Written by Christopher Kelly
Oct. 27, 2016
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Christopher: Hello and welcome to the Nourish Balance Thrive Podcast. My name is Christopher Kelly and today I'm joined by Dr. Tim Gerstmar. Hi, Tim.
Tim: Hi, Chris. Thanks for having me on.
Christopher: Thanks for being on. I'm very excited to finally have you. I've been stalking you since 2014 when I saw you at the Ancestral Health Symposium in Berkeley where you talked about methylation. And I've just re-watched that video this morning. And it's fantastic. I love it as much now as I did then. It's like a really genuine attempt to teach people something that is very, very complicated. So, congratulations and thank you on that.
Tim: Well, thank you. I mean, I appreciate that. It's definitely something I strive for in my practice. If you don't mind me just telling a quick little story, this was brought home for me. So, a number of years ago, my mom was diagnosed with cancer and she did pass away from it. But I was with her at a visit with her oncologist. And we were sitting there and I was a doctor so I understood everything that was said. And I watched my mom and she was nodding her head and smiling at her oncologist and he was kind of proceeding telling her everything that was going on and what he was going to do about it.
And we ended up leaving that meeting and we went to the car and I was driving her back home. She turned to me and said, "I didn't understand a word that that doctor said. Can you explain to me what he said?" And it was like my jaw fell open and it suddenly was reflecting back on my work with my patients that, as a doctor or someone involved in medicine, you're telling someone something and we learn these complicated words and language around medicine and we look to the person in front of us and see, to try and see if they understand what's going on.
But what we realize is people are pretty polite in general. And most of the time they don't want to look stupid or they don't want to bother you by saying like, "I don't understand what you're saying." So, it became a mission of mine after that to try and find the easiest, simplest way to explain concepts that I could so that people would actually understand what's going on for them. Because I find -- I'm sure you do too -- so many people come to us and they're like, and you're asking, "Well, what happened here? What did they say about this?"
At least a lot of my population, they're saying, "Well, I don't really know. The doctor told me everything was fine." Or, "They were talking about something but I didn't really understand it." And so one of my goals became to empower people by helping them to understand what's actually going on inside their bodies. So, when it came to methylation, which is a heinously complicated topic, I don't even want to pretend like I know quite a bit about it but there's still so much more to understand. It's such a complicated system. It really was, how can I boil this down to try and make it accessible for people? And so, thank you. That was one of my goals.
Christopher: It's a balancing act, I think. You need to make it simple enough so that we get the general thrust of what you're saying but not oversimplified to the point where I can't follow up. If you don't use some of the special key words then I can't follow up and read some scientific papers by myself. And so, yeah, it makes it possible for me to learn.
Tim: Right, right. So, obviously, it's a tricky thing. And, of course, it's going to vary because some people like yourself, really well-educated, really diving into this stuff and really trying to learn, and so you're, obviously, kind of on the one side of the curve. And then your average person who hasn't really thought about or been brought into this is going to be in a different place. It's trying to find that balance. But thank you for saying that. Definitely, anyone out there, if you're looking for an introduction to methylation, maybe you've heard that term or you think it might be an issue, I invite you. The video is free out there on the internet. You can just go to YouTube and type in my name or type in Ancestral Health Symposium 2014 Methylation and you'll find that video.
Christopher: Yeah. And, of course, I will link to it in the show notes for this episode as well. Dr. Tim, tell me about your practice. You're a naturopathic doctor in the Seattle area, I believe. Is that correct?
Tim: Correct. Yeah. So, I'm up here in Seattle. I'm actually in Redmond, which is a little city outside of the center of Seattle where Microsoft is. So, if you think of the home of Microsoft, that's basically where I am. I really focus, I honed my expertise in really three areas and that's gut problems or digestive issues, as one. The second is autoimmune disease. And the third is those hard to treat cases. And we like to say if you've been to four to ten other doctors and you've kind of stumped them. They can't figure out what's going on for you. Or you've tried their treatments and they don't work for you or you haven't gotten better, we're the kind of people who pick up from there.
And so, that focus is what led me down the methylation pathway for one thing because it was okay. We're hearing about this methylation pathways and they have a big impact. And if you're in good health, is methylation something you really need to look into? No, not especially. But if you're someone and you've tried it, methylation, one of the biggest areas, the most obvious areas that it tends to play in is brain function. So, people with anxiety, depression, OCD, ADHD, we've seen people with autism. Every person with autism that I have seen has had methylation defects.
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I'm not saying those caused autism but they're definitely a piece of what's going on for someone with autism. And so we definitely, if someone has autism, we definitely go down and look at those methylation pathways and see where the issues are. And then today's topic, we're talking more about toxicity and obesogens, endocrine disrupting chemicals, and other avenue.
So, the thing I like about working with those really challenging patients is it keeps me on my toes and always pushing me to try and understand more, to know more, to refine my treatment protocols because these are the people that have gone down the easy and obvious roots and haven't gotten help for it.
Christopher: Talk to me about your pyramid. I think you did a really nice job of presenting the sequencing of things in this pyramid. And the methylation is probably not the thing that you should try first if you're not feeling good. So, can you talk to me about that pyramid?
Tim: Right, absolutely. There's a tendency -- I mean, I know for myself, I'm sure for you, Chris, as well and for a lot of people out there who are listening, to kind of jump to the top of the pyramid, the kind of really sexy, really interesting, most cutting edge things first and look for that to be the answer to our problems. But the reality is that for most people, things like methylation can be a factor but aren't the primary issue in whatever dysfunctions that people have going on.
So, I always start at the bottom of the pyramid, which is the same basic diet and lifestyle factors. Because in my practice, we refer to it as the foundational habits. If you're not eating real whole quality food, if you're not getting enough sleep at night, if you don't have a good balance of exercise and recovery, if you're not managing your stress loads effectively, if you don't have good quality relationships with the people around you, then we can start stacking all of these other things on top of it, but it's like a tall building with a poor foundation. You're constantly like the Leaning Tower of Pisa.
They're constantly having to pull that thing back up and reinforce, embrace it so it doesn't just break and fall apart because the foundation is poor. And so, the same goes with health. We try and get people in my practice so that we restore their health, we get it as good as we can and then, frankly, we want to have them in the place where they rarely need us anymore. And so, if you're not solidly attending to your foundations throughout the course of your life, it's eventually going to catch up with you.
If you want to chime in here, feel free. But I was going to say, what we tell people, just because you eat well, you exercise appropriately, you get enough sleep, you manage your stress, just because you do these things, unfortunately, it doesn't guarantee that you will be healthy. If you don't do those things, it basically guarantees that you won't be healthy but just because you do them doesn't mean you will be. So then we have to go on to look at gut function, one of my favorite topics.
So, you could be putting the best quality food in your mouth, the best grass fed, the best organic, the best everything. But if your digestion is really poor, if you're not effectively breaking down and digesting and absorbing that nutrition, it's essentially going to waste. If you have an inflammatory gut microbiome, if you have a leaky gut, the best food in the world isn't going to give you the results that you're looking for. So then we have to go upstream and look at these different systems and make sure that they're functioning effectively.
Christopher: And then how often do you see someone that come to you and their main complaint is some result they've got from 23andMe? Maybe they think they got a defect in MTHFR or maybe there's some other gene that they think they have a problem with. And they say to you, "Oh, yes, all these fundamental habits, they're all in order." And then when you do the investigation, it's perhaps what they thought was in order but perhaps not what you thought was in order.
Tim: Right. That's challenging because people will come in and say -- So, basically, I employ health coaches as a big part of my practice. And so while I'm attending to the medical side of things -- So, we'll do the testing, we'll arrange the c-MET and put treatment plans in place -- we have the coaches that go through all those fundamental pieces and more with people and fairly common refrain that we get is, "No, no, I don't need any of that. All of my fundamentals are fine. They're all really good."
And it can be a challenge sometimes but I'll tell you a lot of times when we really dig in and explore someone's fundamentals, we find that they aren't as good as the person thinks that they are. Some people totally have it down and then it's like, that's great. That's awesome. But a lot of people think they're in pretty good shape but the reality is that they're not.
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So, we really encourage everyone that comes through my practice, look, at least have the evaluation, get checked out and see. And best case scenario, everything is fantastic. We don't have to deal with that. And more commonly, you're doing pretty well but things aren't really serving you as well as you think. Then when it comes to like a 12andMe, for example -- We were all really impressed by 23andMe and the results. And we're really excited. And the issue with genetics right now, just in general, is that we see a lot of things that we truly don't know how impactful it really is.
Christopher: Right now. Right. So, even if you could figure out one moment in time it may not be true tomorrow.
Tim: Right. Because we have all these issues, for example, something called penetrants where you have a snip or a genetic mutation and we see that it's there but what we're not yet able or we're barely able to tell is how impactful is that snip. So, for example, like the methylation mutation, the C6770 and A1298C and possibly some other mutations as well in the MTHFR gene, but those are the two that had been most well studied. And we know that the prevalence of those genes among the general population is relatively high especially in Mexican, people of Mexican descent.
The C6770 mutation can be up to 30% of the Mexican population, which is really substantial. And if that mutation alone were causing serious problems for people, evolutionarily, we'd expect that that shouldn't be so high. And we'd expect a much greater range of issues. So, one of the questions we have that we're struggling to figure out -- and by we, I mean myself and clinicians and also the scientists as well trying to decode a lot of this -- is, A, do you have the mutation and, B, just how impactful is it actually on your life and your health?
And so sometimes we have people and they're in really great shape, their fundamentals are really good, their blood work is really good, their testing is really good, sort of Robb Wolf's criteria of look good, feel good, perform well, it's all in really good shape. But they'll grab a 23andMe and they'll come in and they'll be like what about this and what about this? And it becomes very difficult to how to effectively coach someone in that case or advise them because in the absence of any symptoms our science is not yet strong enough to really tell us just how impactful some of that is. And I know that it's disappointing to me. It's also disappointing to patients as well.
Christopher: Right. I know I think that sometimes people -- me too. You want to take hold of that result and say, "Oh, this is my genotype. This is inevitable for me. There's nothing I can do about this. This is, obviously, my problem." And then you kind of hand the problem off to someone else. "Can you deal with this? Can you give me a list of supplements I can take to deal with this problem of mine?"
Tim: Right. The other side is, we know epigenetics is, in many cases, equally or more important than the genetics themselves. And so the epigenetics is how are those genetics expressing themselves? And the question is, does diet and lifestyle, can we switch -- We may have "bad genes" or harmful genes and can, again, those fundamentals, what we're eating, how we're moving our bodies, our sleep, stress management, our social relations, can those factors turn on and off harmful genes or turn on or off good genes?
And the preliminary data that we have suggests in many cases that it can. So, yes, our genetics are important and I don't want to downplay them and they're certainly are genetic illnesses. For example, I have a person in my practice with a genetic degenerative nerve issue and certainly we're doing everything we can. But if that's the case or something like down syndrome or some of these others where genetics are really strong markers and have a really profound influence on a person.
But what we're finding in many conditions like obesity and many of these other issues, a lot of the other immune disease as well, is that the genetics are a part of it, but in and of themselves are not sufficient. And so how much is the epigenetics, the diet and lifestyle and the other factors playing in? And we like to think it's huge. And so, it kind of circles back. We have this 23andMe results, we have some of the other genetics that are coming out, and we use it to inform what's going on but they're not sufficient in and of themselves to solely drive a course of action for a person. Does that make sense?
Christopher: It does make sense. It does make sense. Well, let's shift gears a bit because I really want to talk to you about your 2016 AHS presentation which was environmental toxicity and obesogens. And, again, it was another fantastic presentation that I should link to in the show notes for this podcast. What persuaded you that this was a problem that was worth talking about at AHS and where does this fit into your pyramid of things?
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Tim: Right. So, the whole concept of environmental toxicity. In this case, let me give a few basic definitions for people. Because this is an area where you're going to find that most conventional providers really severely downplay the whole impact of environmental toxicity other than a few specific instances. Like one that most people have probably heard about is if little kids get lead, whether it's lead paint in the houses or remember about a year ago the lead in the water in Flint, Michigan, and they're talking about the irreparable harm that lead can do.
So, they'll talk about some acute or really intense exposures that a few certain things can cause for people. But by and large, the conventional community doesn't acknowledge the impact that these environmental toxins can have on human health and well being. And that's in contrast to what an accumulating body of scientific evidence is showing us. So, when we're thinking about -- So, again, for me, it's looking at these patients who don't get better when "they should" get better.
Like we've diagnosed that here's their issue or organ system or bodily function that's not working, here's therapeutics that we can put in place that have consistently helped other people with that problem. Really common example, like thyroid dysfunction. We know that someone is very hypothyroid and we go ahead and put in the correct medicine to correct that hypothyroidism and we expect that they should lose weight, get better energy, better mental function, their constipation should clear up, their skin should get better, all the metabolic functions of the body should get better.
But then they don't get better. And so, obviously, there are a lot of pieces that could fit in here. But in doing research I found that their environmental toxins, various chemicals that can block every single step of thyroid function of the body from the top where the brain is able to sense the amount of hormones that are in the body and then release that hormone called TSH to tell the thyroid how much hormone to make, all the way down to the very bottom, the level where the thyroid hormone is influencing genetic expression at the level of the cell.
Toxicity can interfere at every single level of that function. And again, not every person but some people who have thyroid dysfunction get the standard or even standard in functional integrative medicine doctors and the question is why don't they get benefit? And so always this pushing. And so, for me, I knew about environmental toxicity, I knew about what are called endocrine disrupting chemicals. Endocrine is another word for hormone. So, these chemicals that can disrupt hormone function in the body. But a lot of people come to me and want to lose weight and can't lose weight. Why can't they lose weight?
And one of the things in my research that turned up is there's this whole emerging body of science around a specific type of environmental toxin or endocrine disrupting toxin known as an obesogen. And so, again, most people have never heard of that word. They've heard of carcinogen. So, gen means to birth or to creation. Carcinogen is something that would cause cancer. Obesogen is something that would cause obesity.
Christopher: Right.
Tim: Yes, sir.
Christopher: Oh, sorry. I thought I lost you then.
Tim: It's okay. I don't know where you want to go from that point.
Christopher: Okay. So, talk to me more about obesogens and how do you identify -- Someone turns up on your doorstep on Monday morning, how do you know whether they've been affected by these obesogens?
Tim: Absolutely great question. We have to understand that in general, every single one of us is exposed to this gamut of environmental toxicity. What I tell everyone, and it's the reality, is that human beings have put around 100,000 manmade chemicals into the environment in about the past 100 years especially since the end of World War II when the synthetic chemical industry really geared up. And the reality is that most of these compounds have never been adequately tested.
According to the European Union, 99% of these chemicals have been under tested or basically not tested at all. In America, we tend to have a policy of put them out there and then if they turn out to be problematic we'll recall them at that point, which we understand, unfortunately, doesn't work very well. A lot of these compounds are persistent. Meaning, they don't break down very easily. Once you put them out there, they hang around for quite a long time and they bioaccumulate, which means that they build up in things.
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And so, like that's why, for example, you'll hear people talking about fish and choosing small short lived fish or fish that are low on the food chain because they don't have a chance to build up high levels of many of these compounds where most people have heard about like tuna and sword fish and shark, are really fish -- You shouldn't eat them. You should avoid them because they tend to live a long time, they're high end predators so they tend to be on top of the food chain. So, they tend to accumulate a lot of toxicity in their system.
Human beings are animals, we're high up on the food chain and we tend to live a long time so we bio accumulate a lot of these things as well. So, my long winded way of saying, A, all of us have some degree of environmental toxicity. And to kind of come back to your earlier point, how much it affects us is partially dependent on our genetics. And we're just barely, barely scratching the surface of understanding this.
Now, there are certain lab companies that will run your genetics of your various detox pathways, which can give you a sense of how effectively you're able to detox many of these compounds. But again, it's still kind of in its infancy and so if we're doing that, we can say, "Okay, Chris, you're really weak in this variety of pathways which means that you're probably not able to detox so well or you're really strong in certain pathways so you're probably better able to get rid of some of this." This is a thing that affects all of us. But the question is, and we're trying to figure out, who are the people that are especially susceptible to this?
Christopher: So, what's the answer?
Tim: The answer is we're trying to figure, a frustrating we're trying to figure it out. Now, there's certain people -- So, for example, like in our paper work, we ask the question, essentially, "Have you been exposed to higher than, to greater chemical radiation or other exposure than everyday normal life?" So, I'll give you one obvious example. We had a patient who grew up on a farm which, A, is a red flag purely for just growing up on a farm. But in this person's life when they were a kid, they snuck out. Their parents had cleared the orchards because they were going to go over and spray the orchards with an airplane.
And this particular patient snuck out of the house, ran out into the fields and hid in the fields as the crop dusters and everything went over spraying the fields. This patient got super sick and almost died from that exposure back when they were a little kid. So, a really obvious example. Another obvious example, we had a patient who grew up in France next door to a nuclear power plant. And when we did a metal screen on that patient we found years and years later still very high levels of uranium in that patient's system.
So, some of it can be obvious. If people think back through their life history -- I'll give you another example. A person, they have thyroid cancer and had to have their thyroid removed. And then they found out that literally down the street from them when they were a kid, it was a gold mine that is now been classified as a super fund site. And that just means that the government has classified that as an extremely toxic and polluted area that gets extra money to try and remediate all of that.
People can look partly trying to identify it. It still is a bit of a hit-and-miss. It's a bit of is there -- When we do a timeline and we go back through a person's history, are we able to identify any obvious toxic exposure? There are some, trying to remember the name of it. Oh, scorecard.org. That's correct. It's a little out of date and I'm hoping -- I haven't checked it recently. I'm hoping they've updated it. But they were doing, if you punch in your zip code, they were showing you some of the worst polluters in that zip code and some of the most common things that were being released from those polluters.
So, you could see in 2013, when I did the Ancestral Health Symposium in Atlanta, we did a scorecard.org and we found that, if I'm remembering correctly, and I maybe wrong here, but I think the Ford plant was the biggest polluter and it was showing some of the most common compounds that were released. And so we're trying our best here to triangulate what's actually going on for that person. And, of course, there are some testing. And it's certainly not perfect. But they can give us a sense of the kind of toxicity that a person might be having.
Christopher: And, I think, now would be a good time to mention the previous interview that I did with Bill Shaw who is the director of the Great Plains Lab. He started doing his urinary toxicity test. And I'll be honest, we're still trying to figure it out. I did the test and mine came back as, according to Bill, was the cleanest that he'd ever seen or one of the cleanest.
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And we've had the first few results come back from that podcast and they are not like mine. And Bill was right when he said to me in a seminar that you won't just see them, these markers, mildly elevated for certain pairings of chemicals. You'll see them off the charts. And that is what we're seeing. And so, I think, what this is going to do is launch an investigation in these people's lives. They can say, okay, so what the heck? Where is this coming from? And I'll start thinking about things in a way that they previously wouldn't.
Tim: Absolutely. I mean, I've seen that case even just a basic -- So, we do a lot of organic acids and another type of test and they have a quick marker on there for xylene exposure. Xylene is just a solvent and I came up with a family that all had off the charts levels of xylene. And it was like, where in the world is that coming from? And the good news is that prompted a thorough investigation for them of their home, their work, looking for where this exposure could be coming from. And the reality is sometimes that's easy to find fairly straightforward.
People are like, "Oh, right, okay." And sometimes it's really difficult. And sometimes it's even beyond a person's control. So, let me give you another example. I have a patient who has been seeing me who lives downwind from a recycling site. Normally, we think recycling site awesome but they've had the air quality tested in that person's neighborhood and it's off the charts for a number of toxic compounds.
And people in that neighborhood have actually banded together to file a class action lawsuit against the recycling plant because they're over the EPA limit for a whole variety of things. And I've had to tell this particular patient that it would be in their best interest if they moved, which is an easy thing to say to someone. Of course, a really hard thing to do. But I've seen that this patient's health is stagnant. They can't get better despite we're trying. We're detoxing them, we're supporting them or doing all these other things. We're trying to help.
But that constant toxic exposure that they're getting day in and day out every time that that person goes home is like a big anchor around their neck and they just can't swim to the surface and get better until they get that anchor off. And we see that with mold toxicity for people, we see that with these toxic exposures. Sometimes, it's a really hard thing to do but what's more important at the end of the day is--
Christopher: Right. If you've not got your health, you've got nothing, right?
Tim: Right. And I get that. I mean, I understand. If someone said to me, "By the way, you have to leave your house and, by the way, everything in it is contaminated with mold and you have to leave it all," I can try and put myself in that place and say that would be so hard. But what do you do? Like we said, it's either your health or your stuff. And without your health your stuff doesn't really matter. Some of this stuff is really hard and I get that. And that's why a lot of people really want to ostrich and put their head on the ground and try to ignore it.
But certain people can have really robust genetics, they have fantastic detox systems, maybe their exposure is fairly low, and this isn't a problem for them. But then just like that bell curve, we're looking at most of the patients that I see would be kind of off to the left hand side. The people with poorer detox genetics or heavier exposure or expressing symptoms and problems, and most people are going to be kind of in the middle.
So, when we talk to a lot of people who say, "Well, maybe I'm not obese. Maybe I'm just a few pounds overweight. I hear you about carcinogens or these other endocrine disruptors or toxic chemicals. But I'm pretty healthy. Do I really need to take some of these extra steps?" I mean, like everything, the answer is it's your call. But we know these things are there and they're real. And just like we would say with pre-diabetes, that maybe it doesn't bother you right now. Maybe you haven't noticed any signs or symptoms or any trouble from having that persistently elevated blood sugar.
And so it's like why should I change my diet? It's not affecting me. But we know that most people, if you let that thing run its course over time you'll eventually have diabetes. And if you don't treat your diabetes eventually you'll have problems with your eyes, problems with your kidneys, problems with your heart and cardiovascular system, problems with your nerves. You may have to have feet amputated or other issues that are going on that will shorten your life. Why don't we take some sensible steps to deal with that now?
And for a lot of people, that's this environmental toxicity. You may be one of those people with super strong genetics and, again, hopefully, in the next few years, our genetics and our genetic predictions will get stronger and more personalized, more individualized and we'll be able to give everyone out there a better sense of how this stuff affects them. But for right now, I'm a big fan that there are sensible avoidance strategies and sensible things that everyone can do, and I think everyone should be doing, more or less on a regular basis.
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And then for most people, I'm a big fan of whether it's once a year, twice a year, doing some sort of mildly aggressive detox. You don't have to go out there and do something really, really intense but doing something because if people want to look, the environmental working group, which is ewg.org, Environmental Working Group -- There's a couple of studies a few years back on what's called body burden.
And so if people want to conceptualize this, they can think of the human body as whatever, I'll say like a bathtub or a sink. And we have the water flowing in and the water flowing out. And how much stays in that sink or that bath tub is going to be affected by the ratio of how much water goes in to how much water goes out. In our case, we can think about the water coming in as the toxic burden coming from outside of us. The water going out would be how well our bodies are able to detoxify and get rid of those compounds and the amount of water that stays in that bathtub or sink would be the body burden, the amount of stuff that we've got inside of us.
And so, the EWG, a few years back, grabbed some average ordinary people without excess exposure. These weren't the people in the apple orchard when the crop dusters went over. These were like office workers and average ordinary people. And they subjected them to a whole big battery of tests looking for a whole variety of compounds and they found that the average person had hundreds of these compounds in their fat tissue and in their bodies. And so that's my call to everyone of us has this. Most of us, even if we're healthy and we're doing fine, need to take some sensible steps and deal with this. And then those of us who are really sick or dealing with these issues probably need more aggressive treatment around us.
Christopher: Talk to me about the more aggressive treatment? What does it entail?
Tim: Sure, sure. Well, we can think about it and it's going to vary a little bit. I think you've talked a good deal about heavy metals, for example. One particular kind of toxicity that we've known about for quite a long time both because the affects have been known so it's always a fun story to talk about, the Mad Hatter and Alice in Wonderland, that character came from the real thing.
The Mad Hatter, because back in the 1800s, people who made hats would often use mercury in that whole process. And so they would get exposed to a lot of mercury and they would find that over time they would go crazy. The mercury would damage the function of the body and mercury is not good for your brain, can cause degeneration in the brain and other issues. People had known about some of these things for a long time. Heavy metals, like mercury and arsenic and lead, are relatively easy to look for.
So, for example, like Doctor's Data is one company that we've always used for our heavy metals. They've been around a long time and the tests are really, really solid. When it comes to some of these other compounds, I'm excited to see more tests available because the solvents and some of these other things are much more challenging to actually look for and it's awesome that we're now able to start looking at this stuff.
So, heavy metal, when they're researching like detox, they may have run into heavy metals and this whole idea of chelation in specific compounds. They can help the body get rid of them. But when we step back for a second and we're just saying, okay, how does the body process and get rid of this stuff? It's primarily the liver and the kidneys that are responsible for detoxifying a lot of these compounds. It's divided into water soluble compounds, that is things that can be dissolved and be carried in water, and fat soluble compounds, things that can only be dissolved and carried in fat.
And we know that a lot of the burden that people have is going to be these fat soluble compounds. Because the good news is if you're taking in, whether it's your breathing or eating or drinking or putting on your skin, water soluble compounds often they're going to stay in your blood, they're going to be processed by your body and they're going to pass out of you relatively quickly. They can do damage while they're in you but they don't tend to stay in you for a very long time.
The problem is these fat soluble compounds can come into you. They're not easily cleared out of your body and the body will often stick them into fat issue to try and get them out of the way so they'll cause less damage. So, we need to augment these pathways, the liver and the kidneys. And so that's everything from making sure that someone is having adequate protein, which is an important in a lot of these detox pathways use various amino acids to do their jobs.
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They're also highly vitamin, mineral and nutrient dependent so things like -- there's a lot of them but like magnesium and zinc and B vitamins and a variety of these other compounds are necessary to run those pathways. And so, the average person who's eating a calorie rich nutrient poor diet with more toxicity in it, those pathways aren't going to be able to run at optimal capacity.
So, first and foremost, we need to be sure that our bodies have enough nutrients to run those pathways effectively, that we're building, for example, glutathione in sufficient quantity. But you were talking about how can we make it more aggressive? And so it's a several step process where we need to, first of all, get that stuff out of those fat cells. So, that's why most of the intelligent well put together cleanses that you'll see out there are using some degree of caloric restriction whether it's from full on fasting, not eating essentially anything, to mild caloric restriction so we can get the body to tap into its fat stores, starts releasing that and, in addition, a lot of that toxicity will come out.
Then we need to make sure that the liver and kidneys are well equipped with the vitamins, minerals and other nutrients. Then we can bring in herbal medicines as well. So, many people have heard of milk thistle, for example, works as a hepatoprotective. Meaning, it protects the liver. So, while we're liberating a lot of this toxicity, we want to protect the liver itself from being damaged by it. Milk thistle also stimulates the production of glutathione, for example, and more glutathione means that, again, many of these detox pathways run more effectively.
Another compound that we like tremendously is broccoli seed extract or sulfuraphane, has been shown again to stimulate the -- If I'm going too deep for you here, Chris, let me know.
Christopher: No, no, this is good. All of this is going to be transcribed if anybody wants to find the words. And, of course, I'll do the show notes too so that people can find these things.
Tim: Right, right. Activates the nerve too which goes to the antioxidant response element, which is going to stimulate the body to make a lot of protective compounds and to increase these detox pathways. So, a more aggressive detox is going to be -- We want to make sure that we're nutrient rich but we're going to induce a caloric deficit to free up some of the stuff. We're going to make sure that someone is peeing and pooping regularly because, basically, if you're constipated you absolutely don't want to do a detox.
Because you're going to pee away a lot of your water solubles but a lot of those fat soluble compounds are going to come down through the digestive track into the feces or into the poop and then they need to be passed out of the body. If someone is constipated and that poop is just sitting in their colon we're going to see a lot of reabsorption of compounds. And so, basically, it's like you put the trash on the curb and the garbage man shows up, grabs your trash cans and throws them back into your house again. That completely defeats the purpose.
And so someone needs to be peeing and pooping on a regular basis. Definitely, there's data showing that like sweating and saunas can be incredibly helpful as well. And so if someone can, has access to or can get into the sauna and do a regimen there, that can be really helpful. So, there's a lot of bits of pieces that we can put together. Again, I'm recommending that everyone sort of be engaging in sensible avoidance, so that can be choosing organic whenever you can, reducing your exposure to household chemicals.
So, that's everything from, where you can, choosing better carpets, better furniture, better paints, better clothing. Now, we know the State of California was one of the first to come out not too long ago and stop mandating that fire retardants be put in kids clothes and in clothes in general. Because they found out that the guy essentially, the scientist, who was testifying that got all of those flame retardants put into clothes had basically falsified and made up his data.
He was talking about these little kids who had been burned horribly because their clothes lit on fire and so we needed all these flame retardants in clothes. And that data was found to be completely false. Of course, we don't want our kids, we don't want anybody to be on fire, right? But we know that many of these flame retardants are high in bromine and bromine is another endocrine disrupting chemicals and these flame retardants can be problematic as well. It's this balance.
So, wherever possible, we want to try and reduce our exposure through the foods that we're eating, choosing organic, free range pastured fed, like the best quality food that we can. If someone can't afford that, I completely understand. They want to make the best choices they can.
[0:40:00]
So, again, the environmental working group, highly recommend those guys. They publish their dirty dozen and clean 15, so if you can't afford all organic, stay away from the dirty dozen, the 12 fruits and vegetables that are most highly sprayed with pesticides and other compounds, especially choose the clean 15, the 15 fruits and vegetable, conventionally grown fruits and vegetables and have the lowest amount of those compounds
If you're going to do conventionally raised meat, we recommend leaner cuts because, again, the fat tends to bioaccumulate a lot of this toxicity and so leaner cuts are going to be better choices. Then, like we said, things around your household from paints, carpets, other building supplies, furniture, mattresses, for example. So again, mattresses can have a lot of toxic compounds. Like if you've ever been to IKEA or one of those places, you open up a mattress and you're just like, holy cow, the smell is really strong.
That's off gassing. That is volatile chemicals from the plastics and the other things that are in those mattresses off gassing. So, as a minimum, go ahead and stick that thing out in your garage. Let it off gas until the smell is completely gone. Then move it in. Otherwise, your little kids or your or I, whoever is sleeping on those mattresses, for eight hours, hopefully, around eight hours a night, is going to be breathing that stuff in. And then I'll keep going here if you want me to, Chris.
Christopher: Yes. So, what I'd like you to talk about -- I'm jumping around a little bit here, I know, is the use niacin. We were talking about -- There was this big conversation going on. This is kind of how we get things done in Nourish Balance Thrive. We have a Slack which is this chat application. So, there's this big jamming session yesterday. We were putting a detox protocol together for these people that we found have been exposed to a bunch of environmental toxins. And Tommy is furiously pasting all of these studies that have been done into our Slack chat and I'm trying to read them all. I can't possibly keep up with him.
Obviously, niacin comes up as part of many of the detox protocols. But then he also mentions, and I notice that you mentioned it as well in your methylation talk, that niacin burns through methyl groups and it could be not a good thing for people who have poor methylation status anyway. So, how do you balance those two things?
Tim: Right. This is where truly like the art comes into it where we don't have the absolute, like where it's not just a cut and dried protocol where it really has to be individualized to a patient. Yeah, niacin can be really helpful. It's especially used a lot with sauna, again. So, if anyone has taken a bunch of niacin, they've had that niacin flush which feels weird, doesn't hurt you in any way but gives you kind of red itchy skin and the thought process there is it's opening all the superficial capillaries or all the superficial blood vessels close to the skin and bringing a lot of blood up close to the skin.
And often that's usually in conjunction with the sauna therapy where we're getting all the blood up close to the skin so that you can maximally detox that through the skin as well. But, yeah, niacin can burn, if someone has marginal methylation status, niacin complete methyl donors and could make the situation worse for people. And again, methylation is involved in detox itself. And so I've seen this multiple times if someone has really screwed up methylation genetics or is in a bad methylation place, they're typically not going to be detoxing well either.
And so, this kind of comes back to a point I make to people that detox is really important but the timing of detox is also important. And so just as a general, general rule, if someone is weak and depleted and their body systems are not functioning very well, that is not a good time to detox someone. Instead, the focus should be really on building that person up and getting them functioning effectively and then when they're stronger then you want to detox.
Because detox is an inherently depleting process. It's going to burn a lot of minerals, vitamins, nutrients, energy from the body to process and then get rid of this stuff. It's also going to tax our antioxidant systems which have to buffer and deal with a lot of this stuff as the body's processing it and getting rid of it. And so if someone has really bad digestion, their nutrient status is in poor shape, maybe their mitochondrial function isn't very good, they're low energy, they're not peeing or pooping very well, and they just look kind of weak and depleted, I'm going to recommend that you do not detox that person because likelihood you can make them worse.
[0:45:00]
Christopher: You mentioned this earlier but talk to me a bit more about enterohepatic recirculation because I think that's really interesting. What's it for and why could it hurt us?
Tim: Right, right. So, enterohepatic recirculation, just to break it down for people, entero means guts and hepatic means liver. So, it's the gut liver recirculation. So, things essentially kind of going from the liver to the gut and back around again. When we're getting rid of these fat soluble compounds, your liver is processing them and then sending them down to the gallbladder along with bile to be put out into the intestines. And so, then, at the top of the small intestine, you're going to have bile release. It's going to work its way down. And then at the end of the small intestine, before the large intestine, most of that bile is going to be reabsorbed back into the system to be recycled and reused again. Evolutionarily, it's being thrifty.
Christopher: That's hard earned stuff. You want to save it.
Tim: Right. Hard to make, why don't we use it again? So, it makes sense from an evolutionary perspective. Again, if we look at this environmental toxicity from an evolutionary perspective, we can see that it's completely novel. Yes. Did our ancestors from 2,000, 5,000, 20,000 years ago have environmental toxicity? Yes, of course, they did. But did they have the sheer volume amount and novelty of environmental toxicity that we have today? The answer is no, they did not. So, a system that was highly effective and worked extremely well for 9900 years up until about 100 years ago isn't up to the challenge of dealing with our modern environment. And so that's why things like these cleanses and supporting detox pathways and testing and looking and taking specific steps to avoid a lot of this stuff, all becomes relevant now and not a long time ago.
So, to get back to enterohepatic recirculation, the system that was designed to put it out into the guts and then reabsorbed and save it is now problematic. Because these fat soluble toxins go out in the bile into the digestion and then can be reabsorbed back into the system again leading to a very poor amount of toxicity that actually if nothing, absolutely nothing is done, a low amount of that toxicity that's actually cleared from our body. So, we have to take steps to essentially defeat the normal function there and stop so much of that enterohepatic recirculation.
I also want to say it's very, very interesting. It dovetails into my work in researching the gut microbiome that we know the gut bacteria play a role here as well. Because the "bad bacteria" or some of the ones we don't want can specifically go in on some of these toxicity and break some of these bonds, break specifically like some of these glucuronidation bonds that have been made so that the body absorbs that toxicity at a much higher rate. Part of effective detox as well as having a good gut flora. So again, in one of the many, many, many ways, it's important to have healthy gut flora. We see that it impacts our ability to detox as well.
Christopher: Right. And are there any specific supplements that you use to feed enterohepatic recirculation?
Tim: There are traditionally or conventionally here, there are a variety of ways. And so it comes down to how can we bind up some of that bile and those other fat soluble toxins to prevent them from being reabsorbed? And so, conventionally, there are a couple of drugs that are used. The funny example I gave in my presentation but has been used by docs into environmental toxicity has been olestra, which if people remember was the short lived fake fat that came out in chips a number of years ago.
So, Lays, for example, have these reduced fat chips and olestra will prevent the absorption of fat in the intestines. And so it can partially prevent the re-absorption of fat and these fat soluble toxins into the system and, thereby, increase the amount going out. Now, I'm not the biggest fan of olestra so I don't use that. The best data that we have is using rice bran. So, we'll also use psyllium and we'll use some other supplemental fibers but the best data out there is on rice fiber or rice bran which is shown to markedly increase the amount of fecal fat and some of this toxicity coming out for people. I'm often supplementing with a range of some of these fibers and the thought there is if the fibers themselves bind up this fat and bile and toxicity, then it is no longer available to be reabsorbed by the small intestine or by the body.
[0:50:09]
Christopher: Was there anything specific about rice bran or is it just some property in fiber in general that works?
Tim: Well, it's a good question. I haven't seen it. They say that there's some magical component of rice bran in particular that did it. So, I often will use a blend of fiber or will use a few or, again, rice tends to be fairly well tolerated by most people. And again, this is the bran and not the actual carb containing part of the rice or some of the more allergenic components. So, most people tolerate it fine. But I'm not wedded to it. My general thought process is, look, fiber, if we understand the mechanism that the fibers are binding to a lot of these fat soluble components and essentially dragging them out of the body as they pass in the large intestine and then out of the body, then it just makes sense to me that probably any of these fibers would be having beneficial effect.
I have seen, I can't remember if it was a study or just talking with colleagues or talking about using apple pectin and some of the apple fibers as well that seem to work against psyllium seems to be beneficial. I really do think if people are fine with rice bran they want to use it. To this date, that's the best data I've seen in some scientific studies but I do think that any of the fibers or a blend of several different fibers will probably be really beneficial for people.
Christopher: Well, fantastic. Aspire Natural Health. And I will, of course, link to Tim's website in the show notes for this podcast. Is there anything else you'd want people to know about, Tim?
Tim: Well, I mean, just a couple of things in closing. First of all, that environmental toxicity is real. It's not just some crazy hokey thing designed to give people colonics or drink really nasty tasting stuff. And it's not just for people who are super sick with things like mold toxicity or multiple chemical sensitivity or the outliers. Every single one of us, unfortunately, by virtue of -- There's a lot of cool things about living in the modern world. I definitely am glad I'm here. But we also face unique issues.
And this issue of environmental toxicity is one that is really, for the most part, uniquely modern. And it's something that's going to affect all of us. It is not the only reason for illness or dysfunction but it is a significant one. And it's one that flies under the radar. And when we talk about preventative medicine, we do the foundations.
[0:55:03]
Eating healthy, getting some exercise, sleeping well, all of those things. But really come to a place where the sixth component of my foundations is some ongoing and periodic detoxification. If you're like Chris and you're really sensible about what goes into your body, you do that kind of testing and you see that you're exceptionally low, most of us, the body burden studies, tell us that this is real and we have it in our system. And there's no need to panic. You don't need to go live in a bunker underground or something.
Christopher: Like I do too.
Tim: Yeah. There you go. But you need to take some sensible steps. And if you do a health history on yourself or your practitioner does a good health history and you look back and you realize that you've had abnormally high exposure then it ratchets up a few degrees in terms of the care that you need to give yourself. So, I would just urge everyone -- And then lastly, I'm really big on banging the drum about pre-conception care for both women and also men.
Men tend to like get lazy in this and think that, hey, all we have to do is the sperm donation and then like we're good to go. It doesn't really matter. But data continues to accumulate that the way fathers live their lifestyle epigenetically influences the health outcomes of your kids. And so this isn't about guilt or blame or shame. But it is about understanding that how we live our lives impact our kids. And the crazy thing is epigenetics has been shown to go through three generations.
So, what we're doing with our lives could potentially affect our great grandchildren and the health issues that we're going through could in part be due to what our grandparents, our grandfathers and our great grandfathers did. And so, I'm really big on pre-conception. I know it's a very hard sell for many people. But if you're out there and you're thinking about getting pregnant or your spouse or whoever is thinking of getting pregnant, I highly recommend take at least six months, get your diet and lifestyle in really good shape, get your nutrition really dialed in so that you're full of all of the good nutrients that you need and do some detox work so you can at least clear some of this body burden so that we're not passing it on to a future generation.
Because one of the scariest things is to see how much sicker our children are than when we were kids. And so just, please, a passionate plea out there, if you're not thinking of having kids, without being that person, but if you have grandkids who are thinking of having kids or you, in some other way, try and influence these people. One of the most important things we can do is tend to the health of the next generation. Because some of this, some of our health concerns as 20, 30, 40, 50, 60 year olds or whatever is that. And we can manage it and we can do our best to deal with it but some of it we just got.
But if we can intervene in the coming generation so that they never have to have these problems in the first place and, I guess, my very last thing, Chris -- thank you for letting me step up on my soapbox here -- is that when it comes to environmental toxicity, there are the individual things we can do. We can individually make choices to reduce our exposure. We can do sensible detox regimens to get this stuff out of us. We can look at our genetics. We can look at tests to know how all this is affecting us.
But the other thing that we all have to do is look at societal and world changes. Like we need to push that these 99% of under-tested compounds, they need to be better tested. And we should have more testing on things before they're just willy-nilly released into the environment and that it's a matter of 'whoops, shouldn't have done that.' So, we can vote with our dollars by choosing more environmentally friendly food, clothing, all the way down the line, and all of those things. And then we can push our governments, our senators, all of those pieces to enact stricter laws to prevent more of this stuff from going out into the environment. So, that is my soapbox and thank you for letting me.
Christopher: No, I'm right with you. I'm right with you. I think that's the only way it can really work is to just vote with your dollars. Don't buy stuff that you don't think is going to be good to put in your body. Eventually, those products will go away if enough people will do the same.
Tim: Absolutely. There was an interesting study that came out that the dryer vent, so where the hot air is exhausted out of your house. If you're using dryer sheets and other cleaning solutions that are full of these compounds, they were just measuring how much toxicity was pouring out of that dryer vent. And the simple change to using more environmentally friendly soaps and other products there can make a huge difference. So, just little things. There are little things that we can do that compounded by thousands and tens of thousands and millions of people can make a really dramatic difference.
[1:00:09]
We're seeing that shift starting in the food sphere where more and more people are choosing organic. They're choosing grass fed and free range and sustainably caught and they're making that change. Farmers Markets have exploded. We can do the same thing with many of these environmental compounds by making better choices with our dollars.
Christopher: Awesome. Thank you, Tim. I really appreciate you. Thank you.
Tim: Absolutely. Thanks for having me on, Chris. If anybody wants to look me up, I'll just say it real quick, our website is aspirenaturalhealth.com. And we're pretty active. You can find us on Facebook at facebook.com/aspirenaturalhealth. All right?
Christopher: Thank you.
Tim: Thank you.
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