Transcript for:
Understanding Allergies and Gut Health

let's start with a big question that so many people who watch this show have which is can I recover from lifelong allergies that I've been suffering from people typically come to the clinic for something else let's say IBS or an autoimmune disease and we see allergies at the same time incredibly frequently and what I tell them is we're going to work on what you came here for and in the process of doing that work rehabilitating your gut working on your immune balance your allergies are going to go away and they never believe it but six months 12 months in that's absolutely the case so there's a lot of nuances in this term even allergies right so let's start off with just a little bit of clarification and then we're going to go right into what are some of the root causes of these allergies so everybody stay tuned so just let's make a little distinction there's allergies there's food sensitivities and there might even be some other things in between I think it's really really important for the audience to understand this so they understand how to actually get to the root so can you clarify some of those terms of course so three major categories when we talk about a dysfunction between the immune system and the interaction with Foods the first is a food allergy food allergies are you know the classic one is a peanut allergy you think of a child who has some exposure to peanuts and has a full-blown anaphylactic reaction that involves the ige part of the immune system and those reactions will happen in extremely short time intervals um you know something from on the order of minutes and you know typically we see those present initially in childhood and can persist later on in different forms people also talk about food intolerances now a true food intolerance means the body's inability to break down a product classic example there is lactose intolerance you don't have the enzyme to break down lactose therefore if you consume it they're going to be some ramifications of that that actually doesn't involve any immune dysfunction that's a genetic deficiency and something that typically also people have from a young age If you're lactose intolerance you pretty much have lactose intolerance from a young age you're going to be born with it but you know most genetic deficiencies will pronounce they'll become more pronounced as we get older so you probably have some lactose intolerance when you're born and it gets worse as as you get as you age essentially um people use that word intolerance a lot to mean that there is some immune dysfunction there for example gluten intolerance dairy intolerance is kind of the colloquial way that we discuss this but the true terminology is actually a food immune reaction sometimes we talked about that as being a sensitivity now that's a IGG and sometimes IGA mediated immune problem essentially what happens there is during our first several years of life we're programming in our thymic land what is dangerous to our immune system and what is not in other words self versus non-self and part of the programming is obviously also being able to decipher what is food and what is an external threat you know in other words we don't want our immune system identifying food the same way we would identify bacteria viruses parasites we need to make that distinction and those are not part of us but we need to be able to attack them or not attack them appropriately through the course of let's say what's going on in the modern world we're finding more and more adolescents adults basically losing that tolerance losing that ability to say this food is not dangerous to me and essentially attacking it the same way that you would a virus or a bacteria and the immune system will use IGA and IGG antibodies to be able to mount that attack so a very different part of the immune system than a food allergy is involved in a food sensitivity and increasingly what I'm hearing from you is over the years you're seeing more and more people that are suffering from this so this is not something that's in our genetics this is something that's happening in our world in our environment around us that it's causing the situation where yes it's food but also people are more reactive to even things like pollen and other situations which might have something to do a little bit with our gut health not always but there could be some links there that we can chat about in a little bit so is that what I'm hearing you say that it's increasing over a period of time that it seems more and more people are eating things that maybe in the past we would have tolerated but now we're not doing well with absolutely the most extreme example of that is celiac disease that's a full-blown autoimmune condition triggered in the intestinal lining by the consumption of gluten wheat products typically are the gluten containing food that we talk about the most 15 years ago we had an incidence of about one percent of the population with celiac disease and now we're up to three percent so a tripling in that time frame absolutely cannot be explained by anything other than environmental change making up that difference so let's talk about in that context of those three different things that you mentioned right you talked about a pure allergy right somebody could have uh shellfish allergy they could have a peanut allergy um they could have uh in some cases I've seen people uh later develop allergies to other foods that are traditionally categorized which is very specific then there's an intolerance right as you mentioned lactose intolerance are there any other things that fall in that bucket of intolerances that you see typically that are a true intolerance besides lactose not commonly I mean there are people who are born with the inability to break down certain amino acids ability inability to break down fat for certain genetic reasons but true food intolerance is outside of lactose intolerance are actually quite rare okay got it and then there's this big category that most people watching today who probably came across this video or podcast they're dealing with which is they're eating certain things and they don't feel good and many of those people have gone to their doctor well-intentioned and said hey I think I have an allergy to X Y and Z or I think I have an allergy to something I don't know what it is and they get a traditional allergy panel done from their doctor tell us what is that panel looking for and why does it fall short when it comes to this category of these sensitivities and this immune response that's going on in the body okay so there's two major ways in which a physician would test for quote-unquote food allergies the first as you alluded to would be a blood panel now the blood panel is essentially going to look for the development of ige antibodies to different foods or other environmental agents like pollen mold grass whatever it is that you want to look for and ige stands for it's immunoglobulin e so that is the part of the immune system that triggers an allergic response essentially the formation of that ant to body leads to the allergic response to the presence of whatever it's formed against in the environment so if you have an ige allergy to peanuts you get an exposure to peanuts that's what drives the immune system to have that anaphylactic reaction so part of that would be a blood test is that also when you see classically sometimes people come back from the doctor's office and they have a prick test is that another version of these tests that's another version in theory of doing something similar to that so the second way that Physicians typically try to confirm allergies is a prick Test Now what is a prick test you're basically putting a minute amount of the actual allergen itself on these tiny needles piercing them through the skin where they have exposure to the surveillance cells of the allergic immune system which are called mast cells and once they penetrate the skin then the body can form the ige allergies and if you get a hive or a welt or something in that location The Physician will say well you have an allergy to whatever was on that needle there are issues with that test in particular you know they you just in general if immunological testing is going to be accurate that thing that is either inside the well for a blood test or the antigen that is on the tip of that needle needs to be pure and it needs to mimic what is actually out there in the real world so a lot of times with commercial testing whether it be blood testing or prick testing we're using industrial synthetic versions of the environmental antigen because let's say the the alternative to this is taking a large concentration of a tree pollen and extracting the protein out of it and then putting it on the needle tip that's very expensive that's very cumbersome to do so you know using synthetic versions are far more efficient but they are not the same thing as what's out there in the environment so it's difficult to draw a hundred percent one-to-one conclusions that the reaction in the skin or the reaction in the well is entirely the same thing as what that human being would experience in the real world so some people could have an allergic reaction to pollen and they live in Texas yeah and because the pollen they're regularly exposed to might be different you know it's actual real life real world pollen that's there but they got their testing done and the synthetic that they were exposed to in for example a prick test and in a blood test they're also exposed exposing the blood to a synthetic in a tube is that correct correct right so they take your blood they expose it to something uh you know pet dander or pollen or this thing or that thing whatever mold but what you're saying is that there could be a gap because it's not exactly the same so you could still have an allergy towards something or an immune response which is a little bit different um allergy is still an immune response but there's obviously a spectrum of immune responses that you're talking about earlier and so those tests are not perfect but they give some people some insight yeah again I think probably the most meaningful information that's going to come from a traditional allergy test is thematic information about where that person's allergic immune system is right so if you see thematically lots of reactions to things on the prick test in other words that individual just becomes one big red Hive after they have that test performed on them you're going to say hey your mast cells and your allergic immune system are really pissed off right now maybe you can't draw one to ones about what did it but you know overall that part of your immune system is not happy it's not balanced same thing with the blood testing you can get that thematic information but the most important thing I think also is to remember that when you're doing an allergy test you're only gathering information about food allergies ige ige so you know the watery itchy eyes the swelling of the throat skin reactions and again these would happen in the order of minutes following the exposure it's an immediate thing you need something you're having an immediate response that's traditionally detectable through these things that you mentioned right watery eyes other stuff but you could also have there's foods that I eat which we'll get to in a second and you too that when I have them especially in a large amount I get a runny nose yeah but that food has never showed up for me in a traditional ige test yeah traditional test so this whole other Spectrum remember there's three there's traditional allergies there's intolerances and there's sensitivity they're not showing up for me these Foods on an allergy test I'm not having an intolerance to them but there's this whole food sensitivity thing which I've done some Labs that give me some indication that these Foods may not be the best foods for me doesn't mean that I can't have them ever there might be some people that can have them ever and we'll talk about your story but that's the whole mystery that unlocks this food allergy quote unquote equation and can help people eat better in a way that doesn't make them feel like they just don't feel good so going back to the what you mentioned there still can be things and times where you eat foods and you don't feel good but it's not showing up on an allergy test right so that's what we talk about in the public realm as being a food sensitivity the medical term is a food immune reaction whereas an allergy is mediated by immunoglobulin e or ige the food reactions are mediated by a completely different compartment of the immune system and the antibodies are IGG or IGA that's why an allergy test would never pick up a food immune reaction or sensitivity you know just to bring this up here to tie this back to the first question as people are following along and you're understanding and you're building a map of this world in this category of food sensitivity can you get better and can some of the symptoms of eating certain foods and feeling extremely tired or a runny nose a headache can those things get better can you get better from a food sensitivity yes you absolutely can once you have correctly identified what the I think root of the problem is which is in general going to be intestinal permeability plus food immune reactions and and you know we begin the healing process by removing the offending organisms and then repairing the barrier people absolutely can get better from it awesome and we're going to walk people through that whole process so coming back to and closing and putting a little bow tie on the test that are there whether they do blood tests or prick tests and traditional allergy testing just to connect the dots for everybody it doesn't mean that you shouldn't get these tests because from what I'm hearing from you you're really looking for two things number one if you have a strong reaction to something you probably have an allergy to that thing right that's number one number two is that if you have a lot of reactions to different things that also can give you some information that whoa your immune system shouldn't be this reactive to everything something deeper is going on and that deeper thing spoiler alert has something to do with your gut health we're going to break that down would you agree with those two statements that's completely accurate okay great so it's not that we want to you know a lot of people say well my doctor ordered me this allergy test should I do it should I not do it great especially because those tests are typically covered by insurance if you've never done one before it could be helpful but understand there's both possibilities of false positives and false negatives you have to understand that test in context and unfortunately well-intentioned doctors that are running this may not be aware of this whole world of food sensitivity so they would tell you no you're fine just keep on eating anything you want you scored nothing on this test meanwhile all these people are running around like I don't feel fine I feel sluggish I feel brain fog when I eat certain things I feel like uh my face gets more redness which is something that happened to me eating certain foods so just understand these things in context that it could be helpful but there are false positive false negatives but here's how they could be helpful extreme reactions and also if you react to a lot of stuff then you have to start digging deeper for answers now let me ask you when you Google you know a lot of people are Googling especially with the topic of a few years ago a lot of people were talking about gluten sensitivity and the whole gluten-free movement was taking off and there was good things that came from that and there was not bad things but things that were a little bit misguided you know everything was being labeled as gluten-free that was gluten free and a lot of people were putting uh just thought that gluten-free immediately made something healthy right but obviously you can have gluten-free Skittles you can have gluten-free candy this that um and in that process a lot of people were Googling do I have a gluten sensitivity because the word sensitivity started showing up more so you started to see CNN Fox all these media Outlets uh Harvard this place that all these institutions media Outlets saying to people a lot of advice was if you don't have Celiac which can be tested for right even that test is has to be interpreted a little bit but generally most doctors can test for it now there's awareness this whole idea of gluten sensitivity is right don't bother with that it's all marketing it's all uh you know Wellness Trends don't bother with it if you don't have Celiac you don't have a gluten sensitivity I'm using this example because gluten-free probably was the most popular one you know next to maybe Dairy right and people Googling do I have a dairy sensitivity so help us understand why were so many people and people who seem very accredited and big institutions why were they telling everybody that this whole idea of sensitivity and gluten sensitivity was and then tell us how you look at it well I guess the only way to kind of have that discussion about why there was so much pushback against this um growing awareness in the public about how food is impacting the way they feel is that medicine in general is very resistant to change and very resistant to new information I think some people argue that that maybe that's necessary because when you're treating human beings you can't uh you need to vet things you need time essentially to vet what's real and what's not real because science is a malleable process I guess that's probably the nicest way to say that that's why there was so much pushback since then there have been a number of articles that have absolutely you know kind of concretely proven that a different version of gluten sensitivity other than celiac disease exists now we call that non-celiac gluten sensitivity ncgs in the medical literature but um you know I think probably the thing that we see in clinical practice in the functional and Integrative Medicine world is you know bread and butter somebody comes in with Hashimoto's you do a gluten sensitivity panel on them you know they show up as positive on the gluten sensitivity panel you remove gluten for them and their TPO antibodies will drop almost immediately and their thyroid function will improve and that has been shown now in clinical studies in the medical literature to be true so we we know that this exists there's no question about it um and you know when you look at numbers in the population upwards of maybe 10 of the US population has non-celiac gluten sensitivity it's not a small number of people out there so I think that essentially despite the pushback from the medical establishment when this information was coming out and this is also beginning in the early 2000s it's been a long time we're talking about 24 years since Alessio Fasano first published his initial paper on on leaky gut can you talk about him just for a quick second oh sure who is he where did he come from and how did his work sort of change the medical understanding for Physicians that were paying attention right just so everybody's clear you know I have a lot of physicians in my family you are a physician you have a lot of Physicians and people in in the medical world in your family Physicians are well-intentioned right just like most people are well intentioned sure are there bad anything in any kind of group of course there's going to be bad teachers there's going to be bad this that that that's a small small percentage of people that are not well intentioned or are malpractice or this or just you know whatever and they largely are practicing medicine based on how they were trained and for a lot of Physicians like how long ago that you were in medical school started in 2004 finished in 2008 17 years ago that's 15 years ago right so a lot has changed in the last 15 years especially when it comes to certain Cutting Edge topics especially this and outside of drug reps visiting people's offices or a physician's own interest of course there's continuing education credits and other things that you have to stay on top of to keep your boards active and other things but it's usually not the most Cutting Edge thing and which isn't just hey what is this Wellness influencer doing or that it's actually dissecting the latest papers so Alessio Fasano who is he and how did he change this whole approach of food sensitivities at least in one big category which is related to gluten so I'll start off with saying I have great admiration for him I think what he discovered and what he pursued afterwards absolutely changed the current state of Medicine so Alessio is a pediatric GI very brilliant guy he's from Italy extremely Charming has written a great book by the way he was investigating causes of third world mortality and morbidity because he's a pediatric GI he was focused on kids that were dying he was investigating cholera which is a bacterial infection cholera kills kids in third world countries by causing a water wasting enteropathy what that basically means is their digestive tract gets so destroyed that they just are pooping out water to the point that they become so dehydrated that they die he wanted to know how cholera had the ability to do that presumably bacteria have that ability to do that to us by having a specific toxin that can do something so he isolated the toxin a candidate for the toxin from cholera didn't know what it does gave it to monkeys and immediately saw that the monkeys developed a water wasting enteropathy so he said aha I found it this is it this is the cholera toxin so he wanted to find out exactly how does this toxin do this how does it disturb the gut so much to the point that you're just losing all of your water through the GI tract so he he gives it to monkeys again looks at their intestinal tracts post-mortem under electron microscopy and essentially finds that their tight junctions of their small intestine are completely open and just to clarify for the audiences it doesn't know about this tight junctions little sort of tangent on that small intestine for simplistic discussion is is essentially lined by a single cell uh that are called epithelial cells very similar in function and structure to what you have on the outside of your skin the inside of the small intestine has a single layer of that that separates food bacteria the microbiome on the inside and blood on the other side so this is a very very vital interface for us a place where we interact with our outside environment internally and there's literally a layer of cells that protects you from that internal uh environment so to keep that single cell layer from being able to you know perform its probably the most vital function which is to serve as a wall they're glued together essentially but they can't be glued together in a permanent fashion because then you would never be able to pull nutrients in when you want to you would never never be able to send an immune cell across the wall to the other side to find out what's there and then be able to come back in so we have these malleable Gates if you want to think of them that way called tight junctions that are just in between the epithelial cells and at the time we didn't know this but through Fasano's work essentially what he found was the cholera toxin artificially opened that gate and kept it stuck open and with an open gate in between epithelial cells the body can't keep what's called a hydrostatic balance and you just flush water in because also you the immune system thinks it's under threat so it's trying to get rid of whatever is causing that severe injury hence why animals and human beings all get diarrhea when they are exposed to certain things the body feels like it's under threat and diarrhea which we think of as a bad thing is actually a defense mechanism that the body's trying to just get rid of everything inside to finish the system exactly so Fasano basically finds the cholera causes this by is essentially creating massive leaky gut okay now we knew in the medical world that leaky gut existed but the only context in which we really knew that leaky gut existed was in celiac disease and that was almost 100 years worth of data at that point in in the in 2000. uh the idea that leaky cut could exist outside of celiac disease not something that we knew or accepted in the medical literature that didn't deter him okay so the next thing he did was a mouse study and he gave mice what he now called zanyula occluding toxin that's what the name he gave the cholera toxin z-o-t why zonula occlude in toxin because those are the proteins that make up the tight Junction and that's what the toxin is interfering with so zanyula occludin are the the proteins that they mess with so he gives mice zot the next thing he knows a couple weeks later those mice develop type 1 diabetes wow huge huge Discovery now we're talking about doing something to the gut of an animal and inducing a systemic autoimmune disease for them yeah and just to be clear for everybody type 1 diabetes is an autoimmune condition it is an autoimmune condition characterized by the destruction of the pancreas by the immune system so you have something changing the environment and normal physiology of the gut and the next thing you know the systemic immune system is attacking an organ something that it is designed under no conditions to do it's the cardinal sin of the immune system yeah and bear with us here because all this connects right this all comes back to food allergies and why people feel shitty sometimes when they eat certain things even if they don't have type 1 diabetes we're laying down the groundwork so that you understand how this is all connected this story is probably the most important one in I think in modern certain immune understanding honestly not just functional and Integrative Medicine the whole medical community should know this story okay please continue so he's Fasano is bright enough to understand the implications of this because a gut driven systemic autoimmune disease is groundbreaking so first he wants to know does this happen in in human beings with autoimmune disease so he takes patients with celiac disease the most likely uh group of people to have intestinal permeability and he does a study and confirms that they have a much higher incidence of having intestinal permeability how does he measure for the intestinal permeability This Time by looking for the decoupling of zonulin from the tight Junction into the blood so essentially he has now gone two steps confirmed that gluten a gluten induced autoimmune disease has a leaky gut problem and confirm that you can test for that leaky leaky gut problem with a blood test okay next study adults with MS so he took another autoimmune another autoimmune condition this time the brain we're not interested in the gut anymore because that seems pretty clear so he wants to confirm does intestinal permeability the thing that he did to the mice can that result in an autoimmune disease elsewhere the brain is very far away from the gut so he took Ms patients there's two subtypes there's a spontaneous Progressive subtype of Ms where essentially they unfortunately just keep going and going and going there's another subtype called relapsing remitting so these are people who have MS flares and then have periods of time where their Ms is completely quiet right and traditional medicine they don't know why why are you having these symptoms and all of a sudden they seem to disappear correct and then you have them again correct exactly so in the subgroup of relapsing remitting Ms when they were actively in a flare the zonulin levels therefore their leaky gut was extremely elevated versus relapsing remitting Ms in remission the same levels of zonulin as the control group so just to link this back to his original studies right he was able to create sort of this diarrhea in Apes for example and he identified you know this methodology of doing it and also seeing that these zonyan levels were high yes right so it's like okay this is correlated with them not feeling good but then also in these type 1 diabetics same situation of this zonulin being high that could be that well in the mice right was a mice trial yeah when the zanya was high he was able to induce this autoimmune condition type 1 diabetes and now he's continuing that thread to see same sort of situation in the MS at least in one category of Ms I'm going to summarize it one more time because it's really really important so the first thing he discovers is leaky gut is real yeah that's what he discovers when he extracts the toxin from cholera like it's an actual medical thing that's going on in the body yes all the literature even for 10 years or 15 years after that Discovery said that's but he discovered concretely that leaky gut is real number two leaky gut is controlled by a protein called zonulin number three leaky gut can cause an extra intestinal autoimmune disease huge Discovery gluten consumption is tied to leaky gut and zonulin and we can talk about you know how we have gone a Step Beyond this in research since then but zonulin is a reasonable marker for leaky gut meaning you don't have to do a small intestinal biopsy on human beings to prove this and then since then several studies showing that gluten is one of the potential sorry one of the biggest triggers in the environment for inducing leaky gut via zonulin so that's where we got to the point of non-celiac gluten sensitivity what happens to those individuals is they're consuming gluten their immune system is reacting to it they get a zonulin release and they induce intestinal permeability a small version of what cholera does essentially a minute version but one that could happen day after day after day after day if that human being doesn't know that it's happening to them yeah and to take this back to the question that I had asked you about why do so many what seems to be well established individuals institutions and obviously the Press sort of quoting them say things like hey you know gluten sensitivity is and even before alessio's work there there was some there was studies that were out there that were pointing out different things but he concretely connected the dots so if somebody's still saying that it's either you know I don't love this word but it's misguided information you know I don't say misinformation but it's misguided information that is just related to they're not aware of that work that's out there they're not up to date on the literature I would say is the right way to discuss yeah somebody who's not aware of this at this point and so tell us you know before I talk about you know you mentioned something really interesting you mentioned for example somebody comes to your clinic let's say classically it might be a woman who's dealing with Hashimoto's because 80 I think 80 90 of Hashimoto's cases are women is that correct that's correct so it's a woman you know maybe in her 30s 40s 50s 60s who's been uh either diagnosed with Hashimoto's or is starting to maybe Google and sees that they have symptoms that might be related to Hashimoto's and that they come in and then through advanced lab testing they find out that one of the things that might be playing a role is that they have in this case they've been eating a food their entire life that they didn't know is agitating and encouraging their Hashimoto's symptoms it's not that non-celiac gluten sensitivity or just gluten sensitivity is causing their Hashimoto's I don't think we're at that place we could say it's directly causing but it's definitely seems one of the be one of the big factors for many patients that's influencing it is that a way to say it yeah it's a big chunk of their um pie of how something like that happens right of course stress plays a role other things play a role but in this particular case what are some other examples of chronic diseases that people are dealing with every day that even if it's not gluten that it could be other foods that are out there that they're in this category where they are dealing with the food sensitivity and they may not know that that food sensitivity could be potentially a big chunk of why this chronic disease is there in the first place or why they have really bad symptoms from this chronic disease number two most established in literature Beyond Hashimoto's is multiple sclerosis and multiple sclerosis is not typically gluten so the target antibodies the target tissues in multiple sclerosis are myelin basic protein or myelin oligodendrocytes they have what we call significant cross-reactivity with the dairy protein casein what is cross-reactivity mean the immune system is not a perfect system it when it recognizes things to attack it does so with maybe 70 or 80 percent specificity if there is another protein in the environment that looks that 70 or 80 percent similar it essentially cannot tell the difference between the two of them that is the case for myelin basic protein myelogol myelo oligodendrocyte targets essentially they look extremely similar to the immune system as dairy protein so if an individual with known diagnosed MS has a food immune reaction to Dairy the consumption of dairy will drive the antibody formation against their neurological tissue put that in a different context if that person takes Dairy out of their diet their immune reaction against their neurologic target tissue is going to drop and they are going to feel better yeah this might be uh for example people have heard of like Terry walls who's been on this program before medical doctor and a researcher in the space of Ms published multiple studies on her walls protocol and she classically has talked about getting off of certain foods that she didn't have an allergy towards and that was one of the things that helped her gut heal in the process of her journey of getting better which literally she had progressive MS she was in a wheelchair and it kept getting worse and was in terrible terrible pain she still is dealing with some of that pain but she is walking she rides her bike regularly she works out she's been on this podcast multiple times before so if anybody has a mess we can definitely link to that so separate from Ms and and uh Hashimoto's and autoimmune conditions there's this other category of people who haven't been diagnosed with a chronic disease they just feel like crap FLC as uh you know Dr Hyman sometimes calls it yeah I've even referred one of my friends recently to you who's in this category right just somebody who feels bloated regularly doesn't feel like their digestive system is working well regularly feels like they don't have the opportunity to have their system working in the way that they wanted to feels lethargic on a regular basis so there are people that are in that category um obviously I'm not asking you to diagnose a whole group nor could you but do food sensitivities play a role for those individuals or can food sensitivities play a role for those individuals in the vast majority of them there's a food sensitivity issue now for them is it the same mechanisms right because they may not have a diagnosed chronic disease or maybe it's not bad enough yet for it to be that way but how do certain foods end up causing this immune Cascade in the body that has them feeling like crap so I think the first thing that everybody should understand is when you're dealing with an environmentally induced immune problem there are stages so there is a pre-autoimmune stage then there's three stages of actual autoimmunity most people who have several different parts of their body that aren't functioning the way that they think they should be functioning or it's a significant drop from their Baseline are suffering from that pre-autoimmune condition the environment essentially driving their immune system into a chronic inflammatory imbalanced State yeah and just so everybody's clear environment just means anything outside of your body correct the food that you're eating could be chemicals that you're exposed to largely what you're talking about is of course food but there's a whole host of things that are part of that yeah I mean in reality food is the biggest part of the environment that you're exposed to I mean you know you're consuming food three four five times a day depending on what that is that could be regular continuous inflammatory exposure so in the reason we focus so much on food is number one it's the biggest part of the environmental conversation and number two it's the thing that you have direct control over you don't have a lot of control over the quality of the air that you breathe on a daily basis you have some control over it but not as much as what you consume right so that's why we really focus so much on it it is the biggest piece of the puzzle and it's the most movable piece of the puzzle so you were talking about these three different stages right yeah so you explained the first part which is this pre-auto mean stage yeah right and and we're not necessarily talking although it's related to you're not just saying that hey everybody's going to end up with an autoimmune disease even though autoimmune diseases are skyrocketing and I think are one of the fastest growing classifications of diseases what's the estimate in the United States is it 80 million people currently we're at 15 of the U.S population with a known diagnosed autoimmune disease but most autoimmune diseases have a latent period of somewhere between three to eight years so if you kind of want to back extrapolate that data we're looking at maybe upwards of 25 percent of the US that's crazy and what's the population right now of the US do we know can you Google that what's a I think we're like 300 yeah and something million 331 million so that's a lot of people that have autoimmune conditions diagnosed and there's some people still to this date magazines media Outlets even some doctors that I see that will tell people oh we're just getting better at medicine so we're catching these diseases that's that's why there's so many people that have autoimmune is because our medicine and access to Medicine in the United States has grown and that's why we're catching it tell us why that is not the answer or at least definitely not the full answer it's very clear from the literature that that's not true I mean we have very robust data in the nhanes trial if you look at the percent positivity of a positive Ana over time during nhanes you see doubling of that percent population and andahanes in that regard has only been analyzed I think back to 2015 at this point so no question there's there's no way to discuss this other than scientifically true fact that autoimmune disease is on the rise yeah and only in the last 15 years let's say which is a very very alarming time frame to experience something like that so something's been going on in the last 15 years right something's been going on that's not just affecting people who have diagnosed autoimmune diseases although you gave two perfect examples Hashimoto's is one Ms is another but also this other category of just people who just don't feel good on a regular basis people who think that they're eating healthy something has been changed in the environment it's not our genetics our genetics takes millions of years to sort of evolve even in the smallest realm but there is our epigenetics that are going on in the body which is how we react to the environment so what the hell is going on in the last 15 years in your opinion it's all I think the majority happening in that pre-autoimmune category which essentially if you want to break it down to a cellular level it's really the normal physiology and function of our entire gut environment and the immune influence from that that are completely broken the the most important regulator of our immune system is a cell called the T regulatory cell the T regulatory cell we have different populations of them there's a gut dependent or gut populated t-regulatory cell which is essentially responsible for the balance of what in my environment do I want to attack or not attack so when you have let's say a food sensitivity or you have a new adult allergy that you didn't experience before is essentially dysfunction of the T regulatory cell that brought that set of symptoms on also if let's say you consume foods and you get brain fog or runny nose and digestive issues afterwards it's essentially the environmental triggers that are pushing that t-reg cell to imbalance that are responsible for that if you really want to break it down to one part of the immune system t-reg cells their balance you know essentially is fed entirely by what they see as threat versus non-threat in the localized internal environment of the gut and with so many people experiencing intestinal permeability so much dysbiosis out there so much constant exposure to chemicals the T-Rex cells see themselves as under constant threat and when they see themselves on constant threat they're going to try to fight back and the way they fight back is with a chronic inflammatory response from the immune system and we feel like crap when our immune system is in a chronic inflammatory state everybody's walking around over inflamed not everybody but a lot of people most people they're walking around over inflamed and it's because their body is trying to fight something inflammation is a tool right so even though we don't like these symptoms brain frog runny nose these are all defense mechanisms these are all sort of signals these are all canaries in the coal mine that are an indication that some sort of localized inflammation or or chronic inflammation is happening inside the body and even though we don't like it our body doesn't make mistakes right our body is doing this for a reason because it's under threat why isn't it a threat because our border in our body which is our gut health and is is out of whack because the foods that we're eating dysbiosis meaning we have too much of the wrong bacteria not enough of the good bacteria and also the chemicals that are in the environment but would you say out of the ranking all those food still is the number one trigger for most people of their body being in a constant state of threat yeah it doesn't begin that way I think but it rolls in that direction you know we probably have silent ongoing injury to that intestinal lining for years and then when there's enough permeability then we start developing the food reactions I think that's an important thing that you mentioned because we're not saying that or you're definitely not saying that you know this food caused this issue you're saying that this food is part of the story of this issue right and the story started much earlier and it just so happened that certain foods are more likely to perpetuate this issue yeah so we don't want to be demonizing foods and I think that's where a lot of people in the traditional world of medicine they get upset when they see Wellness people podcasts like myself other individuals they see on social media that they feel that are they're demonizing foods which causes a lot of uh food anxiety for people and prevents people from nailing the basics and sure there is some misguided communication around that right but here you're getting a chance to clear it up that we don't want to demonize a food we don't want to in just immediately say certain foods are bad or certain foods are good you want people to understand how they're part of this story so tell us how for a lot of these people when you sit down with a patient and you're spending an hour in your first appointment right or your team is spending an hour meeting with them and going through their history and asking them about early life experiences what are you looking for to put that story together about why they may be feeling the way that they do I'll talk about my own story because I think it's very reflective of the majority of people that we see coming into the practice so I was born in Los Angeles my mom had me via vaginal delivery she did breastfeed me for a few months actually I think almost a year so did her best to try to help nourish my intestine micro environment try to feed my immune system the correct things but uh I got sick a lot as a kid I remember very clearly a pink bottle of amoxicillin that just lived in our refrigerator antibiotics antibiotics right and back then in the mid to late 80s Medical Practice was you know a kid's not feeling great here's a tablespoon of antibiotics and just keep doing that and his baby too so I'm riding that boat yeah I'm telling both of our stories at the same time you know I remember loving that pink uh syrup that was sweetened and tasted good to me um but you know what those years and years of of antibiotics were doing were eventually depleting my microbiome of their most essential members chronically over the course of five ten whatever years that was yeah and and the research has shown just even one round of antibiotics can destroy and I'll link to this in the show notes but I remember clearly at a at a functional medicine Institute of functional medicine presentation even one round of antibiotics can have a serious impact on the total quantity of good bacteria inside the gut right and this is no knock on appropriate use of antibiotics you know if you have strep throat you should treat it right you know the ramifications of that are are not untreated or are not good you know if you have sepsis antibiotics save your life no knock on that but I think in that era we were very very clearly dramatically over prescribing antibiotics and that that had ramifications um and that that practice likely existed up until recently um so you know that's a huge chunk of the population that had that ongoing regular hit to their microbiome you know also coincided with a dramatic rise in the availability of industrialized food fast food um you know I think my parents were are doing their best but they both worked full-time and we ate fast food uh pretty often maybe two or three times a week and that's Ultra processed you know tons of gluten tons of dairy typically coming from food sources that are you know mono agriculture High pesticide exposure you know very improper breeding tactics for the cattle that's used for the dairy that's used in those products it's essentially the cheapest way to grow anything that you're going to be consuming so fastest and cheapest fastest and cheapest right and probably chemically engineered to taste the best and be most addicting um you pair that with somebody who has dysbiosis and you know those t-reg cells that are developing inside of my gut at that time are just going to be bombarded over the head over and over and over and over again until they're essentially going to say okay whatever we're doing isn't working here we're under continuous threat we're going to recruit everybody here and we're going to start fighting and unfortunately though that comes from good intent from the immune system that inflammatory signaling propels the leaky gut and propels the food immune reactions to another level and that's where you can start getting dedicated antibody formation to foods and you know like the the inflammation just ticks up a notch and people can have lifelong issues from that for me I had IBS and chronic sinus infections for a very long time um I was very fortunate that when I was in medical school in 2000 and five my dad was in in the process of developing some of the first clinical applications of testing for these things essentially the first food sensitivity testing he had actually dabbled with it in the late 1980s and was bringing it back in in the 2000s and he ran his earliest versions of gluten sensitivity and dairy sensitivity panels on me yeah that's a legend in this space By the way thank you he like totally transformed because one of the big problems was starting off at the beginning of the podcast is that most people just have these allergy tests and as we mentioned there's false positives there's false negatives in the way that we explained earlier and then there's all these researchers that are on The Cutting Edge that are like we need something better we need to look for something different and your dad was the main guy that did that in this field of Integrative and functional medicine yeah I'd say um he's the The Godfather of bringing leaky gut and food sensitivity testing to the modern world and at the same time also just continuing to push the now known idea that the environment impacts the immune system that is responsible for this spike in autoimmune disease and we owe him a great great attitude debt of gratitude I'm very proud to be a son of course your son how much of your story was a driver in him looking for these answers you know it was actually his mom's story so uh my dad just won the ifm Linus Pauling Lifetime Achievement Award congratulations I deservedly so I know I'm biased in saying that but uh the man is a humble scientific genius and he deserved it um he was driven actually by his mom's story his mom my grandmother suffered from um really debilitating rheumatoid arthritis another autoimmune condition autoimmune condition but it did not kick in until her Middle Ages um and really uh he has a really remarkable story about kind of watching this happen she you know they were growing up in Israel and you know Israel was very much a developing country at the time and she had some serious Dental issues Dental cavitations infections and they weren't treated appropriately she eventually had her teeth pulled but without antibiotics and um she the my dad's ideas essentially that watching that happen to his mom was the triggering event for the R.A and we now know through his own research and several other people's research that the dental organisms of infections in the mouth are very much responsible for the development of RA in certain individuals so and is that through the process of when these teeth are extracted you have these cavitations and these cavitations become infected and that can in a way leak bacteria into the body is that the mechanism 100 okay yes and you know there probably was a chronic infection for that individual for years before it was ever detected so it's one the setup of The Chronic infection then the extraction event and then the flood of the bacteria from the cavitation into the bloodstream yeah and it's not to say that you shouldn't have teeth extracted it's just you know looking for a dentist that understands to make sure that no living matter is sort of left in and that the cavitation is completely sterilized before they go ahead and close it up otherwise it's like taking a bunch of trash throwing it out of the room and locking it and that trash ends up fermenting and attracting rodents and this and that and that's how people get affected by these cavitations exactly so so he essentially in real time watched my grandmother develop ra as the result of this Dental infection so he wanted to dedicate his career in Immunology to shedding light on this you know shedding light to the idea the number one the environment is responsible majority in the majority for the development of autoimmune disease and then number two mapping out what those things in the environment might be and then number three developing tools so clinicians like myself can accurately identify those things in our patients and you know I'm very grateful that I have those tools available to me because they are the thing I think that allows me to be a more precise physician for when people come into the office let's go back to your story how early did you notice some of these symptoms that you were going through I mean you mentioned that you would get sick a lot as a kid you gave us some examples but when did it really start to get bad for you in medical school early medical school I couldn't keep up with the demands I had a sinus infection every single month like clockwork I just didn't feel like myself I couldn't concentrate the way I wanted to I was having a hard time sleeping and yes medical school is stressful but this was beyond that and and that's when he took my sample and said you have a gluten and dairy Sensitivity I you know this is 2005. nobody was executing a gluten-free diet or a dairy-free diet I mean it was it was like what are you talking about Dad what the hell what is gluten what are you talking about so he said listen I know this is daunting do it for three weeks just do it for three weeks see how you feel and if you don't feel any better I'm wrong but if you feel better then maybe you should think about doing it so I followed his advice um I haven't had a sinus infection since obviously he was right and I feel dramatically better when I remove gluten and dairy from my diet and I noticed the effect within a week I was clear I was sleeping better I just felt more like myself and um anytime I do have a little Excursion to Europe and I try a little reintroduction I get a reminder of why I remove them two things on that story number one congratulations I'm so glad you aren't having sinus infections anymore I had a lot when I was a kid same situation as you always on antibiotics even with my parents coming from like ayurvedic influence in our background and they did bring in some of those things you know they would bring in some of those things to treat like strep throat when I had it but I was in this constant cycle of medication getting sick medication getting sick and my gut was irritated all the time my gut was irritated all the time I remember even just as a young kid having an aversion to eating sometimes because I just intuitively felt like I don't want to feel bad right I don't want to feel bad and so I'm just not going to eat certain stuff which made me both a picky eater but probably not a good eater uh so your story is obviously there's themes of that they're going to be applied to a lot of people that have food sensitivity but there's also uniqueness you and I were on a lot of antibiotics maybe for some people they weren't on as many antibiotics but it's also not just antibiotics it could be adverse childhood experiences that people have you know you grew up with an alcoholic parent you grew up in an unstable family situation something that put a lot of extreme stress on you you were sexually abused even these things have been linked to you know look it up the aces study these things have been linked to autoimmune conditions these things have been linked to gut permeability and leaky gut as well so it could be antibiotics could be extreme stress there is a friend of mine uh uh nishta who lives in um the UK and her daughter crazy story was in their teens they went to visit I believe they were in Dubai they live in London they were jet skiing I think and something happened and her daughter fell in the water and she drank a bunch of water that also had like contaminants like oil from like you know the area I think even some bacteria and ever since then they didn't know it was that she developed IBS so you could have a few different things that can be these external environmental factors that come in and basically start to disrupt the system but I just want to make sure that people are clear you're not saying that for everybody it's gluten and dairy or that every single person out there has a gluten dairy issue right these are the common these are common size there are everybody has their own individual version of this and you know what I look at is my task when I'm seeing a new patient is first what was the initial like the most recent trigger for them ending up in this situation and then also more importantly than that what was the road that they traveled to get to a Tipping Point so both of them are incredibly important to identify and the road traveled and the Tipping Point are both unique to everybody who comes into the clinic and unique to everybody out there yeah and that being said it's not just gluten and dairy for some people there's other food sensitivity same story that they end up with what are some of the most common sensitivities if you would continue that gluten would be maybe number one Dairy would be number two and obviously there's a whole question about types of dairy fermented dairy other stuff that some people seem to be more reactive to and some people seem less reactive to me included that I want to ask you about what goes on from there what are the other common food sensitivities that tend to make people stay in this sort of inflammatory Loop the top five are gluten dairy corn soy eggs from there you can go further there's a theme of different food proteins that cause this potential in the realm of agglutinins lectins are included in that as well things that have glutenons or legumes lectins are carried in many different foods but you know essentially top five gluten dairy corn soy eggs from there we go on to other veggies and just to be clear some people could be more reactive some and not reactive to others absolutely you could have somebody who's you know 9 out of 10 reactive to eggs has no issue with gluten or dairy it's not common but it can happen how do those play into this whole other category and my mom is a perfect example growing up my mom would go I don't know if it's every week or every few weeks to go get an allergy shot right should go regularly because she would regularly have to take things like what is it Zyrtec right allegras or Allegra Zyrtec singular because she always had allergies yes what's going on first of all for people who are in that boat where they're taking a medication like those mentioned or they're getting allergy shots what's going on in that category okay so first of all one in three Americans adult Americans experience some type of Allergic Disease be it asthma allergies or eczema we are talking about a humongous number of people out there huge and then one in four children have an allergic disease so this is uh not not small numbers crazy okay crazy so again the the development of an allergy to Something in the immune system can happen in two phases right the the Early Childhood form versions of allergies happen essentially during the development of the immune system in the first three years again that thymic land is responsible for programming T cells in the thymic land we're programming those t-reg cells that I was discussing earlier if those t-reg cells aren't programmed in the correct fashion you can end up with allergies to things in your environment that you shouldn't have developed allergies to sometimes you know they will persist into adulthood sometimes they will only exist during childhood but essentially that's the the basis for those childhood allergies it's it's improper programming of the immune system improper programming of t-reg cells in the thymic land and the gut is very much responsible for that in adults the t-reg cells also in the gut not in the thymic gland are responsible for that development so we hear stories all the time of adolescents and adults developing allergies or maybe developing more severe allergies than they had before in today's world and again the T regulatory cells that are living in the gut are responsible for that shift they are controlling the state of the most important part of our immune system which is the Adaptive immune system and it breaks down to a balance of the different arms one of them is called T helper one the other one is called T helper II so in short if your T regulatory cells are upset in a specific way in the gut they will drive T helper 2 to be more powerful than it should be it's called the th2 dominance and in that th2 dominance you're basically going to drive those ige allergies that we talked earlier because you're producing far more ige antibodies to things in your environment than you were before so our immune system is ramped up obviously how you grew up stressful situations you know my mom didn't take a lot of antibiotics growing up but just lifestyle eating processed foods Etc now your immune system is already ramped up you get a little bit of leaky gut that turns into a lot of leaky gut as you get older because your body's not rejuvenating as much and then certain foods can even trigger that further correct and now all of a sudden even though you never had an allergy to pollen you're an adult now and you're taking Zyrtec or whatever and getting a regular allergy shot because your immune system is so ramped up that other things are also ramping it up and for some reason in some people pollen could be one of them correct wild yes and what what is an allergy shot doing in that situation so it's a really I think important Point allergy shots by the way are nearly 100 year old intervention so um what are you doing with an allergy shot it's it's a long commitment you know you're basically talking about spending your life doing some period of continuous injections into your arm and what the allergist is injecting into you is escalating minute amounts of the protein that you're allergic to and what are you doing essentially you're trying to convince those t-regulatory cells that are identifying that thing in the environment as non-self AKA harm an attack is coming in we're ramped up we don't like this you're essentially trying to induce what we call desensitization you're trying to convince that t regulatory cell over just repetitive periodic exposures that this is not harmful and by starting with a tiny amount and just escalating that's a way of trying to induce that desensitization does it work works for some people short term sure it's not a root cause solution because everybody who does allergy shots knows that they need a quote-unquote maintenance shot going forward to maintain whatever benefit and they also don't work for everybody right so why is that it's you're not addressing where the problem came from or at least what a very potent driver of that problem is which is again going back to the gut those T regulatory cells because of what you're eating the intestinal permeability maybe a lack of correct uh micronutrient support to them they're upset and as long as they remain upset your tendency to th2 if it happens to be that direction is going to remain so you can induce desensitization to the T regulatory cells as much as you want you're going to be best off by addressing both the gut and doing something like that at the same time spoiler alert around my mom she no longer takes allergy shots she's doing amazing she no longer has quote unquote allergies to pollen and dust which she would react to before and a lot of it was because she got to a situation and I I got introduced this whole world of functional medicine we brought in a few doctors not actually there to treat her allergies this is a common thing that you see you get a lot of people who come in and they're not coming to you for dealing with allergies they're coming to you because they feel tired all the time they're coming to you because they just got a diagnosis of Hashimoto's but they're not sure what to do but they've read that flute food can play a role they're coming to you because they have now symptoms of IBS and it used to be okay and manageable but it's getting worse they want to do something about it right it could be a whole host of reasons those and many more and when the doctor that I brought in to work with her she had this magical moment after about a month two months I mean this wasn't a long period of time she I think it was a long time ago right this is almost like 15 years ago so I don't have the details accurate but I know that she ended up skipping or missing an appointment for one of those regular allergy shots and she was just noticing her regular maintenance level of stuffy nose eyes you know watering up during allergy season where we lived in Delaware at the time it just it just wasn't as pronounced the doctor didn't tell her like Hey we're doing this for your allergies we were working on some other stuff and she thought and brought it up and they said yeah you know this is a common thing and kind of we're walking through some of the things that you explained they weren't as eloquent as you are but gave her the big picture and she said well you know do I still need these allergy shots they said look if you feel like you do go for it but let's just see how this plays out and that was the last time in her instance obviously working with a doctor that she ever took an allergy shot and she hasn't taken Zyrtec or whatever he was on at that time ever again and it feels like a miracle but really it's supporting the body's innate ability to repair itself and start to quiet down the immune system so it's not as reactive yeah so I want to come to back to you and how you talk about this and how you work with it on in your clinic which actually is just down the street over here in uh Los Angeles you guys are just right over here on Wilshire right yes not too far away uh just name of the clinic if you could for the audience yeah regenerative medical um we're we're on Wilshire and federal here in uh in Brentwood awesome we'll have a link to you guys in the show notes if people want to check you out appreciate great team a bunch of people that have been there that are part of my network that love you love your team so let's connect the dots when somebody's coming in and you hear this story right a typical story these early stressors or some major life event or something exposure to mold in some cases right there's these early stressors those create this environment where the gut is not healthy they're dealing with leaky gut and then they're eating certain types of foods that perpetuate and now their bodies in this inflammatory Cascade this inflammatory Loop that's there because you are a person who both you're a doctor and you have all this clinical experience but then there's this whole other side that you and your dad do research you're not just immediately going to say to the patient like hey you a hundred percent are having this immune response you'll also do testing right so what is a typical test that you might do to see if in there this category where their body is reacting to certain types of foods I think this is where Art and Science meet in in medicine so the the art part of it is you know quite frankly getting to know the person taking an extremely detailed history from them knowing how to pull a string and just be able to chase a path a little bit more and get the necessary detail and there's a lot of intuition that goes into that too to be frank um and with that information I then say okay this is where I think our high-yield areas of Investigation are I there's no point in me doing an A to Z work up on you now I've got a specific task so I want the data points that are going to get me to that specific task as you know efficiently as possible um so I'll tell them based on your story this is what I think is happening with your immune system I'd like to confirm that by doing this intestinal permeability testing food immune sensitivities to these specific Foods sometimes we do a full-blown immune profile where we map these th1 th2 th17 and other cells because I I need to really see how clearly and balanced we are and then other times I'll say this is why I think this happened to you I think it was this and this and this and this and that was the long road that your car traveled on you know it picked up a flat tire here it broke its radiator there uh you know your brakes completely gave out right here and then you crashed into this wall right and my job is to basically do a reverse first wind up and take your car back to its pristine condition so I have to know all those potholes on the road I have to know where your brakes broke down so I'll I will try to pick up those data points too did you have mold exposure in your childhood home is it potentially still impacting you both your microbiome and you know your intestinal barrier did you you know grow up on the East Coast did you spend a lot of time in the woods did you get a tick bite that you don't know about and you've had this you know chronic spirochet infection this entire time all you know all those things are important in putting together the picture of that individual and being able to lay out the personalized plan for them of some of those tests you do your dad created a couple of those tests uh more than a couple of them can you just name them and like just to also be clear these are not like a consumer can just go and order them typically these tests come with a lot of education and they are tests that are available made available to doctors uh any doctor that wants to go and get educated in this process and really understand so for these tests that are there like what's the brand name that people might be looking for or be looking for a doctor that you know implements these testing as part of their workup in addition to the core Foundation which is just truly listening to the patient and having more than a 10 minute appointment sure so I the my dad is the chief Scientific Advisor for cyrex labs all of the testing for cyrex labs has been developed and is produced by my dad um and our team here locally in Los Angeles and they specialize in a lot of these sort of food sensitivity but they do some other things as well absolutely so the the core of psyrox is definitely doing accurate intestinal permeability testing blood brain barrier testing food immune reactivity testing there are over 180 foods that can be tested for in their menu but you know knowing that my dad's passion is mapping everything in the environment that we know of today that can trigger autoimmune disease it covers all of the bacteria viruses mold fungi tick-borne illnesses all the chemicals that can be issues and then you know I think the other thing that my dad and I are very passionate about is in this realm of dealing with an autoimmune epidemic we need the tools to be able to identify when somebody is in the earliest phases of this so that we can stop the process and prevent them from becoming one of the 80 to 100 million people who have a known diagnosed autoimmune disease and you do that through something called predictive antibody and immunophenotyping testing so what does that mean in an autoimmune disease the characteristic is essentially the development of an antibody against your own tissue depending on the autoimmune disease that can happen for anywhere from 3 to 18 years before the actual autoimmune disease itself develops that means that you've got this very large window for detection so there are panels in cyrex that are essentially designed to try to capture people in that window so you know what you're dealing with and then the most recent additions to the menu are Amino immuno phenotype testing which is the newest way to identify where someone's immune system really is again looking at that th1 th2 th17 dominance and then there's a gut brain panel also that is meant to be a tool for clinicians to identify when they might be on that gut brain Pathway to a neurodegenerative disease yeah and you know just everybody's listening or watching on YouTube like we're not here to plug cyrex right they're a great company in your dad's Labs that he created is like it completely changed the game we're mentioning because it truly is the best tests that are out there in this space and also too I personally believe while there's a lot of really great companies that are doing direct to Consumer Testing and are trying to sort of navigate that space and eventually one day we'll get there there still needs to be in my experience having been in the space for a while even though I'm not a physician there can be a lot of misinterpretation on this data and a lot of these tests are sort of stretching and people are getting you know no testing itself is immediately going to just tell you do this don't do this you kind of need a doctor to know your story right somebody trained in this world who can help you navigate this otherwise you can end up in a place where you're totally confused and more worse off than ever before so I just want to make that known that's a lot of in the beginning I was like amazing everybody needs to do these tests and do it from this company or that or this one does it direct to Consumer and I've been a little bit more cautious and I feel like working with the good doctor is a big part of making sure you don't go crazy in this process once you get back your results and it's not just about the foods and that's the next part of this discussion for many people not everybody they actually might be able to eat some of these Foods again that they were reacting to maybe they're not eating it for breakfast lunch and dinner in the case of gluten and dairy but they can have some frequency not everybody and a big part of that comes back to gut repair and if you're not working with a physician that knows the space you're going to end up avoiding a ton of foods and never repairing your gut and you're going to be miserable can I give you the most common scenario that we see that by the way I completely agree you know I hope that it's not always the case that this is going to be you know um rare to find a physician who understands how to interpret these testing understand how to order them appropriately you know this should be more available and everybody should have access to this everybody yeah we need technology to help with this AI other stuff that's the best hope of AI yes Everybody's scared of AI and I'm like okay look you should have caution but it's going to change the medical field and make all this stuff way easier if it means that everybody gets meaningful access to let's say what I do in my clinic nothing but good things can come from that okay like the health of the nation the health of the world will be in a much better place if that's the case so I'm all for it um again you're doing immunological testing right so you're also getting feedback from the immune system about what's going on with it at the time you can order a 180 food immune reactivity panel and a hundred of those foods can come back positive on that test somebody who was not familiar with what that means thematically to the immune system is going to look at that and say like sorry Roger you know like your panel came back positive for 100 Foods we've got to remove everything that's positive which is a huge problem because you're going to induce an eating disorder for that person they're going to be terrified of eating something and they're going to become micro micronutrient depleted as well too that's not what the test is saying the test is telling you in that situation that person's immune system is so pissed off that it can't even make an antibody to one single thing anymore it makes an antibody to everything that's something called poly reactivity and we know that people with severe cases of intestinal permeability and gluten sensitivity and or people with Epstein-Barr virus reactivation are very prone to poly reactivity so somebody who knows how to interpret that test and I hope more people do now after talking about it here we'll we'll look at that and say you know what we can't remove a hundred of these Foods that's not the right thing to do here the right thing to do is focus on the intestinal permeability be a hundred percent about gluten let's find out if you have EBV reactivity too that that's the way this data should be used yeah it's so important um obviously you know we mentioned your clinic it's down the street desirex and knowing that they've trained a they've they've been part of the training for a bunch of Physicians that are out there um some that call them functional medicine but a lot of doctors who are just regular quote unquote conventional doctors who were starting to become really hip to this yeah do they maintain any kind of database of people that are out there that are trained in these tests if somebody for some reason can't make it out to Los Angeles or doesn't immediately know somebody like you do you know if they have a database of Physicians I don't believe that they do um they should we've brought it up to them several times I do believe they're working on it you know cyrex is really a gold standard test in functional medicine so I think that the chances are if you find somebody who is ifm certified Institute of functional medicine Institute of functional medicine certified that they're going to know you know Cyrax and really all the other tools that we should be using stool testing whatever it is uh they'll know it pretty well yeah and again all Physicians are trying to do their their best in the space whether they're functional medicine certified or not and one thing that's there is that it is a common thing with people who are new to functional medicine or integrative medicine they get these tests and they haven't been doing them for a long time they can they're coming from a good place but they can induce a lot of fear and anxiety by just telling patients just get off of all these foods and and hopefully with training they'll get better but I do want to tell people even within the functional medicine space and you know you come from this space and I hang out with a lot of doctors in the space and go to conference you gotta look for the right individuals that have the right experience that goes for any category just because somebody's certified in this or that doesn't mean that they know how to work through in this particular case food sensitivity which is really the ultimate end goal is gut repair right and it's okay to ask questions and ask like how long have you been working with people in this space how long have you been familiar with this test you know um you can ask is there any other questions you might ask if people are interviewing or trying to find a physician in this space specifically in this category of getting better from food sensitivities and repairing their gut I I think number one ask what kind of training they had you know like doing doing a full ifm certification I believe is a really strong background you know me even coming from a scientific research background growing up with my dad I mean you know is was everyday education for me the ifm training really gave me a lot of what I needed yeah and that is like you're fully certified fully assertive right it's not just all the courses a lot of people say they're functional medicine doctors they've been to one course they haven't gone through the full certification full certification yeah so it's called ifmcp is a fully certified uh practitioner with ifm um you know I'm an MD I think that there's some things that MDS can do that nobody else can do if you're dealing with an actual medical diagnosis like lupus Ms Crohn's disease whatever you probably want to be in the hands of an MD naturopaths do incredible work you know I have a nurse practitioner in my practice Amy Donahue she's amazing she can do it all um highly recommend her as well too but you know it really depends on what you're looking for yeah right you know um if it is you know something that requires a deeper dive make sure that it's someone who's been doing it for a while is fully certified um and you know a higher degree yeah absolutely okay so now that we got that out of the way that's an important part of the conversation because people are always hitting me up and they're like who's the best functional medicine doctor in my area or what should I do here I'm like look it's it's it's gotten it's gotten tougher right honestly a lot of the really good ones that are out there and I I feel for them they're big givers they want to be there for people and a lot of them in my personal experience many of them got burnt out during the pandemic because they were taking care of so many individuals who were really suffering and they were fighting for patients who their doctor wanted to put them on a ventilator early on and they were trying to say like no this isn't the right approach and we need to go about it this way so a lot of people got burnt out but again you know that's the situation that we're in there's still good doctors that are out there just got to do a little bit of digging yeah so coming back to this core idea which is all these roads are leading back to gut repair right obviously there's another big gap which is even our traditional Health Care in the United States is not accessible to everybody right a lot of other countries have you know Universal Health Care we don't have that right now so even regular medicine and even people who do have health care the number one cause of bankruptcy in America is still Health Care bills right so even people who do have insurance there's problems with that now on top of that because insurance does not fully cover functional medicine Integrative Medicine a lot of people have to pay out of pocket and that's not accessible to a lot of individuals it's getting more affordable and technology is going to help other things so we are in a place where things are not perfect but this is how we build a Groundswell of changing things changing ideas so people may not be able to be getting to a place of a doctor's office so also keeping in mind that if they're thinking about gut repair right and they feel like there is dysbiosis that they have leaky gut they're listening to you and they're like this is me and they don't have access to those tests are there things that they can do to begin to go down the pathway of starting to repair their gut and hopefully have their immune system start to quiet down a little bit yeah I I think you know it's important to recognize that for whatever many people that I've seen in my clinic or have been seen in clinic successfully here in the U.S there's probably an exponential larger number out there who have done their own version of healing just by taking the information and implementing it um which is part of the power I think of this movement is that it really provides people a pathway to make yourself feel better and that's just growing and growing and growing in popularity the basics of it are remove and and then repair so what does remove mean remove means at least temporarily take things off of the table that are perpetuating this chronic inflammatory problem if you want to think about it simplistically what's driving the leaky gut just you could say I probably have it my immune system is probably in this pro-inflammatory state how do I take things off that just give that immune system some breathing room that's following an Elimination Diet Start by removing gluten do that for a few weeks see how you feel if you're not responding progress to removing Dairy you can go to Corn soy eggs next some people don't want to play that waiting game you know depending on how um willing you are you could go straight to a paleo diet I mean a paleo diet is basically playing the odds and saying it's maybe a grain it's maybe gluten it's maybe Dairy it's maybe you know corn it's maybe eggs let me just take them all out focus on Whole Foods minimize my sugar intake you know it really is going to cover 95 of people out there you could just go straight to a paleo diet yeah the challenge with the Elimination Diet step by step by step it's it's very exhausting yes it takes a long time I still don't know many people that have done it that exact way just one at a time there are people out there there are people out there I just find it so much easier to do some sort of program where again people hear paleo and they think oh I gotta go eat a bunch of meat no no it's not necessarily the case and obviously if you are a vegetarian that's fine you can do that too you can look up versions of this for that but you can you're still eating vegetables as you're talking about Whole Foods but in particular you are still removing Dairy because now there's this whole component as paleo has evolved and this was one of my questions that we'll get to in a minute the navigation around Dairy now some people feel like okay actually Dairy can be part of a paleo diet as part of their interpretation but they steer people towards fermented dairy right so we'll get to that in a second sure but a classic sort of paleo diet where you're focusing on whole fruits vegetables can you do nuts and seeds yeah I include nuts and nuts in there it's really maybe staying away from that early list that you mentioned gluten uh Dairy yeah would you put grains in that category I think grains would be the next step okay grains all grains would be the next step quinoa rice anything that fall in that grain category sorghum and the reason for that is that people who have really significant gluten sensitivities have a tendency to also have a grain sensitivity as well too why that is I don't think anybody really knows a hundred percent but you know theoretically it might have to do with the way crops are grown or stored or maybe even some cross reactivity between the proteins there but gluten dairy and then grains would be next yeah and then if you wanted to go even more sophisticated later on like maybe they don't have to get to corn and eggs yet those are a little bit less but still they would follow in that cross-reactivity category correct but at least for most people gluten dairy grains that's gonna Encompass ninety percent of people which yeah and then try to take the opportunity and focus on eating Whole non-processed Foods yeah I mean that's probably the most important part of all of this yes which will require a little bit of work but it's like guess what requires a lot of work being sick yeah right nothing is more expensive than being sick nothing will cause you to give up more opportunities not want to pursue the job of your dreams not want you to start that new side business that you've been wanting to do or write that book or start a podcast or whatever it is nothing will cut off opportunities like being sick being sick is the most expensive thing you could possibly do I just want to remind everybody of that because I've seen it time and time again and even in my own life yeah when you are sick you would pay anything to get out of it yes right so a little bit of an investment in prevention is huge in as far as paying dividends so they're doing this for what would you say some people say three weeks at least minimum well in theory if you are having an IGG antibody response to the food the half-life of those antibodies are somewhere between four to six weeks so what does that mean in reality that means you could stop the gluten exposure on day one still have those antibodies rolling in your system in some significant fashion three weeks later and you might not have seen a noticeable effect so I generally counsel six weeks you want you want a half-life of those antibodies to kind of come down a significant amount so the immune system can chill out great so you're doing this for six weeks and one thing that I've personally seen I'd love to hear your account is that even by two weeks people start to notice things what have you noticed that your patients who tell to do this or people who write Into You Who maybe can't afford to come to the clinic or fly out here and you tell them or give them guidance you've written a book also let's bring that up Tessa it's it's called when food bites back when food bites back and food bites back for the practitioners out there there is a textbook that my dad and I also wrote called food Associated autoimmunities so both of them yeah let's bring up the when food bites back just for those that are looking at Amazon and they can see the cover it's a person eating a french fry yeah when food bites back taking control of autoimmune diseases we're linking to that and again even if you don't have an autoimmune disease this book can be helpful because you're walking people through action items like this yes what do people start to notice often not everybody but often even by 10 days two weeks of doing this the quickest things that will resolve are brain fog insomnia and joint pain those are like the three things that if they're gonna happen they happen right away wow amazing and immediately right now there are people are watching or listening they're like I want that so it's like okay let's try it right what's the worst thing what's the downside of this okay you spend a little bit more time cooking at home which is good good for you anyway you're probably eating less processed foods you're probably eating foods that are going to improve your metabolic health because you're not overeating on grains and starches and other stuff that are out there so there's not a lot of downside to doing this I I you know you're testing your commitment to something um you know some people might have some hesitancy to do that but it's it's a good challenge for everybody no question so now that you've done this for six weeks what's the next step you know you're feeling a little bit about you're feeling a little bit better maybe some things have resolved some things are not 100 better but they're a little bit better where do you go from there at the end of six weeks so then you want to repair right and repair means two things you want to repair that intestinal lining that's been damaged for all those months or years before you started doing that time will take care of some of that but there are things that you could take to try to accelerate that process and you also want to repair those pissed off t-reg cells the immune system sometimes could use like an external hug to try to convince it to come down back to its normal balance so if you're going to do like an intestinal repair you know let's say you're doing it with food the intestinal barrier loves specific amino acids it loves growth factors and it loves probiotics so consuming collagen better consuming bone broth making sure that you're in taking a really decent amount of live probiotics in your food sauerkraut kimchi kefir whatever it is that you decide that you want to do those are going to do wonderful things for repairing the barrier and the t-reg cells are very much influenced by both probiotics and the thing that they produce when they're in association with Fiverr which is a short chain fatty acid postbiotic so do that vitamin D zinc fish oil all those things if you're going to start taking supplements can really accelerate that healing process I remember reading your book when it first came out but I don't recall do you have a protocol inside of there that walks people through this process or is there one yes you just so people can get that inside of the book as well my favorite supplements for doing this foods that you can consume if you want to do this entirely with food which is absolutely possible um and yeah it's all in there yeah and you already mentioned a few of those highlights now a couple caveats for people and I think you mentioned this the last time you're on the podcast is a lot of this is also contextual based on how bad things are people who have had really bad IBS or IBD which is an autoimmune disease irritable bowel disease they start to include even some of these healthier foods that are fermented and have fiber and it feels like a bomb went off in their stomach so they gotta go slow or they might need to focus on more of the reparative process before they can bring in or find the best tolerated versions of those things in in in general they're not going to do well with typically a lot of raw vegetables correct a lot of fiber at once if they weren't taking fiber and and that's why you really gotta go slowly and see what your body can tolerate do you want to add anything to that yeah absolutely there's a subset of people out there a big subset of people who have these chronic immune problems and the results that happen as the result of really severe bacterial and maybe even fungal dysbiosis we call that sibo sifo you know I'm sure they're going to be different terms that we start using for it in the future but essentially at its core there is an overgrowth of A Dysfunctional type of bacteria and or fungus and also the presence of the of them in places that they shouldn't be and bacteria are fermenting organisms yeast are fermenting organisms so as part of their metabolism they produce a lot of gas and for some people if you're going to flood the system with more probiotics or more fiber raw uncooked fiber you're gonna really push the gas pedal on that not to use a pun but you're just going to be producing a lot of gas essentially it's going to be really uncomfortable it might cause diarrhea it might cause constipation so in those individuals you have to consume in this I think low fermented diet style you know essentially you want the veggies to be cooked so that the fiber is broken down a little bit you want to avoid the consumption of probiotics and in those people I actually Focus entirely on the postbiotic supplement realm so those are things like short chain fatty acids tributarin is I think the big one in that space there's a postbiotic from Pomegranate called uraleth and a um and then a secondary bile acid called tadka so typically when people are really sensitive to the pre and pro side you're removing the Prebiotic foods and then you're just pushing the postbiotic and eventually over time for many of those individuals as you influence the T-Rex cells to calm down the immune system will therefore be able to do what it is intended to do which is to regulate the microbiome I'd love to get your thoughts on this you know I put my dad on a Elimination Diet this was probably 2009 and it was just for him he wasn't complaining about anything specific maybe a little bit of joint pain in his fingers but he was a cricketer he played Cricket you know actually professionally in Kenya and then stopped right around the time that I was born you know and then you know we moved to the United States so he just thought maybe it's just injuries from that you know if he was Knuckles or kind of his fingers look like a cricketer's fingers which are gnarly so he just thought that joint pain is just coming from that but you know what I'll try this thing right I'll try this thing so he did it and by the second week one of the things he noticed because he had never not had gluten in his life and had never not had grains for a period of time and um he did it and he noticed I think it was like day 15 16 17 it was like a 21 day program that we put him on he came downstairs and he said you know I uh and I was living with my parents at the time because I was helping to take care I just dropped out of college and I was starting my first business so I was saving on money but I was also helping to take care of my grandfather who was really sick and had cancer and both my parents were working at the time so I was helping my grandmother um he came downstairs and he said you know what's really weird is that I haven't had that morning back pain that I've just been used to for years yeah I said that's great dad like that's interesting like let's keep note of that and anything else that you come across now when his 21 day period right I didn't do the full six weeks I didn't know you at the time sure so you did three weeks still saw some benefits when that 21 day period was done uh there was part of him that even though he had felt better but it was a kind of a slow process even with this back pain it kind of was a slow process there and he had spent his entire life eating these Foods he didn't like fully I'm not gonna say believe it but basically that right he's like okay there's something to this but it's kind of a coincidence maybe I also had him on some supplements maybe it's the supplements that he was on so I'll just do the supplements and I'm gonna go back to eating a lot of these Foods in the same frequency and I said okay yeah do that Dad because even some people some medical doctors tell people to do this on purpose they call it the reintroduction phase because they want you to see how you react now in a formal process you would reintroduce those Foods one by one right for because you if you reintroduce them all at the same time you don't notice What food did what so I said let's at least do gluten and dairy because we're not going to do the whole list that you're on let's at least do gluten dairy so let's start off with dairy so you reintroduce Dairy generally it was fine he felt a little bit of stuffy nose which is still something but he felt like okay I can I can handle this and then a few days later on after reintroducing Dairy a little bit at a time over three to four days then he did he stopped the dairy again and he reintroduced gluten and that was immediately the next morning he noticed that pain come back and that was a big aha moment for him when you were describing these steps of you know stopping certain foods Elimination Diet and then going into repair how important do you feel a reintroduction process is and is that worth people trying out to really drive home what foods they're reacting to it depends on the context so if I'm going to do a reintroduction it's typically going to be for somebody who does not have a known diagnosed autoimmune disease because in that context I don't think it's worth the potential flare of the autoimmunity itself for the reintroduction because sometimes irreversible damage is done in that flare so that's the first really important counseling point if we're just dealing with you know no autoimmunity chronic inflammatory symptoms um you know I usually will counsel wait until we know for sure that your intestinal permeability is resolved because that's when we know your physiologic resilience is back meaning you're more likely to pass the trial which is what we want wait until then and then we can do a reintroduction and you know depending on the foods that they reacted to I'll make the list in kind of reverse order of what I think was causing the issue and do the reintroductions a week at a time essentially we we counsel people to do three days of small introductions sequentially and then to pause for four days and just be sure that over the course of that week they feel the same as Baseline the idea there is sometimes the delayed reactions will occur for people and you just want to make sure you're observing that cleanly and then you move on to the next and the next and the next that's great thank you for that clarification so once people go through this repair process which can take time right your body didn't get sick overnight even if you had a flare-up that caused you to really feel like it was that bad to deal with it in the first place this thing had been building up for years that whole pre-autoimmunity phase um so once they've gone through this repair process uh then sometimes they can start to look at these foods that are there let's talk about in your case in your story you've done repair work on your gut and what have you found for these foods that you had sensitivities towards in particular gluten and dairy in your case can you eat these Foods now or do you still stay away from them I fall into the unfortunate minority of people who cannot touch even a small amount of these things again uh because one of the best efforts what happens I'm sure you tried at one point in time if it's gluten I will get significant IBS uh like symptoms and I will get brain fog from it yeah it's so bad for you that you're like it's even the best piece of bread from Italy you know that has been you know anointed by royalty it's not worth it I am to the point I've I've you know the the what your dad went through with wanting to reintroduce and challenge this Paradigm is human nature it's part of the journey so I've been doing this since 2005 that's 18 years I've had many of my human moments where I wanted to challenge the a paradigm and I've had the negative reaction so many times now that I've developed an aversion if I even think let's say I'm in Italy of trying it my body just shuts that down is like nope we're not doing that focus on something else nothing tastes as good as being healthy feels and for you when you eat these Foods you genuinely do not feel good gluten specifically okay now I can have small introductions of dairy I will feel perhaps a slight tingling in the back of my throat I will immediately get pressure in my sinuses so I think that like sinus irritation that comes from a dairy product is really what I feel and you know it might last a couple of hours it usually goes away afterwards and as long as I don't sequentially do it I'm typically fine yeah and for you if you choose to go down that path right are there dairies that you find that are better for you or worse for you and generally what have you noticed with your patients let's talk about dairy in particular okay I need a little bit give everybody a little bit background so we're saying these reactions are happening as the result of the development of IGG or IGA antibodies against the foods antibodies react in the three-dimensional space right so proteins peptides they have three-dimensional and two-dimensional structure so the the state of their three-dimensional structure is what ultimately matters so it turns out that the three-dimensional structure will change based on the type and preparation of the protein case in point you know the protein in a raw egg is very different than the protein in a cooked egg because it has a completely different three-dimensional structure as a result of the cooking so with dairy you have a wide range not only of proteins but also of potential three-dimensional structures in which they could exist the biggest Protein that's inflammatory in Dairy is casein now casein exists across the different mammalian dairy products so it's in goat's milk it's in sheeps milk it's in cow's milk there are slight variations to the case in in the different animals so sometimes people might have a very strong cow's milk reaction but nothing it's a sheep or goats milk that's not common and we've actually looked at this in the literature we published this in the journal uh I think dairy in 2017 my dad and I anybody could look this up but most often when you have a cow's milk antibody it's going to also end up that you have a sheep or goat's milk antibody but it's by no means a hundred percent it's probably thirty percent of people who don't have those reactions now hard cheeses have a different case in structure than a soft cheese hard cheese is probably also have less intact protein is just a result of that longer production process so people have a tendency to react less to a hard cheese like a Parmesan than they would to a soft cheese like a mozzarella butter is not a whole milk product really so it has its own proteins something called butyrofolin that are in there and it's got a little bit of casein when you go another level and you start clarifying the butter into ghee there is even less of the casein in there because you're removing it in the clarification process so one individual might react to butter they might not react to ghee then with ghee we have even another level which is fermented ghee and in the fermentation process a lot of those proteins are again further denatured out of their three-dimensional structure so you know somebody might react to butter have a very mild reaction to ghee and have zero reaction to a fermented ghee and it all has to do with the amount and type of protein and the three-dimensional structure of the protein in the product itself in your instance do you feel any of those themes for you so if you do choose Dairy and you're out somewhere or whatever family event uh Persian holiday uh will you choose certain things for you that you know I will still pay a little bit of a price maybe my throat will feel itchy but it's not as extreme like you're not going for a whole glass of milk no definitely not going for a whole glass of milk or a dairy ice cream or you know a slice of pizza with regular cheese on it that that would be too much but we Persians depending on the restaurant you go to love putting some butter on Rice yeah and uh sometimes that butter is pre-mixed into the rice and there's nothing you can do about it um some restaurants also love slathering butter on top of Kebab so you know I'll get some butter exposure I'll feel that I definitely will feel a little something but it's not a huge price but you can handle it if I'm going to have something that was prepared with a fermented ghee I probably wouldn't feel it you'll never see making a little ghee yourself no into the restaurant and talk to uh no well you probably talked to the chefs in Spanish and tell them hey put a little bit of this ghee on yeah I think I think they probably would tell me to leave the kitchen they love their butter there's uh no replacing it well I love sharing a little bit about my story because you know I talk about different aspects for me so I never had so I went through a whole gut repair process for years I've waited gluten and dairy and other stuff and my life was better because of it and then I started to have curiosity about can I introduce these things back in now that I've done through gone through this repair and I even think a couple years ago I came to you and I even tested some of these tests and we looked at it and largely my ige response was pretty good like it showed like I had at least largely healed my gut from where things were before right it kind of confirmed a lot of the questions that I had which is was I reacting to a lot of different things and I wasn't I think there was a couple things that were on there that I had to pay attention to which was really just an indication of maybe not those foods but that my gut had been largely repaired so I found that in particular you know for anybody who's watching on video like I have a big pimple right here on my right next to my right eye right I'm facing the camera um you're brave for pointing that out I love to I share all my stuff with my audience and I generally have really great skin but I know if I've stacked the gluten and dairy for a few weeks in a row little bits here and there and it's summer people are visiting La we're traveling a little bit you know there's cheese at dinner there's a little bit of sourdough bread organic a really great restaurant I want to try it I was in Vancouver I ate a little bit more than usual I might notice certain things first thing I'll usually immediately notice for myself is not one day not two days but let's say like right now at three days even if I have like one or two servings like I was in Vancouver and my buddy really wanted me to try this croissant and and he also has a gluten issue he's a patient of our clinic in Massachusetts he's like look we're gonna go it's so good you're gonna you and I are gonna go down together if we go down so we tried it and the croissant was fantastic right a big part of life is if you can tolerate these things and you enjoy it like people understand like food is part of life right and I know I can handle those things right one croissant fine great we went back the next day and we had another croissant and then I had Dairy as well and I was probably at a restaurant that cooked a lot of the food and Seed oils later on the evening so I was stacking a lot of stuff I did not feel good the next day and immediately I noticed that I have a little bit more I feel a little bit more constipated than normal and I feel like I have great digestion so even the tiniest bit of constipation I'm like okay red flag something's going on so I start to pull back naturally that's there and then uh we went somewhere also on another trip my wife and I and I hadn't had uh cappuccino with milk in it in a little while and the place had organic milk and I thought you know what there's this funny meme on Instagram it's floating around everywhere it says my toxic trait is eating foods that I know that don't work for me even though I have the whole history of them not working for me that's definitely one of mine right and I had a little bit of dairy and then I had a cappuccino the next day also too that had organic dairy inside of it boom got a pimple and it showed up pretty much right away after the second latte the next day and it was a tiny it was probably not even a full cappuccino it was like a macchiato type thing I know this this is what happens to me I know that that's the response and it's usually sort of pain threshold how much pain do you have how much vanity do we have a wedding that week where I need to look good in photos so that a friend's going to or do I have a big event okay it's just the normal podcast fine I'll get a pimple for that right that's basically my own internal logic so I have like many people you kind of find your own tolerance of these things for me my gluten situation is not as bad as yours and for me too I've also developed a better relationship before I said again this is for me I'm not prescribing this for anybody else I would say I'm never gonna have these things and then when I would include them back in I would kind of go big on it and it'd be in Europe or somewhere else now I might have a tiny little bit I know my threshold I pause and then I don't let it get worse into something else I don't want brain fog I don't want this thing I don't want that so I have my own version of your tolerance for me so it's those foods that can have infrequently the highest quality and in particular for me for dairy I have found that fermented dairy I can actually have on a regular basis like fermented grass-fred Greek yogurt and I don't get any uh of the normal symptoms that I would have if I would have traditional Dairy that's not cheese sure so first of all the most important thing is that you had the Journey of recognizing that things that you were consuming were impacting you then you went through the repair phase and presumably what you did was you took yourself from a path going forward where you were potentially at significant risk of several chronic diseases and if I would have had those things on a regular basis if you had never made that Discovery if you had just drew lived his life oblivious to the fact that food was impacting him right that path was one in which your risk of several diseases goes up uh significantly over the course of your life you had the discovery process you went through the repair phase you put yourself on a different branch in the universe that significantly lowered those risks that's the most important part of this entire journey and then step two is for everybody how much of this can I tolerate because the reality is that a little bit here or there is not going to put you back onto that other branch that you were on before it's not not even going to cause any significant deviations from that Branch so that question as you mentioned is like well what what can I tolerate what works for me this is my life I presumably only have you know one of them I don't know if I have many of them but presumably I have one of them so I want to also kind of think about the enjoyment and I encourage patients to do that again as long as we're not talking about a context of a known autoimmune disease right that's a whole different story but absolutely embrace the idea that you're you're living once you might have a reaction for a day or two or three and you're going to go back to Baseline once you clean everything up and then all everything's good again it's really that initial part of the discovery saying the AHA things in my environment are impacting my health because by making that acknowledgment you will also open your mind Horizon to things other than food and your path will be healthier in many many ways by kind of thinking in that way going forward so that's the most important thing from there you know if you can tolerate a croissant or whatever or every once in a while and nothing major occurs good for you yeah that's well said are there people that are out there that they grew up in a great environment you know they didn't get exposed to antibiotics and largely they grew up in a household or a family where they were eating Whole Foods or even they were eating a lot of processed foods but for whatever reason their gut is so strong that many of these foods do not impact them have you seen any of those folks that are out there I definitely hear anecdotal stories from people that say look I know a lot of people are sensitive to gluten and dairy and other stuff I just don't have issues with those things yeah and and there are people where you know they have a known autoimmune disease and we're looking for intestinal permeability and food sensitivity as part of their initial workup even though they don't have gut symptoms and they'll come back negative and if the evidence says you're doing fine and you feel fine on these things then my job as the clinician is to move on and say well you know there must be other higher yield things in your environment that we haven't discovered yet and it could be mold it could be heavy metals it could be something else because your body does not want to attack itself of course which is what an autoimmune thing is so maybe it's not food it's food for most people plays some role if not a major role but there are some people that they are the small percentage how many obviously you get sick people that primarily come to you they have something wrong you're not just focusing on optimization even though you have some patients in that category what percentage of your patients would you say that food is not the primary culprit regarding their autoimmune condition I don't think this is representative of the population out there in general because because you get sicker patients yeah people who are diagnosed most people have tried many things before they've come to me either on their own or they've been to other practitioners before before they're in our Clinic because that's just what we specialize in but I would say in our Clinic about 25 of people 25 is food is not the main thing not a significant part of it and there's something else not a main thing I think it's about half okay got it yeah um we'll we'll still find food is the main thing for about half of the people again because it's the bulk of the environment um but 25 really seem to have no food involvement at all which you're saying in the larger population that actually percentage would be lower because you're saying a lot of people that come to you they've already tried the food thing and it's not that now it's they have not repaired their gut appropriately and or it's that there's an environmental factor or stealth virus which is a whole other category that we have to do a podcast on one day anytime um so there could be other components yeah too much to talk about in this episode but just for people to know that there are situations like that and so if you are somebody that gets better from removing these these foods and significantly better also just remember in your process of wanting to evangelize everybody around you not everybody is on the same Spectrum for sure usually you've had to have some sort of gut damage environmental exposure Etc and you end up this position but most people would largely benefit and some people can actually get better from these allergies that they've had if they fix the food thing which is also first and foremost fixing the gut Elroy this has been fantastic you're always a favorite not just for me but for the audience thank you so much for breaking all this down any final words you want to leave our audience with and how can people be in touch with you and your clinic um I I just want to finish by saying again that like idea of starting that journey of trying to see if things in your environment are impacting you is one that every adult out there I think deserves to do for themselves at some point it gives you the capacity to become self-empowered about your health going forward I'm sure that's not something that I have to preach to your listeners but really everybody owes you know at one point in their life to say is what I'm eating impacting the way that I feel and if that's the case what else is doing that too um as far as getting in touch with us the name of the clinic is regenerative medical um we are currently two practitioners myself and my wonderful nurse practitioner Amy Donahue will likely have a third coming up here soon um and we're uh you can call us at 424-256-0272 website I'm sure you guys will link this video might blow up you're gonna get a lot of calls my front office staff might be mad at you but it's okay uh you you gave your dad a shout out I don't think we officially said his name and is he active anywhere that people can follow him at all yeah so my dad is Aristo vojidani uh he's an immunologist um I think his uh ifm tag is kind of like the father of functional Immunology which he very much is um he's the chief scientific uh officer for Cyrax Labs he we also have a small private lab in Beverly Hills called immunosciences where he is a expert in chronic viral reactivation and runs Laboratory Testing for that um he's not really active anywhere other than he's active in the lab he's doing his thing he's active in the lab he's reading his papers he's doing what he loves I don't think the man will ever retire um I hope he doesn't because he enjoys it so much but he he he teaches a lot he lectures a lot that's really there are some video lectures of him available on the web I think couple yeah I'll actually plug um he and I have done a couple of cyrex specific boot camps with Rupa they were each six weeks long we did that in conjunction with Jeff Bland of plmi and we covered a lot of this in detail I think that Rupa allows their clients to go in and access that database whenever they want to so for those of you that are Rupa members please look at the cyrex boot camps we probably will have another one that's more in-depth coming up in January as well too but that's a good way to continue the learning from us rupa's great I'll reach out to them after this episode and see maybe they can unlock it for some people or put at least a teaser so some people can watch it and continue the education all right thank you again always appreciate you brother my pleasure thank you hey YouTube If you enjoyed what you just saw keep watching for more great content on how to improve your brain and your life it's what mitigates and controls inflammation oxidative stress and immune dysfunctions the key contributors to all chronic disease so when you develop endothelial dysfunction and we characterize that by