Is Anxiety All in Your Head, Or Is It In Your Body?

we do know that the bacteria in our gut make serotonin for us so one of the things we want to think of when we're looking at people with anxiety is let's look at their gut [Music] welcome to doctors pharmacy in a special episode of house call and today we're talking about anxiety if you have anxiety and you suffer from anxiety it may not be what you think it is we often think it's in our head but turns out it may be somewhere else and today that's what we're gonna dig into with dr. George Peppa nicolau one of my colleagues here at the ultra Wellness Center extraordinary physician who's doing such great work here and taking care of patients in such a way that we are just seeing extraordinary results so welcome George mark it's a pleasure to see you in the flesh particularly during these times six feet away we are six feet away and everybody's wearing masks besides us so we're good yeah so I'm so excited to talk about this topic because years ago I wrote a book called the ultra mind solution which is how to fix your broken brain by healing your body first and what I discovered through my years of functional medicine practice was that when I was treating my patients for their physical problems their digestive issues their hormonal imbalances their food sensitivities whatever was nutritional deficiencies that they would report back to me god my anxiety is gone my depression is gone my ATD is so much better my OCD is better my bipolar symptoms are better my memory is better and I'm like well what's going on here and I began to really think about it and realize that we talked about the mind-body effect which is sort of a sudden incorrect way of thinking about it we maybe we talked about the body mind effect which is how the body affects the brain right but neither of those really explain what's going on it's really a system your body the system the body effects the brain the brain affects the body and it says it's complete the synergistic system and if you don't think about it listicle e you're actually going to treat people by dealing with the downstream symptoms and not the upstream causes absolutely so I began to really learn about how these physical issues can explain psychological symptoms and how we often attribute psychological or emotional problems to symptoms that are really physical and then when you treat the physical cause all these problems go away that doesn't mean we all don't have psychological issues right but it's alessa's we cannot deal with them once you've cleared up all the garbage that's actually causing these symptoms right so if you're just an example everybody knows if you are tired and you haven't slept you can't focus as well you feel depressed you're more irritable as sex it's I mean is that because you're depressed yeah or you have dementia no it's because you didn't sleep right and it's an easy example but there's so much more that we know about actually how the body affects the brain and we're gonna dig into that today with dr. Jorge particularly about anxiety and so traditionally in medicine when you have anxiety what's what's the general approach that we that we have general approach is you've got five minutes to see your patient they tell you anxiety and great you're on an SSRI or some other anxious that an SSRI is a serotonin specific reuptake inhibitor and all it doesn't present present the present its Prozac its lexapro it's to tell a pram it's all those things that everybody out there is taking all the hams yep it's dams and they basically all they do is they allow the serotonin that's in your brain to do its work longer but it doesn't account for why isn't there enough serotonin in a brain to to begin with great question that's the difference between regular medicine and function notice it says oh the cause is not of serotonin let's get this serotonin up right no the causes and there's not enough serotonin that causes something else that's causing the serotonin not to be okay so what's causing the low serotonin right so that can be any number of things but the first thing you need to do is ask the question you know why why isn't a serotonin elevated so you know we do know that the bacteria in our gut make serotonin for us so one of the things we want to think of when we're looking at people with anxiety is let's look at their gut and we always talk about the gut brain connection yeah and that's a it's a very tight connection so the difference between you know functional medicine and the conventional approach to anxiety is that we are going to say and I know I do this and been doing it for years anxiety is just a symptom of other problems and the cases that we're gonna go over anxiety was it was a part of the presentation but it allowed me to get into the history and figure out what was causing it and in both these next cases we're gonna see that there are multiple things causing it it's never one thing so so that's Dean it's not just a prozac deficiency it's not a prozac what it is not it is it's usually a deficiency or it is a an addition of a toxin into the system that can either be a relationship or it can be a xenoestrogen or it can be letter mercury or it can be bacteria but it's never just anxiety right and it's never just one thing right right so that's the other thing is you know we often sort of a reduction in our approach and traditional medicine we go well you have anxiety that's what's causing you to feel anxious no that's just the name of what your symptoms are the causes are multiple right I mean maybe it's one thing maybe it's just you've got too much light in your system but it's often many many different things that are all reflecting an imbalance in your system and that's interviewing functional medicine and traditional care is functional medicine says how do we restore balance in the system how do I take out the things that are causing imbalance and how do we add the things that are going to restore balance and that's the difference and we use a very in-depth set of tools both through a detailed history and ask a lot of questions that normally don't get asked like or you're breastfed right you know worry so much tuna fish and this is these are the questions we ask that are different and then we do diagnostic testing functional medicine that are helping us to reveal causes not just yeah sort of do you have some terrible disease well we want to know like the most of the tests you know you go to your doctor they go all your tests are fine you must be fine well you test that your doctor does typically or only abnormal if you're really sick like for hospitalized patients you'll see an abnormal electrolyte or a normal kidney function or normal liver like it's is unless you're really sick these tests are pretty normal so we look at a difference that yeah pull the veil back at me there are thousands and thousands of metabolites in your blood and to think that you know what's going on by looking at 30 or 40 on a typical blood test is a joke right and in fact mark you know we don't most doctors won't even get a blood test for anxiety you know they don't see it as anything other than a psychological event right and so or and a biochemical event you know it's reductionistic right it's it's it's necessary turning a brain serotonin reuptake inhibitor works for you great and I don't you know and that's it and now and we do know by now that they don't work that they're very ineffective and you really don't get to the root cause of the problem I mean people suffer through anxiety they go from one antidepressant or anti-anxiety to another never getting to the root cause and sometimes I'm gonna help with symptoms they do and they can be life-saving but but you got to go deeper ultra Wellness Center here in Lenox we we go deeper know now we're doing all virtual consults which is great so if you're new patient you want to come and see us you don't have to schlep all the way to Lenox we can do it all virtually right and you can get the tests you need and and we work with a great team we've done that really it's really been interesting and amazing it's almost like you have more focus and more of the attention of the patient there's there's a whole different dynamic that occurs that has its own benefit you do it but when you do it you know bazoo yeah we do zoom right yeah and I've asked my patients afterwards so how was this for you and not one person has complained they've always said I felt connected to dr. Papanicolaou I got what I was looking for so it's been really yeah a positive experience it's true I did my first you know five patients last week doing zoom and it was like wow this is awesome yeah you know it's great and I think it was it's not it's not the same as being a person but it was definitely quite good so I feel like we have really had the ability to take care of patients and particularly now more than ever and people are feeling anxiety people are feeling worried and and there are real things right you lose your job you your economic you know resilience is threatened by what's happening economy your your fear of getting sick and your health issues I mean so these are real absolute psychologically hard time yeah but but you can become more psychologically resilient by making yourself more physically resilient so you become less victim to the waves of emotional stress that we're having and learn how to sort of manage it I think I'm feeling it you're feeling we're all feeling it I have to work every day to regulate that and I do it by taking care of the physical things if I don't work out if I don't get outside if I don't sleep enough if I don't eat okay like I don't feel as good and I'm not I'm actually more susceptible to the emotional imbalances that occur because of the reality what's happening in the world right now and I think I think this is a perfect time for people to start to focus in on their own health because not only will make it less like they get over 19 but they actually can can really deal with issues that have been going on for a long time and they can they have the time and you can actually deal with the lifestyle issues much easier not traveling I mean for me I don't travel more breathe it's been a renewal for you know me and and and a lot of my friends we've talked about it's the opportunity I think a lot of people deep down are sort of happy that the world slowed down a little bit yeah you know and so faster yeah you know and you're like wow like I don't have to wake up on Saturday and do like a soccer tournament for the whole weekend you know and I I don't have to be rushing off to you know all these practices at night or to this class or to and I've noticed a difference in my own kids they are more relaxed or I'm home and you'd think there would be more tension but we're actually getting along where we're playing board games are playing chess again I'm like my 24 year old is home and it's been very enjoyable what has been really important though and that's why I chose these anxiety cases yeah number one I love being a sleuth I love being a medical detective that's what I love function that's what function medicine is you nailed it right right and so I get to tell you these I have disease mysteries this morning all right so it starts out with anxiety but that anxiety really is that really the the culprit or is there you know is there a secret hidden person or character in this plot that's causing a problem you're like the Sherlock Holmes of Medicine I love you so so that's that's so tell us about this patients 32 so we're gonna jump to the case we're gonna forget about was going to tell you about kovat and getting ritual and routine we'll go right to the case so yeah so he's a 32 year old and he came in with his partner his wife and they his major complaint was I have panic attacks particularly at night and when I'm having panic I'm also feeling bloated and distended no interesting that was his main reason for coming in he's panic attacks and then during the day I'm finding I'm having a harder time getting my work done I've become a really intricate part of the business of our that we do and a lot of responsibilities been placed on me and I'm finding it harder to get work done and I can't concentrate I can't focus and I'm getting anxious well okay that's that's the fundamental story I want to know where it all started so we do the timeline we go backwards it turns out with this this young man is 32 that his problem started a long time ago he had a really bad diet growing up sugar tooth said you know standard American diet ate a lot of sugar was having problems in school early on developed school phobia and then anxiety that was so debilitating he had to stop his first year of high school I mean know his senior year of high school so then he went to college where he had a little bit more control oh and he found some friends who had adderall and he tried adderall and bingo hello and bingo he was a forced to call it speed yeah he actually did well through through college but after college he had successful years until one year they went traveling and he developed a really bad gastrointestinal infection and shortly after that he started gaining lots of weight and that's when the anxiety and the panic and everything started to multiply until they came to the office so it's a traditional psychiatrist you go there's another anxiety I panic attacks they're not like well did you have traveler's diarrhea that you get bloating and was it connected to your garden let's look at your poop but maybe that's where the answer is right so so there's this thing that I call pattern recognition so when I hear when I reason why go back to get all these clues is because all of those clues together start to create a puzzle or a mr. Rorschach and I have to then you know have a pattern recognition and say oh this is starting because of the experiences I have with people yeah I begin to see these patterns and I can start to see that you know what yeah there's something going on this guy's got oh yeah and there's there's some sleep issue going on here it's not just anxiety it's not just I can't sleep there's something else going on so in his particular case I understood the pattern of ADHD and I saw that as an early issue for him and there's gonna and that also Clues me into weird am I gonna look where does that come from so we do this again a TV as a symptom yeah it's a symptom so it's coming from you know and and there are a lot of culprits there are a lot of of things and facets to ADHD that come into play and one of the things I thought about with him is what is this DNA gonna tell me what's his what what is his DNA gonna tell me about his brain that predisposes him to ADHD panic and anxiety so I knew that okay I'm gonna do some tests wait wait wait wait so you're saying that your DNA controls your mood anxiety it can everybody's dr. Hyman thanks for tuning in to the doctors pharmacy I hope you're loving this podcast it's one of my favorite things to do and introduce to you all the experts that I know and I love and that I've learned so much from and I want to tell you about something else I'm doing which is called marks picks it's my weekly newsletter and in it I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health it's all the cool stuff that I use and that my team uses to optimize and enhance our health and I'd love you to sign up for the weekly newsletter I only sent you once a week on Fridays nothing else I promise and all of you do is go to dr. Hyman com forward slash pics to sign up it's dr. Hyman calm for size pics P IC K s and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live longer now back to this week's episode your your DNA predisposes you to different conditions and states of being so we actually adult Ramona Nair do a swab at cheek swab or just take a little busy q-tip and rub against your cheek stick it in a vial sin in a lab and it's called DNA mind right so tell us about what is this DNA mind and what his show so the DNA mind is going to actually look at genes the blueprints that your body uses to make amino acids and proteins that are going to be the basis for communication in your brain they can determine mood they can determine cognition they can determine memory and so you can tell if you're more likely to be anxious and more likely be depressed maybe an addict yeah exactly so DNA mine will look at the area to look at the genes in multiple different areas that can impact neurodegeneration your mood and your addictive qualities yeah and so we look at very specific genes that are well researched and we understand that if they do have variations what those variations will mean and then you know we can do about and then informs me what I can do about it yeah those genes are actionable you know you get at 23andme you get 5,000 values you don't know what 4999 of them do right right and so we only test or DNA health only tests actionable genes in critical areas so this is really an important point yes you know people hi my DNA and personalized medicine and most of its noise right so we we actually have genes that are common in the population that have clinical impact mmm that we know a lot about and how to modify the expression of those genes and change what's going on so that you have a positive clinical outcome as opposed to just checking your twenty thousand genes and not only one half of the mean or 99% of the mean like you said I mean there one is one in particular is not very common that people have anxiety and what if what is it MTHFR and there's also um taste comt catecholamine transferase and that's a big mouthful but essentially that G's really good that gene is involved in metabolizing the stress hormones adrenaline yeah the catecholamine all right so the adrenaline elements noradrenaline right dopamine yeah and if those can't be properly processed by the body you get a buildup mm-hmm of these stress this is a great point so you feel really like my anxious and I mean everyone one of my staff members has this gene and she was giving me an IV the other day and she was like so nervous and I said you must have that gene and just like I do and I'm like but then you can fix it right how do you fix it right right oh how do you fix it oh okay so that's one thing to know you have it so so let's go back to him because this is this is just a perfect segue I'm gonna tell you how I fixed it with him so what was really interesting is is that I put that pattern recognition at the first visit I understood that he's got a ADHD I think he's and the way described his personality I thought he had you know a dopamine deficiency mm-hmm so I put him on and dopamine is one of the neurotransmitters yes we focused my attention and the COMT gene has an impact on that because you can either metabolize your dopamine very quickly and keep it at a low level or you don't metabolize it at all like the norepinephrine and you'll have high levels of it and if your so each one of those conditions has a phenotype or way that you're going to appear if you have that so in his case he's sort of like was distant and didn't feel emotion all the time and and he had a hard time with you know focus in general so I thought that he had dope my pattern recognition so I put him at the first visit he left with something called l-tyrosine l-tyrosine is a precursor to dopamine and I took a building block the building blocks are things in amino acid building block fer the correct transmit right its own protein exactly so interestingly enough when he comes back for his six-week follow up to the overalls labs one of the things he wrote in his medical update to me was that I'm not depressed but I'm sleep feeling things I've never felt before I'm a lot more tearful and a lot more emotional and a lot more engaged emotionally with people well why because he's getting dopamine in his brain that he hasn't had for a long time and now that dope means allowing him to experience and feel emotion they didn't have before and he's able to concentrate that this is a purple of functional medicine because it talks about how he personalized based on genes based on person's lifestyle and based on their levels of their labs and we really create a customized approach for each person yeah to target in like a medical tank up on the things that make the most difference yeah yeah just gave him a simple amino acid right but it's like wow how simple was that but it was knowing that you needed to do that that was the key yeah and and here's the cool thing when they looked at his DNA to go over those results with him he had to see him T defect that you know that didn't process his the over processed his amino his amino acids that made dopamine and norepinephrine so it matched up so his genes is clinical if there's a clinical picture and he responded appropriately to the dopamine precursors that were going on that in his gut that you mentioned that were relevant so how does his gut play a role in his brain health okay so this is this is this is always a favorite area so he had what we call small intestinal bacterial overgrowth that's when bacteria that should not be living in the small intestine is there and it can cause bloating and distension that's what he was having that's what was waking him up in the middle of the night you got a food baby you have a food baby he was eating foods that were fermenting in his small intestine and you know they would cause that gas that would really cause him discomfort and wake him up and like when you got apple cider and like the the bugs grow in there and it creates that like that thing that you open I was like explodes right yeah so like that absolutely and so so he was also gluten sensitive so his we do a test to look for gluten sensitivity so now you have that can also cause anxiety and depression exactly so now you have gluten and you have you have overgrowth of bacteria the two of those can disrupt the epithelial barrier membrane in the intestine basically you your intestine is a hollow tube and then the first layer is a layer of cells that's that that's that barrier there's only selfish it's one sec one cell between you in a sewer basically it and it's very tightly control so those cells can separate and then close separate and close to let things in and keep things out so in his particular case he has two things going against him he has gluten sensitivity which is gonna lead to leaky gut he has bacterial overgrowth that's gonna lead the leaky gut and creates inflammation and that you have leaky gut you have leaky brain so you have two things possibly going on with him the the leaky brain caused a general neuro inflammation and then what you're saying is you're saying is that when you had bad bugs growing in your gut and you're getting gluten it inflames your brain yep it does Wow okay yeah it inflames your brain because what happens is is that you can have an autoimmune response that can be triggered against neural tissue from the gluten and also from the inflammation you caused in the gut that inflammatory response can be generalized and affect the brain a lot of people call SIBO irritable bowel syndrome right now we have a better name for you know figure out what it's caused by and not all arrabal bowel is SIBO but what we found was that when I was in training and I'm sure was like this for you George we were taught that people with irritable bowel syndrome were psychologically impaired that they were anxious and that's what was causing their gut issues I'm embarrassed to say that and and we had this sort of pejorative term called the functional bowel disease which wasn't like functional medicine was just like meaning it's like we had this sort of secret code where we called super ten toriel which means it's in your head right and and so it was kind of a medical inside joke and it was very judgmental in what Jordan it was and what we found was that actually it's the opposite that that when you look at and it was published in the New England Journal years ago or they looked at people with irritable bowel and what it does it triggers inflammation irritation in the gut and because there's a gut brain connection and there's a huge nervous system that connects your gut to your brain that it feeds back to the brain and creates an irritable brain so it's not the irritable brain that's causing your ballots irritable bowel it's causing your over ain't exactly that's a very different frame of thinking about it and and also Natalie's you can fix it by fixing the guys fix like it did with this guy was about so we fixed his gut and the other connection there to mark is when you have an imbalance of bacteria remember up to 70% of your serotonin can be made in the brain and serotonin does have a big impact on your mood so he had multiple things going against him all have stemming from the gut and so basically with the gut you know we and I don't want to get too much into the treatment for what we did for him but we do why not tell us about what you did so so so so how do you treat the gut like that that fixed the brain so the first thing you do is you alter diet so you put patients on what we call low fodmap diet and these are foods that are easily fermentable so we take them off these foods and we put them on foods that are gonna be easier for them to digest not ferment yeah you're not basically feeding the bad bugs you know they're bad food which is starch and sugar and right yeah processed foods and so we do that and then we also give them some probiotics and you have to be careful with probiotics because they are bacteria and you are treating a bacterial overgrowth so I'm very careful if I'm gonna kill the bad guys first right yeah you want to kill the bad guys first but we do know that sometimes that some people with SIBO respond well to probiotics but you have to be careful which ones you use um I'll tend to use spore based they may tend to fight and yeah you gotta get a problem yeah so it's a careful balance but it's basically change the diet then we give them some nutrients like glutamine that will help heal that barrier lining and and then we just we use antibiotics to get rid of the bacteria yeah and those antibiotics can be herbal protocols sometimes I will use pharmaceutical grade depending on what organisms what gasses are being produced but what organisms yeah so we we actually look at breath testing to see what's growing is that hydrogen is a methane and then we can customize our herbal treatments or our even our prescription drugs which can clear out the bad guys so we gotta do this one called weeding feeding and seeding program which is we basically get rid of the bad guys we seed it with the good guys and we feed they got to get it healthy you call it the five hour program and it's something we do really well here at the ultra the center and it's amazing how many things that can fix so in this case the patient had more psychological issues ad D and in the blood anxiety that was that was definitely the Siebel it was driving this the sepa was driving part of the anxiety it was sort of like again you have this genetic predisposition you're you're under lots of stress which is one driver yeah you have you develop SIBO and stress can be one of the causes of SIBO yeah then he also had the gluten sensitivity calls a leaky gut and there was another piece to this is that he had sleep apnea yeah so before you die I was not gonna give this really interesting I want to talk about to see the big issue but but the gut issue is so interesting because now in medicine we were understanding for example if people take antibiotics they get to my question that if your gut flora is off it can cause psychological symptoms which we didn't really know before and I wrote this book twelve years ago like it was published in 2009 but I wrote it like 12 years ago and I wrote about the discoveries I was making from a clinical perspective of what happened when I treated people's gut around anxiety OCD ATD it improves depression it's a it's amazing right and it doesn't mean that that's the cause of everybody anxiety it was a cause of his things I just remember another patient who I remember came in and he was like so every day at 3 o'clock I can terrible panic attacks I'm so anxious I thought you want to die I'm sweating I can't breathe my heart's racing I like oh well tell me about like what's going on in your life as well you know I work on Wall Street and I'm like we work hard all day and I I don't eat much and then like at night I eat a lot and I drink a lot and then I go to bed and I wake up I'm not hungry so I don't eat again tulay and then every day around it's paying I'm like hmm maybe you're hypoglycemic right why don't you eat breakfast don't eat so late stop drinking like great panic attacks oh no way yeah so that was his problem but this guy was different everybody's different because you say you have anxiety or panic attacks doesn't know something and somebody else it may be truly from like I have a friend who was in war zones and you know was was has PTSD and that's what causes pain so it's very different everybody and I and it is and I I chose him too because I don't want everybody to think that SIBO is always gonna use ayat e always is gonna be just you see Bo it's just it's never just one thing this is a contributor to a gentleman who had a genetic predisposition but he also had some metabolic findings as well you know he had things that we call crypto PI roles and he had urine peptides what is that so yeah I gotta tell ya so now these are not tests you get a traditional no you do not get these additional ways of looking at brain function through the urine that are so helpful what what are the yeah producing so will tell us about them yeah so so your in peptides when you break down your dairy products like milk you break them down into two whey and casein but you break them down into other proteins and some even things call it there are smaller than proteins called peptides that's less than 100 amino acid 58 5050 so so yeah these peptides and so if you break them down to certain peptides particularly with milky break them down into KC amorphous and these are these peptides that can cross your blood-brain barrier and then they have an opiate like effect on the brain which can affect mood cognition and memory so it's like you're stoned all the time on heroin right he had he had really high peptides in his urine he also had wait wait yeah this is not an allergy to Dairy and they'll hold the pro react his body just not even a sensitivity is that his digestion wasn't working and he couldn't digest the dairy proteins so they were partially digested they were getting absorbed across a leaky gut they went to his brain and had morphine like effects size changes cognition behavior and then you can see them coming out in the urine because they're excreted in the urine bingo so it's really a different way of looking at this yeah and you're not gonna get this a conventional doctor use not and so then I also checked it for crypto pyro so what equipped the Pyro's well your red blood cells break down periodically and when they break down they have iron in them and that iron has to be metabolized everybody does it one of the metabolites is equipped a pyro well crypto Pyro's are benign and they go out of your of your blood and in through your bloodstream and into your urine and leave the body but if you happen to be a person who breaks down too much of your iron and decrypted pyre rolls and you have lots of cryptic eye rolls when cryptic piles leave the body they take b6 and zinc with them b6 and zinc are really critical cofactors to neurotransmitter function in the brain and and you won't get it on a blood test because it's intracellular loss and this test is what we call a functional test yeah and it tells you what's happening that is due to the defect or the the lack of b6 and the lack of zinc this is really what we called a nutritional psychiatrist right it is and his cryptic pie rolls were way off the charts and so I can't reverse that but I can supplement him with b6 and zinc yeah because and we find when we do we take care of urine peptides and we take people off their dairy to avoid those and we give them a zinc and to be sent back we we add to the benefit you know we fixed his gut we take care of his urine peptides we take care of his cryptid pie rolls and now we're putting all these pieces together and he's getting better it's just never one thing and by the way in order to convert tryptophan which you get in your diet to serotonin right the enzymes require vitamin b6 yes so maybe it's not prozac needs but b6 right oh yeah that's really important so this is such a great case he had a TD that got better you target him with supplements like fish oil and another neurotransmitter support you got you got fixed right you got a sleep apnea fixed it's so great this is such an amazing case and I think mark I just gotta say one thing yeah the sleep apnea piece is is like another critical piece I just have to say the one thing your sleep apnea is that you know what sleep apnea is is it's pauses in your breathing that happens intermittently and frequently when you're sleeping and when that happens you have a lack of oxygen to your brain and you have disrupted sleep so that your brain can't do important things one of the important things that happens with sleep apnea is it impacts REM sleep the most and in REM sleep is where you're consolidating memory mm-hmm and if you're not getting mmmm sleep it's gonna make it harder for you to function the next day not only you're gonna be fatigued but that part of your brain responsible for memory isn't going to be working as well you're gonna forget your keys you're gonna forget your tasks you're gonna read something and forget what you just read in that sleep apnea and so and it's under-diagnosed we think that it's only obstructive sleep apnea which is one of two forms of sleep apnea only a current obese people but it can occur in thin people because it's not just the weakness of muscles in the throat that caused it but also the upper airway your Airways a narrower yeah and so he had sleep apnea Hayden's snoring all his life point being is sleep apnea maybe it's a TD and anxiety was probably do is sleep you know he steal my thunder mark yeah read your mind so it's I slept last night that's very possible that his snoring his snoring as a kid was driving his ADHD hmm right and as you age we have a lot of adults that are being diagnosed with ADHD some of the matter all their life some of them are developing it because of their sleep apnea so we fix his sleep apnea we fixed his urine peptides we Fichte scripta pyros he picked his gut we got him off a gluten we reduced inflammation in his brain in his body not only is he feeling better but we just helped him to begin to create a floor plan for the rest of his life yeah that's gonna keep him from chronic disease and let him perform and as Hisle well that's the other really important point you're making is in functional medicine we don't just keep people on forever we give them the roadmap of how their body works on a personalized level how to take care of it for life and how to optimize it right I mean if you know what they needed to know if we can see him periodically but most the time we give people the ability to fix the things that have been going wrong we teach them how to take care of their bodies based on their own unique characteristics yeah and then they do great and it's a part of the problem in functional medicine is you know you don't often get long-term patient's because they get better and I'm like what happened to you why didn't you ever call me he's like I was better oh my god I was like oh you were like I'll find out like five years later they'll call me for something I'm like what happen to you I know that's been hard for me because you know in my traditional practice you know family practice I raise a generation of patients you know two generations of kids and families and I saw people over and over and over again ain't probably with the same problem you do manage they're doing them with their medicines and so we had a really good relationship right here people get better and then you know here yeah sounds like it's like yeah you we don't manage we want to get rid of them get rid of them and that's the beauty of function medicine for most the time you you you can do this we have a little bit of time with they want to go through this next case it's so great okay it's another woman with anxiety and brain fog hair loss and fatigue so so tell us quickly about her so so the key piece to her was is that very healthy woman who had her symptoms of anxiety fatigue and hair loss start you know probably about ten months after one of her babies or I think her last baby was born yeah and so again she you know I said so when do you think this all started we looked for the trigger and once we can find a trigger when's the last time you felt healthy that's a starting point for me to start looking for clues it's like playing clue did it happen in a library that happened in the in the kitchen did it happened you know in the garage and so getting that that that first point where she thinks her life changed that being ten months after pregnancy first big clue because women can get an autoimmune thing called postpartum thyroiditis which is an autoimmune process so with hair loss and fatigue I'm thinking fog brain fog I'm thinking there's there's at least an autoimmune process going on here so I got that first clue going around she had problems he did but another key part was her irregular periods so she had been having irregular periods for most of her life and she had lots of pms and around his period of time she'd had brain fog so I started thinking about okay hair loss fatigue anxiety she's 42 year old and I started thinking about her hormones I started thinking about all the stress she's under with her kids cortisol relationship to estrogen relationship the thyroid I knew there was a hormonal piece and she had recurrent hives recurrent hives means yeah definitely something autoimmune is going on because we know hives can come from autoimmune processes can come from Stealth infection and we're gonna look there John come from gut yeah right Candida in the gut okay interestingly enough get her hormones back this is where she's estrogen dominant and what does that mean estrogen dominant means that you can have normal levels of estrogen and progesterone but relative to one another estrogen can be much higher than the progesterone and estrogen is really good for a woman gives a nice thick hair it makes your skin look beautiful it you know helps her maintain her vibe you know her or vivaciousness and her energy but when you have way too much of it and not enough progesterone then it can cause bad things it can have impact on your thyroid because it blocks thyroid hormones from getting to the receptors and doing their job it can cause fat deposition and lead to insulin resistance and as much as you try and lose weight if your estrogen dominant you're gonna be that patient it says I do everything dr. Papanicolaou weight I find out they have your regular period that's how they make cow's fat for for slaughter right they write the steer they give mr. Jenner look estrogen look PMS and we not you and I have talked about this PMS is not normal it's not correct and it affects 75 percent of women right and water normal condition so why do you get it one of the big things is xenoestrogens so xenoestrogens means xeno means you know guest or stranger or foreigner I like to call it strange like xenophobia yeah because yes like xenophobia because women who have xenoestrogens have have a stranger danger I call it stranger danger because now you got these strangers creating a dangerous environment for you and what's that dangerous environment estrogen dominance will lead to stimulation it creates a cancers a cancer-causing zone yeah and it increases your risk for breast cancer you know estrogen estrogen positive breast cancers and so it's really a big issue and when you have that many women having PMS and a lot of those women can have estrogen dominance it's a very important and the symptoms are calm like to get heavy bleeding because if you have more s true which might want more clots like you get premenstrual migraines so you get breast tenderness and fluid retention really common symptoms and guess what this woman hatch it endometriosis so which is another yeah estrogen stimulates the breast so you can get fibrocystic breast disease it stimulates the uterus so you can get uterine fibroids which is a buildup of uterine muscle tissue and you can get endometriosis she had the endometrium which is estrogen tissue like uterine tissue growing in other parts of your body right other poor outside of you can grow inside your uterus outside of your uterus on your ovaries and even attach itself to your intestines so so she had this estrogen dominance along with this auto dis underlying autoimmune issue and then I thought well their gut your gut is an issue and why she didn't complain about her gut until I started asking her questions about it and all of a sudden well yeah I do get bloating and I do get distension and I I do have a food baby every once in a while all right well you know it's sounding like SIBO so it reminds me of that patient was like you have trouble your digestion no it's just like are you are you regular yeah I'm regular I said I said how can you go she was once a week I said that's number it was just regular for me I'd go every week I'm like that just people think of as normal and it's just not normal yeah maybe no optimal yeah you learned that you learn to live with what you got yeah you know so so she in her mind didn't think she had gut problems even though she did she did when you dig into this - right so so here's here's where it all comes together is that when we get hurt when we get her testing back we do something that's called a complete diagnostic stool analysis and I will see your complete gut microbiome and it will measure different bacteria and all the different species but it also can find can now since I suspected that he's or ye so all can you there all kinds of speech that can grow on the gut and so I tested her for the most common one which is Candida I did and it's hard to find so I did an antibody test I did her stool test and I looked for it on one of her organic acid tests that we do found a positive in all three what does Candida do Candida metabolizes progesterone neither breaks it down to break it down you have less so here's an estrogen dominant woman who has Candida causing her hives and her fatigue and a brain fog is part of partly and it's it's chewing up progesterone increasing and making her her estrogen dominance worse and estrogen dominance itself those high levels of estrogen can cause anxiety it can cause depression mood swings brain fog and all the things she was experiencing that's amazing so everything tied together with her so I fixed her gut and get rid of her Candida her hives go away and then I started treating Reza Juun dominance and with that you fixed the gut in the hives go away just said that like that whatever people suffer horrible lives and it and and have terrible yeast issues and and it can be debilitating I I this woman she had this angioedema thing which shoot it's like hives on steroids literally it's like terrible and she had a terrible gut same thing she had terrible yeast issues we clean up her diet we fixed her gut we got rid of the yeast and like it's just my way and she was like it's loaded inflamed person to just looking beautiful and it's so easy actually when you know what's going on and instead of taking all these antihistamine drugs and steroids and epinephrine shots it's like it's such a mess when you look at traditional approaches to this and when you dig in and it's different for different people but if you find out what the issue is it's actually resolved pretty quickly and it's just she was even coming complaining of that right now that's the point both of these cases came in with anxiety as one of their top two complaints and that's what you say I'm sorry that's what you said I was tapping so you know anxiety it's it's just never just anxiety it's just never one thing as the body affecting the brain and so she was a really good case that everything sort of seemed the connecting shoes also had gluten sensitivity yeah and gluten her hair loss is a big issue she had alopecia areata which is an autoimmune process so what the hair loss is that one of the best causes of exactly it drives it it can actually drive the body to make antibodies against the hair follicles in your scalp and you lose them and what's the conventional treatment for that steroid injection yeah and I bet Paige was like literally go bald right and then we figure out it's gluten they got food and within you know months it all comes back and they get like a flight I just one page you come in it kind of with a big hat and a scarf and like she was kind of playing a trick on me because I haven't seen her in a while and she was completely bald last time I saw her and she lifted her scarf off and she had a big full head of hair like yeah and so within six months this woman's hair they actually started slowing down and by six months she was growing hair back needs a lot of things for her you treated her gut you got rid of the yeast you got the estrogen balanced how you do that so that's where your balance so basically you want to help her metabolize your estrogens better so there are different compounds that we can use so I use one of those compounds called diethyl methane you can also even what is that sounds like a big word like a big drug but it actually comes from broccoli broccoli broccoli yes yes why is that so great because it helps with detox yeah so so broccoli contains these compounds called this it it creates the ability the body eight stalks by the estrogen yes yeah and it helps with these compounds that are called Luca scintillates and so flora feigns and and it's all more things right societal methane is one of those compounds and it's been actually shown to reverse cervical cancer comes in hormone balanced he talks about estrogens so I detoxify your estrogen so I get her estrogen down by tot you know by metabolizing it better and we can also use something called calcium gluconate which will bind it and and so then you know and also gonna make sugar and starch from processed food alright we got it yeah and did I get it I was gonna end with and of course we changed your diet put her an autoimmune Paleo diet but going back to the estrogen dominance and then depending on the woman she might need a little bit more help so then I'll add some some I want to increase her progesterone so I'm getting her estrogens down I am increasing her progesterone by getting rid of Candida but she might need some help so I might give her something like chase Berry so chase Berry is the nerve it's an herb vitex my text yeah yeah so it's called bite X and it will actually help promote your body to make more progesterone and sometimes I might need to use some low low level progesterone cream operable you know topical just before her cycle or so in that and that can help and we did those things for her and her periods she don't no longer had breast tenderness she wasn't having heavy bleeding and things just really this was a remarkable case they seems like a miracle but it's not it's just good functional medicine and what's fascinating is you know sue is 42 and what happens with women as they enter their 40s their cycle start to change they don't ovulate every time they get lower progesterone they have more stress or diet breaks down so your end up with these estrogen dominant patients and they get you know fibroids and heavy bleeding in you know regular cycles and migraines and this stuff is so easy to fix using a functional Edison approach right so I I think exciting case is a very amazing cases and you know it just sort of shows you that through the lens of functional medicine you can have insights into the root causes of why people have common symptoms with uncommon solutions except in functional medicine their comments yeah and I throw on a center here we were so lucky to be able to use this model to treat our patients and now we're actually doing it all virtually which is awesome so we can actually help you whether you live in Timbuktu or whether you live in New Jersey or you know Russia we can actually help help from a remote distance and we have a great team of doctors nutritionists we have physicians assistants and health coaches nurses really are capable of taking care of these issues remotely and we just love helping people because it's so satisfying in fun for us yeah the sad part is we don't get him as much because they get better than they leave and go live their lives which is what we want anyway but it's a gonna feel a little bit lonely but I think you know we really want people understand that they're they don't have to suffer if there are so many people needlessly suffering from chronic problems yeah they have solutions that you just need to know how to dig a little deeper for and that's why functional medicine is the future of healthcare is it not some fringe Road it's not alternative medicine it's not integrative medicine it's it's looking at the biology we have through the lens of systems thinking and systems medicine and biology and that gives us really a leg up on everybody else we all understand the complexity of human biology but understand that there are common themes that we can fix the gut and optimize nutrition and optimize hormones and deal with different imbalances and we do that so easily and well and it's it's just it's so satisfying and George you you've been such a great addition to the ultra Wellness Center and and I'm just so happy to have you here helping these patients these are such amazing cases and you know makes our job so fun and most you know most I'm being a doctor is tough because know you get incremental benefit and you can help people suppress symptoms and they do okay but you're constantly managing them they don't just get better and I think that's the unique part about functional medicine is that there is a way out for so many people who suffer needlessly and I just encourage you all not to just accept the status quo yeah and don't accept a diagnosis and don't accept is single treatment for your diagnosis particularly if you're not getting better or you're or you're just being maintained you know remember that there are doctors like us our function medicine doctors here at the ultra Wallace Center that are going to realize that they're unique we have to ask the question why we have to unpack the mystery of that of those integrated systems that require so much support and they work so well together but when they're out of sync you know this can go wrong and we can figure that out and you should really don't accept the status quo as Marcus said and and seek help with a good function medicine doctor and we're always willing to do that here at the ultra oh that's right you've got Ultra Wellness Center calm you can go to get started page learn about all our services and just so happy to help and I think for those listening just to remember you know you're not alone out there all the stuff that there are solutions and sometimes it takes a while for people to find the right place but I just I just hope you understand that if you have some diagnosis just don't accept that if you have anxiety or if you have you know PMS or you have a bowel or whatever it is like you heids I mean these are these are just symptoms they're not a diseases diseases are are these labels these names we give to things that really have no connection often to what the cause is and so functional medicine is really about digging deep into the causes sorting through all that and and we just are just so happy all the doing this kind of health care it's really the future of medicine yeah don't accept the cover-up you'd have hives and your doctor says hey pigs eyes out for the next 10 years yeah that's a cover-up which by the way cost like twenty thousand dollars yeah yeah that's a cover-up get help yeah great all right well well you've been listening to the doctors pharmacy our special episode of house call with dr. George Pepin nicolau and we're here at the Ultra Wellness Center sharing a lot about what we're doing and we're just excited to share this with you if you love this podcast please share with your friends and family on social media leave a comment we'd love to hear from you subscriber every good podcast and we'll see you next time on the doctors pharmacy [Music]

Channel: Mark Hyman, MD

Views: 44,533

Keywords: Dr. George Papanicolaou, Dr. Mark Hyman, doctor’s farmacy, anxiety, anxious, gut health, gluten, ibs, sibo, functional medicine, anxiety medications, adderall, adhd

Id: YXZaZYVDn_k

Length: 52min 37sec (3157 seconds)

Published: Fri May 01 2020