Written by Christopher Kelly
Feb. 23, 2017
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Christopher: Hello and welcome to the Nourish Balance Thrive Podcast. My name is Christopher Kelly and today I've got something a little bit different. I'm going to syndicate a podcast from Dr. Tim Gerstmar's show over at Aspire Natural Health. This interview I thought was really interesting. It's a fly on the wall conversation between Dr. Tim and my own Dr. Tommy. They talked about what it takes to be a great practitioner. They talked about the system in which they operate. They talked about the things that they think that people are doing that are getting great results and the things that people are doing that are being harmful. I think, overall, it's a really helpful conversation.
Another thing I really appreciated about it was the audio quality because it's recorded in person. It's so much better than what you're used to, I think. Just one last thing. If you would like to get a highlights email from Tommy and me each week, it's going to be super short. It' going to be an interesting paper that we think that has very actionable advice. It's going to include some nonsense that we've read or heard this week and why it's nonsense.
So, I'll give you an example of this, a really good example, actually. Recently, we had on the podcast someone say that thyroid hormone, specifically free T3, was the most important hormone in the body and we think that's false. We think that cortisol is the most important hormone. And the reason is if you lose the adrenal cortex you die very, very quickly. And that is not true of the thyroid gland. We'll link to some old school physiology that was done in animals that show that when they cut the thyroid gland out, as long as you left the parathyroid intact, which is very important for calcium homeostasis, typically animals do okay at least for a while. Yeah, I think that's one good example of some nonsense that we heard on the internet.
I think they're really important. I think you'll agree that there's just so much stuff out there now and maybe the thing that you really need to do is to prune back some of it and see which is most important. And then, of course, we're going to send you something awesome that we've read or listened to and we'll tell you why it's awesome. Head over to nourishbalancethrive.com/highlights, just pop in your email address and we'll send you this email each week. Now, over to the show.
Tim: Hey, folks, this is Dr. Gerstmar with Aspire Natural Health. I am here today with Dr. Tommy Wood at Third Place Books here near Kenmore, Washington where I went to school and I was telling Tommy that years ago now I used to come here with my fellow students from Bastyr and we'd study anatomy. So, we'd sit down with the big textbooks and we'd be cramming in every branch of every nerve, every blood vessel, all the different names of all the tendons and muscles and all the pieces of the body and mainly complaining about our cruel, cruel anatomy teacher making us learn all those.
Or we'd be studying all the biochemistry pathways and how this goes to that, goes to that. At that time when we were learning that, a lot of us were questioning like why. Why do I need to know this information? What does it matter if there's 16 branches of this one nerve? Does it affect what I do? Why do I learn this? And our teachers and the veteran doctors were telling us, "Listen, you need to know this information."
And I've come to a place where I would argue the exact same thing. Do I need to know all 16 branches of those nerves like on a regular basis? Like, no, not at all. And frankly, a lot of that information is receded to the back of my brain possibly never to be retrieved again. But the bottom line is, just like in anything, you need to achieve proficiency sort of before you can go away from it. So, what I see out there, and Tommy and I can talk a little bit today, there are a lot of practitioners who are really light on the basics.
They don't know their biochemistry very well. They don't know their anatomy very well. They don't know their physiology very well. They don't know how drugs and supplements and herbs actually work to the best of our knowledge. And so they end up with a very shallow knowledge of how these things work and that really limits their ability to do good work to actually put a lot of critical thinking. So, they may learn for irritable bowel syndrome, you use X, Y and Z.
We see this a lot in sort of the functional medicine sphere where practitioners are sort of venturing out from conventional medicine. They may be attending some workshops. They're sort of learning some new protocols and they're very excited. And they get into practice and then someone comes in with irritable bowel syndrome and they say, "Awesome. I just learned a new protocol. You take X, Y and Z at these doses because this is the protocol that I learned."
If that works, honestly, fantastic. My world, the type of patients that I deal with, many of them have tried those protocols and either got some results but not what they were looking for or it didn't work for them or it even, in fact, made them worse. And what we find with practitioners who don't have that depth of knowledge is they don't have sort of the base to draw from to analyze it and figure out why didn't this protocol work or what's going on for this person?
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And so it's just to say that if you're a health practitioner out there and you're looking and saying like, really, is it worth investing my time in learning a lot of these foundational things, the answer is yes. Are you going to need to know those 16 nerve branches or whatever it is or the exact biochemical cycle in your day to day practice? Probably not. But is having that foundation that then you can use to go forward for critical analysis and understanding and troubleshooting and helping people that those basic particles don't work for, is that helpful? Yes.
If you're out there looking for a practitioner, is it important that you ask them about what their education is and that you can see that they have that education and that they can do that work. And one last piece here. I know Tommy is waiting very patiently for me to finish my rant. But the analogy that we always use is between cooks and chefs. So, a cook is someone, in my world, who can follow a recipe. They're told, "You cut these things up, you mix these things, you put them in the oven at this temperature, you do this and then you should at the end of it get this result."
But if you don't or you need to deviate from that recipe, are you able to do that? And your average cook is not. Because they don't understand how all the ingredients marry together and what the purpose of X, Y and Z in the protocol and why you're cooking and doing and chopping and doing these different things. They just have a recipe to follow. A chef, in contrast, knows each of those components and how to put them together and how to use different techniques and temperatures and different tools. And if that recipe doesn't work or they want to change it, they know how to do that.
So, when it comes to health practitioners, I think it's critically important -- Cooks have their place and they're very useful. And if you've gotten help from a "cook," great. But if you really need a chef, it's to step up and find someone with that expertise. Let me introduce Dr. Tommy Wood. As some of you may have heard, I've been on Chris Kelly's podcast a couple of times. He and I met at this year's most recent Ancestral Health Symposium. And he has talked up and down and waxed poetic about Tommy here and that I have to meet him and I was lucky enough that a few months ago Tommy moved to Seattle and he and I could get a chance to sit down. So, let me say hello and thanks for joining me today, Tommy.
Tommy: Hello. It's a huge pleasure, first, to meet you and to have a conversation.
Tim: Absolutely. So, you have an interesting kind of back story. You've come from very conventional medicine to sort of a very unconventional place. So, share your story a little bit with us.
Tommy: Yeah, of course. I'm probably the exact opposite of the kind of person you are talking about because I've spent most of my life in education, actually. So, after leaving school, I went to the University of Cambridge. I did an undergraduate degree in Biochemistry. But because of the way the system works there, there was also a lot of physiology, basic chemistry. I did pharmacology, and all that kind of stuff. And then couldn't really figure out what I wanted to do next and one of my friends said, "I'm going to apply to medical school." So, I was like, "Oh, yeah, that sounds interesting."
And I'd had sort of my own, not a big health journey, but just sort of losing some weight and getting interested in being healthy and all that kind of stuff. So, I kind of wanted to maybe help other people with that and that's why -- Whenever you go to your medical school interviews, they always say, "Why do you want to be a doctor?" You say, "Oh, because I want to help people." That was exactly me at that time.
And then sort of you go through, went through medical school, and this is kind of being hit over the head continuously with biochemistry and anatomy and all that stuff that you're talking about, which is hugely interesting. But when you go -- And so I worked in London in a hospital as a doctor for a couple of years and I did internal medicine, different kinds of surgery, emergency medicine, just because the training in the UK after you graduate medical school is more general for a few years before you specialize.
Tim: Interesting.
Tommy: We do a lot of different rotations. And then that's the first point we realize that what they teach in medical school isn't what you need to survive the hospital environment. But, again, the basics, whenever you're really stumped by a problem then you can always go back to the basics and fall back on that knowledge. But then after working for a couple of years, I actually got an invitation to go to Oslo to do a Ph.D. I just finished my Ph.D. in physiology and neuroscience in the University of Oslo. I defend my thesis next week. I'll stand up in front of my family and friends and the whole department and I'll be grilled by international experts on the work that I did.
Tim: Nice. Well, not nice. I mean, it's good to get it over with.
Tommy: And, I guess, throughout that whole process, I kind of realized that what traditional medicine was doing is hugely important at certain times.
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So, when you're working, worked in orthopedics fixing broken bones, worked in the ER, getting people fixed so they can go home, heart attacks, even cardiac arrest, traumatic brain injury, all that stuff, it's hugely, hugely important. But throughout my time in medical school, I actually started to do some work on multiple sclerosis particularly because my stepbrother has multiple sclerosis. And my stepfather is a chemical engineer. And what chemical engineers are really good at is solving problems. That's basically what they do.
So, what we did is we read, I think, a thousand papers, maybe probably more actually by now, and we build this huge like, basically, chemical engineering diagrams of all the things that can possibly happen to lead to multiple sclerosis. And what it essentially looks, ended up looking like is sort of a functional medicine kind of picture. Because we talked about methylation pathways and heavy metal toxicity and maybe some kind of chronic infections or anything like that, all this stuff that people are talking about in terms of becoming healthy.
And at that time I didn't realize that because I was still in education. This is something we're doing completely separately. And then it's quite nice to see that from first principles you come up with the same answer, which is really encouraging. So, during my Ph.D. time, I had the time and space to read more on PubMed and I was more interested at spending some digging into this kind of helping people in terms of getting this knowledge. I started a blog and my own podcast.
What I really was to start with is this person who has a lot of knowledge but hasn't really applied it in the real world. I know I've done the hospital medicine stuff but applying this kind of, these functional medicine ideas to people and helping them wasn't something that I've really done. And that's where I was very lucky to meet Chris. Basically, the story that he tells is he was on Robb -- This is initially how it went.
He was on the Robb Wolf Podcast and he talked about the stuff that he was doing and I was listening. I was like, "This is great. This is a British guy. He's in the US. He's doing the stuff that I'm really interested in doing." He's doing free consultations. So, I booked a free consultation with him. I called him up and he didn't know what I wanted to talk about. I was like, "Yes. So, how do you do what you do?"
He kind of fobbed me up a little bit and said, "I did a Kalish training course and maybe go and do that and all this stuff." And then, basically, I bombarded him with emails for the research papers for like a year, I think it was. "I was reading this interesting thing and maybe you like this pathways," and all this stuff. And then, I think, eventually, he kind of realized that we could join up. What then happened as I became -- So, I'm the chief medical officer of Nourish Balance Thrive now.
The way he describes is that I've become the architect and he's the builder. I do some client calls and patient facing stuff. Usually, when people are really interested in digging into the nitty-gritty stuff, because that's where I spend a lot of my time. But most people don't need that. So, I spend a lot of time helping to build the protocols, the important stuff that we can then apply to people and then he and the other practitioners then apply that to the actual clients that come through the door.
Like different expertise came together. And actually what he's helped me do is learn how to apply that stuff because you can have all this knowledge but, I think, there's a lot of people out there -- So, the opposite of the practitioners who don't know what they're doing is the people who've read all this stuff and are putting out all this information but actually they have never helped anybody fix a chronic health problem. So, there's definitely a balance of the two. And so Chris has helped me not be that person and actually try and apply that stuff in the real world.
Tim: Right. I know it's a tricky thing because certainly there's a lot of bloggers out there and there's a lot of pieces and people, PubMed warriors and stuff. So, just for anybody out there who may not know what that word, PubMed is basically a giant US database where many but not all scientific papers get indexed and put onto PubMed. So, they have -- Think of it almost as kind of Google for scientific studies. You can go to their website and you can look up different search terms and it will spit out papers for you and everything and give you a starting place to look at things.
Tommy: Yeah, absolutely. There's kind of a trick to it. And what helps and what, again, a lot of people don't have is traditional scientific background. So, I'd done basic research in the lab with cells and animals and some stuff with humans. When you write this stuff up for a paper, which is then what goes on PubMed, you have to write an abstract, which is basically 250 words to summarize what you did. And you normally write it in a very sexy way to make it sound really important so that when the editor is first reading, of the journal, they're like, "Oh, yeah, this is the paper that maybe we want to publish."
Rim: Right, right.
Tommy: And so what a lot of PubMed warriors, as you call them, will do is they'll read the abstract and then they'll, "This is fact." And then, actually, if you go digging into some of the details and you understand how the experiments are performed and all this stuff, you start to realize that maybe that wasn't really the case.
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But as a starting point, it's brilliant because it can sort of get you in, access to that real research but you also kind of need to understand how that world works to kind of get the most out of it.
Tim: Right, right. This can feel very overwhelming for people certainly. Again, it comes down to the basic fact of having a good health care team on your side. Because listen, most people don't want to make this their full time job. They don't want to learn how to read or they don't have the time to learn how to read scientific papers and dig into them and that's why we need Tommy, from what I'm hearing, sounds like what we need, which is someone who does synthesis.
Because we have specialists and scientists increasingly sort of fragmented into specialists which are necessary as you keep exploring deeper and deeper levels of things which is great. But we find that people get siloed or kind of stuck in their little area without sort of the ability to really relate their findings to the greater body of knowledge. And we really need people who can understand the work that those people are doing and yet, kind of what you were saying, where you were building sort of a model of different factors that could influence multiple sclerosis, we need people to go down in and look at these kind of deeper levels but then bring them up and synthesize them together into models that work.
Tommy: Yeah, absolutely. And, I think, if you look at people who come from the traditional medical and scientific areas, they are exactly not trained to do that because you need to be really attentive to detail. It takes a huge amount of work just to learn one thing about one pathway. And so, actually, you almost don't want those people to be then the people that synthesize. You need somebody else to come in.
I think there's actually a really good -- I myself am not an engineer but my fiancé is an engineer. I have a family full of engineers. And that's what they're actually really good at. People might have heard of -- Have you heard of Ivor Cummins?
Tim: Yes.
Tommy: So, he goes by the moniker of The Fat Emperor but he's basically a chemical engineer who's done the same thing with heart disease, causes of heart disease, sort of digging into that. So, you kind of -- There's this special, like a special training and approach that takes and sort of synthesize all this information and, I think, maybe hopefully people will realize you get to a point where you need the people to do a really detail-oriented science and then you also need people to then synthesize that together because those skill sets aren't necessarily the same.
Tim: Right. We were talking before we started recording that in essence there is also a third piece you need which is your popularizer. So, which are people who can then take that information and push it out and get it in front of a lot of people. And we were venting a little bit that it's not just the internet but the internet has let some people who are very good popularizers, who know how to push out information in front of a lot of people, who know how to monetize things and sell things.
Again, there's nothing per se wrong with monetizing and selling things. But all right, folks, had a battery -- Batteries ran out there. So, we've got a new set in and let's pick up. There's a lot of people out there who are good at popularizing who don't necessarily have the best information. They have maybe good sellable information but they don't necessarily have good information. So really, we almost need three classes of people, if you will, the specialists who dig down and uncover issues, the synthesizers who then reach out to a broad base of all these specialists and bring it together into a coherent system, and then the popularizers who are able to get that information out in front of people and mak8e it actionable for them.
Tommy: Absolutely. And, I think, maybe the only place where that becomes tricky is people not being honest about where they are on that scale. If you're somebody who is a popularizer, which is very important, maybe you need to be more honest about the fact that actually you don't understand the nitty-gritty details that much so that people want to know that they need to go somebody else rather than try and sort of that person muddle their way through so they sound like they know what they're talking about.
Tim: Right, absolutely. So, what brings you to Seattle?
Tommy: A girl brought me to Seattle. It's just probably why any man goes anywhere. But during the end of my first year of my Ph.D., went to a conference in Maryland, and met a girl who is now my fiancé, got engaged just before Christmas.
Tim: Congratulations.
Tommy: Thank you. And so, basically, for the remaining two years of my Ph.D. we had an entirely long distance relationship. So, plane trips every month or so, lots of time on Skype and Facetime and those things. And then when I sort of got to the end of submitting my thesis in the summer, we planned for basically a year to move to Seattle. She just moved over from Johns Hopkins so she's now an assistant professor of Chemical Engineering here at the University of Washington.
And then as a woman in the field that I did my Ph.D., neonatal neuro protection, so basically looking at ways to treat brain injury in babies, she's also at the University of Washington and I'd met her a couple of times at conferences and things and she collaborates with Elizabeth, my fiancé, and offered to give me a job and turned out was great.
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So, I'm working now as a -- I think I'm technically a visiting scientist because I can't be a post doc until I've actually gotten my Ph.D. but I'm sort of working in a similar area. And then over the summer, hopefully the next few months, I'll transition away from that and then go and be working for Nourish Balance Thrive full time as we try and expand and work with more people.
Tim: Nice, nice. Planning to stay? I think you'll stay in the Seattle area?
Tommy: Yeah, I think so, at least for a few years. So, Elizabeth will stay at the University of Washington at least until she gets tenure, but she really likes the department, we really like the city, planning to buy a house, all that stuff. I think we'll be here for the foreseeable future.
Tim: Well, good, good. And just so you know, I don't know -- I'm sure you probably do know this. But your work on multiple sclerosis is very relevant because Seattle has one of the highest incidents of multiple sclerosis around.
Tommy: I didn't know that specifically but having seen like the epidemiology on the map of US that would make perfect sense, absolutely.
Tim: Right. Certainly, there's a lot of people here who need help and a good solid functional medicine approach that tackles a lot of factors. So, you guys have recently done some training on Alzheimer's disease and other kind of neurologic or brain based dysfunction and we were having some interesting conversations about that. So, you want to delve a little bit into that?
Tommy: Yeah. So, this is something that we're expanding into just because there's, A, the approach is very interesting but because, B, there's just a huge need for it. And this is the work of Dr. Dale Bredesen who some people may have heard of. He is based in California. I think he's partly associated with UCLA but then does most of his work at a place called The Buck Institute in Marin County. And I believe he is the first person who published case reports showing actual reversal of cognitive decline, so people who were having some memory issues.
So, cognitive decline, as you call it, has multiple stages. So, it starts with subjective cognitive decline which is like there's just not, somebody says, there's just not something right. But you could do all the tests and things but you can't find anything wrong but they know something isn't right. And then it goes on to moderate cognitive decline and then it will go on towards over Alzheimer's disease.
And so people various stages along that continuum by identifying certain factors, and they could be sleep, they could be stress, could be heavy metal exposure. He's got a subset of Alzheimer's disease now he calls toxic which is associated with things like mold toxicity. And then by identifying those and treating them he has then not only been able to show that people's memory improve but people who had to leave work because they couldn't function properly are going back to work. Doing MRI scans, you do a scan of the brain, you look at the size of certain parts of the brain that tend to shrink as you get older or get cognitive problems. They've actually been growing back. So, you can actually see that on the images.
He's definitely the first person that's been documenting this and he's now training practitioners to then go out and help people because the prediction is there's going to be tens of millions of people in the US with Alzheimer's disease and one guy certainly can't treat all those people, right?
Tim: Right, absolutely.
Tommy: He's getting this stuff out there. And it's still kind of evolving and he has just recently brought in different subtypes of Alzheimer's disease so people can do some slightly different tests or some slightly different treatments depending on the individual factors in an individual person which is really important. But they're kind of just now figuring out how to roll out the test, how to get the right supplements for people. They've partnered with a company based in the UK that was doing some cognitive supplements based on their protocol. It's really in its infancy but there's a huge demand for this and it's really exciting to kind of see that grow. And, I think, there'll be a number of practitioners who actually are really be able to help people reverse brain aging particularly and keep that quality of life going for much longer.
Tim: Right. Yeah, we're looking at a huge problem in the making, basically, with dementia broadly speaking and Alzheimer's or being a huge component of that. And the conventional approaches are just lousy honestly.
Tommy: So, I did some time -- So, I did a lot of internal medicine when I was working in a hospital but also I did a few months on what we call the elderly care ward. So, I think, people had to be over 65 and need some rehabilitation and things. So, they usually come in with something else, spend some time on an internal medicine ward and then come to us kind of the longer term stay. And we used to have something called dementia screen which is basically four, five blood tests, B12, folate, vitamin D, maybe some iron studies.
And then somebody gets a CT scan, a CAT scan or an MRI depending on whether we could convince the radiologist to spend the money. Because it's different in the UK. It's not based on insurance. The government pays for it so you really have to bend somebody's arm to get a picture of somebody's head, which is the opposite here maybe.
Tim: Well, partly. One the one hand, there are tons of those tests done. On the other hand, a lot of times getting--
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Like, for example, I had a patient in the last couple of months and they were showing signs which could have been multiple sclerosis and I was pushing to get an MRI done to just say, "Listen, we're still going to do some of the basic stuff no matter if this is MS or not MS. Issues need to be corrected, basically. But if it is MS, then it sort of shifts what we do and lends some more urgency to certain parts of what we do."
And it was a bit of a knock down drag out fight to get the MRI authorized because even though we do tons of them sometimes it seems when you really want or need them you can't get it done but when you don't really want or need it, they're done all over the place. So, we finally did. And the good news for this patient was everything looked clear and we're not looking at MS in this case. So, that's great news. But, yeah, so go on. Some blood tests, scan?
Tommy: Yes. They're basically saying that a few blood tests and a scan, and that's basically all that's done. So, if you notice particularly B12 and folate, vitamin D, we know they are associated with memory issues, cognitive decline. So, if we found a deficiency there, we fix that and that's about it. We do some baseline cognitive testing that you hope would improve and then that's like you set the baseline and then from there that person is only expected to get worse.
And within the constraints of a normal healthcare system, maybe you can't expect much more than that. Hopefully that will change over time. But that was essentially what was done and, I think, in reality what you can do and what hopefully people will start doing is much greater and also much more tailored to the patient.
Tim: Right. Well, we don't want this show to devolve into insurance but I've heard some arguments about it. So, the unfortunate reality in the US is, obviously, we have for the most part all these private based insurance and the statistic show that because of all this price hikes that people are constantly in businesses and everything or constantly reevaluating policies and constantly switching to cheaper policies to try and contain costs, and it's all understandable.
The upshot of that though is that the average person isn't on a private insurance policy for very long before switching to either a different company, different policy, and so it ends up disincentivizing any one company or policy from doing much preventative work because if, for example, with dementia, if we do work now we spend a chunk of money right now to see the benefit ten, 20 years down the road, there's no incentive for a private insurance company to do that unless that person is going to be on their policies ten or 20 years later.
Because they'll end up spending the money but won't end up seeing the cost savings that result from that. Whereas, I've heard, some more hope or some more enthusiasm for adoption of some of those policies into more single payers, things like Medicare or things like the British National Health Service, where those people, the system is incentivized to spend a little bit money now to save a lot more money at a later point in time.
Tommy: Yeah. I think when you lay it out like that, it makes so much sense, right, because spending a few thousand dollars now so that somebody doesn't end up spending decades in an institutional care home unable to look after themselves which cost millions of dollars, that makes perfect sense. But equally, you also have to convince somebody to do a huge outlay now because it still is huge if you cover all the people. And, I think, that's definitely the problem we're having in the NHS in the UK at the moment. I haven't worked in the system for a few years now but you just see that they're still trying to continue cuts as we try and save money. But what you really need to do is, if you had one burst of investment, you'd see that benefit for decades to come.
Tim: Right. And, I guess, on the flipside, so we'd say in the same way the politicians who are in office now will hopefully and probably not be the politicians in office ten, 20, 30 years down the road. So, it's one thing to say, "Hey, folks, we're going to spend a ton of money right now, a big infusion, we're going to raise taxes right now to cover that, and then ten or 20 years down the road we'll see all these cost savings and everything else."
Again, those politicians are going to get the negative press of saying, "Well, so and so raised taxes. So and so cut here, cut there, did this or did that." And they won't get the benefits down the road. So, this goes to the fact that human beings are just as a whole, we have a design flaw, if you will, which is kind of extreme short term thinking, which is an evolutionary advantage when we're in a place where food is uncertain, survival is uncertain. It doesn't make sense to invest time or energy in something that's a long ways away when if you don't attend to the needs of today you won't even make it down the road.
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So, it makes sense. But again, this is where we talk a lot about evolutionary mismatches and sort of if you will the default programming or the default systems in the human body which make perfect sense for our evolutionary context. We've changed our environment so much and so much of what we're dealing with these days. We have to go against some of our default programming, and this comes to where we need to change the systems around people.
So, it's easy to say don't eat junk food, basically. When our evolutionary systems are hardwired essentially to drive us to eat junk food, high calorie, sweet, fatty, salty foods, all things that out system is designed for. It's one thing to say get out there and exercise when, again, our system is designed to say do as little work as you possibly can. So, relying on an individual, and this kind of comes to even this functional medical approach, where we're telling people you need to do something very different from what your family and friends are doing, from what society is doing.
You need to make investments both just in your time and energy but also in your money to do things that run very much against the grain of what other people are doing. And some people will absolutely step up and do that. And if you're listening, obviously, we encourage you to do that. But fundamentally, we need shifts in society as a whole. I was reading an interesting just yesterday about how Iceland has tackled its drug and substance abuse problems. And they said in the '90s alcohol abuse and drug abuse was the highest in either the world or in Europe.
Tommy: Definitely in Europe.
Tim: In Europe. At that time. And now it is basically the lowest in Europe at the time. It wasn't about simply educating people about the harms of drugs and alcohol. It wasn't chastising and encouraging individuals. It was about changing the whole environment around these kids. Anyway, I'm on my soapbox here, Tommy, about that.
Tommy: I was going to say I find that very interesting because I'm actually half Icelandic. I have a huge amount of Icelandic family. And you're right. It becomes the whole concept there which is very similar to trying to get any kind of change in anybody is not -- You shouldn't promote the negative part of what they're doing. You need to promote a change around them so that it's just easy, it's much easier to do the positive thing. In that case, it was encouraging families to spend, parents to spend time with their children during weekdays like building these systems so that kids go and do something else rather than hang out in parks and take drugs or whatever.
And that works much better than a war on drugs or anything like that which has never really worked as far as I'm aware. And actually, I've had a few, worked with a few people where they come to you and they're like, "So, I make my own meals. I do my own stuff. My wife doesn't believe in this." And it requires such a huge power of will to do that. And willpower is a finite resource. So, for some people, they'll spend all their time making sure that they get their own food and it's separate from their family and they do all the stuff that they want to do.
But actually, that's also, now that I think about it, you're probably reducing the amount that you're then able to interact with your family, you're reducing the stuff that you can do together, which is also so important for long term health. And then, I guess, one of the benefits of the way that we've been working with people, so now with cognitive decline, is often the person that contacts us is the wife or the husband or the sister. And actually, when it's -- We usually say that nobody cares about your health problem more than you do so you have to really invest in it.
But equally, if you have somebody who's investing in it for you then automatically you have an ally. Automatically you have someone that can help make those changes easier. I think, particularly in that situation, that's going to make things a lot simpler because you've got somebody who's doing it with you. And, I think, any time when you're trying to make any kind of change and improve your health, improve the systems around you, having someone to do that with, especially if you can get the family to buy in, it's going to make it so much easier.
Tim: Oh, 100%. I mean, community is -- Again, human, we are communal animals. We're not solitary animals like tigers or something like that. I mean, we are to our core community animals. And Tommy's point exactly, we can see people become very isolated by the health changes that they're making. And food is probably the single biggest thing. But we'll also see people, in order to sleep more, which is critically important, now they're not going out with their spouse or they're not going things or they're going to bed early, they're not getting to spend bonding time with their spouse or with their kids or with all these things.
It's a factor that needs to be thought of. These things can't be done in isolations. So, one example here, I have a patient, ended up going on antibiotics, gut issues, but ended up having to go on antibiotics over the Christmas holiday. And they said they were able, for the first time in a long time, they were able to eat whatever they wanted, they partook in all the Christmas goodies and everything else.
[0:35:07]
And this person said it was such a psychological break for them. I didn't have to micromanage and think about my food every moment. I didn't have to see these trays and platters and things in front of me, use my willpower to say, "No, I can't eat that." It was just like my family was there enjoying it. I could be part of that.
Tommy: Yeah. And I think that should often be the goal. There are so many parts of the diet that we obsess over the negative effects that they have on us and, yes, in terms of -- Somebody has a chronic health problem that they need to get over, at that time it's very important to look after those things. And for anybody to be healthy in the long term you probably need to reduce as a general pattern those things in your diet.
But there's a huge history millions of years essentially of us communally eating with others and enjoying that with others. I think if you're denying that from yourself, essentially indefinitely, potential for some real like detrimental effects there. So, once you have achieved some degree of health, it should be good enough so that you are robust such that you can enjoy some of those things and maybe you'll get some benefit there.
Tim: Correct, correct. I haven't actually looked at the stats but someone was telling me the other day that in kids and teens with celiac disease, that the rate of suicide is higher. And we can talk about the physiology and the neurochemical changes and blah, blah, blah. But one aspect that was being zeroed in on is because they can't eat wheat and they can't eat gluten that it separates them from their peer groups and everything.
So, they're "weirdo" off to the side of the cafeteria who can't eat all the food that all the other kids are eating. They get social stigma around that. They may get picked on because of that. They become different. And, again, speaking to groups and everything, being different historically evolutionarily really isn't a good thing.
Tommy: No, absolutely. I think we've tended to embrace that a little bit more. The geek has become cool recently, which is very useful for me. And hopefully when if kids manage to get through that bit they'll then find the niche and the people that will then, that they can then build a group around for the rest of their lives. But particularly during that period of time, when you're a kid and you're isolated, that really has the potential to set you up for long term problem.
Tim: Oh, absolutely. And so, I think, when we're talking "health," it's not just the physical health of your body or what your bio markers or what your lab test tell you. It also includes the mental state, the emotional place, the connection. I have seen people, not my target audience per se. I'm, again, mostly helping sick people, chronically sick people and those who have not gotten help from other doctors. But we do some people, kind of the "biohackers" and the people who, the kind of athletes, and the people who are really looking not to get well but to ratchet up things to the nth degree there.
And I've seen people who are perfect physical specimens. I mean, their lab work is just perfect. Their body composition is Adonis like god of body composition, all these things. But when you dig in, mentally, they're miserable. Everything is so regimented down to the minute in their protocol, what they eat and what they do and everything. There's no spontaneity. There's no joy. There's no real connection. Their pursuits sort of cut them off from everyone around them. And we have to say like you've achieved an absolute remarkable feat of sort of physical perfection, if you will, but on some level, why, and on some level at what cost and is it really worth it?
Tommy: Yeah, absolutely. And, I think, there's two important parts of that and one is that type of person is usually trying to find a way to have that, to be able to perform at a maximum level indefinitely. And there's a problem there because whatever you take, whatever you do to achieve that, yes, in the short term you will feel great, you'll smash all the goals you're trying to achieve, maybe you'll do really good work, whatever it is you're trying to do. But there's absolutely no biological free lunch.
And if we talk about all the things that the human body needs or the way we are evolved or designed to work, it is that we will work really hard, will achieve our goals and then we will relax. And we will spend time with family. We'll not move at all. So, the guys who go out and did the hunting, they then sit down and maybe two or three days they just sit around because they did their thing. They expended their energy. So, everything we do that expends any kind of even mental or physical energy requires a time to then rest and recover afterwards. And so whatever you're doing just trying to achieve optimal performance all the time now then probably have some detrimental things that can potentially happen in the future.
[0:40:02]
Tim: Right. I know for me there's a book, I forget the author, but I believe the book is called The Power of Full Engagement. He talks very much about mentally and physically humans are sprinting animals, which is just sort of what you said, a burst of hard activity followed by a fairly significant downtime basically. And that kind of concept has gone out of favor in terms of sort of the machine or computer analogies that people want to run it 99% to 100% all the time every time with absolutely maximizing every second of productivity in their day and everything. And it's impossible. It's not how we're built.
Tommy: No, absolutely. And I've had to force that upon myself too. I think particularly it goes back to actually when I was teenager. I talked earlier about how I've got my own health journey. But what happened to me is I became obsessed. Definitely I always say that I had orthorexia before it was called like, just back when nobody really heard of it. The quality of every little thing that went in my mouth, it had to be perfect. Perfect in terms of what I thought was perfect at that time, which is not the same now.
And it just had this huge negative effect on me. So, when I was at university and there were a lot of people who knew me back then particularly when I went to university, I started as an undergraduate, I wouldn't go out, I wouldn't socialize with people the same way they did. And you can argue where there's socializing around alcohol is the best way to do. That's just the way people did it. And I didn't do that because I didn't feel like it was part of what I needed to be optimally healthy.
Actually, that ended up with me not having nearly as many connections as the people around me as I could have done. And so now part of what I try and do to be healthy, and some people would think that I'm obsessed about some stuff and I probably am, but equally I will have my unhealthy food occasionally and I will just enjoy it and that's part of my mindfulness around the system that that's something I do and enjoy it. Just like there will be times when I'll sit, watch TV with my fiancé and do nothing else and enjoy it. I think people almost need to stop building those systems in when they spend so much time obsessing over all those things to be optimal.
Tim: Yeah. I mean, I agree with you. Look, at the end of the day, what we're saying is balance. Obviously, people can go to either extreme. They can hear this kind of message and use it to justify eating crap all the time because oh, I want connection with my friends so I'll just binge drink and eat crap all the time. You're going to pay the price to do that. On the other extreme, if people haven't heard of it, there's this term orthorexia, which Tommy just said, which was coined--
So, people have heard of anorexia, bulimia, kind of your classic eating disorders, psychological issues that then lead to unhealthy behaviors around food. And so this term was coined orthorexia which is kind of the obsession over the healthfulness or the harmfulness of certain foods. And on the one hand, this term is used to sort of bash anyone who really cares about the quality of their food. If it's like, "Oh, I don't eat this or I don't eat that. Is this organic?" It's like, "Oh, you're just orthorexic," which is just a way to sort of discount it.
But truly, there are some people who do become orthorexic and that's a sense where this obsession with food becomes essentially psychologically damaging to the person. And that would be the other extreme. You get people -- I always joke, so as a naturopathic doctor, one of my nightmares is getting together with a group of my colleagues and then having to choose somewhere to go out and eat, which is just like, well, I can't eat, one person I can't eat this, another person I can't eat that. And then you're just like, "Well, crap, let's just sit here and drink some water."
Tommy: I was going to say that reminds me of this conference I went to in the UK. It's called Health Unplugged. It was the first Paleo conference ever to be held in the UK. It was run by a guy called Darryl Edwards. You might have heard of it. He does a lot of primal play kind of stuff. And so I spoke at that conference and then we went out, the speakers all went out to dinner afterwards. We went to this burger place and I genuinely don't eat a lot of bread or cake or cookies or something but if I occasionally have it that's fine.
And so we go around the table and everybody orders their burger without a bun. And the server comes to me and he's like, "Do you want a bun?" And I was like, "Not around these guys." It's kind of that pressure that's built into that system of all these people. You have to be perfect in front of your peers who do this kind of thing.
Tim: I have to say I have an inner rebellious nature so I'd be the guy who would specifically order the bun just to get the crazy looks from everybody because it's like -- Again, listen, if you have celiac disease, if you have a severe issue with wheat or bread or gluten or whatever, please do what is right and sensible for you. I think, with Tommy, most of the time most people we could cut out those processed grains and everything and it would just be better for everybody.
[0:45:05]
But again, it's not what you do once in a while that matters. It's what you're doing day in and day out that's going to shape your health. And so eating a bun, oh my god, if you don't have a serious problem around it, just calm down a little bit.
Tommy: I think, hopefully, part of this whole, people who listen to this who are very, very interested in health journeys, they'll probably realize hopefully part of our journey is becoming mindful about who you are and what you need to be healthy. Hopefully, you'll be able to realize where you are in that continuum. So, if you're the person who's listening to this and be like, "Oh, well, Tim and Tommy said that we could just eat crap sometimes and it's fine," if you're that kind of person then maybe you need to tighten things up. Whereas maybe you'll realize that you're the person who's super strict about everything and it's holding you back and then maybe you can relax a little bit.
Tim: Absolutely. I mean, that's the biggest thing I know you guys deal. So, let's talk a little bit about what you're doing, what you and Chris are doing. So, you guys have -- I don't know if company is the right word, sort of practice, you can describe it, but it's called Nourish Balance Thrive. And you guys had primarily been working with athletes and kind of other high end people. And in that population I find one of the most unwelcome messages is sort of that sprint message of saying, ook, in this athletic world, this sort of culture of grind away and work really hard and push yourself is sort of mandatory almost.
But saying, listen, and again, I saw this a lot, cross fit, lots of pros and cons to it. It seems like it's waning a little bit, sort of the height of its popularity was a couple of years ago. But we'd find people and they're grinding away like five to seven days a week doing this high intensity exercise and then wondering why is their body composition deteriorating, why is their sleep deteriorating, why is their general health deteriorating, why is their blood work looking so poor and everything and it's like, well, maybe I just need to work harder. It's like, no, you need to work less hard. So this message of sort of rest and recovery was so critical to them. So, what are you guys doing in Nourish Balance Thrive then?
Tommy: Yeah. So, I was going to say that that's actually one of our most important messages. Somebody turns up and they send you their -- We have like a questionnaire and you ask about their training program and their diet and all that stuff, and I often see something like -- It comes through and this guy is training 20 hours a week and he's probably an executive somewhere so that he can afford all the fancy Ironman equipment which is what they tend to do like long distance triathlons.
And then he's going and racing an Ironman in a different country maybe once a month and not only is that training volume is huge, it's that racing volume is huge. Then you just like, I look at that and I'm like, "All you're going to get is divorced. And you're not going to see your children anymore." So, one of the most important messages we have is, basically, allowing people to step back, take their foot off the pedal and say this is what is actually going to make you faster.
We've worked with people who've won world championships, people who've competed in the Olympics. And actually, a lot of the times, it's actually eat more carbs, because probably I say that more than anything. And also actually take some time to find ways to deal with stress, find ways to improve your sleep. Usually, we tidy up the diet, do some kind of elimination diet. And the reason why this sort of came together initially is because Chris, who is a professional level mountain biker, he doesn't get paid to mountain bike but he races against professionals at that level, and he had really poor health.
He couldn't sleep. He had terrible sexual function. He doesn't want me talking about that. Because he talks about it all the time. Obviously, I wasn't there. And so he basically completely couldn't get an answer to the traditional medical system because they were like, "Well, here, have some Viagra. And if you think you have celiac disease, eat gluten for two weeks and then we'll do an endoscopy and see." And he was like, "No, thanks. Thanks very much."
And so he did autoimmune Paleo diet and then sort of started to look at all this other stuff, did some training courses, and then basically built this practice with his wife and another medical doctor, Jaime, who is the CEO of Nourish Balance Thrive, and she's also an elite level mountain biker. And so the idea was just to, basically, fix athletes who've broken themselves often training and eating the way that they're told to by just huge amounts of volume and then loads of carbs afterwards particularly refined, which causes a lot of problems.
So then we started out just fixing those people, and we still do that and have had more and more people at all levels, national, international, all the way down to just weekend warriors and people who want to perform better. And then recently we've expanded and we're doing sort of telemedicine for these Bredesen protocols for cognitive decline. And that's just started in the last couple of weeks actually.
What's really interesting actually is when I'm not talking to the clients most of the time although I will do more of that once I'm working full time. But because I sort of have the high level overview, if you look at what you need to do with somebody who has cognitive decline versus somebody who wants to optimally perform whatever it is that they do, and we work with a lot of those people too, because they're very similar to athletes.
[0:50:05]
Tim: Sure.
Tommy: All athletes. The basic stuff that you need to function as a human being is always the same. That doesn't change. It's usually a case of just taking care of those basics and then, yeah, we'll do some of the testing very similar to the testing that you do and tweak some of that stuff. But actually, we don't have the same experience of dealing with really complex cases that you do, say, and we've worked together on some of our clients. You've consulted with us on that, which had been hugely helpful. For 99% of people, just the same stuff makes people healthy.
Tim: Right. Yeah. Tommy and I, we were geeking out before we kind of started recording here. And we were saying, look, to the point at the beginning of the show, you need to know, as a practitioner, you need to have a grounding in the biochemistry, in the physiology, in these aspects. But at the end of the day, it's funny, you go deep, deep down these pathways and you come swinging back out and you go, well, it's the end of the day, the actual, the treatment or the recommendations are the same, basically, in that way.
So, Tommy's point, the analogy that I use is, look, if you have a plant, you can look at the leaves, you can look at the stalk, you can look it all and you can diagnose all these different diseases and issues that are going on with the plant and those may need specific treatments based on what's going on, but also at the end of the day, a plant always needs good soil, water and sunlight. And you can be doing all these fancy high tech super in depth most cutting edge treatments and if you forget to water the plant, it's not going to work.
Tommy: Yeah, basically.
Tim: And that's the same way with human beings. There are basics. I often find that some of the people who are the most educated, the most hard driven are digging down into that minutia and they're looking to say, well, should I have 23% of this or 24% of this? And you're saying like, hang on, let's back up for a second. To some of our earlier points, what's your connection like with your family? How are you doing with your spouse? What's the quality of your sleep like? How do you manage your stress?
And a lot of times these people can be very resistant. It's like, "No, no, I need to know if I need 4.5 milligrams or 4.6 milligrams of something." And it can be hard sometimes to say, "Yes, yes, those pieces are there. But we also need to make sure." We call them the foundations of health in our practice, whatever you want to call them, fundamentals or basics or whatever. But those are the pieces that need to be in place. And then, yes, you may need to go on to do other corrections and other issues that are going on for people.
But if it's something that people can take away, you may think you're doing all those kind of fundamentals and foundations correctly and you might be. But a lot of times, I guess it's human nature, we tend to fixate on one or two of those factors. And so someone may be exceedingly good on their diet but then really poor stress management or they may be getting enough sleep but they're not really doing good exercise basically. And this is we're having someone from the outside to come in, do a survey and look and say those things that you don't like to do or those areas that you don't consider very important, those might be really critical for you.
Tommy: Yeah, absolutely. I think that's the -- I always say that even coaches have coaches. So, if you look at the athletes, say, often the coaches are also elite level athletes in their own right. But they don't coach themselves. They have somebody to coach them. It almost always, and some people can navigate this by themselves and that's great but you almost, if things just aren't going right and you know they're not, then it's really helpful to have a coach come in and say, okay, so we can stop worrying about the diet and then let's maybe try and find some techniques to try and improve all this other stuff. I think that if anybody is ever struggling any point then finding a good coach can really, really help do that.
Tim: Absolutely, absolutely. So, let's talk a little bit about telemedicine. They're, obviously, a big subject. But one of the most common complaints that we get in my practice is we get contacted by people really all over the world, basically, and the most common concern or complaint or asked is, who near me does the kind of work that you guys do? And the sad reality is a lot of times the answer is no one around you does the work we want to do.
I'm not sure if you've seen there's an organization called The Functional Forum. They're here in the States and their mission is to sort of popularize functional medicine and bring it out there. And they've just, or they're just about to kind of launch a branch in the UK and their statement is the UK in this regard is at least ten years behind the states as far as the functional medicine approach.
Tommy: Yeah, absolutely. I got that when I was in Norway but I had an online presence to some degree and people would email me on like how do I access this functional medicine stuff in the UK? And three or four years ago, I had to say, "You know what, I actually don't know." And that's changing now. I'm on the Board of Advisor for company that's trying that out with some great people who know functional medicine in the UK. And so it's coming. But right, I mean, ten years is probably about right.
[0:55:09]
Tim: And so for a lot of people, they're reading blogs, they're listening to podcasts like this or watching videos, maybe they're doing some online trainings or courses or things like that, and they're trying to reach out to practitioners. I mean, the common story I hear every single day: So, I recognize the importance of these different things and so then I take it to my conventional MD, my primary care doctor, my family doctor, whatever, and I say, "Hey, could we do this test?" Or, "I'd like to do this treatment or I'm thinking of taking this or I am taking this or that. Can you help me?"
And sadly, all too often their answer is not only, "No, I cannot help you," "No, I'm not going to do that. You need to stop doing that. It's a complete waste of time, money." To our earlier point, "There's no science behind any of this stuff." When the reality is, there's plenty of science that many docs -- Again, not trying to throw stones or cast blame -- not haven't had the time or the inclination to look into this.
Tommy: I always, whenever people bash MDs, I always like, well, I've done that, I know how it works, it's not that they don't care but they genuinely think they're doing their best and they are with the knowledge that they have. And they are not in a system that allows them to learn new stuff such that they can integrate it. So, they're very good at what they do but then when you ask them to do something that they don't know anything about, and particularly if it's like, "Why don't you know this?" You're never going to get a useful conversation.
It's about both sides should understand where the other person is coming from. And I always think that if you want to bring some stuff, bring some information, start a discussion, it needs to be very open and friendly and then you'll find that a lot of doctors are interested because they do want to help people. What often happens is a lot of "Oh, well, my physician MD, whatever, is useless because he doesn't know this," and then you'll never going to get anything useful out of them. It definitely requires a certain approach to try and get the best out of that relationship because it will be useful at some point.
Tim: Right, right. To our point earlier, unfortunately, this falls on the individual patients to try and broach and build relationships and not that the system as a whole support this kind of approach. And again, hopefully, that's changing. I actually have some optimism that it's changing as well. The interesting funny story -- So, I was talking to an integrative psychologist the other day and he uses kind of an orthomolecular, biochemical approach for treating things like anxiety, depression, a lot of these issues beyond just sort of talk therapies and things like that.
And he was saying whenever a patient would come to him he used to write a letter or an email or whatever it is and he would write a correspondent to their primary care physician saying, "Hello, this person is seeing me. This is the approach that I'm taking. I just wanted to reach out to you and let you know." And he was saying he found that in about seven of ten cases the PCP would turn around and basically tell the patient, "Don't go see the psychologist. They're doing -- Like I don't know what they're doing. They're doing crazy stuff. Go pick another psychologist who's doing what I expect them to be doing."
So, he said he's recently sort of changed his protocol where now he's waiting to get some results for those persons before introducing himself. In other words, it's like, "Hey, Tommy, I've been seeing Jane Doe. We've been doing this approach and her anxiety is 70% better than when she came in. I just wanted to let you know if you have any questions let me know." And he's been finding that approach has shifted things a lot because now it's the doc goes, "Oh, well, wow, there's a significant change." And sort of at worst the docs are saying, "Well, I don't know what this is but if it's working for you, just keep doing it basically."
There's a lot of pieces here. Telemedicine. A lot of people, the internet has turned a lot of people on to these concepts and they're reaching out and a lot of times not getting the support, not getting the guidance, not getting the help that they need from the practitioners who are around them. And so having to reach out. So, this idea of telemedicine, so doing medicine at a distance, whether it's phone calls or whether it's online video services, it's sort of growing in popularity as people are reaching out from all over the place to try and get some help.
I mean, we were talking about that there are some legal issues around it, certainly for those of us with medical degrees and licenses. Those laws are really behind the times, basically. And for a lot of people, there is real legitimate concern that you're doing, you're practicing medicine without a license. So, for example, I'm a licensed doctor in the State of Washington so I can do all the rights and privileges and everything of being a licensed health care provider in Washington.
Unless I hold a license in all 50 states and then even in other countries and other places, basically, technically, depending on what we're doing, it can really hamstring someone's ability to practice. So, do you want to talk a little bit about kind of what you guys are going and the idea of telemedicine and everything?
[1:00:07]
Tommy: Yeah. I think that, at the moment, it's really important in all of these scenarios that I've sort of been a part of -- So in the UK just because there aren't that many people doing that kind of stuff than in the US because it's so vast and there are large areas where they just arm those pockets of the kind of practitioners. So, maybe up in Seattle, you're kind of spoiled for choice for people who know what they're doing. There's a great community of functional medicine practitioners around here but that's not the case everywhere.
And it's difficult for me because anybody who comes to work with me, I am never taking over as their medical care provider. For somebody, I can provide advice and coaching so I am health coaching at most. And I can be a consultant in that respect. It even becomes, if a doctor then wants to speak to me, that is possible but I will never pretend that I'm being somebody's, taking over somebody's primary care provider.
And some people will manage to do some telemedicine whilst also taking on that role and that's fine but that isn't what we do. But equally, we find that most of what needs to be achieved doesn't require that and most of what you need to do to help somebody. People can usually get access to their own test without a physician. There's a lot of companies that are helping people do that. So then what you just need is somebody to help you interpret that and then make the changes.
And then sometimes you need to go and speak to your doctor. So far, those conversations have been largely productive. You just need to sort of set them up in the right way. So, generally, we say, because we're generally working with athletes, so we're coaching, health coaching, and that gets us most of the way. And in reality, like I said, most of the stuff that it takes to help somebody go faster, feel better, doesn't require prescriptions or anything like that. So, you can get most of the job done without active medical care if you want to call it that.
Tim: Right. How do you see that changing with working more with Alzheimer's and dementia and those kind of issues?
Tommy: Yeah. I think that it does potentially make it a little bit trickier. But you're going to have -- Most of those people, at least the ones we've interacted with so far, have like I said, some family and support networks around them. And I've noticed particularly it's beneficial in the US compared to, say, in the UK, is that people are a lot more open to less traditional methods of healthcare.
And where we can really support the approach is that Dale Bredesen has published and is publishing a huge amount of data in this area and I can say, "Look, this protocol is published. Here are documented cases of reversal of cognitive decline using these approaches so we are just going base off the published literature." And, not all, but most neurologists, primary care practitioners, I think will find that interesting particularly as the data increases.
And that's one thing that we're kind of hoping Dr. Bredeson will be very good at is integrating the data from all the practitioners doing this kind of stuff and then really get that out there. That's going to really legitimize it. And that's one area that I kind of feel that the functional or alternative medical world is -- What it isn't very good at is they've got all this stuff which is making people better and nobody knows about it.
What I mean knows about it is like it's not in the formal published literature. And being somebody who comes from a very traditional background, I, therefore know why somebody will come in and say, "Well, this is crockery because there is no evidence for it." And part of what I would like to do in the future is help practitioners publish that data because as soon as it gets out there and you can prove that this works then it's going to become much more accepted and more people have access to it.
Tim: Right, absolutely, 100% agree. Again, The Functional Forum, you can check them out in YouTube if you just go to YouTube and you type in functional forum. I believe their website is functionalforum.com. But they talk a lot about the change from functional medicine sort of. Again, many different terms, functional, alternative, integrative, natural, like whatever you want to call it, basically.
But the change from functional medicine 1.0 to functional medicine 2.0, what they say, and I agree with this, is functional medicine 1.0 was essentially lone practitioners sort of, just out on their own. They came to it because of kind of conversion experiences whether in their own health or in patients' health or whatever it is. And they're sort this self-contained little island working alone, if you will, and helping people get better.
And now the switch to functional medicine 2.0 is sort of taking all those lone practitioners and networking and integrating them together into communities to your point exactly what is the way that we can get these protocols sort of, get the scientific backing behind them to get the broader conventional medical community to accept that there's benefits. So not just where they're going, like well, I guess, this person seems better, so great. Keep your diet, exercise, the supplementation herbs, like whatever, are you better, so whatever, just keep doing it.
[1:05:00]
To actually these approaches have merit and what we'd like at the very least is if the primary doctors, the family care doctors, even if they say like I don't know anything about that but they can say clearly there's some evidence for it and go find a different practitioner essentially to go get those pieces done.
Tommy: Yeah, absolutely. I think part of that also will be at the other end which is, I think, there are some things or a lot of things that some alternative medical practitioners do that either doesn't work or shouldn't be done and hopefully as those worlds come together and learn more about each other then some of that stuff will fall out. Because I think that will improve the health and safety of the patients as well. So, it's not just that the alternative stuff needs to come into the traditional medical world. It's that the alternative, some of the alternative stuff just needs to go away.
Tim: Absolutely. 100% behind that. The danger. So, you've seen, anybody out there in the internet has seen sort of the explosion of what's called N equals one, which is basically experimenting on yourself, finding what works for you and then pushing that out there. I'm on one level 100% behind that approach. Each of us needs to find what works best for us. The down side to that is just sort of a lot of stuff that it seems like it helps or people are not sure if it helps but it just sort of gets perpetuated out there.
One of the complaints of the conventional system is, look, by sort of looking back into traditional medicine, we're pulling a lot of superstitions forward and everything. And there is truth to that. One the one hand, if a system of medicine or a civilization has been using therapies for a long time there probably is good evidence that those actually are helpful therapies. On the other hand, it is possible that it's just sort of superstition that's carried forward. And so there is a need on every side not to blindly accept things just because it's the way it was done or the way it is done.
One famous, a number of years ago, was in knee surgery where everyone was doing knee surgeries and people seem to get better until that dogma got questioned and they found out actually really it was just a placebo effect. And nothing whatsoever against the placebo effect, but not in abjectly useful therapy and so that needs to fall out.
Tommy: It reminds me of -- Chris and I have a good friend, a guy who we've worked with and will actually hopefully come and work with us in the practice as well because he's doing some functional medicine training currently, as like a shifting career. And it reminds me -- I found out that he just lost some marks on a midterm because he didn't recommend, to a fictional patient he didn't recommend a certain therapy that he doesn't believe in because there's no evidence to support it.
And so having that kind of dogmatic approach to these people, you need to recommend this and having that as part of the training course has really set us up for danger in the future particularly if you want to get some of that stuff legitimized. So, I think, hopefully, all of that will start to balance out as people try and figure out what does work, what really is evidence based and that includes taking some of the stuff that we do into the real world and then also may re-analyzing some of the stuff that sort of the functional world does that maybe they shouldn't do.
Tim: Honestly, all sides, my goal is every couple of years, what I'd like to do is be able to look back on what I was doing a couple of years ago and go like, "Oh, man, I can't believe I was doing that." Better data comes out. And when we speak about data, again, it's not, for people who are listening I'm sure you guys get this, but it's not just about double blind placebo controlled studies. It's also about clinical experience. It's about all of these pieces.
And at the end of the day, my belief is the only dogma we should have should be what gets results for people. And if people are getting better that's what matters. At the same time we need to be driving towards finding the most effective therapies that do get people better. And again, this is the strength from the integrative or natural alternative, whatever word you want to use of networking people together. It's how can best practices emerge?
And so circling back to our bigger conversation before, because a lot of functional providers were sort of islands to themselves and sort of grew up, if you will, in a hostile environment -- They may have been overtly being attacked by the conventional system. A few podcasts ago, I had a chiropractor on and he talked about how it was cut and dry the American Medical Association was absolutely targeting and trying to drive out and delegitimize all the chiropractors and they actually lost a major lawsuit where it went against them because the evidence was so ironclad.
So, we had, in years gone by, and little bit today, sort of overt campaign to drive sort of some of these approaches out of the business, out of practice, to just sort of hostile environments and things. I even know years ago, when I would call up an MD to try to talk to them and they would find out my credentials as a naturopathic doctor, some of them would straight up refuse to talk to me, hang up the phone on me and everything else.
[1:10:08]
And that is changing, thankfully, now. And so, they came from this hostile environment and they also, some of these people, again, nothing against them, but they came up sort of these promoters we were talking about before, marketing themselves, getting themselves out there, building a name for themselves, trying to earn a living. We have almost on some level this old culture of sort of secrecy.
Well, I have my own personal private super special protocols and you almost sign a non-disclosure agreement when you go in and work with them and everything. And on one hand I can kind of see that but it impedes progress. We need to be sharing best practices among each other and we need to have the humility to say, okay, right, I did do this. But the bulk of evidence, again whether it's clinical, whether it's scientific studies and everything, points to the fact that this was either not the best approach or honestly was a bad approach to take. And now I've upgraded my skills and my knowledge.
And so to anyone who sort of, one of these integrative practitioners we often turn a harshly critical eye to MDs and the conventional system and they deserve it in many aspects. But we also sort of need to turn that own critical-ness back on ourselves as well and say a lot of the approaches just are incorrect.
Tommy: Yeah.
Tim: All right, Tommy. I think we're kind of coming down to the end of this session. It's been great sitting and chatting with you. I think we'll probably have a lot more opportunities to sit and chat. Is there something I haven't asked you that you want to share?
Tommy: No, I don’t think so. I would just say that if anybody is, so say particularly an athlete or a high performer or wants to be a high performer that thinks he needs some help with that, then that's obviously something that we've been doing a lot of so they can come visit us at Nourish Balance Thrive. We're doing more work with cognitive decline, like I said. So, probably I should, like I did at the beginning, I really thank the team that I work with which basically they allow me to put this stuff into practice. Without them, it's just knowledge that doesn't get used. Thanks to them, our brilliant team. And if anybody does come work with us you'll realize that too. They're all fantastic.
Tim: Absolutely. Ego aside, the best results come from a team based approach. Just another red flag out there. If your health care provider, no matter what the initials after their name are or aren't, if they're telling you they're the only person that can do it, super special proprietary protocols are the only way to kind of get success or everyone out there is idiots or there's no space or room for collaboration or work, to me, that's a big red flag.
Tommy: Definitely.
Tim: No one knows everything. No one has all of the answers. It is impossible, basically. We each do the best that we can. Clearly, there are, just like in any profession, there are better and worst health care providers. There are more skilled, more knowledgeable and less skilled, less knowledgeable providers out there. And, of course, seek out the most knowledgeable, most skilled providers that you can. But again, know that no one knows everything. That's why we need you guys as patients to work in collaboration with us.
Tommy: Absolutely. And I would just take that point and say that a lot of the people, just because the group that we work with are people who are very interested in doing the research, going and reading stuff, and often they'll bring stuff to us and say, "We read about this. What do you think about this? What about this study?" We're learning stuff all the time from our patients.
Tim: Absolutely.
Tommy: So, often, it's less of I'm imparting knowledge to somebody else. It is more like a meeting of minds. And I would just like give some thoughts and ideas and they can run with that. I think doing that is going to help everybody learn much more and also get better faster.
Tim: Absolutely. Well, we're really big on partnerships. Like we talked about, it has to be a partnership. There needs to be respect that flows both ways and we see where that goes wrong. Sometimes these highly educated patients have no respect for the medical providers and it's sort of like we occasionally have people who treat me, who want to treat me like a prescription pad in order to get the therapies, the tests, the treatments, the various things they need. They come in and basically say, "This is my problem. This is the treatment I want, give it to me, basically." And it's like, "I'm sorry. No. we want a partnership."
On the other hand, a lot of people come in and they talk about how essentially their doctor does that to them. It's like, "Stop talking, person. This is what's going on. This is what you need to do. Just shut up and do it, basically." And it's like, no. That doesn't work either. We need a collaborative partnership where there's respect for the provider, all the work, all the knowledge that we bring to the table. And there's respect for the person who's sitting in front of us. You live inside the body that you've got. Your insights, your opinions, your self-knowledge and research, all are absolutely valid too. So, both sides need to come to the table.
[1:15:04]
Tommy: Yeah.
Tim: All right. Where can folks, if they want to look you up or they want to find you, where can they find you?
Tommy: Yes. So, nourishbalancethrive.com is the best place to go. I do have Facebook page and Twitter and blog and they're all DrRagnar. Ragnar is my middle name.
Tim: I was going to say there's the Icelandic that comes in.
Tommy: So, people can find that. I haven't done that much in that stuff recently just because I've been working more and more through Nourish Balance Thrive. So, that's probably the best place to find me. I've been blogging, doing some blogs there and I do a lot of podcasts with Chris as well. And often they're quite technical. So, if people are interested in that stuff then they can go there. That's the best place, Nourish Balance Thrive.
Tim: Nice. So, next week, are you flying back to Oslo?
Tommy: Yes. So, I fly on Tuesday morning, I arrive Wednesday morning, having taken the red eye across, and then all of Thursday is my defense days.
Tim: Nice, nice. And then back to Seattle again?
Tommy: And then back to Seattle and back to work, continue with the research for a few months and then transition and go into Nourish Balance Thrive full time.
Tim: Nice. Awesome. Well, we will definitely, if he's up for it, we'll definitely have Tommy back. And definitely Chris' podcast over there at Nourish Balance Thrive is great. He interviewed a lot of experts, has a lot of great information. It does tend to be at a sort of more in depth complex and technical level. If you're listening and that kind of seems above your head, there's nothing wrong with you and don't feel that you have to go learn that. But if that's something that resonates with where you are, I do recommend go over. Check it out, give a couple of episodes a listen. I'll just say there's a great doctor named Dr. Gerstmar who's been on a couple of podcasts with Chris now.
Tommy: Actually, I just listened to one of those. It's great.
Tim: I know. Fantastic, yeah, yeah. And a lot of other good pieces. So you can check him out. Definitely Tommy is a wealth of knowledge. I look forward to having him as a resource so we can bounce things back and forth amongst each other. Again, community, community, community. Both in your own personal lives. So, again some takeaways, balance in your life, attending to the physical needs of your body and the therapies for your lab tests or your dysfunctions is very important.
Doing it at the extent of destroying your mental, emotional and social life is also a huge factor that needs to be brought into play. So, for a lot of people, we'd say, look, getting to 80% physical health while respecting the mental, emotional and social aspects of your life is better than getting to 99% physical health while destroying essentially those other aspects of your life.
Tommy: Yeah, and that will give you robustness going into the future.
Tim: Absolutely, absolutely. All right, folks. We'll wrap up again. If you have any questions, comments, please feel welcome to leave it for us and we'll arrange to get Tommy back on the podcast sometime in the not too distant future. All right, Tommy, thanks for joining us.
Tommy: Thank you.
[1:17:55] End of Audio
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