through the section of tubing we call the small intestine is by specific breakdown that occurs via acid, enzymes, bile salts, and bacteria.  Proteins are broken down into their lego parts, amino acids.  Fats are broken down into fatty acids, and carbs are broken down into simple sugars. Once food is broken down into its simplest form, it’s ready for transport into the body.

In order to get into the body, digested nutrients have to cross that single layer of cells called enterocytes.  On the other side of the wall lives blood vessels, lymph vessels, and immune cells of the gut.  The amino acids, simple sugars, minerals, and water soluble vitamins (like B vitamins) are transported via blood and the fatty acids and fat soluble vitamins (like A, D, E, and K) are transported through the lymph. A leaky gut occurs when there is damage to that single layer of cells and things that shouldn’t be able to cross over, do.  This damage can occur by sections of cells themselves being damaged, or the bonds between them being broken. When this happens, now we have things like pathogens, incompletely digested proteins, bacteria, and toxic substances entering the territory where immune cells live.  The immune cells immediately recognize them as foreign and plan an attack.  However, if any of them get through that line of defense, now we have them floating in the bloodstream. The body frantically tries to clean it all up, and this produces a fairly global inflammatory state.

I think it’s worth mentioning that those undigested proteins stimulate a part of the immune system that produce IgE antibodies.  Food allergies that cause difficulty breathing, swelling, ER visits…those are due to this IgE response.  This is a TRUE allergy.  However, when antibodies such as IgGs are produced, this is what we call a food sensitivity. The reason we call it a sensitivity is because the immune response produces symptoms of allergies for example, fatigue, mucus drainage, inflamed sinuses, and possibly even things like eczema.  This is what doctors are testing for when they do a blood panel for food allergies!  If you have ever had a food allergy/sensitivity test and it came back with a list of crazy amounts of foods like chicken, spinach, strawberries, etc., you are most likely NOT allergic to those foods.  This is nothing more than a IgG production because food proteins got into spaces they don’t belong.  Once you heal the gut and keep those foods from crossing the gut lining, your body will QUIT producing antibodies against them.  I see this all the time when I work with food allergies.  You can absolutely resume eating most of those foods without issue as long as appropriate care has taken place.  I got off track….back to the antibodies. Of those antibodies being produced, some can be autoantibodies.  When cytokines (chemical messengers) are released, it stimulates both the innate and the adaptive immune system.  This pokes the bear of the adaptive immune system that can result in an autoimmune disease.  If you remember from the previous article, this is where amino acid sequencing can get confused for our own tissues.

I hope I didn’t lose anyone with crazy words, but I think this connection between how the food we eat gets to places it shouldn’t, and the immune response that results is an important one to know!! Why? Because autoimmune diseases live in about 50 million DIAGNOSED people and cancer is only 12 million.  Heck, heart disease is 25 million!  Needless to say, this costs our country more than just $100 billion dollars in direct care costs, it is costing us our quality of life!  Anytime I have a patient that is able to go about their day without worrying about the symptoms of an autoimmune disease, I do a happy dance.  It gives them their life back!  This is priceless.  In the upcoming articles, I will talk about which foods can create the perfect storm, and other lifestyle factors that damage that single layer of cells that keep the good stuff in and the bad stuff out.  These are things you CAN CONTROL!  I’m getting pumped up…can you tell…welcome to what it feels like to be in the audience when I give a talk.  I just can’t help myself….

How does an Autoimmune Disease Actually Happen?

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Without the audience having an in depth knowledge of the body, this can be a confusing process to explain.  However, I’m going to put on my teacher hat and try my best to explain how your body could ever be so confused that it begins to attack it’s own tissues resulting in diseases such as Multiple Sclerosis, Rheumatoid Arthritis, Crohn’s, Psoriasis, Hashimoto’s, etc.  Even though these diseases are present in different systems within the body, the same mechanism of trigger initiates the cascade.  Every autoimmune disease is an IMMUNE SYSTEM disorder.  However, most people focus on the system involved by taking thyroid medication for Hashimoto’s, creams for psoriasis, digestive aids for Crohn’s, and the list goes on.  Most of the heavy duty medications on the market for these problems are immunosuppressants.  That means their entire job is to dampen the ability of the immune system to function in hopes it will quit attacking itself.  This has a nasty side effect of also leaving patients vulnerable to sickness because their immune system is being shut down (hence the fine print in commercials saying not to take them if you are sick, in contact with the sick, etc.)  Many patients will say “Isn’t there a way to help this WITHOUT shutting down my immune system?!”  The answer is “absolutely,” but you will not find those methods in medication.  I hope now you are asking “HOW?!”  Let’s look at how it happens to try to address that question later…

Proteins: Proteins are the building blocks of life.  They are made up of things called amino acids and we use about 20 different amino acids to build every single kind of protein that we need.  Based on how you put the amino acids in sequence, you can create different kinds of proteins.  These creations make up the cells of your organs, your hormones, and the antibodies we call immunoglobins.  You may have heard of some of these amino acids without even knowing it!  We have all heard of tryptophan around Thanksgiving because people blame the sleepiness on it’s presence in turkey.  Maybe you’ve heard of Glutamine if you are in the fitness industry.  Perhaps phenylalanine has popped up as you search the risks of artificial sweeteners?  These amino acids are essentially the legos that make up parts of your structure.

Well, these proteins tend to have a lot of similarities to the proteins in other life forms such as animals, plants, and even viruses.  For heaven’s sake, we have 67% DNA similarity to an earth worm!  Like I’ve said before, this is why biological principles are important to know; we all exist under the same fundamentals!  Small sections of these proteins are recognized by antibodies.  This is the recognition system for our immune system to be able to ID, tag, and get rid of foreign invaders by recognizing specific amino acid sequences present on the protein structure.  When the antibody binds to one protein, it’s common that it will also attach to other proteins containing a similar sequence. This is a good thing if those other proteins are also foreign invaders, but it’s a bad thing if the other protein happens to be our own tissue.

Don’t worry though, we have a quality control system.  Because of so much shared DNA sequencing, this happens all the time!  It happens in everyone really.  However, we have a process called “selection,” that allows T and B cells to recognize self and they are destroyed.  This is all happening in the bone marrow and the thymus gland (hence T and B cells, haha…ok, not funny).   It can also happen via suppression where certain T cells shut down autoantibody production from any cells that may have escaped the first check.  In a healthy individual, this system of checks and balances works beautifully!  However, for those with autoimmune conditions, the body has a breakdown in the second process and simply can’t keep up with the quality control process of destruction.  Let’s just say your employee came in drunk and is no longer paying attention to the bad specimens rolling through!   So, it’s not really a problem with the body making antibodies against itself, because everyone does that.  It’s more about a faulty system in the ability to keep them at a minimum.

Once this breakdown occurs, it’s much easier for the body to then create another autoantibody to a different tissue, which is why so many autoimmune patients can then get another autoimmune disease fairly easily.  When enough damage has occurred to the tissue being targeted, you will start to express systems of the disease.  This is when you show up at the doctor with digestive distress due to Crohn’s, or unbearable joint pain due to Rheumatoid, or heaven forbid the neurologic symptoms of MS.  Here is where the fork in the road happens.  How do you treat it?  You can take medication to address the symptoms presenting, you can take an immunosuppressant to try and shut down your body’s ability to produce antibodies (to itself or to foreign invaders), or you can eliminate the triggers that cause the immune system to attack in the first place.

The environmental triggers for immune system attack can include anything from vitamin D deficiency, bacterial infections, silicone implants, chemical exposures, and yes, intestinal permeability (aka leaky gut).  Even though genes may create the perfect recipe for an autoimmune disease, the environmental triggers are really what start the cascade of events.  This is the reason why many people will say that genes load the gun, but lifestyle pulls the trigger.  This is why it is so important to be testing for underlying infections, nutrient deficiency, eliminating chemical exposure, and doing all we can to correct leaky gut.  If you correct intestinal permeability, you can reverse an autoimmune disease.  I have done this over and over with patients, and the changes in their quality of life and thought of such a different future makes me overwhelmed sometimes.  THERE IS ANOTHER WAY.  If you don’t believe that, then I can only imagine the thoughts that run through someone’s mind knowing it will only progress and get worse.  That part of my job breaks my heart.

The silver lining is that even though you can’t control your genes, you CAN control your lifestyle.  I will be writing a number of articles focusing on different aspects of this including the story of gluten, dairy, nightshades, and eggs in addition to the powerhouses I utilize with patients including ferments, broths, and organs.  I never know much to simplify my explanations to help someone understand the connection, so I have decided to go a little bit more in depth on the blog.  That way I have the easiest answer possible “Go take a look at the articles on the blog and let me know if you still have questions!”  For a professor, it’s like trying to teach 8 years of physiology in 30 seconds (because that’s how long you have until people tune you out if they aren’t understanding).  Good luck with that one!  I hope you enjoy, and if you have any questions you would like to make sure I touch on along the way, feel free to shoot me a comment!

When I Start to Empathize with Sex Education

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As years of patient practice progresses, I get better and better at the art of patient care.  My scientific knowledge has always been on point, but there is a certain art to working with people.  Having the ability to identify their strengths, weaknesses, building a communication strategy, and developing a good B.S. meter are all part of the ART of practicing.  When I was green, fresh out of school, I held a very purist point of view.  The perfectionist in me wanted to know the best way to do things and that was my recommendation.  Period.  I knew there lived a grey area, but the grey area simply appeared a slippery slope to me, and I wanted nothing to do with someone enjoying the slip and slide.  This SERIOUSLY bothered me for a long time when I started out.  I wanted my patients to get better, I wanted them to be healthy, and I wanted success for them!  If I was going to help them achieve these things, how could I ever recommend a packaged food and feel good about it?!  How could I ever give them a sugary dessert recipe and tell them it’s ok?  How could I give them any “best of the worst” options and sleep well at night?!?!?

I was thinking about this the other day when I was talking to a patient about doing her best with the options she had at the moment.  Do I ever recommend a McDonald’s hamburger as healthy?  NO!  But what if that’s the ONLY place to get food for 100 miles?  Then we need to entertain the slip and slide and be honest about how to avoid it in the future.  Then we need to move on and not beat ourselves up about it.

It kind of reminded me of the debate in sex education: abstinence vs. condoms.  What do you do?  You don’t want young people having sex all over the place, getting STD’s and having babies before they are ready!  However, you know they are teenagers and arming them with tools to ensure their safety is necessary.  Do you give a teen a condom and say “I’m giving you this condom, but you shouldn’t have sex, ya know?”  That’s a big problem!  Do you stand by the purist argument saying we aren’t even going to address it because it shouldn’t be happening?  We all know those techniques don’t work very well, and we certainly have learned this the hard way in some cases.  So, how do you talk about RESPONSIBLE risk taking.

Working with patients is no different.  We live in a world full of temptation that is bound to get into people’s lives on occasion.  We can’t ignore the temptations or they will likely be abused in a risky fashion.  This is part of why I created a blog full of desserts.  Desserts are often a huge culprit in the world of health issues because they are full of processed sugars, refined grains, GMOs, and chemicals.  So, I’d rather provide a tool for responsible indulging than to allow you to kill yourself when you see a cupcake.  This is also the reason that I don’t have people worry about meat sources in the very beginning.  WHAT?!  I know, I personally care a lot whether my meat was grassfed, pastured, humanely raised, etc.  However, if finding that is impossible for a patient at the moment (on top of all the other changes), I’d rather talk about what cuts of meat are better if they aren’t perfect specimens.  I’d rather give them convenient or affordable options to make good choices regardless of if those choices aren’t perfect.

You will see this tug of war in my head if you ever ask me a question about food in passing.  It doesn’t give me enough time to preface my answer, but I don’t want to leave you without information.  Therefore, in a split second, I assess what the best answer is for taking RESPONSIBLE RISK.  Then, I hope you become my patient so we can talk about all the aspects of health, what fits into the bad, better, best categories, and why your individual health status may put more pressing need into a certain category of compliance.   Just like mom wants to have an open dialogue of communication about sex BEFORE it happens, I like to talk to patients about the facts, their situation, and how to make the best decision for them and their unique circumstance.  This empowers them and creates sustainability for continued improvement without me watching over their shoulder.  After all, that’s what our goal is in both instances: arm with information so the best decisions can be made when the authorities ARE NOT AROUND.   In that sense, my job is not much different than that of a sex ed teacher.  Food for Thought.

Fecal Transplants: My Prediction for the Future of Medicine

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I have known about fecal transplants for years now, but they aren’t used very widely.  However, the topic came up in full force at Paleofx this year because the focus of the weekend was the microbiome.  If we are 10 times the amount of bacteria than cells, it is pertinent for our bacteria to be balanced, healthy, and happy in order for our body to express health.  Studies have shown over and over than when bacterial imbalance occurs, diseases such as recurrent infections, autoimmune disorders, bowel diseases, allergies, or even metabolic issues can develop.  When a person is in the middle of a disorder that keeps them feeling like crap, it can be a daunting task to think about all the lifestyle changes that need to happen in addition to a treatment phase of care on top of everyday life. That’s probably the toughest part of what I do: teaching a sick person to change their lifestyle while they feel like crap. There is a quick solution: fecal transplants.  Yup,  donated poop from a healthy individual into the intestinal tract of a sick individual.  This simple transplant has nearly cured diabetes in some, completely recovered patients from E. Coli complications, and reversed autoimmune diseases.

I think there is no question we are realizing just how important it is to take care of our bacterial health.  However, in a world of convenience and quick fixes, we don’t have many that address the underlying issues.  If the heart of most diseases today has a component of gut bacteria imbalance, aka dysbiosis, then this is surely the wave of the medical future.  In some ways, this makes me happy that a treatment will be addressing the cause.  In other ways, it is still just a bandaid.  If someone develops a disease and gets a fecal transplant to address it, it’s like giving a new liver to an alcoholic without the expectation that he or she quits drinking!  If the lifestyle factors that contribute to the imbalance in the first place are not addressed, the same dysbiosis will surely develop.  So, once again, lifestyle medicine is crucial to treatment and success.

The other problem I see is if everyone has crappy lifestyles and so many have bacterial balance issues, who is going to donate healthy poop?!  Maybe we will get it shipped from other countries.  That’s a thought, although it may not have great results due to the fact that your environment and ancestry determine the appropriate bacteria levels that are healthy for you.  However, this is a huge issue!  If every American has issues from diabetes to debilitating autoimmune diseases, who are the donors!?  Maybe this will be my side career.  Myself and my healthy friends and former patients will start a poop bank.  We have abundant resources if you consider the number of times one defecates in a week.  It would go for top dollar!  I may be on to something.

Moral of the story is: Bacterial health is crucial to your health.  If you have imbalance that is severe or unresponsive to changes implemented by a knowledgeable functional medicine practitioner, a fecal transplant may be worth trying.  If you were going to try it, you would need to be responsible about the donor.  AND mark my words, this will be the next big thing in medicine, but it will still not make a sick person well for very long if they continue the habits that caused the imbalance in the first place.  Would you take my poo?  That is the question.

Tips to treat your bacteria with love:

  1. Stay away from synthetic medication if you can, especially antibiotics (I can help you with this if you don’t know where to start!)
  2. Eat lots of fresh fruit and veggies, including some tubers (bacteria love to each soluble fiber)
  3. Cut out processed foods (yes, that means ANYTHING in a package)
  4. Take a probiotic (I have links to ones I like in the “store” across the top)
  5. Keep stress low
  6. Get 8 hours of sleep a night
  7. Don’t be obsessed with cleanliness; using antibacterial everything kills the good guys
  8. Buy organic produce and don’t worry too much about having it extra clean (soil organisms actually HELP the gut)
  9. Don’t use essential oils for ingestion on a regular basis, they act as potent antimicrobials and should be used orally for treatment of pathogenic issues for short durations only!
  10. Consume bone broth regularly in order to aid in digestion, maintain gut integrity, and create a nice environment for those little bacteria of yours!

Exercise: No Play, No Gain

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This is another post based on the speakers I attended at Paleo(fx) in Austin.  There were a few speakers that focused specifically on exercise, and I’ll be touching on the more complex theory behind Mark Sisson’s talk, but for now, this is all about a reality check for trainer, Darryl Edwards.  I really connected with his story because, like most of us, I have fallen out of love with exercise at points in my life.  Most people who are active will get really pumped at some point about a new sport, a new workout routine, a new fitness regime.  They will go all in, 110%, cult-syle.  To be honest, I did this with Crossfit!  I loved the competitive feel of the workouts, the opportunity to push my limits, an entire community of people doing what I was already doing alone (functional movement), and the new-ness of it all.  After a couple years, I fell out of love.  Not because anything had changed.  Nothing had changed but my own pressure around it.  I wanted to keep getting better, I was getting more competitive, I started placing expectation around my performance.  At the same time, I wasn’t focusing enough on fueling and recovery, which meant instead of building, I was breaking down. This environment I created around my workout was forcing me to dread going to the gym! I took a little time off, but never gave it up completely.  I just needed a moment to breathe, to redefine what mattered to me, to be realistic about what I wanted out of it, and to allow it to be fun again.  It could only be fun for me if I dropped my performance expectation and focused on the real goal, which was “funning” with awesome people to maintain my functional abilities.

Darryl also fell out of love with exercise…and he was a trainer.  Ooops.  What now?  As he sat on the couch one day, he wrote a letter to exercise.  His letter mimicked that of a breakup letter to a lover.  He related it to the cycle of a relationship and even though I couldn’t take notes verbatim that quickly, here is the gist:

Exercise,

We started off so strong.  I fell in love with you almost immediately.  I looked forward everyday to spending time with you!  I told everyone I ran into about you, how much fun we were having, how great you were.  As the weeks went on, I started to resent you.  You kept demanding more and more from me.  You were taking all my time.  You were keeping me from things I enjoyed in life.  No matter what I did or how hard I pushed, I was never good enough. I’m sorry to say that it all began to wear on me.  I have strayed.  I have been seduced.  I have fallen out of love with you.  You no longer provide me with those feelings of strength, self-worth, and joy.  I am breaking up with you, and I have found another.  She calls me daily and I have decided to give in to her.  You may know her, for she has stolen many of your other lovers, her name is Couch.

Exercise starts so rewarding, you feel invigorated, you tell everyone about it…until one day it becomes too demanding.  It keeps expecting more from you, it doesn’t feel as good.  You may break up or be seduced by your couch.  How do you fall back in love?  Play.

Having fun is the only way exercise remains enjoyable.  For some people, its engaging in a sport, some love dancing, some love being on a team.  I feel as though in adulthood, groups are great because exercise, activity, and movement are always more fun with you are doing it with other people!  It quickly turns into just another childhood night after school when you ask mom if you can go play.  Create fun in your exercise, and you will be must more apt to continue to move.  That is why I never left Crossfit; I love the people.  It never feels like a chore when I show up to Crossfit Michiana and see the faces of all my peeps.  Some days we are team members working with each other in a workout, other times we are fresh and excited about some friendly competition, and other days we are all “just there.”  Maybe the days we were “just there” weren’t our best performances, but we all left feeling better than before we walked in.  We probably laughed, joked, and for a short moment, forgot about the stresses of the day.  Find your play.  Make it fun.  Exercise for our body is as essential as water.  It’s a daily requirement in some shape or form.  It creates the environment around your genes and encourages healthy genetic expression.  We were meant for movement, and it might as well be called “play.”

Darryl runs a website : primalplay.com

We Live In A Borrowed World

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As I work with patients to correct disease, restore health, and give a foundation for their growth moving forward, I often contemplate what the world will be like in 10 years, 100 years, or 200 years.  As a species, we are doing a great job of creating a perfect storm for extinction.  With statistics of diseases growing exponentially, it’s only a matter of time before we will not be able to come up with enough drugs or surgeries to outsmart the diseases that will kill us.  We are looking at a population that will have 1 out of every 2 children born having autism.  Cancer is no longer confined to the elderly.  Diabetes has no mercy.  Anxiety and depression are literally causing our species to be sad, mad, feel as though we have no purpose, and unfortunately creating the tools by which we use to act badly toward one another.  All of these things rising without a real change in genetics.  If this were genetic, we would see MASSIVE shifts in our genome, but guess what, we haven’t seen more than 2% change since hunter gather times.  That means this is all directly linked to our environment.

If we left it at that, it may not seem like it could get any more depressing!!  However, we keep having children, we set our alarms every night in anticipation for tomorrow, we seek out healthcare professionals for answers to our problems.  These things tell me there is hope in the human race; if there was no hope, why would you ever consider bringing a life into such doom and gloom?  Why would you bother to even get up tomorrow?  Why would you give a damn whether or not you could change your health?  The fact that this hope for a better future exists, means that we all have a responsibility to be a part of it.

“Each generation borrows the world from the one that came before it and holds it in trust for those yet to arrive.  Each generation is a steward of this great gift while it is ours.”-John Izzo

On a very simple level, we have a responsibility to treat this Earth with respect, to take what we need and nothing more.  Part of our purpose, the purpose greater than yourself, is to leave this Earth better than when you arrived.  Do we do this by poisoning the crops, which in turn kills our soil?  Do we do this by over-prescribing antibiotics to the point of creating super-microbes that are resistant to any drug we could ever come up with?  Do we do this by feeding animals inappropriately in order to mass produce cheap meat?  Do we create such a shitty environment in our body that we hope our children can overcome all the epigenetic timebombs?  Please tell me we do this by single-handedly creating the sickest population ever to exist while turning a blind eye that we are the ones creating it.  If these are NOT what we should do to create a better future, then what are we doing?!?!

The beauty afforded in all this is that no matter what we do, the Earth and its microbes will still exist even when we have managed to destroy ourselves.  The world began with single cell organisms, and it can certainly maintain its livelihood without us.  If I consider purpose in life, happiness, and the greater good, I can’t help but continually ask: “What have you contributed today to leave this Earth better than when you arrived?”  If we did nothing else but ask that simple question daily, we may have a fighting chance to be happy, healthy, and leave a world worth living in for future generations.  After all, they will inherit the world we have borrowed from those before us.  Would you want to live in the world you are creating?

Lessons From an Oil Change

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I have always had Tuesday’s off from seeing patients, so that tends to be the day I schedule all of my own body maintenance, appointments, errands, etc. On this past Tuesday’s agenda was to get a massage and an oil change. As I was sitting at the shop, waiting for my car to be done (in my greasy hotmess-ness), I started to think about how the two appointments I had that day weren’t too different from one another. I knew I needed an oil change because it was around 3,000 miles since my last one. Was there a noise that sent me running to the shop? Nope. Was there a sensor telling me my oil was sludge? Nope. Then really, how did I know? Because we know that oil has a lifespan and that lifespan (depending on the oil) is around 3k miles or 3 months. What would happen if I waited until my car was throwing symptom after symptom at me that something was up? I may have actually waited TOO LONG to JUST need an oil change!
My massage wasn’t really much different. Did I have an ache, a pain, a problem? Nope. Did I have a “reason” to see the massage therapist? Nope. What I did have was a consistent timeline in my body that knows every month is good maintenance. There are so many benefits to massage that I won’t go into, but what I can tell you is that many times people go in for a massage and during the session, they realize how tight a certain muscle is, or notice a random spot of soreness. These things weren’t screaming in need, they simply had adhesions or stagnant blood flow. You never would’ve been aware they existed unless the massage therapist ran across them. Oh wait, you likely may have known a few months later when something started nagging at you. At that point, you are not getting maintenance, you are in need of acute care that requires multiple appointments within a short time frame.

Let’s look at it from another point of view because my mind does this; therefore, I am bringing you inside of my mind for that 10 minute break I had during the oil change. What happens when you have a check engine light come on on the dashboard? Do you take it to the shop for diagnostics? I would like to hope so. Would you be satisfied if they just put some electrical tape over the light or went in to the computer system and just turned it off without truly diagnosing the problem? What if they came back after that and said “All better! No more check engine light!” I sure as heck wouldn’t want that type of mechanic! Then why do you let the doctor give you a medication for your symptoms? It’s essentially the same thing. You have a joint pain? Take this anti-inflammatory. It will “cover up your check engine light.” What if the problem is actually an overuse pathology, a bone tumor, or a side effect to the cholesterol meds you’ve been taking? Have you fixed the problem? Nope. What if you have heartburn because your stomach isn’t producing enough stomach acid for your sphincter to get the message to close? You reach for a pill that is alkaline (like tums) to neutralize the hydrochloric acid coming up into the esophagus which dampens the symptom of burning; however, it did NOTHING for the underlying reason why the “check engine light” came on. The reason you had the symptom of heartburn is likely because there isn’t ENOUGH stomach acid.

You see, doctors are just like mechanics. However, you hold your mechanic to a higher standard in many situations. You would never put up with a mechanic just covering up a light or telling you to turn up your music so you can’t hear the clunk! Those solutions would be nothing more than covering up the symptom that brought you in. However, you often let the doctor give you a pill for a symptom that comes right back if you don’t take it. You want your body to last your lifetime? Then you must put a standard for it’s care at the same level as your car. At least you can replace a car; you only get one body.

*Thank you to my favorite mechanic, Patrick, at SAS Auto for always DIAGNOSING the problem, giving me all of my options, and doing what’s right for my good ‘ole car that gives me the ability to travel to all my patients near and far!