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1:52

Hey everyone, Chris Kresser here. Welcome to another

1:54

episode of Revolution Health Radio. I've

1:57

had the pleasure of treating many kids

1:59

and

1:59

teens in my practice

2:03

over the past 15 years. And

2:06

as you might imagine, behavioral

2:09

and mental health conditions like anxiety,

2:11

depression, OCD, panic attacks,

2:14

ADHD, and a whole range

2:17

of issues were quite

2:19

common in that population. We know that from

2:21

statistics, and it was no different in my work

2:24

with these kids and teens. I

2:26

was always struck by the surprise

2:29

that parents would express when I suggested

2:31

that the roots of

2:34

their children's condition might actually

2:36

be physiological. Things

2:39

like gut dysbiosis or nutrient deficiency

2:42

or chronic infections

2:45

or other inflammatory conditions that were actually

2:47

driving the psychological, behavioral,

2:50

and emotional symptoms that their kids

2:52

were experiencing. In

2:54

fact, in many cases, no

2:57

doctor previously had ever suggested that.

2:59

It wasn't really even on their radar. They were

3:01

just purely treating it as a psychological

3:05

or behavioral disorder, often with medications

3:07

that were designed to address the symptoms

3:10

but were not even touching the fundamental

3:13

root cause of these disorders.

3:16

So I'm very excited to welcome Dr.

3:18

Kenneth Bach as my guest today.

3:21

He received his MD from the University

3:23

of Rochester School of Medicine back in 1979.

3:26

He's a fellow of the American

3:28

Academy of Family Practice and the American

3:30

College of Nutrition and is a certified nutrition

3:33

specialist as well and the founder

3:35

of the Bach Integrative Medicine Clinic

3:37

in Red Hook, New York. And he's been

3:40

a pioneer and leader in the field of integrative medicine

3:42

for a long time, four decades.

3:45

He's the author of several books. And

3:47

most relevant to the conversation today,

3:50

he is an expert

3:52

on the new childhood epidemics of autism,

3:54

ADHD, asthma, and allergies.

3:57

And in particular, he... has

4:00

done a lot to bring

4:02

our attention to the physiological

4:05

roots of these conditions. How

4:08

some of the things that I just mentioned like nutrient

4:10

deficiency, gut dysbiosis, tick-borne

4:13

infections, other types of

4:15

infections can be

4:18

either primary or at least contributing

4:20

factors to these psychological

4:22

and behavioral health conditions. And

4:25

I'm really excited to talk to Dr. Bach about

4:27

this because like I said there's just not enough

4:30

awareness in the general community

4:32

about that link

4:34

and it's the fastest way to make progress

4:37

on these conditions in many cases. So

4:39

I hope you enjoy this conversation

4:41

as much as I did. Let's jump in.

4:44

Dr. Kenneth Bach, such pleasure to have

4:46

you on the show. I've been really looking forward to this.

4:49

My pleasure to be with you, Chris. So

4:52

you know I have been

4:54

treating kids and adolescents and teens for

4:57

some time. You for quite a bit longer I think.

4:59

You have four decades of experience in this

5:02

field. And one of the things

5:05

I've always been struck by you know when I

5:07

would treat a child

5:09

and you know they're oftentimes one

5:12

or both parents is there and I would suggest the possibility

5:15

that their

5:17

ADHD or depression and anxiety

5:20

might have a physiological or biological

5:22

route like disrupted gut microbiome

5:25

or chronic infection, a tick-borne illness,

5:27

nutrient deficiency. The response

5:29

was often huh?

5:31

You know or you

5:33

know something to like like no one had ever

5:35

suggested that as a possibility. It was

5:38

never really even on the radar and

5:41

oftentimes they were they were relieved

5:43

because there was some

5:45

something that they could possibly address

5:47

or some some cause or reason that

5:49

could make sense for what was happening.

5:51

But I'm just curious like

5:54

when did you become aware of this in your career

5:56

and what has your experience been over the

5:58

past 10 years?

5:59

let's say in terms of the awareness of this

6:02

in the medical field and in the general

6:04

public.

6:06

That's kind of two questions. Let me take

6:08

the first one because that goes back more than 10 years. Sure,

6:11

of course. This is my 40th

6:14

year. You make me feel a little bit older there. It's

6:16

great experience. Experience

6:19

is valuable. I actually

6:21

think it's invaluable because when you've

6:23

seen thousands and thousands of kids like I have

6:25

you really, I

6:26

tell parents they have an N of 1 and when

6:29

you have N of thousands, it really makes

6:31

a difference in how

6:34

you can treat. It's really interesting.

6:36

It dates back to, the first book

6:38

I wrote was 1997 called The Road to Immunity.

6:43

At that point, I was

6:45

really researching the immune system

6:48

and

6:49

talked a little about this, these little peptides

6:52

called transfer factors. Somebody

6:54

had read it and got in touch with me and I started to

6:56

do some research on transfer factors. Little tiny

6:59

peptides that are immune modulators. That means

7:01

they balance the immune system.

7:04

I was really looking how it affected,

7:06

at that time, TH1, TH2.

7:09

There really wasn't a lot about TH17 at

7:11

that time. I think

7:12

it came after. So it was mostly TH1,

7:14

TH2. It wasn't always clear cut,

7:16

but I was doing a lot of research. In an

7:18

autism society,

7:19

they got a hold of some

7:22

of my writings, my research, and asked me to speak. I

7:25

spoke at this conference, probably

7:27

like a thousand parents. They

7:29

didn't know me, really. I was at the end of the conference, one

7:31

of those things that they put you in the nutshell.

7:34

Because

7:35

I had this integrated medicine approach,

7:37

it really hit the parents

7:40

and the practitioners in the audience. Anyway,

7:42

to make it short, a lot of the parents

7:45

started to bring kids to see me in the

7:47

spectrum.

7:48

I had a lot of success

7:50

with an integrated medicine approach because I figured

7:53

out that over time you had to sub-type

7:55

the kids, just like what you said, with all the different kinds

7:57

of potential causative factors.

8:00

And so, and that was microbiome

8:02

and infections and autoimmunity and

8:05

inflammation. Inflammation was the underlying

8:08

thing for so many of the kids.

8:10

And as parents start to travel from all over

8:12

the country and then eventually all over the

8:14

world, they

8:15

bring their other kids and they say, hey, would you mind,

8:17

I know they're not in the spectrum, would you mind seeing the

8:20

so-and-so-and-so-and-so who has anxiety

8:22

or depression or panic attacks or OCD,

8:25

mood dysregulation?

8:26

And I said, sure. And applying

8:29

the same approach,

8:30

I was able to find that so many of

8:33

them were also affected by so

8:35

many of these underlying medical biological

8:37

conditions, including inflammation and specifically

8:41

brain or neuroinflammation.

8:42

And so eventually after, you

8:44

know, at least around 10 years

8:47

of that, at least, I said, you know what, I really have to

8:49

try to put this together

8:51

because it's not just the spectrum that

8:53

I had seen so much. And then it was all of a sudden hundreds

8:55

and thousands of kids, neurotypical

8:57

kids,

8:58

some of who were like, quote, normal

9:00

and then

9:01

like deteriorated really rapidly in

9:03

terms of, you know, an infection

9:05

driving brain and autoimmunity.

9:07

So that's really what

9:09

drove me to it.

9:11

And what's it been like over the past

9:13

five, 10 years? Are you seeing more acceptance of

9:15

these ideas amongst your colleagues or

9:18

is it still, you know,

9:20

been a challenge in that regard?

9:23

Definitely more acceptance. There's no, I mean,

9:25

there's more and more research out there. So when

9:28

we first started, it

9:29

was interesting. I mean, it's like my

9:31

whole career has been defined by

9:34

treating conditions that became so

9:36

obvious to me, yet many

9:39

physicians didn't believe existed,

9:41

you know, reactive hypoglycemia

9:43

that still physicians don't believe exist,

9:46

chronic candidiasis or fungal dysbiosis.

9:49

You know, now of course the microbiome is

9:51

huge, but when we first started, you

9:53

know, and I've been doing work with the microbiome

9:56

my whole career. They didn't believe it. Come

9:58

on, you're going to be probiotics. I

10:01

mean, really, look at Lyme

10:03

disease. So, I spent the

10:06

beginning part of my career treating all these kids with

10:08

recurrent ear infections who were getting antibiotics,

10:10

and we had to find out that they had a milk allergy or

10:12

they had chronic

10:14

candida and dyspilosome things. And

10:17

now, I treat so much tick-borne disease

10:19

with antibiotics because, and

10:21

then, now they don't believe this chronic

10:24

Lyme. And that you don't need. So

10:26

it's really interesting. So for this whole

10:28

thing of what's usually referred to as pans

10:31

and pandas, I don't actually like to

10:33

use those terms as much because of the, quote,

10:36

controversy in some physicians.

10:38

So I like, as you read the book, infection-triggered

10:42

autoimmune encephalitis, or in late terms,

10:45

infection-triggered autoimmune brain inflammation, which I think

10:47

really kind of sizes it up for the

10:49

most part. And I think

10:52

lay people have really, the parents have ability

10:54

to understand that. So I do think, to

10:57

get around to the answers, that there

10:59

is more acceptance, no question. But

11:02

there were for a while, and there still are,

11:04

but there are less pockets. I mean,

11:06

places where, because in the medical

11:08

school, I'm not going to give a name because I

11:11

don't want to, you know, it's not a

11:13

common degree, but a really well-known medical school

11:15

in another state, the pediatricians

11:19

would say, well, our doctors

11:21

at the medical school don't believe in this, therefore, we don't

11:23

believe in it. They would literally be, we

11:25

don't believe in it.

11:26

So how could you not believe in it?

11:28

A kid is normal. They

11:30

get an infection. They rapidly

11:33

become an alien with all these

11:36

neuropsych symptoms that could be so severe, but

11:38

we don't believe it exists. But thankfully,

11:40

that's changed.

11:41

Yeah, I'm thankful for that changing

11:44

because that was, it's hard enough

11:46

to be a parent with a child who's struggling

11:48

with those issues. But then if you go into the doctor

11:51

and report it, and you're

11:53

made to feel like you're imagining it, or,

11:55

you know, it's got, that's so

11:57

brutal for a parent to deal with.

11:59

had so many parents over the years come to me

12:02

in tears. You

12:04

know, because

12:07

nobody believed them, their experience wasn't

12:09

valued as a parent. And

12:12

they were just told that it was some

12:14

kind of imaginary thing that

12:16

they and their kid were making up. It

12:18

was a horrific experience. And

12:20

I mean, I love what you said about

12:23

Candida and fungal overgrowth

12:25

because that was – if you were

12:27

to mention fungal overgrowth or Candida

12:29

at a medical conference, that was probably like

12:32

a surefire way of getting yourself laughed

12:34

out of a room or eye rolls or

12:36

whatever. And now you

12:38

look in PubMed and you can find papers

12:40

correlating fungal dysbiosis with

12:43

Crohn's disease and inflammatory bowel conditions

12:45

and all kinds of stuff. You

12:48

know, it's all there in literature. And

12:50

people like yourself and Leo Galland and

12:52

others have been talking about this for years,

12:55

and they're not being taken seriously.

12:57

And now that we have the

13:00

published research to support it, it's

13:02

sort of like a tacit, oh, okay,

13:04

I guess there was something to this

13:06

all along.

13:07

That's not always said,

13:09

by the way, Chris. Sometimes it's like

13:12

we just discovered it. This is like a new discovery.

13:14

Right, exactly. Yeah, like look what we found.

13:18

Anyway, it's positive development for all

13:20

of us that this is now being

13:22

accepted in even within,

13:25

at least within the scientific community. You know, as

13:27

you said, it hasn't necessarily

13:29

percolated down.

13:31

I've often found, and I'm

13:33

sure you have, there's a 10, 20, even 30-year

13:34

gap between what's showing

13:37

up in the scientific literature and what

13:39

you might find with your primary care

13:42

provider even in medical schools, which ironically

13:45

can be the last to change because

13:48

they're just so deeply entrenched in

13:50

the current paradigm, right?

13:52

Oh, really?

13:53

Yeah, I mean, we don't have the time,

13:55

but there's a whole story about penance.

13:59

We don't use it as a medical center. How could it work?

14:03

Right. Well, I want to

14:05

dive in now. It was a good segue.

14:08

You mentioned just calling

14:11

these conditions what they are. It was

14:13

an autoimmune inflammatory reaction

14:15

in the brain. And

14:19

let's talk about some of

14:21

the mechanisms here and causes. We've

14:24

mentioned the gut microbiome, dysbiosis,

14:26

infections, and things like that. But let's

14:28

talk a little bit about how, for

14:30

example, disrupted microbiome

14:33

might lead to inflammation

14:34

and an autoimmune attack

14:37

against the brain.

14:38

Some of the research has come out around

14:40

gluten, and gluten's a sax on the brain

14:42

in certain kids. Whatever direction you

14:44

want to go is fine. But I think it's helpful for parents

14:47

to understand some of these mechanisms,

14:50

at least at a high level. The gut-brain connection

14:52

is so key. I have to say, it's

14:54

been a key for those of us in this field

14:57

for so long. With

14:59

anything from arthritis to dermatitis

15:02

to brain issues,

15:05

you can treat brain fog and all this confusion

15:08

with an antifungal. And it

15:10

goes away. You didn't give anything a quote for the brain.

15:13

So the key is that there are many

15:15

things that can

15:17

cause the intestinal lining

15:19

to become more permeable.

15:22

And that can range from gluten

15:24

and casein. These are dietary

15:27

peptides to all kinds of infections,

15:29

anything from viral to bacterial or fungal

15:32

to tyrosidic,

15:33

toxicants, even some drugs.

15:36

There are so many things that can

15:38

do that, and even stress.

15:40

And when the gut becomes more

15:42

permeable, and in late times,

15:44

we call it a leaky gut. But

15:46

in medical terms,

15:48

it's intestinal hyperpermeability.

15:50

They are these tight junctions. And they're

15:52

important because if you think of what, people

15:54

can only think of what they shovel into their mouth

15:57

and in their guts on a daily

15:59

basis. pretty scary. So the

16:01

gut has to be able to discern what

16:04

it can get through, what's friend, what's

16:06

foe, what it has to react to. And

16:08

you don't want it reacting to everything because you're going to be in

16:10

trouble, especially if it's good stuff.

16:13

So when

16:14

something affects the gut, makes

16:16

it more permeable, it loosens these

16:18

tight junctions, allows these

16:21

mediators, whether they be metabolized from

16:23

the microbiome to any

16:26

kind of inflammatory mediators

16:28

that are initiated by whatever

16:31

is happening, whether it be an infection or a gluten

16:33

or what have you. And it gets into

16:35

the circulation, gets up to the brain.

16:37

And then quite frankly, I

16:40

have slides that show that the actual

16:42

connections between the

16:44

endothelial cells, which are these cells that,

16:46

you know, these single cells that are in the tiny

16:49

capillaries in the brain, that's where all the action

16:51

is, they have tight junctions the

16:53

same way. And so those tight junctions get loosened.

16:56

And then you have a leaky gut leaky brain, you

16:58

have a leaky blood brain barrier.

17:01

And that allows all these inflammatory

17:03

mediators, whether they be immune globulins, because they're

17:05

pretty large, they're large molecules, and

17:08

these inflammatory immune cells,

17:11

and then they wreak havoc on the nerve cells

17:13

and the companion cells in the brain.

17:15

So that is the connection. And

17:17

if you don't heal the gut,

17:20

you don't get people better. That's

17:22

with this brain inflammation, that's also

17:24

with arthritis, and it's also, the

17:26

gut is so key. So that's why we really, that's

17:28

really one of our main focuses. And if a kid is constipated,

17:33

and kid is having all these GI issues,

17:35

you really have to tend to that first, so they

17:37

won't get better.

17:39

Yeah, I've seen, it's almost

17:41

like, show me a kid with a behavioral disorder.

17:44

I'll show you a kid with a gut disorder.

17:46

It's maybe not a one-to-one correlation,

17:48

but it's pretty darn close in most cases.

17:51

And they may not even come into the clinic

17:53

complaining of GI issues, or maybe,

17:55

you know, maybe the psychological behavioral

17:58

symptoms are more prominent. But when

18:00

you do a history and you start asking

18:02

questions about how

18:04

frequently do you have bowel movement? Oh, once every

18:06

three or four days. It's

18:09

not something that's even on their radar

18:11

as being abnormal or something that needs to

18:13

be addressed, but it's certainly a contributing

18:15

factor. I

18:19

mean, is it any wonder with antibiotics,

18:21

highly processed and refined foods,

18:24

all of the dyes and processed foods that

18:27

kids are exposed to, all of the other

18:29

things that threaten the

18:33

gut microbiome these days? We're really

18:35

now seeing in the last two generations

18:38

the effects of all of these

18:40

changes.

18:43

Yeah. So, aside from the

18:45

gut-brain axis, what are some of the

18:47

other and everything that

18:49

goes along with that? And that is kind of a foundational

18:53

factor even with some of these other challenges that we

18:55

might talk about. But you mentioned chronic

18:57

infections. What

18:59

are some of the other things you tend to look for when

19:02

somebody, a kid or an adolescent

19:04

or teen comes and presents with these

19:07

behavioral or psychological conditions?

19:09

I don't want to skirt over the chronic infections because

19:12

they can be acute infections like strep, which

19:14

is the classic. Absolutely. Yeah. It's

19:17

an immune response. I think people need to understand

19:20

that when your immune system reacts to an infection

19:22

like strep, it recognizes

19:25

it and it makes these antibodies. It has T-cells

19:27

that get into the

19:30

fray and also these antibodies made

19:32

by B-cells. But there are these

19:34

what's called epitopes on the strep.

19:36

These are very, very tiny parts

19:38

of peptides. Extremely small. But

19:41

one of those epitopes can look exactly like

19:44

a piece of the basal ganglion in

19:46

the brain. Your immune

19:48

system to make antibodies to strep, it

19:51

may see this part of the brain called the basal ganglia

19:54

and react to that thinking it's strep. We call

19:56

it that molecular mimicry. So that's one of

19:58

the pathophysic

19:59

the mechanisms

20:02

of how it happens in addition to these T

20:05

cells, inflammatory T cells. So

20:07

the strep is one. And the

20:09

last patient I had today was

20:12

cute recurrent strep infections,

20:14

six year old

20:16

from January

20:18

through this year, five.

20:19

And every time he never had a sore

20:21

throat, all he had

20:23

was mood dysregulation,

20:26

hyper ADHD,

20:29

vocal tics and loud noises.

20:31

And finally somebody recognized

20:34

and then referred him to me because they recognized

20:37

that it was the strep that was doing this. So

20:40

that's strep. But I think the tick-borne is

20:42

something I want to really emphasize because

20:45

that's something that might pick up so much and is missed.

20:48

This kid had tick bite when he was a year old

20:50

and didn't have a bullseye and never got tested

20:52

or treated. So obviously I'm checking him for ticks,

20:56

tick-borne disease, but that's one of the things. And

20:58

it's not only Lyme disease, because

21:00

as you know, it's co-infections. It's Bartonella,

21:03

Babesia and Mycoplasma

21:05

and things. But so many kids, if

21:07

they get tested for Lyme, they'll get this one Lyme titer

21:10

from a general lab that's not really very

21:12

good for Lyme. Stats show that

21:14

can only be maybe 55% sensitive. So

21:17

they get a negative test that you don't have Lyme. It's

21:19

a lousy test anyway, and they haven't even looked

21:21

at the co-infections, especially Bartonella when

21:23

it comes to rage, which is what we call Bartonella rage.

21:26

So I think it's so important, the

21:28

key is that your doctor,

21:30

whoever they see, considers

21:33

the possibility of infections. And

21:35

that can range from strep to

21:37

mycoplasma to chlamydia, to all the

21:39

tick-borne infections. Viral

21:42

infections. And viral is like Epstein-Barr

21:44

and CMV and all those things. But

21:46

so we do a very thorough infection

21:50

profile when we see somebody like I did today,

21:52

and you have to. So, okay. Because

21:56

I always say if they have a tick-borne infection, and

21:58

if you, we see a lot of... people from endemic

22:00

areas, which means that ticks are known to

22:03

be there. And these kids are out playing soccer and the

22:05

kick of bull goes into what you go get and

22:08

half, almost half the people generally that they

22:10

don't always get a tick bite and they don't get the rash. So

22:12

it's just important to have it on the top of your mind.

22:15

Okay. And, um, and

22:17

some of these infections are ubiquitous. So

22:19

yeah, I'm becoming more common. Totally, totally.

22:22

I mean, Lyme disease, one point they

22:24

were saying it was 30,000 a year. And then a few

22:26

years ago, CDC recognized, well,

22:28

it's actually 300,000 a year and now it's up

22:31

into the fours for 30, 450 infections per year. It's,

22:34

it's really common. But the

22:37

other thing is anything that causes

22:39

inflammation has to be considered.

22:42

And I want to make sure that people know I'm not saying

22:44

that every psych symptom and

22:46

disorder has

22:47

a medical biological

22:50

underpinning. It's not true there, you know,

22:52

uh,

22:53

you know, a kid, you know, a girlfriend

22:55

breaks up with the boyfriend and vice versa,

22:57

and one of them is, is, you know,

22:59

all of a sudden they're really depressed and,

23:01

and, and hopefully not suicidal,

23:04

but it can be that bad. You know, I mean,

23:06

that's a psychological thing. Now that

23:08

acts, that stress actually causes inflammation,

23:10

but that is, you know, it's a, it's a

23:12

psych trigger that the point being

23:15

is that

23:16

that, that is sometimes sometimes a panic

23:18

disorder is a panic disorder. There's a past

23:20

trauma, this or that, even though a lot of times those things

23:22

do cause

23:23

inflammation, but it's

23:25

like

23:26

anything that can contribute inflammation, like

23:28

allergies, like the kid today,

23:30

it turns out we test them for allergies, they got a milk allergy

23:32

and each tons, tons of milk

23:34

and cheese. Well, that could make a huge difference

23:37

in this kid's psyche. Sometimes milk can cause

23:39

depression and psych symptoms and not

23:41

just floating gas, diarrhea,

23:43

those kinds of things that we think of, and

23:45

it's nutritional imbalances, you know, because

23:47

a lot of the nutrients are involved in the neurotransmitters.

23:51

So we look at B6, zinc,

23:53

magnesium,

23:54

methyl B12, methyl folate, and

23:57

we even look at the MTHFR gene, which

23:59

is. a gene that helps one

24:02

convert folic acid to the active methylic

24:04

for the brain. And it's not

24:06

always a frank deficiency. Sometimes it's just an

24:09

imbalance, and so we have to be

24:11

aware of this. So we test a lot of more metabolic

24:13

parameters and functional tests rather

24:16

than just a static

24:17

level. And vitamin D is a key,

24:19

key level

24:20

because for the blood-brain barrier, vitamin

24:23

D is important as well as for a proper

24:25

functioning immune system. So all

24:28

those things and then hormones. You see

24:30

a lot of kids that may have

24:32

thyroid dysfunction and adrenal dysfunction.

24:35

And along with adrenal dysfunction, you make

24:37

the reactive hypoglycemia, which is low

24:39

blood sugar.

24:40

And you get the right history where a kid

24:43

who gets hangry, that whole hangry way,

24:45

doesn't eat frequently, then gets really

24:48

angry and can even rage or might

24:50

get shaky, whatever. And it's discounted.

24:53

It's just not looked at. And I just don't

24:55

understand, quite frankly, Chris, why

24:57

sometimes it's so late.

25:00

Yeah, I think another big one

25:02

is sleep deprivation, which,

25:05

of course, is inflammatory. It affects the

25:08

gut microbiome. It affects hormone levels,

25:10

everything that we've basically been talking about. Kids

25:13

these days and teens are burning the

25:15

candle at both ends,

25:17

especially, as you know, when adolescent teen

25:20

years set in, they

25:23

actually start to need more sleep again. There's

25:25

a period of time from like 8 to 12 where

25:28

the number of hours of sleep

25:30

that are required drops

25:33

a little bit compared to younger years. And then it

25:35

increases again at the very time when

25:38

kids are being asked to wake up earlier, go

25:40

to school early. They're staying up

25:42

later because their chronotype is shifting. I've

25:45

seen a lot of teens and stuff who

25:47

are going to bed at 11, 12 at night because

25:52

that's how their chronotype is shifting.

25:55

And then they're waking up at 6 or 6.30 in the morning

25:59

to go to school.

25:59

I mean, they're literally two or three hours

26:02

less, getting two or three hours less sleep than they

26:04

need. And that to me is kind of catastrophic

26:07

in terms of the consequences. And I

26:09

agree, I think it's frequent. I really feel like teens

26:11

are in a pickle because school

26:14

is starting earlier because they

26:16

want to allow for

26:18

the team's forwards and the extracurricular,

26:20

I get it.

26:22

But then they're up

26:23

and it's also, they're

26:25

up on social media. On phones. On

26:28

phones. And that's going to keep them

26:30

going to sleep. So I agree with you.

26:32

I mean, I really think

26:35

that teens are getting bombarded these

26:38

days. It is not easy being a team. Much harder than

26:40

I think it was in our day. Much harder. Absolutely,

26:42

yeah. Absolutely feel that way as well.

26:45

And then just not to

26:47

gloss over this too much. Either is, yes,

26:50

there are kids who are gluten intolerant. There are kids

26:52

who are case intolerant.

26:54

But even just kids who don't have those intolerances,

26:57

if they're eating mostly flour, sugar,

27:00

industrial seed oil, which is now like 60% of

27:03

the calories that the average American eats,

27:06

those foods are, you

27:08

know, the bad bacteria and fungi

27:12

and our guts just absolutely have a field day

27:14

with those types of foods. And that in

27:16

and of itself could drive

27:19

gut dysbiosis that can cause these kinds

27:21

of problems. And as you know,

27:23

over the last 10 years, there's been a lot

27:26

of research on this inflammatory

27:28

cytokine model of depression, for example.

27:31

It was always, you know, the idea in the

27:33

past was that depression is an imbalance

27:36

of brain chemicals, ferritone and

27:38

neurotransmitters. And now

27:41

a lot of the more recent research suggests

27:43

that it could actually be a gut brain

27:46

access issue. It could be inflammation in the

27:48

gut.

27:49

Fire in the gut, fire in the brain, right? How long

27:51

have we heard that in integrative medicine? And

27:54

that's why anti-inflammatories work. Listen,

27:56

there's articles. And these don't have to be

27:58

natural anti-inflammatories.

27:59

like Kirkman and Resveratrol and things,

28:02

but they can be even

28:04

cellococcin, which there are articles on that. I

28:07

use that a lot in the kids because unfortunately,

28:09

NSAIDs can also contribute to a leaky gut,

28:12

so there's always a risk, but

28:14

yet

28:15

there are some times you add that and it's huge. Some of the

28:17

kids take ibuprofen

28:19

and it makes a huge difference. Yeah, it can be interesting

28:21

too, just even at the therapeutic trial, right,

28:24

to see like how much of a

28:26

role is inflammation playing. You take a dose

28:29

of NSAIDs and if they have a huge response,

28:31

then that's a good indicator that

28:34

inflammation is a primary

28:36

driver of what's going on, even

28:38

if you then want to find other ways of

28:41

managing the inflammation later, right?

28:43

I always tell them, like, because I use also

28:46

psych meds, I mean, sometimes it's so bad you need

28:48

it this day. I mean, I'm not even going to necessarily

28:51

say I am on mood stabilizers, I happen to like

28:53

the class much better, but

28:54

sometimes low dose of bilefir, you

28:57

need it. I mean, if a kid is so aggressive that

29:00

the family's worried about it, but I always

29:02

say it's not enough to give a psych

29:04

med. You always have to be looking for what's underlying

29:07

it, but it doesn't mean that a psych med is

29:09

not helpful for a while in certain

29:11

situations.

29:12

Yeah, I appreciate that you brought that in and also

29:15

before also said that, you know, we're not trying

29:17

to be reductionist here and say every

29:19

single psychological behavioral

29:22

issue is 100% biological,

29:24

physiological. There are still circumstantial

29:27

factors that affect our mental health and

29:29

behavioral health. And but

29:31

I think what you're saying here is we need to look

29:33

at the whole picture together

29:36

and look for the root

29:38

causes and try to address those root causes.

29:40

And yes, if you need to use psych meds

29:43

as a way of giving relief

29:45

to the kids and the parents and the families,

29:48

then sure, but don't only do that,

29:50

right? Like don't let that be the

29:54

starting place or the stopping place, which is really

29:56

what it is in the conventional

29:59

medical establishment.

29:59

and there's rarely any investigation

30:02

into what the root causes might be. And

30:04

my concern there is

30:06

the psych meds don't solve

30:09

the problem. They help with the symptoms

30:12

generally, but they're not actually

30:14

addressing the cause in most cases,

30:17

it seems. Some of them are actually anti-inflammatory, Chris,

30:19

so they're actually an inflammatory

30:21

component of some of the psych meds. But the same

30:23

holds true with psychotherapy.

30:25

I mean, I like them, all my kids

30:27

could be going through psychotherapy

30:29

because you have to help them cope, you have

30:32

to teach them things.

30:33

But that all this,

30:35

and I think you saw it, all the psychotherapy

30:38

and all the psych meds in the world are not going to

30:40

help a kid get well if he's got an underlying

30:42

tick-borne infection and autoimmune brain

30:44

inflammation, it's just not going to do it.

30:47

That's right.

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Likewise, as

33:52

you're kind of hinting at,

33:55

even if there's a tick-borne illness or

33:57

infection, you may need to address that and layer

33:59

on some psychotherapy.

33:59

therapy because some of those

34:02

issues, once they get started, they can become

34:04

kind of a loop or repetitive patterns

34:07

of behavior that skillful therapy

34:09

can be helpful in resolving.

34:13

So I know a lot of

34:14

parents, and this is not an easy question

34:17

to answer probably, but I'm going

34:19

to ask it anyhow. A lot of parents

34:21

are listening to this and probably relating and

34:25

imagining that this

34:28

is impacting their kids. And

34:31

how do they get help? Obviously, you're

34:33

one option. It's challenging,

34:36

I think, for a lot of parents because if

34:38

they take this kind of information to their local

34:41

doctor,

34:43

chances are pretty low that they're

34:45

going to be able to get the kind of help that they need, the

34:47

testing that they need.

34:49

I think reading your book is

34:52

a really good start because then they understand

34:54

the lay of the land. But

34:56

I'll just say it's frustrating

34:59

for me as a clinician who's

35:01

been treating these kids for so long just

35:03

to not be able to help more people because

35:06

there's a limit to how many people we can see,

35:08

right? That's one reason why I wrote

35:10

the book. Writing a book takes a while because

35:13

it doesn't reach people

35:16

all over. It's actually been published in six languages

35:19

now, so it reaches people all over the world. And

35:22

yeah, obviously people fly to me from all

35:24

over the world, but obviously I can't see everybody.

35:26

I'm not the only one who does it. People

35:28

have to go online. There are pans

35:30

and pandas organizations and there are support

35:33

groups and the parents refer each other

35:35

to doctors in different places.

35:37

And

35:39

the problem is some are better than

35:41

others and some are more thorough than others.

35:43

And hopefully the parents

35:46

have to do their research and things. But

35:48

I think more and more physicians are getting educated.

35:52

I hear more and more pediatricians

35:54

who are open to it, who may start even

35:57

giving an antibiotic for a little bit longer than

35:59

they might for a strong time.

35:59

Because a lot of times you have to treat a pandas since

36:02

at least 30 days, let's say.

36:04

So there's a little bit more of an opening.

36:07

And then if it's beyond them, if it's a real complicated

36:10

case, they refer it. So I

36:12

think all we can do is hope to educate.

36:14

And the parents have to do their research. I mean,

36:16

you know, and obviously see people. And

36:19

you know, it does make a difference if they're experienced, I

36:21

have to be honest, I see some people that have seen

36:24

certain people come to see me and they say, we've

36:26

done everything. I look and I say, not

36:28

even, you probably see the same thing, not even close. Yeah.

36:31

Right. Same thing in the spectrum. I

36:33

mean, not even close, but

36:35

so, you know, it's, it is frustrating, but

36:37

I think more and more there are more options for

36:40

parents. And I do think maybe

36:42

starting

36:43

with the book I

36:45

wrote or other books like that, that can give them a

36:47

label and give them an understanding of what they

36:49

may be looking for and what may be going on,

36:52

because it makes them also realize that they're

36:54

not crazy and their kids may be not crazy,

36:57

but there's actually something going on. Yeah.

36:59

I think we've already touched on some of these points, but

37:01

I want to like summarize it and

37:03

condense it. What are some of

37:05

the signs you look for? Like

37:08

if it comes to the clinic with complaining

37:10

of some of these issues, the psychological

37:13

or behavioral

37:14

issues, what are some of the signs,

37:17

top signs you look for that would indicate there

37:19

may be, you know, biological or physiological

37:22

factors? You talked about constipation

37:24

and gut issues, of course, but what other

37:26

signs or symptoms do you, are the

37:28

biggest red flags for you to

37:31

go looking for? I think that the

37:33

one is the timeline is, you know, is

37:35

the

37:36

frequently the abrupt onset from a kid who

37:38

is really, you know, I guess these kids who

37:40

are top of the heap, you know, I mean,

37:42

they're, they're great athletes. They really,

37:45

you know, eight plus students, they got tons of friends.

37:48

And you know, within a very short time, whether it's

37:50

overnight, which you can be, or within a

37:52

short period of time, they become

37:54

demons, they become different kids,

37:57

you know, they're crying, they're aggressive,

37:59

they're.

38:00

And they don't have an obvious slight

38:02

trigger, like, you

38:05

know, a boyfriend dropped them or they're

38:07

getting intensely bullied. You always have to think about

38:09

that. And I always question whether if

38:11

they're very different in school

38:14

and home, that's a clue that it may not.

38:16

I mean, you know, if you're very good in school

38:18

and you have only issues at home, that

38:21

may be the behavioral issues of a teenager,

38:23

we call it teenageitis. So

38:25

it's really those kind

38:27

of questions that we have to ask. So

38:30

the timing of it, what makes it better?

38:32

Hey, you know, you give a kid,

38:34

they get sick and then

38:37

they probably don't correlate that

38:39

they deteriorate psychologically.

38:42

But you give them an antibiotic and

38:44

they get better and you can't always see that. But

38:46

if it's kind of a repeated thing

38:49

or if they have bowel

38:51

problems or if they have other symptoms, do

38:54

they have a tick bite? Do

38:56

they live in an endemic area?

38:58

Are they out there hiking and camping,

39:00

those kind of things for tick-borne things?

39:02

But even thyroid, you know, they

39:05

call when others aren't.

39:07

Are they gaining weight when and

39:09

they're not on a psych med that's going to cause them to gain

39:11

weight? Are they constipated? Do they have dry hair

39:14

and dry skin? And is it

39:16

related to eating? You know, do they get worse?

39:18

Do they somehow have more emotional

39:20

dysregulation after they eat, which may be like

39:22

a food allergy or sensitivity? Or when

39:25

they don't eat like a low blood sugar where they get

39:27

shaky or tremulous and

39:29

hangry and stuff. So,

39:30

I mean, I think it's just a matter of,

39:33

even before the testing,

39:35

that's why at the end of every chapter in the book, I put

39:38

in all these questions that they, you

39:40

know, the kind of clues because,

39:42

you know, a lot of times the whole thing, as you probably know, as a clinician,

39:44

you

39:45

know, really, I do physical on everybody

39:47

and that certainly can help. But

39:50

that doesn't take that long. It's the history that

39:52

really points you, you know, 95% of the

39:54

time, you know what's happening after you've done a really,

39:56

really good history. And the

39:58

labs confirm it, you know. So, you know,

40:00

I always say I treat kids. I don't treat the

40:02

labs, the labs confirm it. And obviously I can't

40:05

tell them what their zinc level is or their vitamin D level

40:07

is or which tick-borne they have, although I

40:09

have my, so

40:10

it's in, you know, hopefully after 40 years.

40:13

I'm right some of the time. Got some educated

40:16

guesses there.

40:17

Yeah, yeah, come educated, but you

40:19

know, that's. Yeah. There

40:21

are a lot of clues. Let's

40:24

talk a little bit about labs because this is a

40:26

common scenario. I'm sure you've

40:28

seen, you know, over and over,

40:31

a parent comes in and says, we've had

40:33

the labs done, they're all normal.

40:35

And it is typical

40:38

in my experience with a lot of these kids, that

40:41

basic labs might be normal.

40:43

So if they have just a very rudimentary,

40:46

you know, blood work up where

40:48

they're fasting

40:51

glucose and, you know, just

40:53

maybe like a CMP, a

40:56

comprehensive metabolic panel. And some of the basic

40:58

tests that a primary care physician

41:01

might order all come back normal,

41:03

or at least within the standard reference

41:06

ranges that are used. But

41:10

those are not the labs that you're talking

41:12

about. I imagine, you know, you're talking about

41:15

probably much, you know, the functional

41:17

integrated medicine labs or more detailed

41:19

blood work that's looking at inflammatory

41:23

cytokines or markers of inflammation,

41:27

more specific nutrient analysis, et

41:29

cetera. So can you talk a little bit about the labs

41:32

that you find

41:34

most helpful?

41:36

You need a CDC and a chem profile

41:39

because you need to be able to look at liver and kidney because

41:41

certainly if you're gonna use any medicines, you have to make sure

41:43

those things are okay. And with tick-borne,

41:45

they can be

41:46

abnormal. You can have a low white count, you can have

41:49

a platelet-affected liver function-affected.

41:52

So you have to look at that stuff.

41:54

Then, yeah, we do an in-depth tick-borne

41:56

evaluation.

41:57

I wouldn't say on everybody, but on anybody that

41:59

I...

41:59

I think it may be playing a role, and it's certainly

42:02

a lot of the kids. And so that's much

42:04

more comprehensive. It doesn't only look at Lyme.

42:07

And we send them to labs

42:09

that really specialize in tick-borne

42:11

infection. So that,

42:12

you know, really the literature

42:14

really shows the variability of labs

42:17

and how the regular labs really, literally

42:19

for Lyme titers, 55% of

42:21

the time they picks it up. It's almost 50-50.

42:24

So, you know, we use much better labs. So

42:27

that's those. And then you have to remember

42:29

from the regular labs, you can get streptitis and

42:31

you can get mycoplasma and chlamydia and you can

42:33

get your viral titers. That all can come from regular

42:35

labs.

42:37

And then the more integrative

42:39

labs, we'll also do food allergies,

42:42

which again, and depending

42:44

like if they have seasonal allergies, you

42:46

can do inhalants as well. Those again

42:48

can come from regular labs.

42:50

But if you do food sensitivities, that's going to have

42:52

to go to a specialized integrative lab.

42:55

And you can check zonulin

42:58

and markers of intestinal

43:00

permeability or

43:01

hyperpermeability.

43:03

And we get stool analysis that are really

43:06

look at the microbiome and look at absorption.

43:08

So many of the kids have malabsorption.

43:11

I mean, it's not the majority, but certainly a number

43:13

of them have malabsorption. And so

43:16

you have to see that so many have dysbiosis,

43:18

it's just

43:19

uncanny. And then we do

43:21

a, you know, some kind of a nutritional evaluation. So

43:24

again, not only just static going to like

43:26

a lab core quest and just getting a B1 and

43:28

B6 level, but getting markers

43:31

where those, yeah, you

43:33

get, you can test enzyme activity,

43:35

you can take metabolites

43:37

and those metabolites if they're low or high can

43:40

reflect

43:41

the activity or inactivity of

43:44

a certain nutrient like B12,

43:46

B6, B1, or

43:49

zinc, or magnesium. And

43:51

we do look at minerals and heavy metals

43:53

always, but you have to be so

43:55

many of the kids of magnesium deficient, zinc deficient.

43:58

Or you know, lab.

43:59

led Mercury Academy of an Arts

44:02

and Art. Mercury for

44:04

sure. That is a biggie. I mean,

44:06

you know, and it's missed because

44:08

it's not looked at. I mean,

44:10

I have to say, I mean, this is what I wrote in 1997.

44:13

I can't, I mean, it goes way back. I said,

44:15

if you don't look, you won't see.

44:18

And if you listen, you won't hear. And

44:21

how many, I, and again, I don't want to put

44:24

down pediatricians anyway, because they're doing their best.

44:26

They haven't just seen so many kids in the day. Absolutely.

44:29

If you say, oh, you eat, you eat a healthy

44:31

American diet, you're fine. And they'll ever

44:33

look at, maybe some of them are looking at vitamin

44:35

D now, but not a lot. But they're

44:37

not going to ever look at zinc or magnesium or

44:39

whatever.

44:40

And so many kids are zinc deficient, you

44:43

know,

44:44

or relatively have a relative zinc

44:46

insufficiency. And I think that's a big point that

44:48

needs to be made. You don't have to be frankly

44:50

deficient

44:51

to need certain nutrients to help,

44:53

help you. And we all heard of that with people

44:55

taking zinc, vitamin D, and vitamin

44:58

C as the trio for COVID.

45:00

You know? That's right. It's, it's,

45:02

we've moved, we've, we're beyond the, you

45:04

know, we've largely conquered scurvy and

45:06

rickets and Berry Berry and pellagra. That's

45:09

not what we're talking about here. We're

45:11

talking about the optimal

45:14

level of nutrients that can help us thrive

45:16

and, you know, live long healthy life.

45:19

And there's been so much research over the past,

45:22

you

45:22

know, two decades that

45:25

suggests that that level is

45:27

so much higher than the low

45:30

end of the, you know, RDA

45:32

or threshold at which an acute

45:35

deficiency syndrome would take place,

45:37

like Berry Berry ricketers. And

45:39

unfortunately, a lot of the lab reference ranges

45:42

are still configured in such

45:44

a way that they're really designed to detect

45:47

those acute deficiency syndromes and

45:49

not chronic nutrient shortage.

45:52

And on the flip side of that, it's the same with

45:55

the heavy metals, right, where, you know,

45:59

understanding of toxicity was like, what

46:02

is the level of mercury that will cause an acute

46:05

mercury poisoning syndrome, you know,

46:07

that would lead someone to be in the

46:09

hospital was not what's the level

46:11

of mercury that could cause a chronic

46:15

inflammatory response over a

46:17

longer period of time. And that's in

46:19

reality, that's far more common

46:22

in the population to have that level of

46:24

mercury than it is for someone to have mercury

46:27

poisoning. You know, that's pretty

46:29

rare.

46:30

Exactly. And it has to be recognized

46:33

because the point that

46:35

I think you just were making is also it's individual.

46:37

So it's like not everybody needs

46:41

the same level of nutrients like

46:43

that because of your physiology

46:45

and your metabolism, your genetics,

46:48

you may need more vitamin B1 or vitamin B6,

46:50

methyl B12. Or

46:53

you have an MTHFR polymorphism

46:55

and you need more active folate than

46:57

folic acid. And

47:00

if you have that polymorphism, you probably

47:02

don't detoxify very well. So

47:05

what might be a perfectly harmless

47:07

level of cadmium or arsenic for someone

47:10

else might actually be harmful for that

47:12

person because they can't biotransform

47:15

or detoxify it very well.

47:17

So the point you're making, and

47:20

I certainly would totally agree, is

47:22

this is all intertwined.

47:24

And that's why it's more complicated.

47:26

It's in kind of more of a net-like fashion. It's not

47:28

linear.

47:30

And it is dose-dependent.

47:32

So that's why when people think we've done everything,

47:33

you know, we take this malty and it has everything in

47:36

it. When you look at the doses and they're so

47:38

low. And like for some

47:40

of these kids who may have dysordinoma

47:43

or POTS, you know, which where they get, they

47:45

can, they stand up and they get either dizzy or lightheaded,

47:47

get rapid heartbeats and fatigue

47:49

and all that stuff. That sometimes

47:52

a much higher dose of thiamine, vitamin B1

47:54

can be helpful in addition to some of the other

47:56

show-off and foods and everything. But the point

47:58

being is that it's varied.

47:59

some, you know, your B6 is important

48:02

for metabolizing some of the neurotransmitters.

48:04

And some people need much higher doses of B6

48:08

and the metabolic P5P

48:10

and zinc than others.

48:11

And so I think the key is that it's

48:13

not one size fits all. And

48:15

I think that's really, if you know

48:17

that and you don't have one approach to everything,

48:21

you have a chance of success. If you have

48:23

your one protocol for everybody,

48:25

you will hit some.

48:27

So you will, you know, and there's no question about

48:29

it,

48:30

but you'll miss so many others. And I think

48:32

I've prided myself for over all these

48:34

years to be what I call rather eclectic.

48:36

I'm really, you know, hopefully I've gained knowledge

48:38

in all these areas over the years. And

48:40

you do what each kid needs. And sometimes what that

48:42

kid needs,

48:44

another doctor might not agree, unfortunately,

48:46

and I tell the parents that, listen, I think

48:48

this is what you need.

48:50

And you, you know, you'll have to decide.

48:52

We always weigh the risk benefits,

48:54

like longer term antibiotics and stuff.

48:57

You always have to weigh them and you have to protect

48:59

people from antibiotics, just

49:01

like, you know, from site managers

49:03

or anything else. You always, there are nutrients

49:06

we can give like NAC and

49:08

certain herbs like milk thistle. You can protect the liver.

49:11

You can protect the gut with great probiotics

49:13

and spore-based probiotics and saccharomyces,

49:15

all that stuff. So the key is

49:17

that you just don't throw things at

49:19

people without being aware of what they

49:22

can do and how you can

49:24

protect them and how you can deal with any side effects

49:26

if you see it. And I think that's the misunderstanding

49:29

in medicine. They think that

49:31

certain things, oh, no, that's a problem

49:34

when you could really,

49:35

if you test

49:37

people in antibiotics, if they have tick-borne disease

49:39

every month looking at liver, kidney,

49:40

and blood counts,

49:42

yeah, you know, if something pops out,

49:44

you hold it, you stop it. So the key is

49:47

to be aware, to be very thorough,

49:49

and to be very comprehensive. That's

49:52

how I think these kinds of spaces.

49:54

I appreciate that, Lon. I think it's

49:57

crucial, especially as we move forward.

49:59

think this more individualized

50:02

medicine is really

50:04

the future and should have been the

50:06

past too, but we

50:08

didn't have the

50:11

wherewithal and the resources to be able to do it. And

50:14

I have a lot of respect for what we've been able

50:16

to accomplish with conventional medicine that

50:19

we're starting to be able to regenerate

50:22

tissue and cure blindness

50:25

and pretty incredible

50:27

technological advances. And

50:29

then also incredible research, but

50:32

one of the challenges with the way the research

50:34

is set up is the double blind

50:37

placebo controlled trial was

50:39

really designed as a way of determining

50:42

whether drug efficacy

50:44

and effectiveness and assuming

50:46

that

50:47

the fundamental assumption there is that a

50:50

treatment will work the same way with everybody.

50:53

That's baked into the concept

50:55

of a randomized controlled trial. And

50:58

I've had this conversation with Mark Hyman a

51:01

few times and he was really

51:03

dealing with a lot at Cleveland Clinic and

51:05

trying to figure out how to study functional medicine

51:08

because by definition it's a personalized,

51:11

individualized treatment. So it doesn't

51:14

mesh with the concept

51:16

of a randomized, double blind placebo

51:18

controlled trial with the single intervention

51:20

that everyone is doing. So

51:24

it strikes me like

51:26

what you're talking about, what we're talking

51:28

about is much harder, much more complex,

51:31

much more individualized and much more difficult

51:34

to study, frankly, in at least the

51:36

way that we have set things up so far.

51:39

You know, I think part of it you have to accept that. I'm

51:41

one of my best friends, a cardiologist and

51:44

we love each other. We are so close, can

51:46

talk about everything, but we just

51:48

don't talk about medicine because he just sees

51:50

it as that.

51:51

And in cardiology that's how it is

51:54

for them, it's the double blind.

51:56

And now calcium is good. Interestingly enough,

51:58

now they've always statins and...

51:59

and knocking down cholesterol to, you

52:02

know, not to zero, but to less than 70, blah, blah, blah,

52:04

blah. We know cholesterol is important for

52:06

function of cell membrane. But

52:09

now it's a calcium scores, which I

52:11

happen to agree with. And that if you don't

52:14

have a elevated calcium score, maybe you don't need a statin.

52:16

So their studies, they will make

52:19

those changes. I think in our field,

52:21

we have to be more flexible and more

52:23

open

52:24

to research that is not maybe

52:26

as large and double-line placebo control, but

52:30

is enough to let us know that, boy,

52:32

this makes sense. The mechanism makes sense.

52:35

You see, it's helping certain people.

52:37

And the fact that it doesn't help everybody,

52:40

you know, it's, from my perspective,

52:43

in autism was this thing close to Cretan, right?

52:45

It's a neurohormone Cretan.

52:47

Well, there are kids that talk when you get into Cretan.

52:49

Now you could say, oh, it's in the imagination.

52:52

I saw that kids that benefited.

52:54

I had parents swear to me that they did,

52:57

but they did double-blind studies.

52:59

And unfortunately,

53:00

the outliers, we're just seen as outliers,

53:03

and they actually, you mesh them all together. And

53:06

so I think in autism, the field of autism, they're

53:08

really trying to do targeted studies

53:10

where you're really like, gluten-free diet.

53:13

It came from my medical, the University of Rochester,

53:15

did this study, and they

53:17

totally said it didn't work

53:19

when the study was totally faulty. I

53:21

mean, it really was. And it hurt so

53:23

many people because they would say, now

53:26

you don't need to be gluten-free because the study shows

53:28

it doesn't work. And it was because they

53:30

excluded anybody with diarrhea. Well, it

53:33

doesn't make any sense. I swear, that's

53:35

the way it is. Let's just take out the people

53:37

who are most affected by it. So

53:42

in any event, you're right about

53:44

that. And I think we have to kind of build that

53:46

into our

53:47

knowledge. We have

53:49

to use the information we have. And we used to have used

53:51

our clinical judgment. I was trained in Rochester where clinical

53:54

judgment was key. So I always tell

53:56

people,

53:56

use labs to confirm, but I don't treat labs.

53:59

treat the kids.

54:01

Yeah, you treat the kids and you treat the individual

54:03

kids, which is kind of the point you were just

54:05

making with study. That's another issue with

54:08

studies. If you

54:10

come up with a result that's an average result,

54:13

but that average result doesn't take

54:15

into account the pretty significant

54:18

individual variation of results that

54:20

might all average out to a null finding,

54:23

like no change, but

54:25

it doesn't acknowledge that 10 kids had

54:27

an incredible change, incredible

54:29

positive change. And for those

54:32

kids and those parents,

54:34

that's life changing, you

54:36

know, even though the study might have been a null

54:38

result and null finding. And so that's why

54:40

it is so important to treat the

54:42

individual and not, you know, to respect

54:45

the research, but understand its limitations

54:47

in terms of guiding clinical practice.

54:50

And yes, the question, which is not asked,

54:53

what is it about those 10 kids that

54:56

had them respond? I mean, it's

54:58

like, I mean, I remember,

55:00

I know at times running out, but I remember I

55:02

went to a lecture

55:04

down towards New York City by a neurologist on

55:06

the drug N

55:13

But it was only

55:15

one in six, one in seven, which to me is not

55:18

good. I have so much results.

55:20

And so this guy gave his lecture and I told

55:23

him what I was doing. And the results, he said, are you

55:25

kidding? One in six or one in

55:27

seven in the condition we have nothing for,

55:29

that's short of amazing. For me, it wasn't

55:32

because I'm used to such better results.

55:34

But that's the point that, so if you

55:36

can help one in six kids with something

55:39

that's really got a very low risk,

55:42

you know, high benefit to risk ratio,

55:44

and yeah, the others you do with trial doesn't

55:46

work, okay. But if you could figure

55:49

out which ones will respond, and I have

55:51

over the years kind of, you know, tighten that

55:53

up a bit. But the point being is if

55:55

you can help kids so much with certain

55:58

things and maybe not others.

56:00

there's nothing wrong with that. That's

56:02

the thing, as long as you're not hurting them, there

56:04

is nothing wrong

56:06

with having some things that may only work

56:09

in a certain percentage. You know what I'm saying, yeah.

56:12

Absolutely, and like I said, I think that

56:14

is the direction, more personalized medicine,

56:16

personalized supplementation based on

56:19

genetics, genomics, epigenetics,

56:21

microbiome patterns even. Like we

56:23

know, different microbiome patterns

56:26

can affect the response to medication and

56:28

supplements for that matter. So

56:30

I think we're kind of just on the very

56:33

early stages of that being a thing

56:35

and even AI and some of

56:37

the new tools that are becoming available might

56:39

help us to be able to make sense of that and crunch

56:42

all of the data that we're starting

56:44

to collect. But Dr. Bach,

56:46

thank you so much for being here. Can you tell everyone

56:49

where they can find more info about

56:51

your book and just follow your work

56:54

and stay in touch with you? What's the best way

56:56

to do that? Find the book, they can go to Amazon

56:59

and it's brand inflamed,

57:01

Uncovering the Hidden Causes

57:02

of Mood Disorders

57:04

and Anxiety, Depression

57:06

in Adolescents and Teens. And then

57:09

my website is bachintegrative.com,

57:13

that's P-O-C-K and the integrative, not

57:16

with an I-V-E at the end. And if

57:18

they need to get information or call my office,

57:21

it's 845-758-0001.

57:26

And yeah, I mean, basically

57:28

there's a lot on the websites and the book, I really

57:30

think when we're talking about brain inflamed,

57:32

I think for parents, the book was

57:35

written for parents.

57:37

So it's really, I mean, a lot of doctors

57:39

and practitioners have read it, but the book

57:41

I hope you see was really made to be very

57:44

understandable

57:45

and use it as something you can go to your own physician

57:47

with you

57:48

know, I'm not saying everybody has to see me, of course not, you

57:50

go to your own physician, you bring the book, you bring the questions,

57:52

you bring the clues

57:54

and hopefully maybe

57:56

you can start the process.

57:58

Yeah, it's a fantastic resource. and

58:00

you see the Amazon reviews or

58:02

exemplary, you see a lot

58:04

of parents talking about how the

58:06

light turned on for them after

58:08

reading the book. And feeling, again,

58:10

like they'd seen so many different doctors

58:13

and just so frustrated to

58:15

not get any validation for what they

58:17

know is true. And then

58:20

finally finding some answers,

58:23

or even potential answers, just knowing

58:26

that there could be these things that they

58:28

could investigate and get to the

58:30

root of what's going on, that gives

58:32

parents hope and kids hope.

58:35

And to me, that's like the biggest gift

58:37

for this population because they spent

58:40

years really feeling hopeless, I think.

58:42

And just the possibility that they

58:44

could find a solution to

58:46

the problem is really an amazing thing. Yeah,

58:49

it's right then that realistic hope.

58:52

And when people have false expectations

58:55

and when kids are sick a long time, you're

58:59

the best you can to bring everything back. You don't know

59:01

what changes may be ingrained in there and things,

59:04

but realistic hope to me is so key. And

59:06

so many of them have been left without any hope at

59:08

all.

59:09

And to me,

59:10

that is, it's really a

59:12

tragedy. It's really a tragedy

59:16

because we go through this whole thing

59:19

about placebos and hope and psychol,

59:21

we know that mind-body is so important.

59:23

And then having parents and even

59:25

the kids, some of the kids I see are hopeless.

59:28

They are hopeless. Absolutely. It breaks

59:30

my heart.

59:31

And hopefully, this is

59:34

my 40th year, I'm still working

59:36

because I want to, because

59:38

I love it. And because

59:40

I changed the trajectory of these

59:42

kids' lives.

59:42

And as I said in the book, it's not only the kids,

59:45

it's the families, the parents, the

59:47

siblings, the uncles, aunts and grandparents,

59:49

because these kids, when they're really bad, as you

59:52

know,

59:52

they can be really, really bad. They

59:54

can retire like on the family. And

59:57

it's worth pointing out as we conclude here

59:59

that every-

59:59

we're talking about applies to adults too.

1:00:02

You know, the population that we focused

1:00:04

on in the interview and your population of kids

1:00:06

out of lessons and teens, but guess what?

1:00:09

Every mechanism that we're talking about here also

1:00:12

affects

1:00:12

adults with behavioral and

1:00:15

psychological conditions. So 100 percent.

1:00:17

I treated adults as well, so I totally agree

1:00:20

with it. Yeah, I mean, no question,

1:00:22

no question. All right. All

1:00:24

right. Well, thank you again, Dr. Bogg, it was a

1:00:26

great conversation. And thanks everyone for listening.

1:00:28

Send your questions to chriscrustor.com slash

1:00:31

podcast question.

1:00:33

That's the end of this episode of Revolution

1:00:35

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1:00:37

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Thanks so much for listening.

1:01:18

Talk to you next time.